Peninsula psychiatrist shares advice for seasonal stress

Jay FitzOur Town Health

With sparkling lights and heartwarming music, parties and presents, sweet treats and savory dinners with loved ones around the table, this time of year ought to be the most joyful of all. Thomas Jensen, MD, a psychiatrist with Peninsula Behavioral Health, says it can easily become a season of stress and sadness instead.

Dr. Jensen is offering his insight on how to make the holiday season brighter.

Seasonal Stress

The most exciting things about the holiday are often the same things that cause stress. An endless list of responsibilities and an endless list of social obligations can drain even the most cheerful among us.

“Even good stress can be stressful,” Dr. Jensen says.

Good and bad stress both produce cortisol, a stress hormone packed with physiological effects. Dr. Jensen says if there’s a sustained release of cortisol, especially over a long period of time, it can have an adverse effect.

“Manage stress by establishing really good boundaries; learn to say no to certain things that may not be as high a priority for you during the holiday season,” Dr. Jensen says. “If you’re going to say yes to something, make sure it’s your best yes.”

Dr. Jensen emphasizes the importance of saying yes to things and people you value most and saying yes to listening.

Loss of a Loved One

The holidays can be particularly emotional for those who are mourning the loss of a loved one. Effectively finding a way through the depression requires doing the exact opposite of what might feel logical.

“I often ask people to ‘act against a will,’ because the will [tendency] of depression is to isolate,” Dr. Jensen explains, “but being with people who love you and support you is always so helpful when you’re grieving through the holidays. Isolation is the enemy of recovery, the enemy of trying to cope with loss, with sadness, with grief.”

Maintaining rituals and traditions can also help when holiday blues come calling. Dr. Jensen says those traditions can help us stay grounded while also giving us the sense that we’re connected to the loved ones we’ve lost.

To help work through the grief, Dr. Jensen prescribes an exercise.

“Process the grief by writing letters to the loved one who’s passed,” Dr. Jensen says. “It can seem somewhat silly at first, but it’s a way of processing the loss, particularly if you weren’t able to say or express the things you wanted to when they were alive. You have this opportunity in a therapeutic way to express those things and bring some closure.”

Dr. Jensen says some of his patients benefit from talking to an empty chair as if the loved one is in the room. “Express those things which you’ve always wanted to say, whether it’s good things, or even maybe some words as you’re trying to work through in complicated grief.”

Family Feuds

The holidays bring families together, and sometimes that can mean complex relationships with different personalities and even old wounds. Dr. Jensen says family is important, but so is mental health.

“Boundaries are key around the holidays, working through family dynamics is key, and also knowing that when you get together, the same old family dynamics are going to come out,” Dr. Jensen says. “Just prepare emotionally for those so that you can cope well afterward.”

If it comes down to it, invitations to family gatherings can be declined.

“You can say no with dignity and civility,” Dr. Jensen says. “Whether it’s for self-care or even because of past pain, it’s always a challenge, but it’s also a healthy thing to be able to say no, particularly if there’s a toxic environment or if there are toxic relationships. It is OK to set up a good, healthy boundary there.”

Feeling SAD

If darker and colder days make you feel uncharacteristically blue, it could be the result of Seasonal Affective Disorder (SAD). SAD comes with an upset in circadian rhythm (sleep/awake hours in a 24-hour period) caused by a change in the amount of daylight and darkness.

“There is a cascade of chemical effects that can occur that affect the area of the brain that controls mood modulation,” Dr. Jensen says. “I’d recommend some light therapy, because that’s a very natural way of helping boost the mood during the winter season.”

Light therapy involves exposure to a 10,000-lux light for 30 minutes a day. Light boxes of 10,000 lux can be purchased online or at many stores.

“It doesn’t have to go directly in front of you, as long as it’s in the vicinity, where you have some exposure,” Dr. Jensen says. “It could be to the side of you while you’re reading a book, it could be while you’re watching television.”

While SAD can last several months or even for years, it is very common and very treatable.

Holiday Spirits

Alcohol flows freely at many holiday parties, and it can sometimes seem like a sanctuary in the loneliest hours when the world outside appears to celebrate nonstop.

“Some people will also use drugs to cope with their sadness,” Dr. Jensen says. “Sometimes they justify a relapse with, ‘Oh, it’s just Christmas,’ but this is the time to double down. If you already have a history of alcohol use disorder, if you have a history of drinking, the goal is abstinence and you really have to get out in front of that.”

Dr. Jensen recommends talking to family and friends about the struggle in advance of parties. They can often help find alternative ways to celebrate the season.

For accountability, stay connected with mentors and educators who have been helpful on the journey to sobriety. If a relapse happens, get support as soon as you can so you can get back on track.

When You Need More Help

The holidays can bring on a complicated mix of emotions, and sometimes they’re overwhelming. It’s important to know when it’s time to seek professional help. Dr. Jensen says that time is when problems and issues become bigger than life, when your mental state begins to keep you from functioning normally on a daily basis.

“If you’re not able to work, or you’re missing work several times a week or a month, and if it’s affecting your ability to function, I would recommend thinking about getting help,” Dr. Jensen says. “If you start having suicidal thoughts, absolutely get help.”

Dr. Jensen emphasizes that for those who are struggling with suicidal thoughts, simply dialing 988 connects callers to mental health professionals who can offer life-saving support. The national Suicide and Crisis Lifeline is always open.

Sometimes counseling or medication management can go a long way towards a more peaceful and joyful holiday season. To learn more, visit PeninsulaBehavioralHealth.org or call 865-970-9800.

Tonya Stoutt-Brown of Covenant Health provided information for this story.

 

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