Symptoms of Anxiety
Anxiety is a feeling of apprehension and fear characterized by physical symptoms such as:
- Heart palpitations
- Feelings of stress
The winter holiday season, with celebrations such as Christmas, Hanukkah, and Thanksgiving, for most people is a fun time of the year filled with parties and social gatherings with family and friends. But for many people, it is a time filled with sadness, self-reflection, loneliness, and anxiety.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms such as:
Sadness is a truly personal feeling. What makes one person feel sad may not affect another person. Typical sources of holiday sadness include
Nonhuman animals react to the changing season with changes in mood and behavior. People change behaviors, as well, when there is less sunlight. Most people find they eat and sleep slightly more in wintertime and dislike the dark mornings and short days. For some, however, other symptoms are severe enough to disrupt their lives and cause considerable distress.
Sadness or depression at holiday time can be a reaction to the stresses and demands of the season. In other cases, people may feel depressed around the winter holidays due to a condition known as seasonal affective disorder (SAD), sometimes referred to as seasonal depression. This is a type of depression that tends to occur (and recur) as the days grow shorter in the fall and winter. It is believed that affected people react to the decreasing amounts of sunlight and the colder temperatures as the fall and winter progress, resulting in feelings of depression. Although this disorder usually occurs in the fall and winter, there are those who suffer from this condition during the summer instead of, or in addition to, during the fall or winter. The incidence of seasonal affective disorder increases in people who are living farther away from the equator.
Risk factors for depression, anxiety, and stress during the holidays include having a mood disorder or experiencing depression at other times during the year and a lack of adequate social support systems. Other risk factors can include recent trauma, life changes, excessive alcohol intake, or concurrent illness. Having financial troubles may increase one's susceptibility to anxiety or stress during the holidays. Stressful family situations and illness in the family are also predisposing factors. Essentially, any factor that can cause depression, stress, or anxiety in an individual can worsen these conditions at holiday time.
Balancing the demands of shopping, parties, family obligations, and house guests may contribute to feelings of being overwhelmed and increased tension. People who do not view themselves as depressed may develop stress responses and may experience a number of physical and emotional symptoms including
Others may experience post-holiday sadness after New Year's/Jan. 1. This can result from built-up expectations and disappointments from the previous year, coupled with stress and fatigue.
In the case of seasonal affective disorder or a true depressive disorder, symptoms may persist beyond the holidays or may be more severe. The symptoms of seasonal affective disorder include tiredness, fatigue, depression, crying spells and mood swings, irritability, trouble concentrating, body aches, loss of sex drive, insomnia, decreased activity level, and overeating (especially of carbohydrates) with associated weight gain.
A simple history and physical exam may be all that is needed to diagnose a case of the holiday blues. Your health care professional may perform lab tests or other tests to rule out any medical conditions that may be causing your symptoms. Likewise, a full history of your symptoms is likely to provide clues that can help distinguish a mild case of the holiday blues from SAD or a more serious and chronic depressive disorder.
Anxiety, depression, and stress can be treated by a variety of medical and mental health professionals. Medical doctors, including family medicine physicians and internists, treat holiday depression. Psychiatrists are medical doctors who have special training in treating mental and emotional conditions. There are many other types of mental health professionals who may treat these conditions. These include psychologists, social workers, mental health counselors, marital and family therapists, nurse psychotherapists, psychiatric or mental health nurse practitioners, and others.
Those suffering from any type of holiday depression or stress may benefit from increased social support during this time of year. For uncomplicated holiday blues, improvement may be found by finding ways to reduce the stresses associated with the holiday, either by limiting commitments and outside activities, making arrangements to share family responsibilities such as gift shopping and meal preparation, agreeing upon financial limits for purchases, or taking extra time to rest and rejuvenate.
Counseling or support groups are another way to relieve some of the burdens of holiday stress or sadness. Knowing that others feel the same way and sharing your thoughts and experiences can help you manage your troubling feelings. Support groups also provide a further layer of social support during this vulnerable time period.
In addition to being an important step in preventing the symptoms of seasonal affective disorder, regular exposure to light that is bright, particularly fluorescent lights, significantly improves depression in people with SAD during the fall and winter. Phototherapy is commercially available in the form of light boxes, which are used for approximately 30 minutes daily. The light required must be of sufficient brightness, approximately 25 times as bright as a normal living room light. The light treatment is used daily in the morning and evening for best results.
Visiting other areas of the world that are characterized by more bright light (such as the Caribbean) can also improve the symptoms of SAD.
Antidepressant medications, particularly serotonin selective reuptake inhibitor (SSRI) medications, can be an effective treatment for seasonal affective disorder. Examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa).
Complications of holiday depression can include worsening of the condition, leading to withdrawal from activities of daily living. As with all cases of depression, suicide or self-harm is a possible complication when severe.
Fortunately, holiday depression and stress can be well-managed by implementing the tips listed above as well as by seeking out social support. Counseling and support groups can be of benefit if the symptoms are too much to bear alone. Seasonal affective disorder generally responds well to bright light therapy (phototherapy). For some, medications may effectively relieve symptoms.
The following tips can help prevent stress, anxiety, and mild depression associated with the holiday season:
Fatigue can be described in various ways. Sometimes fatigue is described as feeling a lack of energy and motivation (both mental and physical). The causes of fatigue are generally related to a variety of conditions or diseases, for example, anemia, mono, medications, sleep problems, cancer, anxiety, heart disease, and drug abuse.Treatment of fatigue is generally directed toward the condition or disease that is causing the fatigue.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Hot flashes (or flushing) is the most common symptom experienced by a woman prior to and during the early stages of menopause, and often is described as the feeling of warmth that spreads over the body, often starting at the head accompanied by sweating. In the Study of Women Across America the Nation (SWAN) women had hot flashes that lasted on average 7 1/2 years. Symptoms of hot flashes include:
Diagnosis is made by taking a patient history and, at times, blood tests. Treatment options include hormone therapy, bioidentical hormone therapy, and medications. There are non-FDA approved natural home remedies such as:
Hot flashes also can be caused by other conditions. Scientific studies to prove the safety and effectiveness of these products in relieving hot flashes have not been adequately performed. Consult your health-care professional before taking any herbal supplement.
Lack of sleep and insomnia can be caused by medical conditions or diseases, medications, stress, or pain. The treatment for lack of sleep and insomnia depends upon the cause.
A tension headache s one of the most common types of headaches, and the exact cause is not known. Factors that may contribute to tension or stress headaches are lack of sleep, increased stress (referred to as a stress headache), skipping meals, dehydration, medical diseases or conditions, anxiety, or changes at home, work, or school. Treatment of tension headaches include prescription and OTC medications, stress management, and treating any underlying illness or condition.