Forget the cliche holiday blues. Social workers, therapists and counselors say more people seek help for depression in January than in December.
Going back to work, burst family illusions, self-reflection triggered by the new year and December's credit card statements can all be bummers, but experts say it's often the constellation of circumstances that can push people over the edge.
For Pat, a member of the group Al-Anon for families of alcoholics, one particularly bad January seemed to compound all his problems of the previous year.
"The holidays were an opportunity for us to compensate for the shortcomings of the preceding year," said Pat, who was referring to the problems he had with his wife's alcoholism.
In an attempt to make it up to his four children, Pat said he ran himself ragged December, buying everything on the children's wish lists.
"We probably spent 25 percent more than what we should have," Pat said.
Then on Christmas morning, "my middle son Dave approached me, and said, 'It's really nice to have all these gifts from Santa Claus, but how come you didn't get me anything?'"
That blow resonated with Pat. He made a mental note to let his kids know he cared the next year. By mid-January, the Christmas spending spree had begun to take a different toll on the family.
"It was always a tough time anticipating the bills and dealing with it," he said. "All the scrambling I did was just met with more drinking on [his wife's] part because she didn't want to face the debt."
With or without alcoholism in the family, counselors say the post-holiday time has a way of magnifying family or personal issues.
In January, "We get one-third to one-half more people, at least," said Jennifer Falotico Taylor, a clinical psychologist at McLean Hospital for psychiatric services in Belmont, Mass.
"Mid-January, is usually about when the bills come, and things in general around people look pretty bleak," said Taylor.
However, Taylor said a lot of the January blues come from a residual personal disillusionment during the holidays.
Reality and the New Year
"[Her patients] often say, 'I thought I was enjoying the holidays, but I was covering up that I really wasn't having a good time,'" Taylor said.
"It never felt real -- they felt like they were putting on an act," Taylor said of her patients. "A couple of weeks into it, they realized the role they put on started to crumble."
According to Taylor, by January people who felt pushed around or disillusioned during the holidays start going through a great deal of self-destructive distractions such as shopping, eating, drinking or starting romantic relationships.
"It's getting into a relationship to cover up their feelings," she said.
By January's end, Taylor said the self-destruction can escalate.
"Things get out of balance -- suddenly things are bad again, and things sort of crash and burn," she said. "Many times the drinking gets worse or they'll start to isolate, and families get worried."
Pat, who helps run the group Al-Anon, said he noticed January is a very busy time of year to help new and old members. One of his associates, Val, has been going through a particularly rough January.
"My sister and I had been really close growing up," Val said. "She's an alcoholic, and she had seven years clean and sober, and now she's back drinking."
Val said her sister's drinking problem interfered with family time over the holidays, since she chose to go out partying instead of visiting.
"Now I have to accept the fact that that's what she's choosing to do. I guess that's a loss for me, because she's one of my best friends," she said.
Although her sister's new drinking problem has been in the making for months, Val said something about reflecting in January made it more poignant.
"In the beginning of the year, you take stock of your life and what's going on in it, and things that are bothering you come to the forefront," Val said.
Aside from holiday disillusionment, self-reflection at New Year's is a major contributor to January blues, Taylor said.
"When you look back over the year, and people are asking how you are doing, it brings up a lot of what you lost," she said.
January Depression Doesn't Have to Have the Last Word
Despite all the January blues going around, psychologists at the National Suicide Prevention Lifeline said there is not usually a sharp increase in suicide help calls during the month. There was, however, a annual spike in calls to the hotline over the course of 2008.
Suicide calls were up by 10,000 calls per month in 2008 compared with 2007, and peaked in October, with a total of 52,233 calls.
National Suicide Prevention Lifeline spokeswoman Amanda Lehner said the calls "may or may not be connected to the economic crisis," but since all calls are anonymous, it is hard for the Lifeline employees to tell.
"They don't typically tend to increase in January," said Gillian Murphy, a psychiatric social worker for the National Suicide Prevention Lifeline. "I always thought you'd see a huge rise. You really just see a small blip and then it goes back."
Murphy said March, April and May are the busiest times of year for calls to the 24-hour 800-273-TALK hot line, which can help individuals, family and friends concerned about suicide risk, or even just concerned about someone's mental state. But she said suicides happen year-round.
"Don't just isolate it to this is the one bad month," said Murphy. "And don't think by asking that you are being rude or triggering if you outright ask, 'Are you thinking of suicide?' It's the complete opposite."
For the less severe January blues, Taylor and Val have a few suggestions.
Val, who also has a master's in counseling, self-reflection around New Year's should be used for good, even if it can be painful.
"We really have all year. Why in January is this stuff sitting in front of our face?" Val said. "But I guess we need time to take stock and redirect ourselves -- otherwise, maybe we wouldn't take action to improve things in our lives."
"We are a product of our habits," she said.
Taylor, however, had different advice.
"It's really about adapting," said Taylor, who suggested patients try to ground themselves in their normal sleep, work and eating routines.
"No drastic changes," Taylor said. That means no lofty New Year's resolutions either. "Cut the goals way down -- smaller accomplishments, reaching out to other people often makes people feel a lot better."