The holiday season brings with it images of glittering parties, family get-togethers and a festive social whirlwind. But these same images often mask a number of serious mental health issues that also can come with the holiday season.
And while many people do enjoy the holiday activities during Thanksgiving, Christmas, Hanukkah and New Year's, for others the season is marked by an increase in depression, alcohol and substance abuse, suicide and domestic violence.
"We see more of it in police reports and hospital emergency room visits," said Jennifer Taylor, clinical psychologist at McLean Hospital/Harvard Medical School in Belmont, Mass.
Expectations about holiday events, often based on the unrealistic portrayals of healthy, affluent families from television and advertisements, can fuel anxieties during the season.
"Each individual needs to think about how realistic this is," said Taylor. "When people try to live up to that and it's not realistic, people become anxious and try to numb their feelings with alcohol or substance abuse. This can lead to domestic violence."
Seasonal pressures come from a wide range of other sources. Financial obligations mount as holiday spending runs amok, final exams and grade reports put students and parents on edge, and increased demands on time and energy can sap the strength from the most resilient party-goer.
"There are tons of extra demands," said Nadine J. Kaslow, professor and chief psychologist at the Emory University School of Medicine in Atlanta. "People feel like they want to do it just right. They run themselves ragged."
SAD, or seasonal affective disorder, also afflicts some individuals during this time of year. SAD is a type of depression associated with the low light conditions experienced during long, dark winter months.
Families are usually a focal point for holiday anxieties. And when family members are serving in the military overseas, have died in the past year, or are estranged from the family, the pressure to have a perfect holiday gathering can cause ordinary social tension to become unbearable.
"There are a lot of complicated family dynamics -- divorced parents, or deciding between spending time with one family or another," said Kaslow.
"Families are redefined now," said Taylor, noting that changes in family structures like gay family members with long-term partners are forcing people to reassess their ideals. "There have been a lot of changes."
Before holiday stress reaches a critical point, experts advise taking proactive steps to minimize anxiety and enjoy the holidays.
"Be realistic," said Kaslow, noting that many people's goals for the holidays are based on unhealthy or unattainable standards. "You're not going to lose 50 pounds before Christmas to fit into that sexy little dress."
Kaslow also explains that many dubious expectations for the season come from nostalgic memories of holidays past. "Focusing on what used to happen won't help. Look toward the future."
This is not the time of year to forget about the basics of staying healthy, Kaslow added. Eating healthy foods and getting enough sleep are even more important now. "And whatever your normal form of exercise is, you should keep it up," she said.
Alcohol and drug use often exacerbate holiday pressures. "Drink alcohol moderately, or not at all," said Kaslow.
"Alcohol is a depressant," said Taylor. "Even things like cocaine -- they might feel good initially, but then there's a crash."
Financial pressures can be managed by taking an objective look at your budget. "Really think about who needs that gift," said Kaslow, adding that many families are paying for their holiday excesses well into the new year. "Just like you don't want to be house poor, you don't want to be holiday poor."
For those people who feel their holiday stress is getting the better of them, Kaslow advises seeking out the assistance of a professional therapist. "If you notice that you're really getting depressed, talk to someone about it or get some help."