Surviving the holidays

What a day to be writing of depression!

In the American tradition, popularized by movies, TV, magazines and books, Christmas Day is the real highlight of the holiday. It begins early in the morning, when family members troop to the living room and there, beneath the tree, dig out the gifts supposedly left for them by Santa Claus, or in other traditions, by the Three Kings.

In my own family, and I guess with many more Filipino clans, the highlight of the celebration really falls on Christmas Eve, when, after a sumptuous dinner, we hold the “exchange of gifts” then troop to church to hear the Midnight Mass, then share another repast when we reach home. Christmas Day is spent recovering from the revelry of the night before, although among the Davids, it’s a day spent with other members of the clan who gather for a Christmas Day potluck, complete with juicy gossip and maybe a bingo game.

Both days are marked by high spirits and glee, overindulging in special dishes and sweets, alcoholic spirits, joyful music and song. So what’s there to be depressed about?

Mental health professionals say the Christmas holidays are prime time for depression, with the joyful surroundings contrasting cruelly with one’s inner turmoil, the tinsel and glitter highlighting the darkness within, the songs of hope and cheer only serving to underscore the downward spiral toward hopelessness and despair.

In her just-published book “And Then She Laughed: Counseling Women,” Dr. Sylvia Estrada-Claudio outlines the essential differences between “feeling sad” and being afflicted with “depression.”

“Feeling sad or discouraged is a normal human emotion,” writes Estrada-Claudio. “If we had just had a wonderful vacation with lots of merrymaking and bonding with family and friends we can be a little sad when we have to go back to work. This can be true even if we love our work. Breaking up with a lover, the death of a loved one and other such life events can also make us sad. When our plans fail despite our best efforts, it is natural that we may feel discouraged.”

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“Depression, however, is not a normal emotional state,” writes the doctor. “People with major depressive disorder or bipolar mood disorder who are having a major depressive episode may have the same emotionally difficult situations that cause us to be sad but their reactions are not within normal. The sadness can be profound and cause significant problems, whereas other people who do not suffer from this mood disorder can overcome those challenges more easily.”

But there are ways by which those beset with a mood disorder can “fight back” or find their way to an emotional balance. “My counselees (Estrada-Claudio’s preferred term for patients or clients) have taught me … how courageous people can be. I have seen the most hurt and miserable people fight with all their strength to overcome. This is amazing to me because depression is both physically and emotionally painful and debilitating. And yet, people who are depressed carry on.”

What is crucial, she says, is for people (even nondepressives) to develop what she calls “happiness habits.” One such habit is finding a job or occupation that offers rewards beyond material compensation, a job that one enjoys and helps one “celebrate one’s skills.”

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Another “happiness habit” is the need to rest and self-nurture. Often, Estrada-Claudio writes, her counselees can detect a “pattern” for their mood swings, the sudden or gradual buildup from depression to mania and back. “If a pattern does exist,” she writes, both she and the counselee learn “to schedule vacation and even sick leaves during periods when they will need to withdraw and rest. Again, everyone should take vacation leaves and even, on a daily basis, allow themselves adequate rest.”

This may seem self-evident, even mundane. But women especially, says the doctor, seem to find that making time for themselves is “selfish” or “self-indulgent,” socialized as they are to be the prime nurturers of their family, the ones who would or should sacrifice themselves for the betterment of others.

“Self-care, as many doctors will tell you, is about getting exercise, eating healthy, getting enough sleep, getting a good balance between work life and home life. All these are the bedrock on which a person with mood disorder can build a better life. For any person, these are also the bedrock for optimum mental health.”

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A medical doctor before she discovered her inclination toward psychology (in which she holds a doctorate), Estrada-Claudio says she “fell” into counseling as a consequence of her involvement with social movements and then her desire to help women caught in difficult situations, particularly violence at home and in intimate relationships.

“My counseling has … made me realize that human creativity lies in choosing, erring, failing, and succeeding—in terms created by the individual person,” Estrada-Claudio says, reflecting on her clinical experience. “Thus, a guarantee of success—especially as that success is pre-defined by others—is a hindrance to creativity. My understanding also is that the abundance that is our birthright stems from the endless variation that life has to offer, which in turn guarantees opportunities for endless creativity.”

On this day, then, perhaps our wishes for each other should not be confined to such common aspirations as prosperity or perfection or even world peace. Perhaps what we should work and pray for is endless creativity, the better to cope with the daily challenges of “real” life, especially for those struggling every day to rise above the darkness.