Have the high spirits of the winter holidays got you down? If the answer is yes, you are in good company. For all their joyful noise, the holidays can be a lonely, stressful, disorienting time for many people. Dr. Milton Anderson is a psychiatrist at the Ochsner Clinic Foundation in New Orleans. Below, he offers some no-nonsense advice about getting through the holiday blues.

How can people manage the tension and anxiety that often accompanies the holidays?
Anticipation is your best defense. Start by analyzing the tension a little bit. Let's say your mother-in-law makes you tense. Try to articulate to yourself what it is she does that you feel unhappy about or uncomfortable with. And think about what you do that may allow it to happen. Is there some way you can take control of this situation and minimize the amount of toxicity that's going to arise out of it this year?

You may not be able to change another person's behavior much, but if someone is going to insult you, and you know it's going to happen because it happens every year, then try to limit the opportunities for them to do that. You could also say, "Hey, don't insult me this year; I'm here to have a good time." Put them on notice and they may do what you ask them.

Let's say you're having an acute panic moment in the kitchen, preparing a holiday dinner. What do you do?
The first thing to remember is that panic-level anxiety never killed anyone. If you have heart disease it might trigger a heart attack, but that's a different issue. In and of itself, panic-level anxiety never killed anyone. So the first thing to do is remind yourself, "This is going to be over. No matter how bad I'm feeling right now, this is going to be over in five minutes or twenty minutes or half an hour." Once you've calmed down, the next thing to do is figure out what precipitated the panic, and see if you can prevent it from happening again. The main thing is to remind yourself that it will pass. If you need to, go find a room where you can be alone to calm down. And get a hold of yourself well enough so that you don't do something you will regret in the meantime.

Like wield the ham knife.
Exactly. Something that would really give you a reason to have the blues down the line.

Also, it's important to remember that you can "just say no" to holiday events. If you have three parties to go to in a night, but it's going to completely stress you out to go to all three, then maybe you should say no to one or even two of them. The little bit of anxiety you feel in the five- to ten-minutes it takes to make that decision could save you from a four-hour anxiety-filled evening. Being kind of brutal about exercising control over your own time is worthwhile during the holidays.

Are there any biological reasons why people may tend to get 'blue' during the winter holidays?
Everyone's body runs a little slower in the winter. We tend to want to sleep more, eat more, and there tends to be an increase in the craving for carbohydrates compared to other times of the year. It's a kind of hibernation tendency, which is the brain's response to shortened daytime hours. In the U.S., the winter holidays coincide precisely with the least amount of daylight throughout the year. So they occur at a time when our bodies are most likely to want to crawl into a cave and go to sleep and do what a bear would do: Eat and sleep.

What can people do to help counteract these tendencies?
Try not to give in to high-density carbohydrate cravings. Snacks are fine, but try to make them fruits and vegetables and healthy protein snacks. Eating Christmas cookies all day is not going to improve your mood one bit. And that's what your body is going to crave. Eat them in moderation. And try to keep your meal times regular, which of course can be hard during the holidays.

Also, get as much light-both sunlight and artificial light-as you can. Take advantage of the daylight hours with a walk. The light on your retina will get that signal sent to the photosensitive parts of the brain to say, "Hey, it's not as bad as it seems…" And use bright lights inside. The brighter the better.

Exercise is helpful too, but try to do it during the daylight hours, or in a well-lit place. If you get your exercise in the morning or during the day, you will give your body a consistent signal that it's not hibernation time.

Keep your sleep habits regular, and don't sleep too much. That hibernation tendency is self-perpetuating. Keep your sleep hours down to eight to nine hours a day; no more than that.

People tend to drink more during the holidays. How does alcohol affect mood?
It has a euphorian effect while the blood alcohol level is rising, but that is only going to last as long as the blood alcohol level is rising. Which means that within fifteen to thirty minutes after you finish consuming that last drink, your blood alcohol level is falling, at which point you're going to start feeling bad. So again, it's best to drink in moderation.

What can you suggest to people who are feeling sad during the holidays about a person who is absent, or perhaps has passed away?
Sadness is a signal. It's a reminder that you had a relationship that was really important to you, otherwise you wouldn't feel sad about it. There may be contained within those sad feelings some regret about things that didn't go well or anger about something that didn't go right, and this can complicate these feelings.

But the reason you miss that person is that you have positive memories of them. So the obvious answer is to think about the positive things, and figure out how you might be able to celebrate those positive memories during the holiday. You're not going to be able to enjoy the time with them, but you can honor them by celebrating them in some way, even if it's a very private thing.

If you're thinking about negative aspects of your relationship with the missed person, you can take action on that too. Look at your life currently and do something to try to prevent that negative exchange from happening again. Where might it be repeating itself in current relationships? If you see it, take a single step to rectify it in a current relationship.

So analyze the sadness and address it specifically?
Sadness is like a red light saying, "Stop. This is important." It doesn't mean you have to sit there at the stoplight and stay there 'til the holidays are over. But take note of it; figure out why it might be happening and do something about it. And then your intervention is going to be very specific and commonsense because it will be responding particularly to what saddens you, not just a vague feeling.

If you're worried that a friend or loved one is actually clinically depressed, what should you do?
If you notice that there is real change in a person's functioning, and you are concerned that they might be depressed, there are a number of things you could encourage. Certainly for suicide issues, there are hotlines that you can find in the telephone directory in just about every place in the United States.

For less severe depression, there are a number of resource options. Some people may feel most comfortable finding pastoral counseling through their churches or religious groups. Others may be more comfortable going to their primary care doctor. Primary care doctors will be familiar with local resources that might be helpful if a serious depression is developing.

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