Advertising, and our own nostalgia, raise expectations for the happiness the holiday season will bring us. If those expectations are not met, or if the holidays merely magnify ongoing family hurts, the Holiday Blues may result. Most will find a way to cope, and their sadness from whatever source won’t derail their pursuit of life, liberty, and happiness. For some, however, sadness will settle in and begin to compound itself, creating the condition known as clinical depression.

Clinical depression differs in depth, duration, and pervasiveness from the blues most of us have experienced. To justify the diagnosis, a depressed mood or a general disinterest in life must last most of the day, and nearly every day, for at least two weeks. Depression may include fatigue, insomnia, and difficulty concentrating or making decisions. Appetite changes and weight gain or loss may also be part of the picture. Clinical depression can prove fatal when the sufferer concludes his or her life is not worth living, and starts thinking about suicide.

Biology appears to be an important factor in whose sadness turns into clinical depression. There is good scientific evidence that significant risk factors for depression are inherited. It is also well established that chemical changes in the brain during depression seem to perpetuate the condition. Thus antidepressant medications have been developed and demonstrated as an effective therapy for depression. This information has made its way into the public consciousness in recent years with high power advertising campaigns by pharmaceutical companies.

The general public has less knowledge, however, of other therapies proven effective in clinical research trials of comparable number and quality to those for medication. Cognitive, behavioral, and interpersonal psychotherapies offer viable alternatives, or in some cases important augmentations, to the benefits of medication. In fact, studies are beginning to show that a successful course of these psychotherapies can result in brain chemistry changes similar to those resulting from antidepressant medication. Moreover, these psychotherapies seem to offer protection from recurrence of depression beyond that provided by medication.

To begin to understand how these therapies work, it is helpful to understand depression as a vicious circle. Let’s take the case of someone who’s had a sad holiday season. It is only human to feel sadness if you have lost a loved one and are spending your first holiday season without them, or if close loving family relationships have always been missing in your life. That natural sadness may leave you prone to criticizing and blaming yourself unfairly or underestimating your personal power. When you criticize yourself, you may struggle to convey your positive attributes to others, and hesitate to communicate your wishes and feelings to them. Such lack of communication often translates into less social initiative and fewer social invitations, reducing your social network and the number of enjoyable and meaningful activities in your life. In turn, it is human to feel sad when there are few enjoyable or meaningful things going on in your life. This is likely to prompt more negative thinking, completing the vicious circle. The bad news about the vicious circle it that it can easily become a downward spiral.

The good news about the vicious circle is that it can be reversed through effective psychotherapy. In reverse, it becomes a healing circle of reclaimed personal power. This process begins by clarifying where you have power and how you might best exercise it. It may be neither possible nor desirable to fight realistic sadness about what is lost or missing in your life. We feel sadness to remind us of the importance of such things. You do have power, however, to prevent or cease the compounding of this sadness into depression. You can learn to catch and challenge negative thoughts that take a bad situation and make it out to be worse than it is. Hopeless and helpless thoughts are particularly pernicious in sapping personal power and fueling depression. You can learn to effectively communicate your wishes, feelings, and strengths to consciously connect with a community that shares your values. You can proactively plan to initiate enjoyable and meaningful action. Each of these areas of personal power corresponds to an established effective focus for psychotherapy of depression. Because clinical depression is a powerful state of inertia, the help of a therapist is important in getting started. Medication may also be necessary to help you make these changes.

Whether you have clinical depression or a simple case of Holiday Blues, you can find the power to overcome it. Part of that power may come from choosing to get professional help. The rest comes from connecting with others and from hopeful action, the most powerful kind of hope.

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