Navigating and Treating 'New Year Depression' in Patients

As clinicians, we know that feeling down or having increased symptoms of clinical depression around the new year is not uncommon. However, keep in mind this not only true for our patients, but for us as providers and human beings. While there is no official diagnosis for a “New Year’s Depression,” we can associate many of the symptoms we see during this time of year with holiday stress, anticipatory anxiety for the coming year, as well as possible seasonal affective disorder (SAD)—a form of depression that is triggered by colder and darker weather. According to researchers at the Cleveland Clinic, around 5% of adults in the US experience SAD. They believe about 10% to 20% of individuals in the US may get a milder form of these winter blues, and that it affects women more than men.¹

There are several potential inciting factors for low or irritable moods after the change in year including:

• Post-holiday emotional let down with financial implications from overspending
• Worsened sleep patterns, poor diet, and less exercise especially in colder, darker climates
• Less socialization leading to loneliness and isolation
• Substance overuse or misuse
• Unrealistic expectations or fear of failure for new year goals and resolutions

Assessing for underlying major depressive, bipolar affective, anxiety and substance use disorders would be clinically indicated for any patient exhibiting the associated hallmark signs and symptoms. A diagnostic work-up and treatment plan for those individuals meeting DSM-5 criteria would be appropriate regardless of the season or situational stressors. It is important to identify a behavioral health disorder in our patients in the New Year as quickly as possible in order to treat them effectively.

Though onset of SAD often occurs during changes of seasons, delayed or undiagnosed symptomatology may occur midwinter. SAD carries unique risk factors as well as opportunities for targeted treatment options beyond psychotherapy and medications including morning phototherapy (10,000 lux light) and vitamin D supplementation.

In addition to psychiatric interventions, there are opportunities as clinicians to guide our patients toward healthy practices in the new year, such as:

• Setting realistic resolutions and goals
• Setting goals for their mental health
• Starting a new habit or tradition
• Staying focused on their accomplishments and granting less mental and emotional space to what others have or are doing
• Looking for something that is motivating and expands their level of comfort while maintaining realistic expectations

Finally, it is important to talk to our patients about preventive measures prior to going into the holidays and new year. In my experience, I like to suggest a few tips to my patients as we transition into the colder fall months each year. These can also translate to New Year’s resolutions for some patients. For example:

• Start up the habit of a low-impact exercise 30 minutes a day, including outdoor activity with exposure to sunlight as much as possible.
• Maintain good sleep hygiene including consistent sleep-wake cycles even during the darker months.
• Eat a well-balanced diet and take vitamin D supplements as needed.
• Practice gratitude. There are many things we all have to be grateful for, so identifying a few each morning when you wake up can give an emotional boost to your day.
• See friends and family, even if it needs to be virtually. Social activities may not only prevent depressive symptoms but provide needed support systems should symptoms arise.

While preventative steps before and during the New Year may work for many patients who are experiencing these symptoms, some patients may need more concrete professional psychiatric help to manage their depression during this time. It is incumbent on all of us as professionals to assess and diagnose appropriately. There are instances when the Winter Blues or a “new year slump” is something more.²

For more insights on how to look out for these sorts of symptoms for your patients when heading into the New Year, we have compiled some additional resources from SonderMind here that can be helpful to share with your client community during this challenging time of year.

Dr. Newton is the chief medical officer at SonderMind.

This article originally appeared in Psychiatric Times.

References

1. Seasonal affective disorder. Cleveland Clinic. Accessed January 13, 2023. https://my.clevelandclinic.org/health/diseases/9293-seasonal-depression

2. Seasonal affective disorder: more than the winter blues. National Institute of Mental Health. Accessed January 13, 2023. https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder-sad-more-than-the-winter-blues