Doc in the Box News

Holiday Ho-Hums: Get Your Jolly Back

Stress and its effects on Athletic Performance

Dec 01, 2015 | By Holly Johnson, M.D.


“I think a lot of people would say that the holidays are the worst time of the year,” says Ken Duckworth, M.D., the medical director of the National Alliance of Mental Illness (NAMI). “They’re just straight up miserable...” 

According to NAMI, approximately 16 million people in the US are depressed, and according to Health.com about 350 million people worldwide fight the blues more than just during the holidays. Depression is more common than diabetes, cancer, and AIDS combined! 

Here is a bit of silver lining inside the Christmas ball: It is actually a myth that more people commit suicide between Thanksgiving and Christmas than other times of the year! Here’s where the ball drops: The truth is that there is a 40% uptick in suicide rates just after Christmas, and rates peak in the spring. 

What is the science behind depression?

Our inner stress response team and the attic of our emotions is housed in what is called the limbic system, or the hypothalamic pituitary adrenocortical system. The limbic system includes parts in our brain called the amygdala, the hippocampus, and the diencephalon. This last organ-part contains the thalamus and hypothalamus. All of these brain parts talk to each other constantly via chemical neurotransmitters that transfer messages from nerve (neuron) to neuron. A neuron looks like a line that has finger-like tentacles called dendrites at one end that pick up a signal and send an impulse to the body, then an electrical impulse shoots to the terminal end of the neuron. That neuron then spits out a neurotransmitter such as dopamine, serotonin, or norepinephrine to the next neuron. 

With just the right balance of neurotransmitters our bodies regulate emotions and our reaction to stress, they drive our sleep patterns, handle our appetite, and control other feelings of pleasure related to survival.

So, do people with depression lack these hormones or what?

Think of the chicken and the egg: which really came first? Same with neurotransmitters and depression — which one really came first, no one knows for sure. These little substances are hard to study as they are present in such small quantities in the brain and they disappear quickly, zipping from neuron to neuron. Since they are removed so fast, they can’t be measured directly, but science can estimate levels based on their break-down products, called metabolites. Some people with depression have lower levels of the three key neurotransmitters and some have higher levels. End of the year deadlines, parties = poor eating and drinking, and cold, dark days can have an effect on our stress hormones and neurotransmitters.

What are some symptoms of depression or the holiday blues?

Here’s a list to check twice: sadness, grief, guilt, constant tiredness, change in appetite or eating habits, trouble sleeping, irritability, anger, loss of interest in things you usually like to do, inability to concentrate, memory problems, difficulty making decisions, headaches, and nonspecific pain are all symptoms of depression. Depression can also take the zing out of your step and negatively effect your athletic performance and has been linked with lower GPAs in student athletes.  Poor athletic performance in previously healthy athletes can also be due to other conditions such as thyroid disorders, exercise induced diabetes, heart disease, poor nutrition, lack of sleep, and even overtraining.

Why is depression so bad?

Depression is an isolating, debilitating disease that can lead to a not-so-heavenly host of other medical problems including cardiac disease and substance abuse and even death. Depression over time raises levels of the stress hormone cortisol. When cortisol levels go up, our immune system is suppressed leading to inability to fight off illnesses, so you get sick more often. During sleep, our body is under repair. If we are not sleeping because we are depressed, our body has no time to repair itself.

What are some ideas to try during the holidays to try to prevent the grinch of depression from cramping the Christmas spirit?

As you are making your list, the first thing to remember is that you are human and it is okay to have feelings this time of year of loneliness, sadness, or missing a loved one. Lower your expectations of what you think is expected of you this season. Gifts don’t have to be perfect, you don’t have to bake cookies for every single scrooge-y neighbor, and you don’t have to go to the office holiday party (or every party) for the entire open house.

As you check off this list, be mindful and intentional to:

  • Do something different this year. Take a destination Christmas vacation. Attend a different church service. Volunteer at a soup kitchen. Refuse to sit by belching Aunt Hilda at the dinner table and sit at the kids table instead!
  • Lean on your support system. I cannot stress this point enough — do not isolate yourself as this will only make you feel worse! Get out of the house. Socialize. Call your friends and family even if they are a few states away.
  • Forget the unimportant stuff. Think instead about things that provide balance between self-care and caring for others.
  • Plan ahead. Put shopping, baking, napping, and exercise time on the calendar.
  • Find positive ways to remember loved ones. Go to their favorite restaurant and celebrate their life with a toast. In their honor, run a Reindeer Run. 
  • Don’t overbook. Know when to say, “No.” (And by the way, no explanation needed, just simply, “no” is enough.)
  • Stay on your schedule, stick to the routine. Keep your visions-of-sugarplums sleep time the same.
  • Exercise! Keep your sleigh bells tuned! Exercise is a much overlooked prescription for depression. With exercise the body releases endorphins which trigger positive feelings, decrease pain perception, and act as a sedative to help you fall asleep and stay asleep. It also helps to balance those neurotransmitters. And the side effects are awesome: more energy, better health, and looking good!
  • Stick to a budget. Don’t spend too much. Shop online to avoid stressful lines and grinchy crowds.
  • Give yourself a break! Treat yourself with kindness and forgiveness; tis the season after all, right?

Please Note: The information in this article is not a substitute for medical advice from your own physician. Dr. Johnson and OYL! are not responsible for determining who needs a mental health counselor or for helping you get out of passing the jello mold. We are not suggesting that the above advice will cure anyone’s depression. Depression is a serious health issue. Only you and your doctor and therapist can come up with the best treatment plan for you. If you need immediate help, call 911! The National Suicide Prevention Lifeline (1-800-273-8255) is also available 24 hours a day.