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3 considerations for your mental health during the holidays

We made it through Thanksgiving – hopefully emotionally unscathed. But for many, managing mental health during the holidays is not easy. Whether you deal with anxiety for months leading up to the holiday, your family is plagued with arguments or more subtle discomfort during get-togethers, and/or you are mourning the loss of a loved one and have an empty seat at the table – the holidays can be tough. In fact, in a 2021 survey, 44% of Americans said that preparing for the holidays is stressful and 39% said that family gatherings during the holidays are stressful.[1]

Holiday anxiety

Anxiety is defined by the National Institutes of Health as “a feeling of fear, dread, and uneasiness.”[2] And why might we feel anxious leading up to what one might consider a wonderous and magical occasion, such as Thanksgiving or a December holiday, with our family? The reasons are endless. It could be a difficult family member we are not looking forward to seeing. It could be that we are not feeling particularly good about ourselves and want to face others. Maybe we are hosting a holiday gathering and worried about getting everything done in time, how much everything will cost and whether everyone will have a good time.

We are barraged with media images of what the perfect holiday looks like, and we may sometimes feel pressure to be happy and festive and live up to expectations.

When we dread an upcoming holiday, it puts a damper on more than merely just that day or specific gathering, but the days, weeks, or even months leading up to it. It is almost like the reverse of excitement or anticipation. But whether we are excited or anxious about something, the actual event often does not live up to our expectations. In the case of holiday anxiety, if we can remember that it may actually end up being better than we think and simply try not to care as much, our anxiety time may be reduced. We can let go of others’ expectations of us and do what truly makes us happy.

Family arguments during the holidays

Yes, most families argue – even during the shiny holidays and behind the scenes of the happy pictures we post on social media. And just when our typical bickering was not enough, our country has become increasingly divided, and it has seeped into our very own families. There are things we can do to prevent the arguments and deal with them in a healthier way when they occur.

You have probably heard the phrase “communication is key.” A lot has changed over the past couple of years and continues to change at a rapid pace. We may think we know how a loved one would like to celebrate the holidays, for example. But their preferences, and our own, may have changed just like so much else has changed.

It’s a good idea to initiate respectful conversations – early in the holiday planning process – with our family and friends to understand where they are coming from on certain issues. It can be a way to identify the topics that should be off-limits during the upcoming holiday gathering and prevent arguments.

During these early conversations and when we’re all together for the holidays, our family members may inevitably do or say something that rubs us the wrong way. At that moment, our reaction will set the course for what comes next. As our feelings come together to form that reaction, why not assume goodwill and the best intentions of the offending person. It may be that their actions and comments reflect the way they feel about themselves and not the way they feel about you.

With so much to disagree about these days, there is also a lot we can agree on. Try to focus on the latter, agree to disagree when possible, and assume that others are coming from a place that is genuinely meaningful to them.

Grief and missing a loved one during the holidays

The pandemic has taken so much from us, including the lives of precious loved ones. The holidays have always been a difficult time to bear when we cannot share them with a lost family member or friend. During this holiday season, you can uphold and honor memories of those you have lost in many ways: Look through photographs of the person and reminisce about holidays of the past; do things you used to do with a lost loved one during the holidays, like cooking or baking a certain recipe, a craft, or decorating; and journaling or talking with others about your feelings.

It can be hard to move on without a person we love, but they would want you to be happy. We will always have their memories during the holidays and beyond, as we carry on with old and new traditions.

We can all agree that it has been another tough year. But we have endured, and it is time to let go of expectations and focus on our mental health during the holidays and how the holidays can be a time to do what makes us happy, spend quality time with those who are important to us and cherish the memories of those we have lost.

Visit MagellanHealthcare.com/Holidays for additional information and resources on holiday emotional wellbeing and how to find peace and moments of joy with family and friends this holiday season.


[1] Collage Group Holidays and Occasions Survey, May 2021

[2] https://medlineplus.gov/anxiety.html


Dr. Candice Tate

Candice Tate, MD, MBA, serves as a medical director at Magellan Healthcare. Dr. Tate’s treatment philosophy includes a strong physician-patient therapeutic alliance and safe, responsible medication management. Dr. Tate joined Magellan in 2017. She has years of experience in psychotropic medication management for a variety of psychiatric conditions in inpatient and outpatient settings. During her graduate medical training, Dr. Tate was extensively trained in psychodynamic psychotherapy and was supervised by experienced psychoanalysts. She is also familiar with cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and dialectical behavior therapy (DBT). Dr. Tate graduated from the University of Tennessee Medical School in Memphis and completed her graduate medical education in General Psychiatry at Northwestern University’s Feinberg School of Medicine in Chicago, IL. Dr. Tate is a board-certified psychiatrist by the American Board of Psychiatry and Neurology.




Beating the holiday blues

The holidays can be a joyous time—a time to spend with family and friends, reflect, and be thankful. Yet, for many people, the holiday season can bring on the blues, including feelings of anxiety, stress, worry, and sadness. These feelings may even be worse for those who have experienced divorce, lost a loved one, or are living far away from family and friends.

The holiday blues

A 2014 survey conducted by the National Alliance on Mental Illness (NAMI) found that the holidays contribute to feelings of sadness or dissatisfaction. Of those surveyed:

  • 63% reported there was too much pressure
  • 57% stated they had unrealistic expectations
  • 66% reported experiencing loneliness
  • 50% were unable to be with loved ones
  • 55% found themselves remembering happier times in the past contrasting with the present
  • 68% reported feeling financially strained

While the holiday blues are different from mental illness, it can lead to clinical anxiety and depression. It is important that we do not ignore these feelings, especially as we all continue to deal with changes wrought by the COVID-19 pandemic but deal with them in a proactive and healthy manner.

Tips for beating the holiday blues

  1. Throw guilt out the window. Try not to put unreasonable pressure on yourself to be happy or enjoy the holidays and avoid overanalyzing your interactions with others. Give yourself an emotional and mental break this holiday season.
  2. Be realistic and try not to expect the “ideal” holiday. Keep expectations for the holiday season manageable by not trying to make the holiday “the best.” Be truthful to yourself and others about what you can and cannot do. And remember, nobody has a perfect holiday or perfect family.
  3. Give to others. Volunteering somewhere, like a soup kitchen, food bank, children’s group home or facility for the elderly can fill you with feelings of love and pride. You will spend time with others and immerse yourself in the true spirit of the holiday season.
  4. Stay connected. Schedule phone calls or virtual gatherings with your favorite folks where you can open gifts together, sing songs and reminisce. Spending time with those who love and value you can be very comforting and help ground everyone involved.
  5. Acknowledge the past yet look toward the future. Change is a constant part of life. If your holidays are not like they used to be, it is OK. Cherish the memories and remember everything does not have to be like past holidays for you to enjoy the season.
  6. Make a budget. Budgeting at the start of the season for holiday shopping and expenses is one of the most effective ways to alleviate stress. It helps prevent accidental overspending and allows you to manage expectations.

Want more tips for beating the holiday blues?

Visit the Magellan Healthcare holiday emotional wellbeing website for resources to help you find peace and moments of joy this holiday season here.




Depression Doesn’t Discriminate

Men, women, and children. Black and white. Rich and poor. Depression affects Americans from all walks of life, regardless of age, gender, race, ethnicity, and socioeconomic status. In fact, the Centers for Disease Control and Prevention estimate that one in thirteen of us is living with depression.[1]

  • In 2019, nearly 13 million U.S. adults and 2.7 million U.S. adolescents had at least one major depressive episode with severe impairment in the past year[2], including:
    • Almost 10% of females and 6.0% of males[3]
    • Approximately 15% ages 18-25, 9% ages 26-49, 5% ages 50+[4]
    • About 7% Hispanic or Latino, 9% White, 6% Black or African American, 5% Asian, 4%[5] Native Hawaiian/Other Pacific Islander, 9% American Indian/Alaskan Native[6]
  • About 31% of Americans in poverty and almost 16% of those not in poverty report having been diagnosed with depression [7]

Recognizing signs of depression

Depression is often referred to as a silent illness. Many people who suffer from depression secretly struggle and never seek help. Signs and symptoms of depression include:

  • Low mood or increased irritability
  • Feeling empty or numb
  • Loss of energy or motivation
  • Loss of interest in regular or recreational activities
  • Feelings of guilt, restlessness, hopelessness, worthlessness or fear
  • Sleeping too much or too little
  • Changes in appetite or eating behavior
  • Poor concentration
  • Suicidal thoughts

If you or someone you love is experiencing any of the common risk factors and warning signs associated with depression, online or in-person depression screening is the first step toward improved mental health and wellbeing.

Benefits of depression screening

Screening is a valuable tool in the identification and treatment of depression. One of the most common screening tests for depression is the Patient Health Questionnaire (PHQ). Early identification and treatment of depression can:

  • Slow its progress
  • Improve your physical health
  • Prevent years of suffering
  • Decrease the risk of death by suicide
  • Place you on the path to a happier, healthier life

Visit here to complete the PHQ-8. Once you complete the assessment, be sure to review your results and any recommendations with your doctor.

Who should take a depression screening test?

The U.S. Preventive Services Task Force recommends screening for depression in the general adult population, including pregnant and postpartum women. Although anyone can develop depression, regardless of their age, ethnicity, or background, depression is more common among people who:

  • Have a family history of mental illness
  • Have another mental health condition, like anxiety
  • Struggle with a substance use disorder, like drug addiction or alcoholism
  • Recently experienced a stressful life change or traumatic event

However, anyone who has any signs of depression should take a depression screening test.

Screening and treatment

While screenings are not a professional diagnosis, they do point out the presence or absence of depressive symptoms and can indicate if a referral for further evaluation is needed. You should see your doctor or a qualified mental health professional if you experience five or more depression symptoms for longer than two weeks or if the symptoms are severe enough to interfere with your daily routine.

Proper treatment of depression has been proven to effectively reduce depressive symptoms, decrease the risk of relapse and recurrence, and decrease emergency department visits and hospitalization rates.

Learn More

Visit Magellan’s Behavioral Health Resources page to learn more about depression and other mental health conditions.

If you’re in crisis or have suicidal thoughts, seek help immediately. Please call 1-800-273-8255 (National Suicide Prevention Lifeline) or call 911 and ask for help, or go to your nearest emergency room.


[1] https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html

[2] https://www.nimh.nih.gov/health/statistics/major-depression

[3] https://www.nimh.nih.gov/health/statistics/major-depression

[4] https://www.nimh.nih.gov/health/statistics/major-depression

[5] https://www.nimh.nih.gov/health/statistics/major-depression

[6] https://www.nimh.nih.gov/health/statistics/major-depression

[7] https://news.gallup.com/poll/158417/poverty-comes-depression-illness.aspx




Depression and mental health screening

Among those who experience a mental health illness, more than half do not receive treatment.[1] The 2019 National Survey on Drug Use and Health reveals no treatment was received by:

  • 90% of the 20.4 million individuals aged 12+ who have a substance use disorder (SUD)
  • 55% of the 51.5 million individuals aged 18+ who have any mental illness (AMI)
  • 35% of the 13.1 million individuals aged 18+ who have a serious mental illness
  • 90% of the 9.5 million individuals aged 18+ who have a co-occurring SUD and AMI
  • 57% of the 3.8 million individuals aged 12-17 who have had a major depressive episode

In fact, what we’ve seen in our data is that 60% of patients who are admitted to inpatient care were first seen in a primary care setting within 6-12 months of the admission and the mental health condition was either missed or not addressed.

Through effective screening for mental health conditions on your own or through a physician or mental health professional, it is possible to identify problem areas and get help, so you can live a happier and healthier life.

Mental health self-screening tools

Magellan Healthcare provides links to reputable, free self-assessments of behavioral/mental health, substance use and more.* Once you complete an assessment, be sure to review your results and any recommendations with your doctor.

*Note these are links to outside websites that are not monitored by or affiliated with Magellan Healthcare. If your screening results indicate you are at high risk, call 911 or go to the emergency room immediately.

We encourage you to watch a recording of our webinar, “Depression is more than just a rough patch,” and find additional resources addressing depression at MagellanHealthcare.com/Mental-Health.


Dr. Candice TateCandice Tate, MD, MBA, serves as a medical director at Magellan Healthcare. Dr. Tate’s treatment philosophy includes a strong physician-patient therapeutic alliance and safe, responsible medication management. Dr. Tate joined Magellan in 2017. She has years of experience in psychotropic medication management for a variety of psychiatric conditions in inpatient and outpatient settings. During her graduate medical training, Dr. Tate was extensively trained in psychodynamic psychotherapy and was supervised by experienced psychoanalysts. She is also familiar with cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and dialectical behavior therapy (DBT). Dr. Tate graduated from the University of Tennessee Medical School in Memphis and completed her graduate medical education in General Psychiatry at Northwestern University’s Feinberg School of Medicine in Chicago, IL. Dr. Tate is a board-certified psychiatrist by the American Board of Psychiatry and Neurology.


[1] https://www.samhsa.gov/data/sites/default/files/reports/rpt29392/Assistant-Secretary-nsduh2019_presentation/Assistant-Secretary-nsduh2019_presentation.pdf