How to navigate the holidays -- and the holiday blues -- during COVID-19

Zoom Thanksgiving? Socially distanced Christmas? UCLA experts on dealing with holidays that look very different.

People who look forward to family traditions during holiday celebrations — perhaps dad always carves the turkey, or grandma hosts the annual Christmas Eve gathering — may find themselves particularly saddened this season.

Dr. Gary Small, director of the UCLA Longevity Center and a specialist in geriatric psychiatry, has a story about a patient who put together a massive Thanksgiving feast for 30 to 40 guests every year. Shopping and preparations would occupy her for weeks ahead of the holiday.

As COVID-19-driven Thanksgiving cancellations rolled in from friends and family, she became depressed. She lost her appetite and was having trouble sleeping.

At her husband’s urging, she saw a psychiatrist, who prescribed medication and therapy, and helped her sort through her feelings about not having the traditional event this year, Dr. Small says. “She came to grips with that and is actually planning a Zoom Thanksgiving.”

The holidays can be a trying time even without a global pandemic. The “most wonderful time of the year” may put extra strain on budgets, schedules, diet and exercise routines and emotional well-being.

This year, there’s COVID-19 to deal with as well. Besides keeping family and friends isolated from one another, the prolonged stress of the pandemic adds tension to the often already stressful holiday season.

“I think there’s going to be a surge in the holiday blues,” Dr. Small says.

Still, there are ways to keep your spirits up and make the most of the season even if your plans and traditions must change this year.

An open-minded approach

The key to a smooth holiday season in 2020 is keeping a nimble, open-minded attitude, says Annabelle de St. Maurice, MD, MPH, co-chief infection prevention officer for UCLA Health.

“I think the biggest thing is an emphasis on flexibility,” she says. “And just understanding that, no matter what plans you may have — even if you’re in an area where there’s very low transmission — things might change.”

Start having conversations now with the friends and family members you typically spend Thanksgiving and the winter holidays with, Dr. de St. Maurice suggests.

She notes it may not be safe or practical to have the usual in-person celebrations this year, especially if they involve different households mixing indoors. This is particularly true if anyone in the group is at high risk for serious illness from COVID-19, including seniors and people with health conditions such as obesity, diabetes and heart disease.

Gatherings centered around food may also have to be planned with some flexibility in mind, such as hosting them in uncrowded venues outdoors and using plastic utensils. The U.S. Centers for Disease Control and Prevention says the risk of getting COVID-19 from eating or handling food is considered to be extremely low. However, the dangers lie in people taking their masks off to eat indoors without appropriate physical distancing, or in handling serving utensils, dishes and silverware touched by others.

Traveling long distances for visits is risky if it involves public transportation by plane, train or bus — that’s hours spent sitting near potentially infected strangers in enclosed areas. There are also risks when it comes to crowded airports or terminals, waiting in lines and eating in busy indoor spaces. However, driving long distances over multiple days may also present issues, with potentially risky interactions at gas stations, rest stops, hotels and restaurants.

Plus, “some areas still have travel restrictions and those could still be in place in November,” Dr. de St. Maurice says. “These are all things you have to consider and really have an honest conversation with your friends and relatives to make sure travel makes sense while understanding things may change over time.”

If you do plan on traveling this year, it’s safest to quarantine both before and after a long trip on mass transit, especially “if you’re seeing grandparents or other people with risk factors,” she says. However, she adds, that may not be feasible if you have time constraints — quarantine periods are supposed to last for two weeks at a stretch.

Beating the blues

Besides staying flexible with holiday plans, keeping expectations realistic can help stave off the blues this season, Dr. Small says.

“It’s not about having the perfect Thanksgiving meal,” he says. “It’s about connecting with the people you care about, and you can do that with video conferencing or smaller get-togethers outdoors.”

Spending time with loved ones — even virtually — is important for avoiding or diminishing a bout of the blues, he says. It’s especially important for seniors: Due to their elevated risk of serious illness from COVID-19, they’re more likely to be isolated during the pandemic, which may be particularly painful during the holidays.

Another way to help keep the blues at bay is with regular exercise and by making the time and effort to intentionally relax, whether through yoga, meditation or just quiet reflection. Dr. Small also advises limiting alcohol and sweets — staples of the season that can exacerbate depressive feelings.

People who regularly experience bouts of depression and anxiety are at greater risk of developing the holiday blues, Dr. Small says. But everyone should recognize that lingering low moods that interfere with sleep, appetite and other everyday functions may merit medical attention. Like the patient and her Thanksgiving feast tradition, seeking professional help may ease the emotional burden of a holiday season that feels very different.

It can help to remember that human beings are incredibly adaptable and have an intuitive ability to respond to adversity, doctors say — a fact highlighted by the many challenges we’ve weathered in 2020.

“One thing about the pandemic is you realize people are resilient. We’ve also become more creative,” Dr. de St. Maurice says. “There are great resources out there for creative ways to celebrate the holidays with your friends and family that you can do safely. It’s just a matter of being a little bit more flexible and open to it.

“And hopefully next year at this time, we’ll be in a different place.”