Holiday joy and happiness have two ugly cousins who lurk in the background from Thanksgiving to New Year's Day.
Known as seasonal stress and depression, this dismal pair just might pay you a holiday visit, county health experts say.
"The holidays can be a high-pressure situation for a lot of people," said Lorna Rice, director of social services at Carroll County General Hospital (CCGH). "And when people have expectations that can't be met, that can lead to depression."
Some of those expectations include a desire to return to the way things were in the past, she said.
"Mom's working, taking care of the kids and trying too hard to do all the things her mother did to keep up the old traditions," Rice said. "She puts too much pressure on herself to make everything perfect."
When families are scattered, there is additional stress in deciding where everyone will spend the holidays. And if everyone decides to go to one person's home, that person gets to bear the burden of even more stress, said Rice.
Rice said that for the "in-between" generation -- parents who are taking care of their own parents -- holidays can have increased pressure.
If their elderly parents are ill or do not travel well, adult children may feel trapped in their home, unable to go to holiday parties or to visit their own offspring, she said.
"That leads to feelings of anger toward the elderly parent, which later can turn to guilt," Rice said.
Rice said that in many of these "in-between" families, everyone used to go to grandma's house for a big holiday dinner.
"Maybe grandma lives with a daughter who works and has a family and doesn't have the time to prepare a large meal," said Rice.
"Or maybe grandma has Alzheimer's disease and doesn't even know it's Christmas. For family members who don't live with her, the realization that things are not the same can lead to depression."
Although holiday stress and tension may seem unavoidable at times, Rice said, a little creative planning can work wonders. Here are some of her suggestions: * Instead of one large family gathering, plan smaller ones throughout the holiday season.
* If you want to play host to a large celebration but don't have time to prepare all the food or money to pay for it, ask guests to bring something for a potluck meal.
* If you are not able to spend the holidays with friends and family, spend some time helping others who are lonely. Helping others can help you feel better about yourself.
* If you usually make six different kinds of cookies and do not have the time or money this year, start a cookie exchange among friends or co-workers. Each person picks a favorite recipe and bakes several dozen cookies. Each person gets to take a dozen different cookies home.
* If you are taking care of an elderly parent who cannot travel but you want to visit other family members for the holidays, look into respite care. Many nursing homes and nursing agencies can provide the service, but you must plan in advance. It can be expensive, but even caretakers need a break once in a while.
Some holiday stress and depression may require more than just a flexible attitude and planning, said Dr. James Choi, a general psychiatrist affiliated with CCGH.
"Some people are afflicted with Seasonal Affective Disorder," said Choi.
"They will be doing fine until October, but by the end of November they begin to show symptoms of depression. Often the symptoms completely disappear by March."
Choi said people with the disorder often improve with greater exposure to light in the winter months. "The best treatment can be therapy and an annual trip to the sunshine states."