depression

Have you found yourself trapped in a seemingly endless cycle of sadness, hopelessness, and lack of energy? If so, you may be experiencing persistent depressive disorder (PDD). While PDD can make life feel unbearable, it’s important to understand that it doesn’t have to be the norm. In fact, PDD is highly treatable, and with the right approach, individuals can regain control of their lives and rediscover the joy they thought was lost. In this article, we will explore the nature of PDD, its symptoms, and effective treatment options that can pave the way towards a brighter future.

Understanding Persistent Depressive Disorder (PDD)

Formerly known as chronic major depressive disorder and dysthymic disorder, PDD is characterized by a persistent low mood that lasts for an extended period, often exceeding two years in adults (or one year in children). It is essential to dispel the misconception that PDD is an unchangeable aspect of one’s personality. In the DSM-V, PDD is no longer treated as a personality disorder but rather as a condition that can be effectively treated.

Recognizing the symptoms of PDD is crucial in seeking appropriate help. Symptoms can vary in frequency and severity, impacting daily functioning. Common signs of PDD include:

1. Depressed mood: feelings of sadness, hopelessness, emptiness, or thoughts of self-harm.
2. Behavioral problems, somatic complaints, or irritability in children.
3. Significant changes in appetite, weight, sleep patterns, or energy levels.
4. Plummeting self-esteem or lack of motivation.
5. Difficulty concentrating or making decisions.

If you notice these symptoms persisting for an extended period, exceeding two years in adults (or one year in children), and symptom-free periods are rare or short-lived, it may be indicative of PDD. Consulting a mental health professional is crucial for an accurate diagnosis and treatment planning.

Treating PDD

Fortunately, PDD is highly treatable, and a combination of psychotherapy and psychopharmacology is often recommended. Here are the main treatment options:

1. Psychotherapy: Cognitive-behavioral therapy (CBT) is the leading approach for treating depression. CBT helps individuals identify and challenge negative thought patterns and behaviors that contribute to their depressive symptoms. Another effective therapy is interpersonal psychotherapy, which focuses on improving interpersonal relationships and reducing interpersonal conflicts.
2. Medication: Antidepressant medication is commonly prescribed alongside therapy to stabilize mood and improve cognitive functioning. It’s important to work closely with a healthcare provider to find the right medication and dosage that suits your specific needs.
3. Psychoeducation and Coping Strategies: Equipping individuals with knowledge about their diagnosis and providing them with coping strategies can significantly enhance their ability to manage and treat their symptoms effectively. Psychoeducation also helps reduce stigma and fosters self-empowerment.

While a singular cause of PDD has not been identified, several factors contribute to its development. These factors may include changes in brain structure, neurotransmitter imbalances, significant life stressors, transitions, cultural adversity, genetics, and gender. It’s crucial to rule out other conditions like hypothyroidism, borderline personality disorder, bipolar disorder, or substance abuse, which may mimic PDD symptoms.

Persistent depressive disorder doesn’t have to define your life. By recognizing the symptoms, seeking professional help, and following a comprehensive treatment plan that combines therapy, medication, and self-care strategies, individuals with PDD can regain control over their lives and find hope for a brighter future. Remember, you are not alone, and with the right support, you can overcome

Written by Counseling Intern Michelle Reiser. If you would like to make an appointment with Michelle, contact us at 412-322-2129 or go here.

Interested in Treating Your Persistent Depressive Disorder?

If you are ready to take the first step towards assessing and treating your persistent depressive disorder, we’re here to help. Contact us today by calling 412-322-2129 to schedule an appointment with our experienced team. Alternatively, you can fill out the form below, and we will reach out to you shortly.

Don’t let PDD hold you back any longer. Take control of your mental health and embark on a journey towards healing and renewed hope.

References:

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

https://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/symptoms-causes/syc-20350929

Kress, V. E., & Paylo, M. J. (2019). Treating those with mental disorders: A comprehensive approach to case conceptualization and treatment. Pearson. 

If you are managing depression and finding it challenging to handle your responsibilities, know that you are not alone. Major depressive disorder (MDD) can have a significant impact, but with recovery and symptom reduction, there is hope. Here are some tips that may assist you in managing depression while fulfilling your obligations:

1. Seek professional help: Never suffer alone, It is important to seek professional help from a mental health therapist or psychiatric provider who can help you manage your depression and provide you with tools to cope with your responsibilities.
2. Prioritize your tasks: Make a list of your responsibilities and prioritize them based on their importance. Focus on completing the most important tasks first and break them down into smaller, more manageable steps.
3. Ask for help from your support system: Some of the symptoms of depression may make it hard to feel the motivation to ask for help. Remember that is the depressive thought pattern talking. Your support system wants to help you! They may be able to assist you with some of your responsibilities as well as provide you with emotional support.
4. Set SMART goals: Set realistic goals for yourself and celebrate your accomplishments, no matter how small they may seem. Setting small, achievable goals can help you feel a sense of accomplishment and boost your mood.
5. Use positive self-talk: Remember negative thinking patterns are a part of depression. Reframe those cognitive distortions and use positive self-talk to motivate yourself and combat negative thoughts. Instead of focusing on what you haven’t accomplished, focus on what you have accomplished and what you can do in the future.
6. Create a routine: Establishing a daily routine can help create a sense of structure and stability, which can be helpful in managing depression.
7. Practice self-care: Taking care of yourself physically, emotionally, and mentally is important for managing depression. This can include things like eating well, getting enough sleep, and engaging in activities that bring you joy.
8. Exercise to boost your mood: While getting up and moving around might be the last thing you feel like doing if you are suffering from depression, it will have a rapid impact on your energy. Try this YouTube video created by one of our therapists: 3 Minute Exercises for Depression For When It’s Hard to Get Out of Bed.
9. Practice mindfulness: Mindfulness techniques, such as meditation and deep breathing exercises, can help you manage negative thoughts and emotions. Breathing exercises like the breath of fire can add energy to your body.
10. Challenge negative thoughts: Depression can cause negative thoughts and self-talk. It’s important to challenge these thoughts and replace them with more positive and realistic ones.
11. Avoid alcohol and drugs: While Depression may make a quick fix like drugs and alcohol seem more appealing, substances will worsen depression symptoms and make it more difficult to manage the disorder.
12. Get outside: Spending time in nature and getting fresh air and sunlight can help improve your mood and reduce symptoms of depression.
13. Consider medication: Antidepressant medication can be helpful in managing depression symptoms. Talk to a psychiatric provider who can support your need for medication management and help you to determine whether medication might be right for you.
14. Be patient and kind to yourself: Managing depression takes time and effort. Be patient with yourself and celebrate small victories along the way. Remember to be kind to yourself and practice self-compassion. Remember that managing depression and responsibilities can be challenging, but with the right tools and support, it is possible to lead a fulfilling life.

In conclusion, managing depression while fulfilling your responsibilities can be a challenging journey, but it’s important to remember that you are not alone. Major depressive disorder (MDD) may have a significant impact, but there is hope for recovery and symptom reduction. By implementing the tips provided you can navigate this path with resilience and strength. Remember, managing depression takes time and effort, so celebrate every small victory along the way. With the right tools, support, and self-compassion, it is possible to lead a fulfilling life despite the challenges of depression. You have the power to find balance and reclaim your well-being.

Looking for Help for Managing Depression?

If you are looking for depression counseling or medication management services, please fill out the form below or give us a call at 412-322-2129. We’re here to help!

Written by Stephanie Wijkstrom, LPC, NCC is a licensed counselor and Founder of Counseling and Wellness Center of Pittsburgh. Stephanie is passionate about offering clinical development and professional training to her team of 85 licensed counselors and behavioral health care professionals. Stephanie’s clinical specialty lies in preventative mental health care and integrative wellness strategies.

Depression is a common mental health disorder that can affect people of all ages and backgrounds. According to the World Health Organization, more than 264 million people worldwide experience depression. If you are experiencing symptoms of depression, you may be wondering, “Do I Need Antidepressants?” 

Here are some signs that antidepressants might be right for you:

1. You have been diagnosed with depression: If you have been diagnosed with depression by a healthcare professional, they may recommend antidepressants as part of your treatment plan. Antidepressants can be an effective treatment for moderate to severe depression.
2. You have tried other treatments without success: If you have tried other treatments for depression, such as therapy or lifestyle changes, without success, antidepressants may be a good option. Antidepressants can be used alone or in combination with other treatments to manage symptoms of depression.
3. Your symptoms are interfering with your daily life: If your symptoms of depression are interfering with your ability to function in your daily life, antidepressants may be a good option. Symptoms of depression can include feelings of sadness or hopelessness, lack of interest in activities, changes in appetite or sleep, and difficulty concentrating.
4. You have a family history of depression: If you have a family history of depression, you may be at an increased risk of developing depression yourself. Antidepressants may be a good option for preventing or managing symptoms of depression.
5. You have suicidal thoughts or behaviors: If you are experiencing suicidal thoughts or behaviors, it is important to seek help from a healthcare professional immediately. Antidepressants can be an effective treatment for managing suicidal thoughts and behaviors.

It’s important to note that the decision to take antidepressants should be made in consultation with a psychiatrist or psychiatric mental health nurse practitioner . They can help determine the most appropriate course of treatment for your individual needs and monitor your progress while taking antidepressants. If you are experiencing symptoms of depression or other mental health conditions, please seek help from a mental health professional.

Antidepressants and Therapy

Antidepressants and therapy are two common treatments for depression, and they can be used together to improve outcomes. While antidepressants can help alleviate the symptoms of depression by balancing certain chemicals in the brain, therapy can help individuals develop skills and strategies to manage their emotions, thoughts, and behaviors. In this way, the combination of antidepressants and therapy can be a powerful approach to treating depression.

Here are some ways in which antidepressants can help depression in conjunction with therapy:

1. Antidepressants can alleviate symptoms of depression: Antidepressants can help alleviate symptoms of depression, such as feelings of sadness, hopelessness, or lack of interest in activities. This can make it easier for individuals to engage in therapy and learn coping skills.
2. Antidepressants can enhance the effectiveness of therapy: Antidepressants can help reduce symptoms of depression, which can enhance the effectiveness of therapy. When individuals are not overwhelmed by their symptoms, they may be more able to engage in therapy and make progress.
3. Antidepressants can prevent relapse: Antidepressants can help prevent relapse of depression by maintaining the balance of certain chemicals in the brain that affect mood. This can be especially important for individuals who have experienced multiple episodes of depression or who are at risk of relapse.
4. Therapy can help address underlying issues: Therapy can help individuals identify and address underlying issues that may be contributing to their depression, such as past trauma or relationship problems. This can help them develop skills to manage these issues and prevent future episodes of depression.
5. Therapy can help individuals learn coping skills: Therapy can teach individuals coping skills to manage their symptoms of depression, such as relaxation techniques, problem-solving skills, and stress management strategies. These skills can be especially helpful when combined with antidepressant medication.

It’s also important to note that antidepressants are not a cure for depression. While they can be effective in managing symptoms, they are not a substitute for therapy or other forms of treatment. Therapy can help you learn coping skills, develop healthy habits, and address any underlying issues that may be contributing to your depression.

It’s important to remember that the decision to start taking antidepressants is a personal one and should be made in consultation with a psychiatrist or psychiatric mental health nurse practitioner. They can help you weigh the potential benefits and risks of antidepressants and determine the best course of treatment for your individual needs. Additionally, it’s important to continue therapy or other treatments while taking antidepressants to maximize their effectiveness.

Find Out “Are Antidepressants Right for Me?” With An Evaluation

If you are interested in an evaluation to see if antidepressants are the right fit for you, call us at 412-322-2129 or fill out the form below.

In more recent years, studies have been emerging that focus on the possible connection between gut health and mental health disorders, including anxiety and depression. The microbiome makes up all microorganisms in the human body. The microbiota encompasses all the microorganisms in a particular location, such as the GI tract. These together are developed while in the womb. During this time, early nutrition can play a role in shaping the developing gut microbiota. This helps with the development of various healthy bacteria.

The Science Behind Gut Health and Mental Health

As solid foods are introduced to infants, the microbiome is exposed to many different energy substrates, creating and developing our metabolism along with new variations of bacteria that make up the gut. It is difficult to determine what a normal microbiome consists of given the environmental, seasonal, and health status of an individual. Although, what we eat can determine what type of bacteria are predominantly present. This can also be directly linked to inflammation of the GI tract, placing stress on the microbiome. This can result in the release of cytokines and neurotransmitters. Elevated blood levels of these pro-inflammatory markers increase the permeability of the blood-brain barrier. Their release influences brain function, leading to anxiety and depression.

Pro-inflammatory cytokines are also important stimulators of the hypothalamic-pituitary-adrenal axis (HPA). The hypothalamus releases various hormones, one in which stimulates the adrenal release of cortisol, a known stress hormone. Cortisol stimulates a pro-inflammatory response, leading to a dysregulation of the HPA axis, resulting in symptoms of depression and anxiety.

When the human microbiome is challenged with dietary changes, coupled by stress, or maybe a course of antibiotics, the physiology of the normal microbiome changes. When there is a loss of beneficial bacteria, this can trigger a pro-inflammatory response and weaken the intestine. This can lead to increased intestinal permeability and allow bacteria to leak through, leading to detrimental effects on our bodies, which can be demonstrated in diseases such as irritable bowel syndrome (IBS), and mental health disorders such as anxiety and depression.

Probiotics, living microorganisms of yeast and bacteria, have been utilized as supplements for aiding in reducing symptoms of anxiety and depression. Primarily, they have been studied in the suppression of cytokines, noting improved intestinal barrier integrity. This promotes a decrease in inflammatory response. As a result, adding a probiotic to your daily regimen could help reduce pro-inflammatory hormones, especially in individuals suffering from chronic inflammation.

Although, there is no FDA regulation pertaining specifically to probiotics, and ultimately, no dosage recommendations. Until more research behind the use of probiotics as therapy for anxiety and depressive disorders is available, probiotics cannot be considered a reliable treatment method as compared to psychiatric medications.

Anti-Inflammatory Foods

When it comes to diet, various components in food can help reduce inflammation. Consider foods that are high in fiber, omega-3s found in fish, oils, and leafy greens, polyphenols (plant chemicals) found in fruits such as berries, and unsaturated fats found in almonds and flaxseeds. All of these foods can be incorporated into your daily diet to help reduce inflammation and promote a healthy gut and microbiota!

1. Yogurt: containing live bacteria cultures, yogurt can help support a healthy gut by keeping the microbiome healthy. The probiotics in yogurt can help reduce inflammation and symptoms of bloating, gas, constipation or diarrhea. Many yogurt varieties contain added sugar, so look for plain options and add your own flavoring with fruit, nuts, and seeds to avoid excess sugar intake.
2. Fermented foods like Kombucha, kimchi, sauerkraut, kefir and miso are rich in probiotics. The good bacteria grow during the fermentation process. Add fermented foods to your diet for a healthy dose of probiotics.
3. Dark Green Leafy Vegetables: Packed full of vitamins like A, K and magnesium, dark green leafy vegetables, such as spinach, kale, bok choy, mustard greens, and collards, are crucial for brain function and gut health. Swiss chard is a great example of a food that is loaded with fiber, feeding the healthy bacteria in your gut, preventing inflammation.
4. Omega-3s: Omega-3 fatty acids also support brain health. Fatty fish such as salmon and tuna, are great sources of omega-3 fatty acids. Foods containing fatty acids can help reduce inflammation, and support healthy digestion. This can help you feel less bloated and sluggish.
5. Healthy Grains: Whole grain foods, such as oatmeal and bulgar wheat, are high in fiber, which plays an important role in stabilizing blood sugar levels. This helps restore a potential imbalance to the gut that can happen when blood sugar levels are challenged. Most whole grain products contain beneficial prebiotics that help increase healthy bacteria in the gut microbiome.
6. Berries: Berries are rich in antioxidants, which can help keep your gut healthy by reducing inflammation. They are also a great source of prebiotics, which promotes healthy gut motility. One of the highest vitamin C foods, which can improve the gut barrier and enhance nutrient absorption.

This article was written by our Registered Dietitian, Kali Alrutz

Get Started with Gut Health Nutrition Counseling

Call us at 412-322-2129 or fill out the form below to get started with Nutrition Counseling. Nutrition Counseling is covered by Insurance.

According to the National Institute of Mental Health, an estimated 21 million adults in the United States had at least one major depressive episode in 2020 so it’s likely someone you know or love has been affected. Knowing what to say to someone with depression isn’t always easy. However, social support can remind your loved one that they are not alone.

Research has shown that strong social support is an important factor in decreasing functional impairment in patients with depression and in increasing the likelihood of recovery. If your friend isn’t ready to talk, continue to offer your support by checking in regularly, either in person, on the phone, or by text.

So, what should you say to someone who has depression? Here are 8 suggestions.

What to Say to a Depressed Friend

1. “I know you don’t see a light right now, but it’s there.”
2. “I am here for you, tell me how you are feeling.”
3. “I see that you have taken steps every single day to conquer your depression.”
4. “You are resilient and you have people who love and care for you, including me.”
5. “What can I pick you up from the grocery store?”
6. “Would you like to join me on a short walk? If you’re not feeling up for it today, that’s okay.”
7. “You don’t have to figure it all out today. We’re in this together.”
8. “I can look for a counselor for you. Would that help?”

If you or someone you know would like Depression Therapy, please contact us at 412-322-2129 or fill out the form below.

Our therapists are here to offer mental wellness support with specific interventions to treat all major mental health disorders including anxiety, depression, grief and trauma as well as relationship issues or any life stressors that you are dealing with.  We teach you new coping skills for a variety of relational, emotional, and psychological issues so that you can enjoy your life. 

While each counselor has their own specialties and approaches to therapy, there are several key things that most therapists want you to know.

Read on for 10 things your therapist wants you to know.

1. Talking to a friend is not a replacement for therapy—therapy is strategic, focused, and an application of scientific methods to heal.  Friends can offer support and connection but can’t replace therapy.
2. Therapy is a safe place where you can be yourself without feeling judged.  We won’t judge your story.
3. Healing doesn’t happen from attending a weekly appointment.  You heal by applying the skills, solutions and methods that you discuss in therapy during all of the hours in between sessions.
4. It is ok to tell us anything and everything you are experiencing or have experienced: feelings, thoughts, intentions, behaviors etc.  You’d be surprised that what you are sharing is something we have most likely heard many times before and it is not shocking. 
5. We’re not irritated by reviewing the same information over and over.  Change takes time and practice.
6. Setbacks are just learning opportunities — we won’t be disappointed in you.
7. It may get worse before it gets better.  Talking about tough emotions, situations and past traumatic experiences may be painful at first but is necessary in order to process them and change.
8. The opposite of depression isn’t happiness.  Often times folks who experience clinical depression make an assumption that they continue to be depressed or are not getting better even after symptoms decrease because they are “not happy” (with life/career/partner).  The marker they use to determine depression is happiness vs unhappiness.  When people learn that happiness takes work, it can be freeing for them and they have an easier time accepting their progress.
9. Therapy can be challenging.  It is not easy.  But first work on developing a therapeutic relationship with your therapist.  Once you have a solid foundation, you are able to work through so much.  Be patient with the process.
10. We won’t say hello in public unless you do first. 

It is an honor and privilege to be a part of this life journey with each and every client we see.

Interested in Starting Therapy?

If you are ready to start therapy, you can call us a 412-322-2129 or fill out the form below.

The Pittsburgh region can be dark and gloomy during the winter months. Fear not! There are myriad ways to bolster your defenses to fight the winter blues.

1. Stay active. When the sun is shining it is easy to remain active and enjoy the outdoors. But it might take a little more discipline to maintain an active state when it’s cold. Just remember the less active you are, the more your energy becomes depleted. So, get outside, try a winter sport or take a winter hike—you might marvel at how different the terrain is all covered in snow and get the extra mood boost that the outdoors provides.
2. Be very intentional in what you are consuming. During the holiday season and cold weather months we crave more fat and carbs. Those kinds of foods actually deplete our energy and cause shifts in weight and mood. Depression and energy does have a metabolic component so by consuming foods that are easily metabolized and nourishing, our energy and mood can be improved.
3. Use Vitamin D supplementation. Vitamin D has been studied as a major component in seasonal depression as well as a host of medical and mental health issues. Take a high quality supplement to increase your body’s stores of it especially during the winter months.
4. Get as much natural light as possible. Overhead lighting can actually confuse your circadian rhythm and disrupt the sleep/wake cycle. It really is the sun’s energy which increases our Vitamin D and has a major impact on our cellular and neurochemical functions.
5. Get your temperature up. Activities such as taking a hot bath, sitting in a hot tub or sauna and taking a hot yoga class can be very soothing during the cold winter months.

Is it the Winter Blues or SAD (Seasonal Affective Disorder)?

It can be difficult to distinguish winter blues from Seasonal Affective Disorder. The real difference is in the severity and length of the symptoms. If you experience a shift in mood characterized by the below symptoms, you should reach out to a mental health professional or medical doctor to be screened for depression. Of course feelings of self-harm should always be brought to the attention of a medical or mental health professional.

Seasonal Affective Disorder Symptoms:

• Feeling sad or having a depressed mood
• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite; usually eating more, craving carbohydrates
• Change in sleep; usually sleeping too much
• Loss of energy or increased fatigue despite increased sleep hours
• Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable to others)
• Feeling worthless or guilty
• Feeling grumpy or irritated
• Body aches
• Difficulty thinking, concentrating, or making decisions
• Thoughts of death or suicide

As many as 10% of the population in Western Pennsylvania could meet the criteria for SAD. Treatment includes light therapy which exposes the patient to light spectrums which helps to regulate melatonin and Vitamin D levels. Of course all treatments work best in conjunction with psychotherapy.

Dealing with Seasonal Affective Disorder or Depression?

If you’re interested in treatment for Depression or Seasonal Affective Disorder,  you can reach us at 412-322-2129 or contact us here.

Holidays are steeped in traditions that are centered around the family and there is a hallmark sentiment that everyone is rejoicing in love with their near and dear during this most festive time of the year. The truth looks a bit different though. Family conflict, tension and even estrangement are more common than you may think. One study found more than 40% of participants had experienced family estrangement at some point.

But knowing you are not alone doesn’t make things happier or easier. The holidays are still hard and may bring up feelings of sadness, loneliness, jealousy, anger, shame or worthlessness. 

To help combat these feelings, here are therapist-verified tips to help beat the holiday blues:

1. Validate Your Feelings. If you fight the thoughts and feelings or judge yourself for having them, then you increase your emotional upset. Acknowledge that you feel sad and allow yourself to feel that sadness. This builds resiliency that you can be present with the uncomfortable feeling of sadness. It also increases self-trust that you can name and acknowledge the feelings you are having—this is especially helpful if your feelings were dismissed or not seen as a child. For example, “I’m feeling really sad and lonely that I am not on good terms with my family. This feeling is valid. I don’t have to pretend it’s not there. I can feel this sadness and use my coping skills to get through it.”
2. Pick a Coping Skill or Self Care Tool That is Most Useful for You. There are myriad coping strategies to deal with feelings of sadness, disappointment and loneliness. Pick a tool that best supports you and be sure to practice it throughout the holidays. Tools include journaling, focusing on what is right in your life and practicing gratitude for that, meditation, yoga, running, watching a funny show or movie, noticing your negative thoughts and reframing them. There is no one right tool so just pick one and try it out.
3. Set Boundaries for Topics of Conversation. To maintain your peace of mind during the holidays, set boundaries with your family on what you are and are not comfortable discussing. If your older brother always comments on your weight, simply tell him, “I am not interested in discussing my weight. I’d rather hear about my nephew’s soccer game.” If your grandmother always nags you about being single and childless, share that this isn’t something that you are open to discussing with her but you’d love to share about your lovely foster cat. Setting and keeping your boundaries will help you to feel empowered over your situation instead of feeling like you have no say in the conversations happening around the dinner table.
4. Temporarily Delete Social Media from Your Phone. For many people social media can be triggering. This is especially true during the holidays when your feed is filled with photos of other people connecting with their family around the dinner table or unwrapping presents in matching pajamas. This may make a person who is excluded from such family gatherings melancholy or jealous they aren’t having the same experience. Allow yourself to take a break from this type of content so you’re not adding on to your emotional burden. It can be as easy as deleting the app from your phone and reinstalling after the New Year.
5. Make a Plan for How You’ll Tackle the Day. Schedule a FaceTime check in with a friend. Enjoy a free yoga session on YouTube. Whatever you decide, make a plan ahead of time and stick with it. Literally put each activity in your calendar. This will keep you accountable and prevent you from having nothing to do and slipping into worsening feelings of loneliness or engaging in poor habits.
   
6. Schedule a Therapy Appointment. If you’re currently working with a therapist, be sure to schedule a session during this time. If you’re not in therapy yet, consider reaching out and getting additional professional support during the holidays.
7. Be of Service to Others. You can always be a support to others who are less fortunate than you by reaching out and volunteering. Clean out your coat closet and take your old coats to a local shelter, choose a child’s name off of a local Giving Tree program and go shopping for the gift, foster a homeless cat or dog through a local rescue group. You could even host a holiday dinner for others who are also alone. Be of service to others while being in service to yourself.
   

Only you can decide what is the best direction for you to maintain peace, mental wellness, and happiness during the holidays and the rest of the year and it is your sole job to protect your peace and wellbeing.

http://jpbsnet.com/journals/jpbs/Vol_3_No_2_December_2015/4.pdf