How To Manage Your Mental Health On Thanksgiving

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By Dr. David Woo - November 20, 2023

How To Manage Your Mental Health On Thanksgiving

Thanksgiving is generally regarded as a time of gratitude and togetherness, but not everyone finds it easy to have a happy Thanksgiving. The holiday can also be a source of stress and anxiety for many. Balancing the demands of social gatherings, sumptuous feasts, and emotional triggers can be challenging, especially for those grappling with mental health issues such as depression, social anxiety, eating disorders, and loneliness. Festive get-togethers and seemingly mandatory holiday cheer can be triggering for those of us processing feelings of grief, loneliness, financial worries, or unresolved tensions with family members.

It’s important not to get sucked into the hype and unrealistic expectations set up by the commercialized, TV-ad vision of Thanksgiving—real life is more complicated than that, and we can’t just put our feelings on hold for the holidays. However, Thanksgiving can be a time of healing and connection if you approach it with self-awareness and compassion. With that in mind, we’d like to share some tips on how to look after your Thanksgiving mental health.

Depression

Depression can cast a shadow over even the brightest of holidays. Here are some tips for managing your mental health if you’re dealing with depression during the holidays, including Thanksgiving:

Self-care: Prioritize self-care by taking some time for yourself before the festivities begin. Engage in activities that bring you joy and relaxation.
Set boundaries: Communicate your limits to loved ones. It’s okay to decline invitations or leave early if you’re feeling overwhelmed.
Reach out: Identify a supportive friend or family member to confide in during the celebration. Sharing your feelings can provide immense relief.
Plan ahead: Create a plan for the day, including structured activities and coping strategies. This can help maintain a sense of control.
Give thanks: It may sound trite, but making an effort to participate in the spirit of the holiday can help immensely with one’s mood and build positive neural connections in the brain, as recent research into the effects of gratitude has shown (1,2). Take some time to take stock of what you are thankful for this season and feel your spirits lift.

Social Anxiety

Thanksgiving gatherings can be triggering for those with social anxiety or anxious depression. Try these techniques to help manage it effectively:

Prepare conversation starters: Have a few conversation topics in mind to ease into social interactions. Ask about shared interests or offer compliments to others.
Small, gradual exposure: If you’re anxious about larger gatherings, consider attending smaller events or family dinners before the main celebration.
Take breaks: Retreat to a quiet space if you feel overwhelmed. Practice deep breathing or grounding techniques to regain composure.
Focus on gratitude: Remind yourself that Thanksgiving is about appreciating the presence of loved ones, not scrutinizing your social performance.

Eating Disorders

Thanksgiving feasts can trigger eating disorder concerns. Here’s how to navigate the holiday while managing these challenges:

Seek support: Reach out to a therapist or support group before the holiday. They can help you set a plan and provide coping strategies.
Create a meal plan: Plan your Thanksgiving meal in advance, focusing on balanced choices. Share this plan with a trusted friend or family member for accountability.
Practice mindful eating: Pay attention to when your body feels hungry and full cues. Savor every bite and don’t be too hard on yourself if you slip up.
Distraction techniques: Engage in conversation or fun activities that don’t revolve around food to divert your attention from eating.

Women and mental health is a critical topic that deserves attention, as research shows that women are more susceptible to certain mental health conditions, such as depression, compared to men. Women often face unique challenges related to hormonal changes, gender roles, and societal expectations that can impact their mental well-being. Additionally, women’s mental health issues can manifest differently, and they may encounter barriers or discrimination when seeking treatment. At Madison Avenue TMS & Psychiatry, we are committed to providing compassionate care and effective treatment options tailored to the specific needs of women, including talk therapy, medication management services, and transcranial magnetic stimulation (TMS). Let´s break down the state of women’s mental health issues today, and how innovative treatments can help patients overcome traditional barriers to wellness.

Are Women More Susceptible To Certain Mental Health Conditions?

Studies indicate that women are more likely than men to experience certain mental health disorders. This discrepancy between the sexes is influenced by a combination of biological, psychological, and social factors. Key statistics include:

Depression: Women are nearly twice as likely to be diagnosed with depression compared to men (1, 2). Hormonal fluctuations during puberty, menstruation, pregnancy, postpartum, and menopause can contribute to this increased risk.
Anxiety Disorders: Women are more likely to experience anxiety disorders, including generalized anxiety disorder (GAD), panic disorder, and phobias (4).
Post-Traumatic Stress Disorder (PTSD): Women are more than twice as likely as men to develop PTSD after experiencing traumatic events. Women are also more likely to experience certain types of trauma, such as sexual violence, which further increases the risk of PTSD (5).
Obsessive-Compulsive Disorder (OCD): OCD affects both men and women, but women tend to have a later onset and are more likely to develop OCD related to contamination fears and compulsive cleaning (6, 7).
Attention-Deficit/Hyperactivity Disorder (ADHD): ADHD is often underdiagnosed in women, who may present with inattentive symptoms rather than hyperactivity. As a result, many women remain undiagnosed until adulthood (8).
Bipolar Disorder: Women are more likely to experience rapid cycling (more frequent mood changes) and mixed states of bipolar disorder compared to men, making it essential to identify gender-specific symptoms and treatment plans (9).
Borderline Personality Disorder (BPD): Approximately 75% of those diagnosed with BPD are women, with symptoms often linked to trauma, emotional instability, and interpersonal difficulties (10).

Do Women Manifest Different Mental Health Symptoms?

Women’s mental health issues often manifest differently compared to men, which can impact diagnosis and treatment. Mental health is not one-size-fits-all, and symptoms can present across the entire gender spectrum. However, women as a demographic display some differences in symptoms in certain conditions, such as:

Depression: Women with depression may experience more physical symptoms such as fatigue, changes in appetite, and sleep disturbances, while men may report more irritability and anger.
Anxiety: Anxiety in women often manifests as internalizing symptoms like excessive worry, phobias, rumination, and physical complaints (e.g., headaches, fatigue), whereas men tend to present externally, with a higher prevalence of irritability and risky behaviors.
PTSD: Women are more likely to experience symptoms such as hypervigilance, avoidance, and emotional numbing, while men may exhibit higher levels of aggression.
ADHD: Women with ADHD often show inattentiveness, forgetfulness, and disorganization, which can be mistaken for anxiety or depression.
Bipolar Disorder: Women with bipolar disorder tend to have more depressive episodes and fewer manic episodes than men, which can affect how the disorder is perceived and treated.
OCD: Women are more likely to develop OCD symptoms related to caretaking, contamination, and morality.

Hormonal changes in women, including pregnancy and the menstrual cycle, may also account for variations in symptoms. Pregnant women, new mothers, and pre- and post-menopausal women all experience changes in their body chemistry that can affect their vulnerability to certain mental health disorders as well as the presentation and severity of symptoms. It´s important to note that hormonal factors should not be an excuse for anyone to dismiss or minimize mental health symptoms—our mental health is intimately linked to our biochemistry, and hormones are a natural part of that.

Gender Differences In Symptoms Of Mood Disorders

This table presents an overview of gender-based differences in symptom manifestation in common mental health conditions:

Mental Health Disorder	Men	Women
Depression	More likely to present irritability, anger, substance abuse, risk-taking behavior, and physical pain (e.g., back pain, headaches).	More likely to experience sadness, excessive crying, fatigue, sleep disturbances, and rumination.
Anxiety	Externalizing symptoms like irritability, anger, restlessness; may self-medicate with alcohol or drugs.	Internalizing symptoms such as excessive worry, fear, avoidance, and physical symptoms (e.g., headaches, muscle tension).
Bipolar Disorder	More prone to manic episodes characterized by irritability, aggression, and impulsive behavior; higher risk of substance abuse.	More prone to depressive episodes; rapid cycling is more common, along with mixed states of mania and depression.
Borderline Personality Disorder (BPD)	Often underdiagnosed; may show aggression, substance abuse, or reckless behavior; stigma around “masculine” emotional expression.	More likely to exhibit mood swings, intense emotional reactions, fear of abandonment, and self-harm behaviors.
Obsessive-Compulsive Disorder (OCD)	More likely to have obsessions related to symmetry, checking, and contamination; less likely to seek treatment.	More likely to have obsessions related to cleanliness, contamination, and compulsive cleaning; higher rates of comorbid anxiety.
Attention-Deficit/Hyperactivity Disorder (ADHD)	Often presents with externalizing behaviors like impulsivity, hyperactivity, and risk-taking; more diagnosed in childhood.	Often presents with inattentiveness, forgetfulness, and disorganization; underdiagnosed and often identified in adulthood.
Post-Traumatic Stress Disorder (PTSD)	More likely to experience irritability, anger, emotional numbing, and substance abuse; symptoms linked to combat or accidents.	More likely to experience hypervigilance, flashbacks, avoidance, and emotional distress; symptoms often linked to sexual trauma or abuse.

Barriers Women Face In Mental Health Treatment

Despite the higher prevalence of mental health disorders among women, many face significant barriers to accessing effective care due to the negative impacts of sexism and societal expectations of women (11).

Misdiagnosis: Women are often misdiagnosed or have their symptoms attributed to hormonal changes or emotional overreaction, leading to delayed or inadequate treatment.
Financial and time constraints: Caregiving responsibilities and lower income levels can prevent women from seeking timely mental health care.
Gender discrimination: Some women report experiencing discrimination in the healthcare system, where their concerns are not taken seriously or dismissed, impacting their willingness to seek treatment.

Treatment Options For Women’s Mental Health Issues

At Madison Avenue TMS & Psychiatry, we offer a range of treatment options designed to address women’s mental health issues. These include:

Medication management: Personalized treatment plans to manage conditions such as depression, anxiety, ADHD, and bipolar disorder
Telehealth consultations: Convenient access to mental health care from the comfort of home, making it easier for women to prioritize their mental well-being.
Transcranial magnetic stimulation (TMS): A non-invasive and effective treatment option for depression, OCD, and anxiety, particularly for those who have not responded to medication or therapy.

As a drug-free depression treatment, TMS is safe for women who want to avoid the potential pharmaceutical interactions and side effects that come with taking antidepressants. This means that TMS is an effective treatment to undergo for women who are pregnant, breastfeeding, or on hormonal medications for birth control, menopause, or other reasons.

Get Compassionate Mental Health Care At Madison Avenue TMS & Psychiatry

Women face unique challenges when it comes to mental health, but effective treatments are available.

At Madison Avenue TMS & Psychiatry, we provide compassionate care tailored to the specific needs of women in a supportive environment. Our clinic stands for gender equality and mental health equity, and we encourage women with mental health concerns to contact us for a consultation without fear of discrimination or judgment.

If you or a loved one is struggling with mental health issues and based in the New York area, contact us today via our website or by calling (212) 731-2033. Our team of professionals is here to help you regain control of your mental well-being and lead a healthier, more fulfilling life.

More Resources On Women And Mental Health:

Sources

Hyde, Janet S. PhD; Mezulis, Amy H. PhD. Gender Differences in Depression: Biological, Affective, Cognitive, and Sociocultural Factors. Harvard Review of Psychiatry 28(1):p 4-13, 1/2 2020. Link. Accessed September 16, 2024.
Albert, P. R. Why is depression more prevalent in women? Journal of Psychiatry & Neuroscience.. 2015;40(4), 219-221. Link. Accessed September 16, 2024.
Farhane-Medina, N. Z., Luque, B., Tabernero, C., & Castillo-Mayén, R. Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review. Science Progress. 2022. Link. Accessed September 16, 2024.
Javaid, S.F., Hashim, I.J., Hashim, M.J. et al. Epidemiology of anxiety disorders: global burden and sociodemographic associations. Middle East Curr Psychiatry 2023;30, 44. Link. Accessed September 16, 2024.
Hiscox, L.V., Sharp, T., Olff, M. et al. Sex-Based Contributors to and Consequences of Post-traumatic Stress Disorder. Curr Psychiatry Rep 25. 2023; 233–245. Link. Accessed September 16, 2024.
Tiyatiye, B., & Akosile, W. (2022). A systematic review of prevalence of comorbid obsessive-compulsive disorders and substance use disorders in clinical settings, 1990-2021. Journal of Substance Use. 2022;29(2), 180–185. Link. Accessed September 16, 2024.
Dr. Noreena Kausar, Amna Ishaq, & Dr. Muneeb Ahmed Toor. (2023). Prevalence of Obsessive-Compulsive Disorder in Psychiatric Patients. PAKISTAN JOURNAL OF LAW, ANALYSIS AND WISDOM, 2023;2(02), 1032–1041. Link. Accessed September 16, 2024.
Hinshaw SP, Nguyen PT, O’Grady SM, Rosenthal EA. Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. J Child Psychol Psychiatry. 2022;Apr;63(4):484-496. Link. Accessed September 16, 2024.
Miola, A., Fountoulakis, K. N., Baldessarini, R. J., Veldic, M., Solmi, M., Rasgon, N., Ozerdem, A., Perugi, G., Frye, M. A., & Preti, A. (2023). Prevalence and outcomes of rapid cycling bipolar disorder: Mixed method systematic meta-review. Journal of Psychiatric Research. 2023;164, 404-415. Link. Accessed September 16, 2024.
Bozzatello, P., Blua, C., Brandellero, D., Baldassarri, L., Brasso, C., Rocca, P., & Bellino, S. Gender differences in borderline personality disorder: A narrative review. Frontiers in Psychiatry. 2024;15, 1320546. Link. Accessed September 16, 2024.

Garb, H. N. Race bias and gender bias in the diagnosis of psychological disorders. Clinical Psychology Review. 2021;90, 102087. Link. Accessed September 16, 2024.

How To Spend Thanksgiving Alone

Thanksgiving can be particularly challenging if you’re feeling lonely or isolated. If you find yourself worried about the prospect of spending Thanksgiving alone, try the following tips to combat the feelings of loneliness during the holiday:

Volunteer: Consider volunteering at a local shelter or charity. Helping others can provide a sense of purpose and connection and has been positively correlated with improvements in mental health by researchers (3).
Virtual celebrations: If you can’t be with loved ones in person, organize a virtual gathering with friends or family members. Share a meal or simply chat to feel more connected.
Connect with people: Don’t hesitate to contact friends or family members and express your feelings. They may be unaware of your loneliness and will likely want to offer support.
Self-compassion: Remember that it’s okay to feel lonely at times. Practice self-compassion and self-love by treating yourself kindly.

Seeking Treatment

Whether you’re dealing with depression, social anxiety, eating disorders, or other mental health struggles, it is crucial to seek professional help. Not getting help can lead to a worsening of symptoms.

If you feel that pharmaceutical medications haven’t been effective for your condition, then you may be a good candidate for transcranial magnetic stimulation (TMS) therapy. TMS has a proven track record in treating depression, obsessive-compulsive disorder, anxiety, and other mental health conditions that have proven resistant to medications.

Madison Avenue TMS & Psychiatry offers talk therapy and TMS therapy for depression and other mental health conditions. Contact us online or call (212) 731-2033 for more information or to make an appointment, and start your journey toward better mental health today!

Sources:

Giving thanks can make you happier. Harvard Health. Link. Accessed October 13, 2023.
Fox, G. R., Kaplan, J., Damasio, H., & Damasio, A. Neural correlates of gratitude. Frontiers in Psychology. 2015;6, 151058. Link. Accessed October 13, 2023.
Ballard, P. J., Daniel, S. S., Anderson, G., Nicolotti, L., Quinones, E. C., Lee, M., & Koehler, A. N. Incorporating Volunteering Into Treatment for Depression Among Adolescents: Developmental and Clinical Considerations. Frontiers in Psychology. 2021;12. Link. Accessed October 13, 2023.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.

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