It’s the "most wonderful time of the year," but not for everyone.

While the holidays are associated with celebration and happiness, it can be a difficult season for those experiencing physical illness, depression, separation from loved ones and loss.

This past summer, Gina Dixon’s brother and mother-in-law died in the same month. “There’s so much pressure to have a happy holiday … and that can be a tall order when you’re grieving,” she said.

Dixon is a licensed psychologist and program manager at Essentia Health Grief Support Services. She works directly with grieving adults, families and people with terminal illness. We experience loss of a job, a relationship, a home, a pet, our health — and while grief is individualized, there are common experiences.

Dixon said grief impacts us physically, emotionally, relationally/socially and spiritually. By “spiritual,” she said she means the impact on our sense of purpose and a belief about what happens after death.

Relationally/socially, people may withdraw or isolate; some might have anxiety about being alone. People may be more tired; or experience sleep disturbances or constant sleep.

Loss of appetite, stress-eating and difficulty concentrating can be symptoms, and there can be “a rainbow of emotions” — sadness, anger, anxiety, rumination.

“Grief is exhausting,” she said.

Besides grief, the holiday season can bring about stress, anxiety, depression or fatigue. There can be financial demands, social expectations, a whirlwind of visitors, travel, and a general disruption to routine. According to the American Psychological Association, the leading holiday stressors are time, money and commercialism. During the rest of the year, work and money lead the pack.

Blue services

Any reason can make the joy of the holiday season difficult to process. That’s why regional churches are offering blue holiday services, which will address the loss of comfort and promote healing, said Mareta Beise, parish nurse at Oak Lake Lutheran in Kerrick, Minn.

This will be the third year her church has hosted a blue holiday service. Others are First Covenant Church in Lincoln Park and First United Methodist Church.

"We’re hoping through that that people are able to see the light and know that God is always with them," Beise said. In a rural area, they’ve seen around 12-15 attendees at their service.

“The intent of the service isn’t to change the way people feel, but to recognize it, and at the moment, feel the rawness of it, (and) hopefully leave with a sense of hope that we aren’t going at it alone,” said Pastor Josh Rude of First Covenant.

First Covenant’s parish nurse Pam Franklin said in their older congregation they see losses of independence, of sensory functions and of loved ones in addition to struggles with substance abuse and financial losses. They're all difficult topics, maybe more so during the holidays because there’s an expectation of joy.

“There’s an assumption that if someone greets you with a smile on their face, they’re enjoying the holiday season, but that might not be the case,” she said.

Franklin first heard about blue holiday services through the parish nurse grapevine. She hopes the area offerings will create a space where mental health and grief are more open for discussion.

It’s easy to worship on a Sunday morning, but challenging to share how we’re feeling. These services provide language to different emotional experiences and recognize that we’re not alone.

Grief isn’t wrong, and we don’t need to mask it, Rude said.

How to help

For people who have a deep faith or some version of the afterlife, that may not relieve the loneliness of not having someone physically present in the here and now. “We might be mourning even while we’re celebrating with those that are with us,” said Dixon.

There are many tools to dealing with the holiday blues.

Be gentle with yourself and others. There may be things you choose to do differently and you may not have the same degree of energy for attending parties, sending cards or other holiday traditions.

“Do what you reasonably have energy to do this holiday season and save your energy for activities that are meaningful to you,” Dixon said.

Limit social media if it worsens emotions.

Focus on the basics of physical self-care. Stay hydrated and maintain adequate nutrition. Dehydration can throw off cortisol levels, Dixon said, and if you don’t have the energy to make big meals, prepare small snacks throughout the day. “Taking care of our nutrition is taking care of our emotions,” she said.

Avoid alcohol or other depressants around the holidays. Significant impairment can affect social relationships, an ability to go to school or work. Reach out to medical professionals, spiritual communities or friend/family circles when needed.

Avoid over-scheduling. Feeling rushed to do too many things in a day can lead to more anxiety and irritability.

Balance time with people you can be authentic with. Limit contact with people who may not be as supportive of your grieving needs.

Allow yourself quiet time, a walk in nature or partake in a religious activity — whatever allows for social connectedness and meaning.

Drive yourself to a holiday party, so you can leave when you need to.

Try to balance activity with rest.

Writing works for Dixon, and reading other people’s stories of grief, which helps normalize the grief experience. She takes walks with her dogs and swaps TV with trauma, violence or high conflict with playful or funny media.

Take time to journal or note areas of struggle along with three good things from the day. “That’s really good for us emotionally, to acknowledge the light as well as the shadows in our days,” Dixon said.

For those supporting loved ones who may be down this holiday season, take time to listen and understand their needs. Instead of saying, “Call if you need anything,” consider giving people options. People struggling with grief or stress may have a hard time making decisions.

Offer to run errands, babysit, bring meals. Practical help does wonders, and keep following through in meaningful ways that help create trust.

It’s hard to ask for help, but positive examples may make it easier for someone struggling to reach out in the future.

For those who don’t see this as a season of blueness, keep your eyes open. People in need can be willing to open their doors, Rude said.

“This isn’t always the most wonderful time of the year for everyone, and that’s OK. We can meet them there.”

Tips for coping during holiday stress

  • Acknowledge your feelings.

  • Reach out.

  • Be realistic.

  • Set aside differences.

  • Stick to a budget.

  • Plan ahead.

  • “No” is a full sentence.

  • Try to maintain healthy habits.

  • Set aside time for yourself.

  • Seek professional help, if needed.

  • Help someone or volunteer.

Mayo Clinic

First holiday after losing a loved one?

Step into the holiday season with these ideas in mind.

  • Swap “celebrating” for “observing” the holidays. It may be difficult to imagine celebration when someone you love is missing. Changing the language may help you detach and show up as best as you can.

  • Make time for remembrance. Consider creating a new ritual or tradition that honors or includes memories of the deceased person.

  • Tell people what you need and follow through. Drive yourself to events, so you can leave when you’re ready. Set clear boundaries for friends and families. Be honest.

  • Give yourself permission to skip events if you’re not up for it.

  • Be prepared for the emotions and memories by being as gentle as possible.

  • Make space for grief and joy. Allow yourself to grieve, also allow yourself to be present and enjoy the light moments where you see them.

National Alliance on Mental Illness, Harvard Health Publishing, Chicago Tribune

More info:

Essentia Health Grief Support Services offers free online services and ongoing adult and youth support groups.

Northland Healthy Minds

National Alliance on Mental Illness

Blue holiday church services

Where: First Covenant Church, 2101 W. Second St.

When: 4 p.m., Saturday

Where: First United Methodist Church, 230 E. Skyline Parkway.

When: 4 p.m., Sunday, Dec. 22

Where: Oak Lake Lutheran, 53131 Shadow Oak Road, Kerrick, Minn.

When: 7 p.m., Saturday