The holiday season can be a time of joy and celebration, when families gather for quality time and cherished traditions. However, for some, this time of year can also trigger feelings of loneliness, grief, guilt, and sadness.

When certain expectations for the holidays are not met, some may be confronted with feelings of loss, strains on their relationships, or financial stress. And some might simply feel “holiday blues” when the season is over.

Experiencing some of these feelings is to be expected. In fact, it’s probably more common than you think. But how can you identify the differences between “holiday blues,” seasonal affective disorder, and clinical depression?

In this Q&A, Grant Mitchell, MD, Chair of Psychiatry at the Mount Sinai-Behavioral Health Center, explains what may be triggering your concerns, when you may need to seek professional advice, and what unique services Mount Sinai offers.

What are some common triggers for “holiday blues” or anxiety?

There are many reasons why you might experience the “holiday blues” or anxiety. People experience stress from the financial strain of holiday spending, or the travel plans and busy social schedules often associated with this time of year. Anxiety can be triggered by a heightened awareness of social isolation or increased expectations of feeling joy and togetherness. In addition to these triggers, the holidays can also resurface sad feelings associated with family conflicts or the loss of a loved one. All of these triggers can be more likely to happen during the holiday season, so it is important to identify them early.

How can people tell the difference between “holiday blues” and clinical depression?

While some symptoms of “holiday blues” may be like clinical depression, they usually do not have a major impact on daily functioning and are tied to specific situations. Symptoms of clinical depression are generally more severe, persistent, and usually interfere with your ability to maintain your usual routines.

Signs of clinical depression include:

• Lasting sadness or emptiness
• Loss of interest in things previously enjoyed
• Changes in sleep or appetite
• Feelings of hopelessness or worthlessness
• Difficulty concentrating
• Thoughts of self-harm

Grant Mitchell, MD, at the Mount Sinai-Behavioral Health Center

What is seasonal affective disorder, and how does it differ from the “holiday blues”?

While the “holiday blues” and seasonal affective disorder can coexist, SAD is a specific type of clinical depression linked to the reduction in daylight that typically begins in the fall and continues through the winter. The reduction in sunlight can disrupt your body’s normal rhythms, leading to fatigue, sadness, poor sleep, and loss of interest in activities. When combined with holiday stressors, SAD can intensify the feelings of sadness and withdrawal.

When should you consider seeking professional help for their holiday sadness?

Seek professional help if changes in sleep or appetite, feelings of sadness, anxiety, or hopelessness persist beyond the holidays and are severe enough to disrupt your daily life or include thoughts of self-harm. Early intervention and support from a mental health professional can prevent symptoms from worsening.

How can friends and family support someone feeling down during the holidays?

If you think a friend or family member is experiencing sadness during the holidays, you can provide helpful support. Checking in, with a simple phone call or text, and validating the feelings they are having, can make a big difference. Including loved ones in plans or respecting their need for space is a great way to show that you are listening and understanding their needs. If your friend or family member seems to have severe distress, or the feelings persist after the holidays are over, encourage them to seek professional help.

What can I do if I am feeling down during the holidays?

Feeling sad or lonely during the holidays is more common than people think. It doesn’t mean something is “wrong” with you, but it means it’s important to take extra steps to ensure you’re taking care of your mental health. Try these five steps :

• Prioritize your self-care and things that bring you joy.
• Ensure you are getting enough rest and exercise.
• Set small goals you can achieve each day, especially when the world around you slows down for the holidays.
• Surround yourself with people who listen and provide comfort.
• Keep in mind that you are not alone.

How can Mount Sinai help?

Mount Sinai offers a full range of inpatient and outpatient services throughout New York City for those experiencing symptoms related to sadness, anxiety, or substance use disorder. Behavioral Health Express Care, located at the Mount Sinai-Behavioral Health Center, is a walk-in service providing evaluations, brief counseling, and medication (if needed) for adults experiencing a mental health crisis or needing acute substance use treatment. No appointment is needed, and the service is open Monday-Thursday 8 am to 6:30 pm and Friday and Saturday from 8 am to 2:30 pm.

With everything going on in your world, it can be easy to overlook the basics when it comes to your health, and the well-being of those around you. So here’s a friendly reminder: Don’t forget your flu shot.

While vaccines may have been in the news lately, there is general agreement on the benefits of the flu vaccine. Indeed, the recommendation of the U.S. Centers for Disease Control and Prevention (CDC) has not changed: Everyone six months and older should get a flu vaccine every season, with rare exceptions.

There are two basic reasons to get vaccinated for the flu, according to Bernard Camins, MD, MSc, Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai.

• The vaccine may not completely prevent you from getting the flu, but the infection, if you do get the flu, will be less severe and can prevent you from being hospitalized. This is especially important for those at higher risk of developing serious flu-related complications, including those 65 and older; those with chronic medical conditions such as asthma, diabetes or heart disease; those who are pregnant; and children younger than five. Getting vaccinated also means you are less likely to expose others to the virus, notably those who may be more at risk for complications.
• You need to get the vaccine every year. Immunity can wane after a few months. Plus, the strains of the influenza virus can change from year to year, so previous vaccinations are not as effective against the current circulating strain.

If you are looking for more reasons to get the flu shot, consider these basic flu facts:

• It takes about two weeks for vaccines to be effective, and flu season usually peaks between December and January.
• The CDC recommends that those over age 65 get a version of the vaccine that elicits a more robust immune response. (You can talk with your health care provider or pharmacist if you have questions about whether this is for you.) And you can get the flu vaccine at the same time as a COVID-19 vaccine.
• Flu symptoms tend to come on suddenly. Most people who get the flu will recover in a few days, according to the CDC.
• Some may dismiss the seasonal flu as little different from the common cold. In fact, it is much more severe with 560,000 hospitalizations and 38,000 deaths attributed to the flu in the United States last season. Symptoms of flu include sudden onset of fever or chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue. If you are feeling these symptoms from the flu, stay home.  If they worsen or if you have difficulty breathing, call your health care provider.
• Vaccination will play a key role in reducing influenza hospitalizations this season. Influenza vaccines prevented an estimated 240,000 hospitalizations during the 2024-2025 season, primarily in adults aged 65 years and older, according to the CDC. The flu vaccine also prevents millions of illnesses and flu-related doctor’s visits each year., and helps people avoid missing work and school.

Many parents may be unfamiliar with hand, foot, and mouth disease, but it’s actually very common among young children. The good news is that it’s typically mild, and it can be easy to treat and prevent. However, hand, foot, and mouth disease may cause parents and caregivers to worry and perhaps even cringe a bit. But why exactly?

It’s a highly contagious viral disease that predominantly affects children age five and under, but it can also affect older children and adults. The most common symptom is a rash in the mouth, and on the hands and feet. Other common symptoms include fever, painful sores and ulcers, muscle aches, dehydration due to painful swallowing, general fussiness from discomfort, and in some cases diarrhea and gastrointestinal problems. It’s known to spread rapidly, especially in daycare centers and schools, and it causes great pain and discomfort for kids.

In this Q&A, Tessa Scripps, MD, a pediatrician and Assistant Professor, Icahn School of Medicine at Mount Sinai, explains what causes hand, foot, and mouth disease, how long it’s contagious, and tips for prevention.

Tessa Scripps, MD

What causes hand, foot, and mouth disease?

It’s caused by a group of viruses referred to as enteroviruses. The most common cause is the Coxsackie A6 virus, but other strains of Coxsackie virus, as well as other enteroviruses, can cause the illness. When there is an outbreak of hand, foot, and mouth disease, there may be more than one type of virus circulating. Since there are different strains of the virus, a child can get the virus more than once. Adults may not be immune to the virus, so as a result, children can transmit it to their parents and caregivers.

How does it spread?

The virus is spread easily through:

• Person-to-person contact with droplets when an infected person talks, coughs, or sneezes. These droplets can land on objects or be rubbed into eyes, nose or mouth. These droplets do not stay in the air (like COVID-19) and do not travel more than three feet.
• Touching skin lesions (kissing, hugging) or coming into contact with objects and surfaces that have been contaminated.
• Coming in contact with an infected person’s poop, such as changing diapers, and then touching the eyes, nose, or mouth.
• Touching objects and surfaces that have the virus on them, like doorknobs or toys, and then touching your eyes, nose, or mouth.

What are the signs and symptoms of hand, foot, and mouth disease?

The signs and symptoms include:

• Fevers
• Rashes appear like red pimples that can transform into blisters mainly on the palms/between fingers/feet and around the mouth. Other common places are knees and elbows and diaper area. Children who have eczema are more susceptible and can have a more widespread and aggressive rash. Rashes normally scab over and heal without scarring, although some discoloration where the spots where can last for some time.
• Mouth sores, similar to cold sores that you can see, can develop inside the mouth and tongue but mainly at the back of the throat. This can worsen appetite due to discomfort, so dehydration is a concern in a child who cannot tolerate fluids orally.
• Diarrhea can occur before, during, or after the skin rash appears.
• Nail shedding and loss of nails can occur weeks to a few months after onset. While alarming, this is not painful or dangerous, and the nails regrow on their own.

How do you treat hand, foot, and mouth disease?

There is no specific treatment for the virus. It needs to run its course, and this normally takes 7 to 10 days. Here are some suggestions about how to treat the symptoms in kids:

• For fevers and discomfort, over-the-counter medicines like acetaminophen and ibuprofen can be used. (Note: Aspirin should not be used in children.)
• It’s important to drink plenty of fluids to prevent dehydration. Cold foods like ice cream, smoothies, and popsicles also help by numbing the area in the mouth. Soft foods like yogurt, pudding, and mashed potatoes can help, and these all can be a nice treat for kids who have trouble swallowing. Avoid hot drinks, sodas, and acidic juices or foods because they can make the pain worse.
• Get plenty of rest.
• If mouth sores are particularly bothersome, ask your doctor for treatments that may ease discomfort like lidocaine gel or magic mouthwash (usually not used in kids younger than 6 years of age).
• For skin rashes, a physician may recommend moisturizers. Symptoms do get better within 7 to 10 days for most people. Children with blisters on their hands or feet should keep the areas clean and uncovered. Wash the skin with lukewarm soap and water, and pat dry to keep it clean. If a blister pops, dab on a bit of antibiotic ointment to help prevent infection, and cover it with a small bandage.
• Try to stay as comfortable as possible, and prevent transmission by washing hands and using good hand hygiene.

 How do you prevent hand, foot and mouth disease?

There are some steps you can take to prevent this condition. These include:

• Wash hands with soap and water often.Hand washing is especially important after using the toilet, after changing diapers or potty training, before and after eating, and before preparing food.
• Keep hands away from the eyes, nose, and mouth.
• Avoid close contact with anyone who has it.
• Disinfect surfaces if an infected person came in contact with them.

When can my child return to school or daycare?

A child can return to school if:

• There is no fever for 24 hours
• There are no new skin lesions or open blisters (most lesions should be scabbing over).
• They appear well enough and active.

When should I call my doctor?

You should call the doctor if:

• Your child is not able to drink normally and you’re worried they might be getting dehydrated (very sluggish, urine less than three times a day, sunken eyes).
• The fever lasts longer than three to four days.
• Symptoms do not improve after 10 days.
• Your child has a weakened immune system (body’s ability to fight germs and sickness).