Public Service Announcement: Post-Christmas Stress Disorder (PCSD)

Going back to 2005, I have been warning blog readers about the scourge of Post-Christmas Stress Disorder. Sadly, this malady did not make it into the latest edition of the psychiatric manual, DSM-V. I am convinced that the omission of PCSD is one of the significant weaknesses of the new edition. PCSD resembles Pre-Christmas Stress Disorder and some people just have Christmas Stress Disorder. In most cases, PCSD spontaneously remits but in severe cases, intervention is warranted. Through research and experience, I have tweaked the criteria a bit over the years.

As a public service, I am again listing the signs and symptoms:

Diagnostic Criteria for 311.5x Post-Christmas Stress Disorder

A. Four (or more) of the following symptoms have been present during the same two-week post-Christmas period and represent a change from previous functioning. The individual:

(1) refuses to take down Christmas decorations within two weeks after Christmas. (In chronic cases, leaves decorations up year round.)

(2) seeks out shopping opportunities on the day immediately following Christmas (Note: In children, new Christmas related requests occur within two weeks of Christmas and may occur intermittently through the year);

(3) describes depressed mood, more days than not (e.g., sings “Blue Christmas” repeatedly);

(4) manifests vocal tics (e.g., “Ho, ho, ho”);

(5) displays compulsive Christmas related behavior (e.g., repeatedly wraps and unwraps presents even though no gift is inside);

(6) displays at least one incident of catatonic behavior (e.g., Stands for long periods of time, immobile, under mistletoe);

(7) describes gift returns which outnumber number of presents received (sometimes buys items just to return them);

(8) displays irrational interpersonal behavior (e.g., Calls recorded lines to say Merry Christmas);

(9) mainfests inappropriate startle response (e.g., jumps or easily startled by video game or other novel noises); and/or

(10) alternatively, avoids references to Christmas (e.g., refers to “holiday trees,” “holiday ornaments,” “happy holidays” and/or “the Sparkle season;”

B. Symptoms do not meet criteria for Post-Christmas Adjustment Disorder

C. Symptoms cause clinically significant distress

D. Symptoms are not due to effects of a substance (e.g., eggnog, fruitcake, punch, etc.)

Specify (for current or most recent episode)

.x1 Mild - minimum number of symptoms are net

.x2 Moderate – six or more symptoms

.x3 Severe – nearly all symptoms but without delusions/hallucinations

.x4 Severe with hallucinations (e.g., Converses with “ghost of Christmas past, present or future”)

.x5 Severe with delusions (e.g., Arms self to protect against Grinch; on constant guard against “war on Christmas”)

.x6 With trauma associated (e.g., Witnesses mother kissing Santa Claus)

.x0 Unspecified

May we all be spared this fate and to all a good night.

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