The Post-Vacation Blues: Diagnosis and Treatment

In the official diagnostic nomenclature of Psychiatry/Psychology (Currently, the DSM-IVTR published by the American Psychiatric Association) , there are various types of depressions defined. These range from the most severe, "Major" depressive illnesses to the generally less disabling "Adjustment Reactions." There is no category, specifically, for the "Blues." That overarching feeling that something is not right, that one is somehow in the wrong place at the wrong time, that one's mood is just down.

The blues can be brought on by many things and are often placed into the category of "Adjustment Reactions" by therapists when we see people who have the blues for lack of a more specifically defined category. Perhaps in the development of the upcoming DSM-V the blues of varying types will be given the attention they so rightly deserve.

Other specific types of Blues diagnoses described have included the Monday Blues and the Barbecue Blues. The Blues is sometimes confused with Clinical Depression and that 'differential diagnosis' is addressed here.

Establishing the Diagnosis

In this article, I am suggesting a specific diagnosis called, The Post-Vacation Blues. This condition, known to and experienced by most people to one degree or another since their early school years, is the somewhat dark, flattened, humorless feeling that descends at the tail end of a vacation on the cusp of being ready to return to one's non-vacation status.

For a child, it usually hits hardest on the day before returning to school, especially after a long (summer, for example) vacation. For an adult, a grown up version of the very same phenomenon occurs on the day before they return to their non-vacationing daily life.

Every psychiatric and/or general medical diagnosis is assessed and confirmed through a series of criteria called "rule ins" and "rule outs."

This proposed new diagnosis can be used for either school-age children or adults (ages 5 and up.)

The diagnosis is most commonly made on the day immediately preceding the person's return to their non-vacationing life.

Following a vacation away from the person's usual school/work daily routine for a period of not less than ten days, six of the eight following criteria must be met to establish the diagnosis of Post-Vacation Blues:

1. An inability to enjoy things in the moment because the person is preoccupied with anticipatory thoughts about the coming day.

2. A general sense of malaise wherein the person does not feel 'ill' but does not feel 'good' either.

3. The recurring thought that yesterday was superior, in all important ways, to tomorrow.

4. Staying up late into the night looking at photos, writing journals and mapping out plans for the next vacation.

5. The person is experienced by those close to them as being out-of-sorts, distant and uncharacteristically somber.

6. A sudden and unusual change in appetite. Extreme over or under eating.

7. The person is flooded with fantasies about retirement or permanent vacationing.

8. The person experiences a lack of pleasure in things that they ordinarily derive pleasure from.

Six of these eight criteria are sufficient to establish the diagnosis of Post-Vacation Blues.

Treatment

Unlike major clinical depressions, the Post-Vacation Blues does ordinarily not require any professional intervention at all unless the symptoms persist for longer than a week after the vacation ends. Should the criteria for having established the diagnosis persist longer than that, the person may have developed an "Adjustment Reaction with Depression" and might benefit from some professional consultation and intervention.

More often than not, the condition herein described as an episode of Post-Vacation Blues, will recede within a week or less as the person resettles into their non-vacation life. Re-occurrence of the condition following subsequent vacations is not unusual. Again, this is not cause for alarm unless the symptoms to not fade over a week or so.

Vocation vs. Vacation.

One little letter can make such a huge difference!