ROUND ROCK, Texas (KXAN) – This holiday season, while many people focus on the joy and cheer of Christmas, many are bogged down with sadness and depression.    

Doctors say the biggest cause of stress this time of year is money and the pressure to buy gifts.

The stress can be so bad that Scott White Round Rock Doctor Ross Tobleman says he sees patients come into the emergency room due to the amount of stress they’re having to cope with.

“During the holidays people want to be perfect,” said Dr. Tobleman. “They go out and they want to have the perfect family dinner and the perfect holidays. It puts stress on people.”

If you’re worried about someone being depressed, you can look for some signs including: a change in sleep or eating patterns, withdrawal from loved ones, and behavior changes.