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Christmas is traditionally a time of celebration, eating, drinking, spending time with family and friends, and generally enjoying the festive spirit. However, for those who struggle with a mental health condition, the yuletide season can be an especially difficult time.
Whether it’s the financial strain that accompanies gift buying, the cold and dark winter nights, or the reality of spending Christmas alone, there can be a number of triggers for mental health problems during the holiday season.
First of all, it’s important to recognise that if you’re struggling over the Christmas period, you are far from alone. Mental health issues at Christmas affect more of us than you might think. A survey from YouGov found that a quarter of people say that Christmas makes their mental health worse, while a survey from the Mental Health Foundation found that 54% of people were worried about the mental health of someone they know at Christmas.
If you’re concerned about the mental health of yourself or someone you know this Christmas, this article can help you to recognise the symptoms early and put steps in place to cope – helping you to enjoy the brighter side of the Christmas period.
Join our expert panel on Perspectives, a series from Priory that delves into the biggest issues in mental health and addictions. In this episode, we discus staying sober or cutting down over winter - including how to deal with relapses.
Depression at Christmas
Society tells us that Christmas is a time of joy, laughter, cheerfulness, family and celebration. However, for people who struggle with depression, these types of pressures and constant reminders that you should be happy, can make you feel even worse.
Key symptoms of depression include:
- Intense sadness
- Feelings of hopelessness and worthlessness
- Low energy
- Changes in appetites and weight fluctuations
These symptoms can be especially hard to deal with at Christmas, when everyone around you seems to be in a good mood. This can make you want to withdraw from other people – which, again, can be difficult during a season of goodwill and catch-ups with loved ones, whatever form they take.
A specific type of depression, known as seasonal affective disorder (SAD), is also prevalent during this time of year. Also known as ‘winter depression’ or ‘winter blues’, SAD occurs primarily in the months of December, January and February as a result of people being exposed to less sunlight. It’s estimated that almost a third of people in the UK suffer symptoms of SAD, whilst depression as a whole has also increased over the last decade. Recent depression statistics show that from 2005 to 2015, the total number of people living with depression has increased by 18.4%.
“Winter months can trigger seasonal affective disorder (SAD) in those vulnerable to the condition. Shorter daylight hours combined with lack of sunshine can impact negatively on your mood. Many people find themselves staying in the house over the Christmas period. However, try and get out at least once a day, even if it is just for a short walk.”
Managing Anxiety over the Holidays
Everything seems to be heightened and more intense at Christmas – from the music and lights to the traffic and crowds. All of the above is daunting for most people, but can be even more intense if you struggle with anxiety.
People with social anxiety disorder may find the prospect of having to make an effort to see people, in person or over video, overwhelming. If you struggle with panic disorder, you may find that the intensity and frequency of your panic attacks increase at this time of year. Generalised anxiety disorder, which affects every 6 in 100 according to recent anxiety stats, can mean that all of your usual worries are intensified during the festive period, and you may find that you’re anxious about a huge range of issues, meaning that you’re unable to relax.
If any of the above seem familiar to you, make sure you’re aware of the symptoms of anxiety so you can work to minimise them if a triggering event occurs.
Here are some of the most common signs of anxiety to look out for:
- A persistent sense of worry, apprehension, or dread
- Feeling fearful, paranoid and tense
- Feeling faint, dizzy or light-headed
- Increased heartbeat or palpitations
Feeling Stressed at Christmas
There’s no doubt about it; Christmas can be stressful. Cooking, buying presents, keeping children entertained, decorating your home, cleaning up after family gatherings – the list of tasks is endless. For people who struggle with chronic stress, this time of year can be overwhelming and exhausting. It’s something that affects women more than men too. YouGov found that 51% of women have found Christmas to be stressful, compared to 35% of men.
There’s also the added pressure of financial worries and feelings of guilt if you can’t afford to buy your children or loved ones the presents that they really want. Christmas also comes at the end of the year, so if you’ve had an especially difficult one, perhaps with the loss of a job or other financial difficulties throughout the year, this may have added further pressure to the idea of buying presents.
Social media can also play a role in exacerbating your stress during the holiday season, as comparing yourself to others’ seemingly ‘perfect’ Christmas Days can leave you feeling like a failure for not having the best decorations, tree, food or presents.
Overall, the festive season can be a major catalyst for stress, which is why it’s so important to recognise the symptoms as early as possible.
Here are some of the most significant symptoms of stress:
- Anxiety, and a constant sense of worry or dread
- Feeling overwhelmed and as though you have lost control
- Finding it difficult to make decisions
- Being restless or unable to sit still down
“My first piece of advice is to talk to them about their spending habits. Have a conversation and explain why you are concerned. Try to find out if they are concerned about anything else. Are they suffering from depression? Is this an addictive habit? If you think they have an underlying emotional problem, then encourage them to seek professional help.”
Many of the social pressures of Christmas, fuelled by social media and the perception that we have to have an amazing time, can also lead to sense of emptiness or loneliness. We don’t even have to be on our own to feel these things. In a Priory survey on the mental health impacts of Christmas on men, we found that 53% of men feel lonely at Christmas – even though they are around other people.
Feelings of loneliness and the mental health issues talked about in this article are very heavily linked. Your loneliness may be a symptom of a mental health problem, or it may become a more serious problem if you don’t take steps to try and address your loneliness.
There are self-care strategies for loneliness you can put in place to cope with how you’re feeling. Here are a few ideas:
- Start a daily gratitude list: Every day, list five things in your life that you are grateful for or happy about. Focusing on the positives can help to lift your mood and put you on course for a more positive long-term mind set
- Volunteer: Despite what you might think, there is lots going on around your local community at Christmas that doesn’t require you to be part of a big family. Volunteering in the community, at a homeless shelter or care home for example, is one of the best ways to connect with other people and boost your confidence
- Be around people: When you’re feeling lonely, making plans can be the most difficult thing to try and do. But as social beings, our self-esteem receives a timely boost when we interact with each other. If you feel able to, put some time in with a friend you really value
Loneliness and Bereavement at Christmas
If you’ve suffered a loss in your family, loneliness can combine with grief to make Christmas an experience that is endured rather than enjoyed. Even with the support of friends and family around you, feelings of isolation, loneliness, and not wanting to do anyhting, are natural and entirely normal.
Around Christmas time, the constant reminders we see, from Christmas trees in the windows of neighbours to special episodes of our favourite TV shows, only serve as reminders of your loss and bring back feelings of pain.
Be it a recent or long-term loss, there are things you can try to incorporate into your Christmas routine that could help you to navigate through an incredibly tough period:
- Plan your time: Fill up your calendar by deciding exactly what you want to do around the festive period and Christmas Day itself. If you don’t feel up to it, don’t feel coerced into celebrating with others
- Say “no”: Don’t feel like you have to do anything you don’t want to. Your loved ones and family members know what you’ve been through – they will understand
- Don’t feel guilty: If you do choose to participate in Christmas festivities, don’t feel guilty if you’re enjoying yourself. Think about how your loved one would have wanted you to carry on with your life
- Ask for help: If you can’t cope with the overwhelming emotions surrounding your bereavement, reach out for support. Confide in a loved one or close friend, or consider reaching out to dedicated support networks such as Samaritans. Support organisation such as Cruse Bereavement Care could also help you
- Structure your days: Try not to limit yourself to just watching TV. Include some other activities, such as exercise, going for a walk or just going outside. Low-key events, such as a trip to the cinema, can also provide a welcome escape
- Be kind to yourself: While it may help to be around others, it’s important not to overwhelm yourself with situations where you may feel obliged to be cheerful. Try not to isolate yourself for the whole time but know that it’s ok to put yourself first. Don’t feel like you have to do all that is traditionally expected of you
Dr Natasha Bijlani, Consultant Psychiatrist at Priory Hospital Roehampton, with a tip on Coping with Grief at Christmas:
“Think about putting a Christmas tree up in honour and celebration of your loved one and in recognition of how you have taken steps to cope – even if they are small ones. Make it a tree full of memories to celebrate the role your loved one played in your life, and their presence in it. Alternatively, perhaps light a candle in memory of a loved one or go through personal mementos or photos of joyful times if you feel able.”
Thankfully, there are things you can do to manage Christmas stress and any of the mental health pressures you are faced with during the Christmas period. It’s important that you don’t bottle it up or attempt to ignore your feelings. Instead, you can put some of these tips in place to help you manage symptoms so you can focus on enjoying yourself.
1. Avoid unhelpful social comparisons
If we don’t think we measure up to those we see online, it can have a negative impact on our self-esteem. Social media and consumer advertising can make this worse, leading to feelings of inferiority that damage our mental health. These factors are only exacerbated during Christmas, when it becomes the focal point of society.
Try to limit your exposure to social media and television adverts over the Christmas period, focusing on the benefits of family time and any other social events you have going on.
2. Have realistic expectations about family gatherings
If you are spending Christmas with your family, the expectation that the festive season is a ‘time for family’ can add further pressure on already strained relationships, particularly among people who don’t see each other often and aren’t used to spending so much time together.
Being realistic about what you can expect from this time will help to avoid disappointment and help you get more out of it. It might also help to avoid a few of those traditional Christmas rows around the dinner table!
3. Participate in your local community
For some, Christmas can be a time of increased isolation. This loneliness can be particularly painful for those who have suffered bereavements, which many people have struggled with as a result of the pandemic.
If you’ve recently lost a loved one, we understand that it’s likely to feel extremely difficult coping with the first festive season without them. Many organisations offer support at Christmas, so finding out what is available in your local area may provide you with a powerful source of support. Volunteering at one of these events might also be a good way of reducing loneliness and giving you a sense of purpose if you’re spending Christmas alone this year.
4. Take a break
Allow yourself to take time out if you find your stress levels rising. You may want to head out for a walk, go out for a coffee or listen to music - whatever will help you to relax or unwind. Of course, we understand that this can be hard to do if you have a lot of responsibilities, so plan your opportunities for breaks in advance. For example, you could arrange with your partner to take the children out for a few hours to give you a break, or manage relatives’ expectations by saying that you have planned some downtime.
5. Everything in moderation
It can be tempting to over-indulge at Christmas, particularly as we navigate our way through spending time largely at home. However, there can be negative side effects from too much excess, such as feeling guilty afterwards, feeling physically bloated and unwell, increased negative emotions from alcohol, which is a depressant, or interference with prescribed medication.
Try to avoid overindulgence, whether you’re home alone or in the company of others – don’t be afraid to politely decline if you’re a guest at someone’s house.
6. Look after yourself
Your calendar might be filling up fast, but try to put some time aside to look after yourself. Exercise, good diet and plenty of quality sleep are as important at Christmas as at any other time of the year.
Shorter daylight hours combined with lack of sunshine can impact negatively on your mood. Many people find themselves staying in the house over the cold Christmas period. However, it’s important that you try and get out at least once a day, even if it’s just for a short walk. These small mood-boosting activities can help keep your mind fresh and focused – and better equipped to deal with any stress that might be around the corner.
7. Don’t look back on the past year
As Christmas is the end of the chronological year, people tend to look back on what they have achieved and what they haven’t. If you’re suffering with depression or low self-esteem, there is a real risk that any negative feelings of under-achievement, or the past year not living up to your expectations, are exacerbated. Focus on the positives and set goals you want to achieve in the following year.