Not surprisingly, research on psychological pathology during the holidays shows us that many people report feeling more depressed and anxious. What’s interesting is that despite rampant reports of stressed out and gloomy patients utilizing psychiatric emergency rooms, the prevalence of self-harm behavior, and suicide attempts and completions is actually lower during the holidays.
Why is there such a discrepancy? Why is it that depressed and anxious people are somehow able to manage their symptoms during the holidays only for us to see a rebound effect thereafter?
I believe the answer is found in the belief that the holidays provide us with hope and comfort. Helping our patients become more aware of the significance of this may help them not only survive the holidays, but hopefully carry a sense of holiday cheer throughout the remainder of the year.
First, Christmas represents a time of faith. For many people, faith during the holidays involves spirituality or religion. Spirituality has been defined as an expression of an individual’s sense of humanity, and can provide meaning and direction.
According to American Psychological Association’s Handbook of Psychology, Religion and Spirituality, empirical studies have repeatedly shown that religion and spirituality are generally helpful to people in coping with stressful life events.1 This is crucial because recent polls show that 90% of Americans profess to believe in God or a higher power.
Some positive religious coping methods that can be useful during the holidays include spiritual support from God or a higher power, spiritual forgiveness, support from a religious institution or clergy, and reframing stressful situations into a larger, more benevolent system of meaning. As clinicians, it is important that we understand the role that spirituality plays in the lives of our patients and encourage any positive coping methods that may be associated with their beliefs.
Second, the holidays often mean more time with family and friends. While it’s not uncommon for the holidays to sometimes mean awkward and tense social events that can provoke anxiety, it can also provide us with opportunity to connect with loved ones who provide us with meaningful love and support.
Most research supports the fact that social relationships have a salutary effect on mental health. And many believe that social support can have protective effects on the development of mental disorders. In fact, research conducted in the 1980s showed that people who are less connected socially have higher mortality rates.2 Accordingly, as mental health providers, we should encourage our patients to seek out and foster relationships with supportive people as part of encouraging mental health.
Lastly, the holidays represent a time of giving. Santa Claus, a lasting figure in the Christmas tradition, is a striking symbol of generosity. His willingness to travel the world to bring joy to all represents the care and compassion of family and friends, neighbors and strangers. The truth is that he helps to promote positive feelings.
Biological data suggests that giving actually activates the areas of the brain associated with pleasure, social connection and trust. Altruistic behavior releases endorphins in the brain and boosts happiness.3 Of course, we should not think of giving as merely buying presents or giving cash. Giving of one’s time is just as rewarding. Mahatma Gandhi once said, “The best way to find yourself is to lose yourself in the service of others.” Therefore, let’s encourage our patients to focus some attention outside of themselves this holiday season as a way to improve their mood.
Ultimately, as we evaluate our patients’ mental health needs this holiday, we should be aware of what the holiday season means to them. Let us emphasize to them the positive elements of the season and encourage them to capitalize on their potential rewards.
Melissa Vallas, MD, is lead psychiatrist at Children’s System of Care, Alameda County (California) Behavioral Health Care Services Agency.
- Pargament KI. APA Handbook of Psychology, Religion and Spirituality. Washington, DC: American Psychological Association; 2013.
- Cohen S and Willis TA. Stress, social support, and the buffering hypothesis. Psychological Bulletin. 1985; 98(2): 310-357.
- Aharon I, et al. Beautiful faces have variable reward value: fMRI and behavioral evidence. Neuron. 2001; 32: 537–551.