Ho, Ho, Holy Stress! Maintaining Mental Wellness During The Holidays

The winter holidays always seem to be full of positive and cheerful references. “Merry Christmas” and carols marking this season as “the most wonderful time of the year” are just a few examples of joyful greetings disseminated around this time. While many people look forward to time off from work and eggnog-filled festivities with family and friends, the sad reality is that ‘tis NOT the season to be jolly for everyone. The Christmas season can be associated with stress, sadness, loneliness and other challenges.

The National Alliance on Mental Illness found that 64% of individuals living with a mental illness felt that their condition worsened during the holidays. Holiday-related stress is affecting all sectors. According to the American Psychiatric Association, 40% of healthcare workers and 37% of office/admin workers are anxious about working long hours during the holiday season. Nearly half of all retail/service employees report that their stress levels increase during the so-called happiest season of all.

“We have been socialized to expect good times and cheer from family and social gatherings,” describes Lloyd Sederer, MD, psychiatrist and former Chief Medical Officer of New York state’s Office of Mental Health. Dr. Sederer, author of Caught in the Crosshairs of American Healthcare, continues: “Sadness and anxiety are frequent feelings during the holidays. Running from them will only worsen your distress.”

Sources of Holiday-Related Emotional Upheaval

So, why do so many of us feel the blues during Christmas time? Financial stressors can be a significant strain on individuals. The pressure to buy the latest toy or designer scarf can stretch already tightened purse strings. In fact, moms worry more than dads about affording holiday gifts whereas dads worry more about affording holiday meals.

Family-time can also be stress-time. The anticipation of spending time with a patronizing sister or a racially-obtuse uncle can cause a surge in cortisol and other stress hormones. Hosting family and friends can be stressful in other ways: cleaning the house, cooking large meals and decorating the tree are all labor-intensive activities.

The holidays are also a reminder of who we’re missing. Exactly eight months ago, my beloved dad (and my #1 fan) died of heart failure at age 89. We loved sitting around the tree, beautifully decorated by my mom, and opening gifts on the morning of December 25^th. My dad would beam a huge smile after Santa left him a bottle of HUGO Boss aftershave and a large box of Lindt chocolates. He’d laugh at my brother’s gift of a hundred dollars-worth of lotto tickets—an annual gift that seemed to surprise my dad every year. This will be our first Christmas without the man who emigrated from India to Canada 50 years ago without knowing a soul and helped pay for my U.S. medical school tuition. I know that our family is not alone in struggling with the loss of a loved one this holiday season.

Of course, we live in a world with other people, many of whom are enduring unimaginable pain and suffering. The reminders are everywhere, including at last night’s lighting of the iconic Rockefeller Christmas tree—an annual tradition that draws thousands of visitors from around the world—where hundreds of demonstrators carrying Palestinian flags tried to push towards the tree but were held back by police (the protest continued down Sixth Avenue). Right now, world leaders are meeting in Dubai for COP28, the 28^th annual United Nations climate meeting to discuss how to tackle climate-related problems. Global events are intensifying local tension, around the workplace water-cooler and our family’s dining table.

Harms of Stress on Physical and Mental Health

Are you feeling chest palpitations or having difficulty sleeping? Are you noticing weight changes related to a change in eating habits? Are you having trouble focusing on the simplest tasks or getting sick more often than usual? These are just a few of the short-term effects of poorly-managed stress on our health.

The relationship between stress and immune function dates back centuries. In roughly 200 AC, Roman Greek physician and philosopher Aelius Galenus (Galen of Pergamon) declared that melancholic women who experienced more stress were at higher risk for getting cancer than women who were more positive and exposed to less stress.

Long-term activation of the stress response system and subsequent over-exposure to cortisol and other stress hormones can harm every system of the body. This can lead to a multitude of chronic health problems including heart disease, stroke, cancer, sleep disorders, pain, anxiety, depression and diminished concentration. Cognitive and memory impairment is related to structural changes caused by stress-induced atrophy of the brain. Both short- and long-term stress can lead to substance use and eating disorders.

Remedies to Achieve Peace and Joy

Despite the whirlwind of angst-ridden local and global affairs, the good news is that help is available. It’s critical to pause and observe your physical and mental states. Try to minimize your exposure to stressful situations. Turn off the television and radio, and disconnect from devices and any other sources of news, at least for a few hours every day. If you can’t avoid difficult-to-handle relatives over the holidays, then set boundaries: don’t bring up uncomfortable topics; if others do, then politely defer (“I’d prefer not to discuss this now”) and change the subject. Remember, no one can force you to engage in an undesirable conversation.

Focus on mindful practice. Activities such as meditation, yoga, writing, mindful walking and eating as well as listening to music can reduce anxiety and depression. Try one of these activities before heading out to a family gathering. Practicing gratitude can also go a long way in enhancing mental wellness. Studies show that expressing gratitude for 15 minutes a day, five days a week for at least six weeks can positively impact physical and mental health. During the high-pressure holidays, take time out to be thankful for your good health, warm home, steady income, delicious meals and/or supportive friends. Volunteering can also reduce stress and increase positive feelings by releasing dopamine. Mental health professionals agree.

“Follow your own compass, one whose true north is kindness, gratitude and caring for family, friends and others in need,” advises Dr. Sederer. The public health doctor recommends that we think, plan and do what will provide us purpose.

As always, if the emotional, mental or psychological struggles are too much to handle, then seek professional help. Counseling, therapy and/or medications can be very helpful in dealing with stressful people or situations. You are not alone.

The truth is that I really do enjoy the Christmas season. I love catching up with friends over hot cocoa and attending holiday parties with other New Yorkers. But I am cognizant of the plethora of stressors weighing on me like a lead blanket: clinical responsibilities, project deadlines, sick family members, travel arrangements and many other tasks. But I do my best to plan ahead, delegate, defer and perhaps most importantly, slow down, breathe, eat, sleep, laugh, be grateful and ask for help. There’s never shame in this. Hope you have a safe, healthy and happy holiday season!