Christmas is frequently referred to as the most wonderful time of the year.

However, financial pressures, increased family tension, overindulgence with food and alcohol, and the pressure to socialise are all likely to create added stress during the festive season. This can be overwhelming for most people, but how do you cope if you’re living with mental health issues?

"Assertiveness can be very helpful if you anticipate family tension. Asking for what you want or saying no to something, can be a way of preventing stress".

To help people navigate the inevitable pressures of the festive season, Dr Sian Hughes, a Registered Forensic Psychologist at Ludlow Street Healthcare’s specialist mental health facility, Heatherwood Court, offers advice on how to effectively manage your own - or a loved one’s - mental health this Christmas.

What issues commonly face people with mental health issues at Christmas?

Balancing the disappointment of expectation versus reality, along with various pressures, can be difficult at Christmas. But when you are already struggling with emotions, it can be overwhelming. In addition, for some people they have never had the ‘magical’ Christmas featured in the films. In fact, for some it has been a painful time for them.

These mixed feelings can affect a person’s thoughts, emotions, and behaviours. Some people may talk about hearing voices or seeing things, while others may feel as though things are ‘unreal’ around them. People may have nightmares or thoughts about past difficult times that they cannot get out of their mind. Most people can feel overwhelmed by sadness, shame, or anxiety, whilst others may feel an absence of emotion.

As a result, people suffering with mental health problems may have very mixed feelings about Christmas and New Year.

Managing these emotions can be difficult, and unsafe behaviours may increase. Some people may choose to avoid this time of year and the feelings it brings, maybe by sleeping more, avoiding family, becoming irritable, over using prescribed or unprescribed medication, or drinking more alcohol.

What can families do to minimise or prevent any distress?

Families are often aware that Christmas and New Year can be difficult for their loved ones, especially if they are in hospital.

They may avoid talking about their Christmas plans to minimise upset. However, this can often make the person feel more excluded. Talking openly with them about this can help reduce distress. People with mental health issues have the best idea of what is most helpful for them and treating them as the ‘experts about their own mental health’ is the best approach.

Where possible, families should include the person in their plans, but these may need to be adapted to prevent distress. For example, it may be better to host a quieter family party at New Year rather than invite lots of unknown guests which could add to the person’s social anxiety.

If a loved one is in an inpatient setting over Christmas and New Year, if you can’t be with each other on Christmas Day, it might be useful to arrange a special family lunch in the days before or after Christmas when some of the family traditions can be shared.

What can people with mental health concerns do to minimise distress?

It is really important to develop a ‘Coping Ahead Plan’ for how you are going to deal with this period. This would identify potential stressors, and where and when they are going to peak. Within this, should also be ideas on how you could cope with the emotions caused. Self-soothing can be used to help cope with distressing emotions; keeping nourished and hydrated is integral to wellbeing.

Assertiveness can be very helpful if you anticipate family tension. Asking for what you want or saying no to something, can be a way of preventing stress.

For those, who would rather avoid this time of year, finding activities to keep yourself distracted can be very useful. Find something that can help you switch off from other thoughts such as socialising with friends who don't celebrate Christmas and throwing yourself into a hobby that you're passionate about. 

Overall, It’s important to remember that this is just one part of the year. January will be soon be here. 



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