Signs of Mental Health Concerns in Loved Ones during Holidays

The winter holiday season is often a time that families and friends come together and spend time with one another.

For people living with a mental illness, the holidays can unfortunately be a time of stress and increased anxiety. A survey by the National Alliance on Mental Illness shows 64 percent of individuals with a diagnosed mental illness say the holidays make their illness worse.

Joshua Andrzejewski, PhD, is a psychologist and clinical evaluator with Rochester Regional Health and gives us insight into ways people can recognize signs of mental health concerns – and offer help.

Added pressure

The holidays are often a wonderful time to gather together with family and friends. At the same time, the season can also carry a higher level of internalized pressure to create great family moments, host an unforgettable gathering, and give everyone the best overall experience.

This outlook can impact people’s emotions and financial mindset – sometimes ramping up levels of anxiety. Comparing one person’s holiday experience to another person’s experience can lead to feelings of shame or disappointment, and lead to more sadness or depression.

Financial strains, transportation barriers, and less overall outdoor activity due to cold weather can also lead to a general malaise that contributes to mental health concerns.

“Some of these things may seem peripheral to the holiday season, but might lead to a person facing that much more internalized pressure when the idea of providing for the holidays is introduced into the conversation,” Andrzejewski said.

Causes for concern

When looking at how a person’s mental and emotional health are affected, there are three areas where it can be seen most often: emotional, social, and behavioral.

Emotional concerns

If a person is struggling with their emotions, they may show signs by:

• increased sadness or depressive moods
• making self-defeating comments
• fixating on negative situations more often
• increased irritability or passive aggressive behavior
• expressing feelings of overwhelming anxiety

“Most people experience some degree of anxiety during the holiday season,” Andrzejewski said. “But an overwhelming amount of anxiety – to the point where someone is unable to carry out day-to-day functions – should raise a flag that all is not well.”

Social concerns

Someone who is feeling depressed or anxious might act more withdrawn or apathetic in conversation compared to how they typically behave.

Other socially-related signs of mental health concerns might include:

• not spending time with their usual social groups
• lack of text messages or returning phone calls
• increased absences from school or work
• starting to give possessions away
• writing notes or letters to loved ones with a concerning tone
• sudden drastic changes in behavior for those struggling with depression or anxiety

Behavioral concerns

Others tend to notice shifts in the way someone behaves. These changes might display as:

• significant increase or decrease in appetite
• significant increase or decrease in sleep
• weight loss combined with emotional and/or social symptoms
• changes in substance use – either new, resumed, or increased use
• changes in motivation (e.g., a sharp and sustained need to complete tasks, or a drastic decrease in their drive)
• increased fatigue

Taking the next step

If any signs or symptoms are concerning, taking the time to address them with the person is important.

Depending on the nature of the relationship and how close people are to one another, the approach might vary. For people with depression and anxiety, a direct conversation is the most helpful – especially if you have a good relationship with the person.

“Conversations in a context like this can allow the person to release some of their feelings and emotions in a trusted space and allow for family or loved ones to extend an offer to help in a way that the person feels comfortable,” Andrzejewski said. “This might include assisting them during the holidays or potentially helping them connect with a counselor.”

In situations where a person may not be as open to discussing their mental health and might minimize any existing problems, or might even lack awareness of their mental health problems, a direct conversation may not be productive. In these cases, demonstrating an attitude of acceptance and a willingness to listen can be helpful. Calm, one-on-one communication works best and gentle reminders of how much their family member is loved and cared for can open the door for future conversations.

If there is potential for immediate risk or physical danger, family members can get in touch with the Rochester Regional Health Behavioral Health Access and Crisis Center, call 211 Lifeline for mental health assistance in Monroe County, or 988 for the Suicide & Crisis Lifeline.