Christmas can be a particularly difficult time of year for anyone struggling with mental health problems
When it comes to the festive period, research by mental health charity Mind found the consequences of the pressure to have “the perfect Christmas” leaves one in 10 people feeling unable to cope.
“Life can be challenging for all of us at times,” says Stephen Buckley, head of information at the organisation. “But when you’re living with a mental health problem, the ups and downs can be that much harder to manage.
“Many of us look forward to Christmas, but for others the huge emphasis on spending the festive period with family and friends can create feelings of loneliness and isolation, while difficult relationships with loved ones can cause added stresses and pressures.”
Experts say various factors can contribute to mounting pressures during this time, making it even more likely those suffering with mental health issues will withdraw from others.
Here’s how to support mental health sufferers this Christmas:
Know when something is wrong
Experts say symptoms of mental health conditions can vary, which often makes it difficult to recognise when someone might be struggling.
Sometimes, a small change in behaviour or temperament could indicate an individual is suffering from a condition such as depression, as Kelly Feehan, service director at wellbeing charity CABA, explains.
"Depression isn't a one-size-fits-all disorder, which means recognising it isn't always straightforward," she tells The Independent
Evidence points to the value of friends and family educating themselves about the signs and symptoms of different mental illnesses.
According to Here to Help, one review found that when the family was educated about the illness, the rates of relapse in their loved ones were reduced by half in the first year.
“Take the time to educate yourself,” says Natasha Devon, mental health campaigner and author of A Beginner's Guide to Being Mental.
“There’s so much information out there which is just as important for people who are suffering with mental health issues, as it is for those surrounding them.”
Don’t make assumptions
It can be incredibly upsetting to hear that a loved one is suffering from a mental health issue. However, it is important to remember it is not your job to diagnose nor attempt to “cure” their condition.
Experts advise you to listen to what a loved one is saying with an open mind and resist the temptation to give advice, as it can often come across as judgemental.
“You can only ever deal with the person in front of you which means if a person is in distress, it doesn’t matter what you think about their issue,” explains Devon. “If someone comes to you with a problem, they often don’t want a solution, rather someone to listen.”
Mentalhealth.org advises listeners to lead a discussion at their own pace and not to second guess the feelings of those suffering.
You should also acknowledge that what a loved one is feeling is a real fear for them, and not something to be brushed off with a generalisation or comparison, says Devon.
“There’s always someone worse off so pointing that out to someone who is in distress won’t help. Likewise, don’t bring the conversation back to you.”
She said the most empathetic thing you can say to someone in this situation is “I can’t imagine what that must feel like, could you tell me more?”
Give the person plenty of time to respond to your questions and try not to allow the perception they are being interrogated, she suggests.
“You need to let the individual know you’re not forming a judgement, but genuinely interested in understanding what they might be going through,” she says.
Dr Abigael San, chartered clinical psychologist from the British Psychological Society, also says you should avoid the assumption Christmas is a happy time for everyone around you.
“Asking someone whether they had a ‘nice’ Christmas assumes the festive period is enjoyable for everyone.
“Remember that while many people have positive, often nostalgic memories at Christmas, it can be a difficult time for others. Bereavements, losses of jobs, and the pressure to spend a lot of time together after long periods of not seeing family and friends can exacerbate tensions.”
MIND has found that over half of people who have experienced depression or anxiety isolate themselves from loved ones.
Meanwhile, research by YouGov for charity The Campaign Against Living Miserably (CALM) found more than a quarter (28 per cent) of young people feel stressed about the festive period, with over a third (34 per cent) revealing they do not feel comfortable talking to their friends when they are having a tough time.
According to the experts, encouragement may be offering an individual the space confide in you about how they're feeling, or simply keeping them company.
"If you think you know someone who is depressed, the best and simplest thing you can do, is to sit down and talk to them," says Feehan. "Show them you're willing to listen to them about their problems, as it may be they've not felt able to speak about their feelings.”
She says it's equally important to keep the quality of the interaction engaging and connected. Repeating back what they’ve said to you is a great way of understanding how they might be feeling and shows you respect their honesty and emotions.
Additionally, she suggests that if you can meet in person, monitor your body language and focus your attention properly (without a mobile phone in your eyeline) so your loved one feels a priority. If contact is conducted over the phone, keep in regular contact.
If someone is reluctant to talk, sharing an activity “can be just as helpful as having a conversation”, according to Devon.
However, several mental health charities warn that taking care of an ill family member or friend can be stressful, and you may need emotional support, too. Likewise, your loved one may require specialised help you may be unable to provide.
As a result, you might need to suggest an individual seeks guidance from a medical professional, offer to go to the GP with them, or help them talk to another family member or friend.
"Encourage your friend or family member to seek professional help but don't become their carer, doctor or therapist," says Dr Natasha Bijlani, consultant psychiatrist at Priory Hospital Roehampton.
"Keep your boundaries; be there for them but encourage them to seek professional input to manage their symptoms."
Nicky Lidbetter, from Anxiety UK says you should do your best not to attempt to control the situation, rather, allow the individual to make their own decisions with your support.
"It’s important not to be too pushy, and allow those with anxiety to breathe and decide their best way of being during the festive season," she says.
Consider your language
Language is a powerful tool but following years of stigmas about mental health, it’s important to recognise the impact words can have on someone suffering from psychological issues.
"Avoid placing blame on the individual for how they are feeling," says Lidbetter.
"Feeling depressed or anxious may already mean the individual is feeling low about themselves and adding further blame or onus on them may overwhelm or add a further negative dimension to their mental health."
Experts suggest you try to understand how an individual might be using their words to express their emotions and reflect that in your questions.
Devon also advises you to ask simple and open questions, allowing the person to explain in their own words how their mental health problem manifest, what triggers it, how it impacts on their day-to-day life and what support they might need.
“Ask questions such as ‘can you feel the emotion anywhere in your body?’ or ‘when did you first notice you felt this way?’ to help create a safe non-judgemental listening environment."
It's suggested you should also try to keep your language as neutral as possible. Devon recommends Time to Change’s list of terminology to use/not use when discussing mental health issues.
“Likewise, asking someone to evaluate their day on a scale and gently probing into when they last felt above a certain number, or the triggers that help or hinder their emotions is a great tool in helping someone open up,” she says.
Keep up a routine
The festive season can be a time of excitement, but experts say that expectations to have a good time and mounting social engagements disrupt normal routines and can be anxiety-inducing for mental health sufferers, according to experts.
A MIND survey in 2015 found that nearly a fifth (19 per cent) of adults have pretended to be sick to get out of staff Christmas parties.
The likelihood of enjoying getting involved in festive events, such as team lunches and parties, was also found to decrease with age (just 32 per cent for 25-34 year olds and 15 per cent for those aged over 65).
When someone suffers from a mental health issue, such as anxiety, experts say it’s important not to put additional pressure on them to do more than they feel comfortable with or force them into situations before they feel ready.
Keep in mind that being unable to control worries is a symptom of many mental health problems.
“When someone is anxious, it can be helpful to help them plan certain activities so they can predict and anticipate certain emotions,” suggests San. “At Christmas, you could plan how you could spend your time together so it’s more manageable for them.”
Lidbetter says keeping up a similar daily routine can be a great way of creating structure for an individual who might be suffering.
For some people, that might be as basic as getting out of bed and eating at regular meal times or "taking a morning jog and some self-care-time", she suggests.
"Make sure you are doing the things which make them feel good and in the best head space."
If you know someone may feel heightened pressure in a situation, be it a family gathering or party, you can also help provide support and remind them they are under no pressure to participate in, and attend, events during the Christmas period, advises Dr Bijlani.
"If your loved one is feeling particularly anxious in the lead up to a festive event, explain to them it is ok to leave early or to say they are unable to attend."
Be aware of triggers
With the pressure to socialise with friends and family at Christmas, there is often the temptation to overindulge in food and drink.
However, while alcohol has become a mainstay of Christmas parties, mental health professionals say that regular consumption of alcohol can have adverse effects upon those suffering with mental health problems.
As a result, Feehan advises being mindful of the amount of alcohol consumed around this time of year.
“Unsurprisingly, alcohol intake can increase at Christmas, and for some drinking seems like it helps to alleviate the symptoms of depression. The truth though, is quite the opposite," she says.
"Cutting down on drinking can actually make you feel better and more receptive to treatments. So, it’s best to avoid the mulled wine over the festive period."
With that in mind, help those with anxiety by letting them decide their limits in order to best aid their mental health.
If you have been affected by any issues mentioned in this article, you can contact The Samariatns for free on 116 123 or any of the following mental health organisations: