Is Holiday Season Stress Getting to You? You're Not Alone.

This article originally appeared in the Patriot Ledger.

Just like everything else in 2020, this holiday season will look, and feel, a little different. Experts continue to warn against holiday travel and gatherings, and the subsequent absence of beloved traditions may lead to increased isolation, exacerbating the feelings of anxiety and depression that already increase in patients each year around the holidays.

Holiday-related anxiety and isolation will be heightened by the collective grief and fatigue from the COVID-19 pandemic, making it more important than ever to address the stigma surrounding behavioral health care and encourage people to seek treatment when they need it.

Holiday spikes in behavioral health issues are not new; a study from the National Alliance on Mental Illness found that 64 percent of people diagnosed with behavioral health issues find that their conditions are worse around the holidays, and every holiday season we see this trend reflected through an increase in behavioral health visits at South Shore Health. This time of the year, many patients report high levels of stress and anxiety. Among those who do not have a large family to spend the holidays with, we see increased feelings of isolation and depression.

Often, this increased anxiety and depression around the holidays leads to an increase in the use of substances such as alcohol, prescription medications, or illegal drugs. Each year, we see an increase in patients seeking our office-based addiction treatment at Grayken Center for Treatment at South Shore Health during the holiday season. Unfortunately, we also know that for every patient we treat, there are many more dealing with substance use disorder not seeking treatment.

This holiday season is likely to be more stressful than ever, closing out a year dominated by a pandemic. For months, people have been confined to their homes, rarely seeing anyone outside of their own households, and often obsessively checking news alerts about the rising death toll, evictions, supply shortages, and everyday struggles. Add on top of this the fact that more than 10,000 families in Massachusetts will be grieving loved ones this holiday season, and it’s no surprise that people are feeling grief, anxiety and isolation more heavily than ever before.

While these feelings are understandable – even normal, given the current climate – we’re concerned that these feelings will correspond to higher levels of behavioral health issues, particularly substance use disorder, which is a medical disease often best defined as difficulty controlling the use of alcohol, prescription medications, or drugs despite negative consequences.

It is estimated that one in 20 adults in Massachusetts have substance use disorder, but many of them go untreated due to the stigma associated with substance use and addiction. Among those with substance use disorder, as few as one in 10 people seek treatment, signaling a dangerous trend that prevents many patients from moving toward recovery. My colleagues and I frequently remind our patients that recovery starts with conversation and connectedness. This is equally true for the cultural stigma around behavioral health: the first step to changing our cultural response to these issues is to have open and honest conversations together about the behavioral health issues that many of us face.

With all of this in mind, we encourage every Massachusetts resident to make an effort to ensure that this holiday season isn’t affected by increased isolation and anxiety for those we care about. Instead, we can make it an opportunity to engage our loved ones in open and honest discussions about depression, anxiety, and substance use disorder.

With the holidays upon us, remind your loved ones that they are not alone. If someone close to you is struggling with substance use disorder or another behavioral health issue, assure them that their feelings are valid, and in fact, common: a recent poll from the Kaiser Family Foundation found that 53 percent of U.S. adults reported feeling like their mental health has worsened as a result of the pandemic. Talk about the importance of seeking behavioral health care, which is more accessible than ever before through both in-person and teletherapy appointments. And when you have these conversations, remember that words matter. Avoid using terms such as “crazy,” “junky,” or “drunk,” which have negative connotations, and instead consider language such as person who uses alcohol or drugs.

As we navigate this holiday season and close out a year dominated by distance, we must come together to break the dangerous stigma around seeking help for behavioral health disorders. We must have honest, respectful, and sometimes difficult conversations about substance use disorder and other behavioral health concerns, and – when needed – encourage our loved ones to seek care or treatment.

Together, we can move further down the path to collective recovery.

Dr. Todd Kerensky is medical director of addiction medicine and a hospitalist at South Shore Health, and is president-elect of the Massachusetts Society of Addiction Medicine.