Christmas and mental health

Why Christmas is a hard time

Christmas can be difficult for anyone, at any point in their life.

You might be struggling this year for the first time. Or you may have found Christmas difficult in the past, and you're dreading it again this year.

You may also enjoy Christmas, but not be able to celebrate it how you'd like to. Or you might find some parts enjoyable, but other parts stressful.

This page covers some of the reasons that Christmas can feel tough, and may affect your mental health:

• Money worries
• Practical issues
• People who aren't around
• Loneliness
• Difficult situations and relationships
• Society and the outside world
• Access to support and services
• Being in hospital

Money worries

Christmas can be very expensive. And worrying about money can have a big impact on our mental health. Mental health problems can also make it harder to earn or manage money.

You may be worried about:

• Not having enough money or being in debt. See our pages on money and mental health for information and tips which may help.
• Worrying about how you're going to afford Christmas, as well as the cost of living in general. Citizens Advice has more information on how to get help with the cost of living.
• Coping with the timings of payments, benefits or wages over bank holidays. 
• Things being closed when you need them. For example, food banks and other support services might be closed on public holidays. Our page of useful contacts has information on the opening times of some services over the Christmas period.
• Extra costs and pressure to spend money. For example, worrying about the cost of buying presents. Or spending more money on Christmas food or clothes. Money Helper has more information on managing money at Christmas.
• Letting people down if you don't have enough money to spend on Christmas. For example, if you can't afford to buy gifts for children or dependents.
• Existing problems with managing money and your mental health, which might feel more difficult at Christmas.

I was constantly anxious about money, living from month to month on Universal Credit, paying off debts. There was no money spare for Christmas or birthday presents.

Practical issues

There can be lots of practical issues to think about over Christmas, which can affect our mental health:

• Finding care for children or dependents, for example if you need to work while they are at home.
• Finding enough time to do everything to prepare for Christmas.
• Travelling, logistics and staying somewhere else being difficult to organise. This may feel stressful or disruptive.
• Being a carer, such as needing to plan for the person you care for within your Christmas plans.
• Impact on sleep and your routine. See our pages on sleep problems for tips to improve your sleep.

Feeling 'other' in conversations about how people had happy holiday seasons can really take a toll, and it can make you nervously anticipate or resent upcoming holidays where a happy nuclear family is idolised in the media.

People who aren't around

Christmas can be very difficult if we can't spend it with people we would like to. There are lots of reasons why people may not be around, such as:

• Estrangement, when you're not in contact with family members. Find support from the estrangement charity Stand Alone.
• Bereavement, whether it's recent or if some time has passed. Cruse has more information about coping with grief at Christmas.
• Fertility problems, miscarriage or baby loss. Tommy's has lots of information about baby loss, pregnancy complications and fertility.
• Divorce, separation and break-ups, which may affect how much you see loved ones at Christmas. Relate has information on dealing with relationship issues at Christmas.
• Health problems, for example if you or someone close to you is unwell. This might mean you need to spend Christmas apart when you'd rather be together.
• Practical reasons. You may not be able to see people at Christmas because of problems with transport or costs.

Loneliness

Not having people around us can feel more difficult at Christmas when there are lots of images of families and friends together. 

Even when we have people around us, we might feel lonely. This may be because we feel like we have to hide our feelings, or act differently around some people.

If you have a mental health or physical health problem, you might feel like you can't join in with Christmas celebrations. You might also feel this way if you're a carer.

Or if you have to spend Christmas in a care home or hospital, this may feel lonely. Particularly if others around you have been able to leave for Christmas or have people visit.

See our pages on loneliness for more information.

I usually have to visit family but as I have autism I find this difficult as it breaks my normal routines and my coping strategies are not accessible. I try and keep the visits as short as possible and then usually come home and sleep.

Difficult situations and relationships

At Christmas, we may feel forced to see people or do things that we don't want to. It can be harder at this time of year to avoid difficult or upsetting situations. This might include:

• Abuse and other trauma, whether it's from the past or happening now. This may include seeing people who remind you of difficult or traumatic experiences.
• People not accepting you. For example, if family members don't accept your LGBTQIA+ identity or understand your mental health problem, or if you encounter racism.
• Difficult relationships, such as with a partner, family member or co-worker. Relate has support and advice which may help.
• Dealing with other people's expectations or decisions. This might include family norms, or religious or cultural expectations.
• Demands on your time, including pressure to socialise or see people, whether it's online or in person.
• Difficulty setting boundaries and having less privacy. For example, having to spend time or share your plans with other people.
• Listening and empathy, including feeling pressure to be available for others.
• Worrying about gifts, such as what you buy, who you buy for and how they'll be received.

I find it extremely lonely and isolating. It all seems to drag on for months as well.

Society and the outside world

Things going on the outside world, and society's expectations, can make Christmas harder to cope with.  For example:

• Feeling pressure to enjoy yourself and look happy.
• Media, adverts and representations of Christmas feeling upsetting and hard to avoid, and looking different to your experience of Christmas.
• Stigma and misconceptions about mental health from the people around you or in the media. See our page on stigma and misconceptions for more information.
• Seeing upsetting or difficult news stories or events in the world. 
• Feeling overlooked if festivals, holidays and religious events you celebrate don't get the same attention as Christmas.
• Public spaces with more noise, lights, smells and long queues than usual, which can be overwhelming.
• Worries about getting sick or feeling pressure to be around others when you don't want to.
• Expectations about food and alcohol. This may include pressure to eat and drink things you don't want to, or can't. Or hearing comments about food, diet or lifestyle. See our pages on eating problems and recreational drugs, alcohol and mental health for information which may help.

Access to support and services

• Some services may not open or may run a reduced service, such as crisis teams and some helplines. And it can be harder to find out quickly what service to use, if opening hours change.
• GP surgeries may close at certain times over the festive period. And you might find it harder to book an appointment. For medical help, you can contact NHS 111 in England or NHS 111 in Wales. Or call 999 if it's an emergency.
• Therapists often don't work over the festive period. This may include if you have online or telephone appointments.
• Pharmacies may close and it can be harder to get medication. The NHS has information on getting out-of-hours medication and emergency prescriptions.

Being in hospital

• It might be hard to spend Christmas in hospital, if you need to. You may not know what to expect, and wonder what your Christmas will be like.
• Visiting rules might be different at Christmas, depending on where you are. You might not want people to visit you. Or you may have people in your life who won't or can't visit, which might feel upsetting.
• There may be fewer staff, or different staff to the ones you are used to. There may also be fewer people on your ward if some people have been able to go home during Christmas.
• You may feel you are missing out on your usual Christmas. You might feel this especially if you have been sectioned or your discharge has been delayed.
• It might feel difficult to avoid Christmas if you don't enjoy it. For example, if the hospital puts up decorations or plans activities.
• You may be able to spend some time away from hospital, for example if you go home at Christmas. But this might you might feel more pressure to take part or overwhelmed by social contact.

This information was published in November 2023. We will revise it in 2024.

References and bibliography available on request.

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