Mental Health & the Holidays: Why Christmas Can Be Harder Than It Looks

The holiday season is marketed as a time of joy, connection, and celebration — yet clinicians know that December often brings a completely different emotional climate. Research consistently shows that the weeks leading up to Christmas are associated with increased financial stress, heightened loneliness, interpersonal strain, and rising anxiety (MacDonald et al., 2022). Many clients arrive in session feeling overwhelmed, overstretched, and wondering why they’re “not coping” with something that’s supposed to feel festive.

But as you know, there’s nothing mysterious about this pattern. December disrupts routine, increases demand, and compresses time. For clients already managing anxiety, mood symptoms, or phobias, it can amplify vulnerabilities in ways that feel disproportionate — but are entirely predictable from a psychological and physiological standpoint.

The Pressure Cooker Effect: Why December Elevates Stress

December compresses tasks, expectations, and social obligations into a very short window. Even clients who typically cope well report a sense of intensity, urgency, or “I can’t keep up.”

This stems from a few predictable mechanisms:

Time compression → cognitive load

End-of-year deadlines, work wrap-ups, travel planning, and family commitments all land at once. Research on cognitive load shows that when perceived demand outweighs perceived time, the stress response heightens rapidly.

Clients often describe this as:

• feeling “behind”

• rushing constantly

• difficulty slowing their thoughts

• emotional reactivity

This isn’t a failure of coping — it’s a predictable reaction to a contracting schedule.

Routine disruption → emotional dysregulation

Clients lose access to protective structures:

• consistent sleep times

• regular meals

• stable work–life boundaries

Routine changes are strongly linked to increases in both anxiety and depressive symptoms [1]. Even small disruptions — like late nights, social events, travel, or irregular meals — affect cortisol rhythms, blood sugar stability, and sleep architecture.

When clients say, “I feel off,” they usually are — physiologically.

Financial Strain: An Underestimated Driver of Holiday Distress

Financial stress is one of the most robust predictors of anxiety and depression — and the holidays magnify it. Surveys have found that 76% of adults report holiday-related financial pressure. For those with pre-existing anxiety this can lead to worsening symptoms.

For many clients, December spending isn’t just about money — it’s about shame, comparison, or feeling like they’re “failing” family expectations.

Clinicians may see:

• guilt around gift-giving

• fear of disappointing others

• avoidance of conversations about money

• tension in couples or families

Addressing financial anxiety compassionately — without judgment — can be one of the most impactful interventions this time of year.

Loneliness and Social Comparison

December can intensify feelings of loneliness, even among clients who aren’t socially isolated. Surveys have shown that self-reported loneliness increases by up to 30% during the holiday period.

Contributing factors include:

• social media comparison (“everyone else is thriving”)

• reduced workplace contact during shutdown

• strained or absent family relationships

• loss anniversaries

It’s important for clinicians to normalize this: the season exaggerates contrast. Emotional pain feels sharper against a backdrop of forced cheer.

What Clinicians Can Do: Practical, Compassionate Approaches

Your clients don’t need lectures about gratitude or “holiday spirit.” They need grounding, clarity, and tools that match the moment. A few strategies consistently help:

a. Slow the pace through intention-setting

Clients often feel time is “speeding up.” Simple interventions like:

• identifying the top 3 priorities each day

• practicing intentional pauses

• scheduling “non-negotiable” rest windows to help downshift the nervous system.

b. Normalize physiological sensitivity

Explain that:

• irregular sleep

• erratic meals

• alcohol

• sugar

• overstimulation

• reduced daylight

all disrupt emotional regulation. This reframes symptoms as biological, not personal failure.

c. Co-create a December coping plan

Many clients benefit from preparing for:

• social overwhelm

• difficult family interactions

• financial boundaries

• travel stress

• loneliness spikes

Brief, structured plans reduce ambiguity and prevent escalation.

d. Help clients identify what actually matters

December pulls people into obligations they don’t truly value. Encouraging clients to prioritise meaning over performance can be transformational.

You might ask:

• “What’s genuinely important to you this season?”

• “What feels stressful but optional?”

This helps clients step out of autopilot and back into agency.

Looking Ahead

For clinicians, December isn’t just another month — it’s an annual pattern of heightened stress, dysregulation, and emotional strain. Supporting clients through this period means helping them understand the real forces at play: time compression, disrupted routines, financial pressure, social comparison, and physiological sensitivity.

By grounding these experiences in evidence and helping clients slow down, set intentions, and focus on what matters, we can offer clarity in a season that often feels overwhelming.

References

[1] Cepni, A. B., Kirschmann, J. M., Rodriguez, A., & Johnston, C. A. (2025). When Routines Break: The Health Implications of Disrupted Daily Life. American journal of lifestyle medicine, 15598276251381626. Advance online publication. https://doi.org/10.1177/15598276251381626