Commentary: The festive season brings loneliness, sorrow and anxiety for some
The holidays can trigger anxiety, depressive disorders and OCD, says one IMH expert who highlights how to cope with these feelings.
SINGAPORE: In the classic novella by Charles Dickens, a Christmas Carol, Mr Scrooge is portrayed as a bitter, lonely gentleman who has no Christmas spirit.
He only grudgingly allows his overworked, underpaid clerk, Bob Cratchit, Christmas Day off with pay to conform to social customs.
He refuses an offer by his nephew to join them for Christmas and turns away two gentlemen seeking donations. However, in the end, he sees the consequences of his bitterness and becomes a reformed man.
A POIGNANT MOMENT
As the holiday season gets into full swing, many of us feel uplifted by the festivities happening all around us. Christmas’ universal messages of peace, celebration and gift-giving speak to our inner child and encourage us to look beyond our present circumstances.
A poignant example was during the carnage of World War I, in the week leading up to Christmas, French, German, and British soldiers crossed trenches to exchange season greetings and talk.
In some areas, men from both sides ventured into no man's land on Christmas Eve and Christmas Day to mingle and exchange food and souvenirs. Men sang Christmas carols together and played games of football with one another, giving us one of the most memorable images of the truce.
A DARKER SIDE TO THE SEASON
Many in Singapore celebrate the holiday season - whether setting up a Christmas tree with decorations, shopping for presents for children, inviting friends over for meals or taking a trip down Orchard Road to view the Disney-themed light up.
It is a time for feasting, gift-giving and catching up with family and friends.
However, for some, the holiday season does have a darker side. In a study done by the American Psychological association in 2006, up to 26 per cent of people reported feeling lonely and 38 per cent felt an increase level of stress during this period.
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A number also complained of other symptoms such as fatigue, irritability, sadness and anger.
Some of the stressors included preparing for meals, balancing work with increased social demands, trying to find the appropriate gifts in the midst of the a rush for gifts at the shopping mall. All while trying to create the perfect occasion for family and friends.
In fact, for some, all this is so stressful that I know of some families who avoid this season entirely and use it as an opportunity to travel.
TRIGGERS FOR ANXIETY AND DEPRESSIVE DISORDERS
It is also easy to be lonely this season and feel isolated during gatherings. The feeling of one getting lost in the crowds is so much more starkly felt. Parties after parties can lead to ennui and feelings of hollowness.
Then, hidden at the edges of society, there are those who are alone. They may be without friends or family. They might have no home to stay and strive to make their living day by day. It is difficult to feel the joyous holiday spirit when you are struggling.
Feelings of loneliness and stress can trigger or exacerbate underlying conditions. When excessive, feelings of being stressed can become debilitating and possibly trigger anxiety or depressive disorders.
Loneliness, excessive ruminations and comparisons with others can lead to a depressive episode. Other mental health conditions like obsessive compulsive disorder (OCD) may also be triggered.
While we know what loneliness and being stressed can feel like, there are also physical manifestations. Poor sleep, irritability, feeling on the edge are part of being stressed and lonely.
Anxiety disorders manifest by persistent feelings of anxiety, ranging from attacks and episodes of severe anxiety to feeling anxious all the time. They are also associated with a heightened “fight, fright, flight response”.
Sufferers also report feeling irritable and, on the edge, they may experience, tingling sensations in their peripheries, fast heart beats and rapid breathing. They may also complain of vague gastrointestinal symptoms and poor sleep.
Depressive disorders manifest by persistent feelings of low mood.
These may be associated with low energy, poor appetite, poor concentration and memory, feelings of hopelessness as well as an inability to enjoy things. They also may have vague complaints of being in physical pain and poor sleep.
TROUBLE COPING WITH OCD
The recently released Singapore Mental Health Study 2016, OCD or obsessive compulsive disorder was highlighted as a disorder of particular concern. Singaporeans seem to have a higher prevalence of this disorder compared to the global prevalence rates.
OCD is characterised by persistent intrusive thoughts, obsessions and rituals. The sufferer feels compelled to repeat certain behaviours or rituals to assuage some anxieties or fears.
For all these conditions surveyed in the Singapore Mental Health Study 2016, the result of the symptoms is that the individual is unable to function. He or she is unable to work at their usual ability and unable to function as a wife, husband, father, mother or friend.
I have six suggestions for those who might have trouble coping with the festive season.
First, lower your expectations. Things do not have to be perfect. Stop looking for that perfect gift or preparing that perfect dinner party. It may be cliched but it’s the thought that counts.
Second, choose your engagements. You do not have to agree to every gathering or party. Spend time with those who mean something to you.
Third, live healthy. In the midst of all the food temptations, eat in moderation. Find time to exercise. Make sure you have sufficient rest.
Fourth, recognise you are not alone. You are not the only one feeling the way you do. You do not have to be the life of the party.
Fifth, volunteer. Help others. Give not only in terms of material goods but volunteer your precious time.
Finally, seek help. It is alright to admit that you are feeling stressed, depressed or struggling with your emotions. It is alright to admit that you are struggling with thoughts of hopelessness and that life is not worth living, even in the midst of this holiday season.
Whether celebrating the season of peace and goodwill to all mankind or even as a chance to indulge in the year-end sales and food offerings, the holiday season is a joyous occasion but it can be a difficult time as well.
We should take steps to keep ourselves healthy and help those around who need some of the holiday spirit this season.
Dr Mok Yee Ming is Senior Consultant and Chief, Department of Mood and Anxiety at the Institute of Mental Health.