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The holidays can be a difficult time, especially for anyone who has recently — or not so recently — lost a loved one. Missing someone is always hard, but the loss can feel even deeper when you’re surrounded by holiday gatherings and celebrations. And while grief and loneliness can strike at any time, the pressure to be cheerful this time of year can compound their effects. Below, Dr. Mariam Wahby, a licensed therapist and the manager of behavioral health education with Memorial Hermann’s Behavioral Health Services, shares some ways to cope with feelings of loss during the holiday season.

Q: Why does loss feel so much worse during the holidays?

Dr. Wahby: With families coming together, the absence of someone special is especially noticeable, and that can really hurt. But it doesn’t have to be the loss of a loved one — it could be the loss of a job, a relationship, a home. Even something like infertility can be especially painful this time of year, partly because the holidays are so focused on kids. There’s this ideal of the perfect, happy family gathering, and if you feel like you don’t have that or don’t measure up, it stings. And when you do get together with family, everybody might be asking, “When are you going to have kids?” It brings the pain to the surface. It’s similar with a lost job or the end of a relationship. This is a time of year when you see people you might only see once a year, so a lot of those interactions are about updating each other, and not everyone has progress to report, making them feel uncomfortable.

Q: What are some of the triggers that might be painful this time of year? How can people avoid those — and should they?

Dr. Wahby: Social gatherings and religious services can be hard — all the rituals around the holidays that you might have done with someone who’s no longer here, or no longer accessible. Christmas songs, certain foods even certain smells can all trigger old memories. It’s also a time of year when alcohol is very prevalent, and someone who’s sober or not partaking can have a hard time.

As far as avoiding triggers, that’s a tough one. I wouldn’t recommend avoidance of situations that have meaning for you, but I don’t want to say face everything head on if it’s going to be really challenging and you don’t have a strategy for it. Setting strong boundaries beforehand can help. Take some time to think about what you can and can’t do and share those boundaries with the people around you. If you’re sober, do you have to go to a party where there’s going to be alcohol? Maybe not. Don’t push yourself into something you aren’t ready for. Or if you do feel up to it, you can be clear about saying “Please don’t offer me a drink.” Practice self-care and self-compassion.

Q: What are some ways of coping with grief and loss during the holidays?

Dr. Wahby: One thing you can do is take inventory of the holiday traditions you participate in. Ask yourself: Is this something I actually enjoy and is meaningful, or is this something that’s too painful or maybe a reminder of someone who was abusive in my family? Which traditions do you want to keep, and are there some you’d prefer to do away with? Give yourself flexibility to start new traditions and create new memories.

If loss is part of the struggle, then you can also find ways to include the lost loved one in your traditions. You can still hang a stocking for that person or set a seat for them at the table. Find ways of including their memory throughout the holiday.

Volunteering or doing some sort of community service can also be a helpful coping strategy for some people. It can help you feel connected to a group if you’re feeling isolated, and it can also help you feel more grounded if you’ve lost the sense of meaning around the holidays.

Q: The “holiday blues” are different from a diagnosed mental illness, but what about people with clinical depression, anxiety and other illnesses? Do they see increased symptoms this time of year?

Dr. Wahby: There are more stressors around this time of year for many people, regardless of whether you have a diagnosed mental illness. A survey from the American Psychiatric Association found that 41% of people reported that their stress level increased during the holiday season because of everything from financial worries to the hectic pace of activities. If you already have depression, you might have an increase in symptoms like negative self-talk, loneliness or feeling inadequate, and that will contribute to worse overall well-being.

Q: What self-care tips do you have for people who’ve experienced loss — or those who haven’t, but still find this time of year challenging?

Dr. Wahby: The good news is you can use the same skills and tools you use all year. Those are things like paying attention to how you feel and what makes you feel worse and giving yourself permission to opt out. For example, if you always go to your sister’s house on Christmas morning and must bring all these things over at dawn, and at the end you’re worn out and overstimulated because there are six other kids there and you didn’t get to spend any quality time with your own kids. So maybe this year you decide that you’ll join them later in the day and spend some quiet time with your own family first, which allows you to not get completely drained.

Accept your own limitations. Maybe I’m not the parent who can move the elf every day for 25 days. That’s OK. Maybe I’m not the Secret Santa at work who searches for the other person’s favorite kind of candy from childhood. Maybe I just grab a Starbucks gift card and move on. That’s OK, too.

Maintaining your regular self-care routine is important. If you typically are careful about what you eat and how active you are, try to keep up with your priorities and your goals. Don’t get too distracted from that by all the treats and parties.

Do the things you enjoy. If you love Christmas movies but hate parties, don’t go to the party — watch a movie. But if you love parties, go to the party. That’s something that can be hard for people who’ve recently suffered loss as well: enjoying yourself. Because there can be a lot of joy around the holidays, and you have to give yourself permission to feel joy, too. Happiness and suffering can exist simultaneously.

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