The holidays can be a challenging time for mental health, escalating any feelings of stress, depression or anxiety. When you add seasonal depression to the mix, as well as COVID-19 and related isolation, this year could present additional struggles for many in our community.

The holiday blues often affect individuals already living with a mental illness, according to the National Alliance on Mental Illness, and dissatisfaction and loneliness are the most frequent symptoms this time of year. COVID-19 has added other elements people now have to factor into the holiday season, such as an increase in suicide risk factors and unprecedented stressors.

Meghan Francone, Director of Open Heart Advocates through Community Clinics at Memorial Regional Health

According to the Mayo Clinic, the coronavirus disease could add stress to an individual if it is actively spreading in the community, if they are worried about themselves or their loved ones’ health or if they are sad or anxious about how holiday plans might look different during the pandemic.

“People need human connections and interactions, which is why COVID-19 has exasperated some of the risk factors for suicide and mental health disorders,” said Meghan Francone, MHA, BS SLP/Aud., CFI, director of Open Heart Advocates through Community Clinics at Memorial Regional Health and Moffat County Coordinator for Reaching Everyone Preventing Suicide (REPS). “We’re more isolated than ever, and we need to be aware of that.”

Rural areas such as Moffat County, specifically, were already isolated prior to the pandemic, which has likely impacted depression, substance abuse and domestic violence numbers, though experts don’t know to what extent quite yet. This holiday season, community members should check in on their loved ones to ensure they are doing OK. It’s important to note that mental health disorders themselves do not increase this time of year, but rather, the symptoms tend to surface or worsen.

“When you see an increase in risk factors, you can see high death-by-suicide rates,” Francone said. “This time could take a toll on our mental health, even for individuals who have not thought about suicide. Everyone’s mental health is being impacted in different ways, and the toxic and cumulative stress is real.”

What happens in Moffat County?

Suicides don’t typically increase during the holidays, though the holiday season may increase loneliness and feelings of depression. Past data shows that most suicides in Moffat County occur from fall to spring, according to Francone — and that’s without COVID-19 in the picture.

Usually, the suicide rate is higher in the springtime, which is aligned with national numbers. According to the U.S. Center for Health Statistics, the suicide rate in the U.S. is highest between April and August. To date this fall, however, Moffat County has had four suicides.

Francone said suicide is not the problem, but rather the perceived solution for individuals, which is why we need to encourage outreach and support as we head into the winter, especially during these difficult times. If you know someone who struggles this time of year, check in on them.

“Let’s do our part and reach out,” she said. “We need to be aware as a community, as a family member and as a good neighbor of the signs and symptoms of suicidal ideations. We need to be aware of risk factors and things that can exacerbate stress factors. Ultimately, we need to act and ask the hard questions, and listen to our family, friends and coworkers.”

For more information on recognizing the signs and risk factors in a loved one, and how you can offer support for your community, check out this article from Open Heart Advocates.

Coping tips

If the holidays are affecting you or a loved one negatively this year, or you’re feeling more isolated than you have previously in holiday seasons, there are some ways to cope and offer help to those around you.

Francone recommends talking to your family, friends and other supportive folks in your life about how you’re doing, especially if you’re struggling. Remember to ask them about how they’re doing as well. Meet with your healthcare provider if you’re not sure where to start, as they can guide you in the right direction and connect you with invaluable resources.

Try decreasing your use of alcohol and recreational drugs during the holiday season, as these substances can lead to impaired thinking that won’t benefit you. According to the National Alliance on Mental Illness, eating poorly and drinking excessively can exacerbate issues like stress, anxiety and depression around the holidays.

Even just remembering the basics — such as eating a balanced diet, exercising regularly and getting an appropriate amount of sleep — can help improve mental health.

A few other tips to de-stress during the holidays, according to Psychology Today, include:

• Taking moments and necessary breaks when you need to calm down.
• Understanding and accepting the differences you may have with family members.
• Writing down a list of all tasks you need to complete and determining what you are able to do yourself and where you need to ask for help.
• Being generous to others, whether through verbal compliments or a donation to a nonprofit that means a lot to you.

Humans are social beings, and in the darker days of winter, especially with the pandemic, experiencing long periods of time without social interaction can increase risk for mental health crises. Francone encourages community members to get creative in their holiday gatherings this year — whether they stay in touch through Zoom or Skype calls, or literally visit vulnerable family members through their home windows.

“There are so many different ways that we can still remain connected, and I challenge us to reach out to each other as much as we can,” Francone said.

Resources for those in need

We can talk about mental health and suicide, but unless we act on these subjects and provide resources to those in need, things can’t progress and get better. Moffat County offers an array of mental health resources, and there are several great local therapists and counselors who have stepped up to meet the mental health demands of their community. Reaching Everyone Preventing Suicide (REPS) is a local organization that pays for five free sessions with a therapist or counselor, regardless of insurance, and is completely confidential.

People are affected by the holidays in different ways, due to their personal life experiences and stories, so knowing when someone is exhibiting abnormal behavior is crucial. If someone you know is struggling or in crisis, connect them with resources or an agency where they can seek help. (see breakout box)

Crisis resources are a good place to start, but they aren’t the only solution. Some people can benefit from other avenues, such as yoga, meditation or meeting with a life coach. Some people might even find peace from getting out and volunteering. The key is connecting a person with a resource that works best for them.

“My hope is that our community takes a collaborative stance on this and openly talks about mental health, suicidal ideations and where to turn for help,” Francone concluded. “We should not only be talking about struggles, but where people should go and what they can do if they are struggling. By having these conversations with our loved ones and referring them to the right resources, we can make this holiday season a little better for everyone in our community.”

By the numbers

Suicide is a real growing crisis, and the best form of prevention is through education and discussion of the topic. According to Meghan Francone, director of Open Heart Advocates, most suicides occur in Moffat County from fall through spring, which is different and longer than other areas and communities.

• Colorado has among the highest suicide rates in the country, with suicide being the seventh leading cause of death in the state.
• About 40 percent of adults experience social anxiety around the holidays, according to the National Alliance on Mental Illness.
• According to the National Center for Health Statistics, the suicide rate across the U.S. increased by 35 percent between 1999 and 2018.
• A Harvard School of Public Health case study found that, in the U.S., states with high gun ownership experience more suicide when compared to those with low gun ownership. In Moffat County, the most common method of death by suicide is by the use of a firearm.
• According to the American Foundation for Suicide Prevention, nearly 50,000 people in the U.S. die by suicide and more than 1 million people attempt suicide annually.
• The Centers for Disease Control and Prevention recorded 1,282 total suicide deaths in 2018, which was the year with the most recent data available.
• It is estimated that COVID-19 will have an impact on suicide rates. Reach out when you see someone who needs help and always know that there are people who want to help you if you are experiencing a crisis.