OP-ED: How to Help Patients Get Through the Holidays

The holiday season, kicking off around Thanksgiving, often never truly ends. Whether they express it or not, your patients may need your support more than ever during this time. Here are some common struggles and ways you can intervene:

Grief and Loss

The holidays can intensely magnify the pain of missing a relative or dear friend. This “grief flare” can push a patient from normal acute grief into complicated or persistent complex bereavement disorder.

Intervention: Validate and normalize emotional expression, framing crying as a healthy parasympathetic response that helps regulate the nervous system. Directly ask patients about their coping mechanisms for loss and screen for complicated grief or major depressive disorder using validated tools like the PHQ-9.

Loneliness and Isolation

Increased social pressure and decreased routines can lead to profound feelings of isolation. Social isolation is more than just a mood state; it’s a quantifiable health risk that has been shown to increase inflammatory markers (such as C-reactive protein) and negatively affect cardiovascular health.

Intervention: Encourage patients to check in with their social support network, emphasizing the biological benefit of connection. Refer them to local community resources, social work, or group therapy, which offer structured social interaction and psychoeducation.

Safety and Prevention

The holidays introduce several biopsychosocial stressors that require proactive attention:

• Injury prevention: Remind patients about common household hazards. Fatigue and elevated stress reduce cognitive bandwidth, making patients more susceptible to lapses in judgment and minor accidents.
• Child safety: Discuss age-appropriate toys and the potential for complex items to cause frustration or injury.
• Travel stress: Advise patients on stress-free travel planning, including allowing ample time for airport security and practicing safe driving. Stress the absolute importance of wearing seatbelts. The physiological strain of travel, including sleep disruption, weakens the immune system and increases vigilance, potentially leading to road rage or distracted driving.

Diet and Exercise Compliance

Holiday gatherings often disrupt established healthy routines, leading to higher caloric intake and lower physical activity. This rapid shift can negatively impact glycemic control and lipid profiles, particularly in patients with pre-existing conditions like diabetes or hypertension.

Intervention: Provide proactive, non-judgmental guidance on managing diet during parties and maintaining a minimum level of physical activity. Encourage a “harm reduction” approach rather than strict abstinence. For example, advise patients to focus on protein and fiber first to slow glucose absorption, or to take a brisk 15-minute walk (which has been shown to temporarily lower blood pressure and improve insulin sensitivity) before or after a meal.

Finally, remind patients that the only thing that should be “stuffed” this season is the turkey—not their calendars, their unprocessed feelings (which increase allostatic load), or their arteries.

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