Mental health issues such as depression and anxiety can be exacerbated throughout the holidays and can carry over into January, according to an Alabama mental health counselor and clinical director.
“I always tell people to begin checking in with friends and family more frequently starting in November until the end of January,” said Malissa Galliher, a clinical director and counselor at JBS Mental Health Authority, a regional mental health facility that serves three counties in Alabama: Jefferson, Blount, and St. Clair.
Though it can be a happy time for many, the rapid succession of holiday events—beginning with Thanksgiving and ending in the New Year—can bring about loneliness and grief, manifesting in depression and anxiety, Galliher said.
“The holidays can be a reminder of what one’s lost, particularly if someone has lost a loved one around the holidays,” she said. “Then there are those who do have family, who often experience increased anxiety because they are out of their normal routine.”
People Who Love Holidays Also Affected
For those who enjoy the holidays as a Hallmark-movie chariot ride packed with friends and family celebrating the years past and present, January can bring a crash back down to an empty routine moving slowly forward, away from those moments with loved ones and back to the short, cold days of winter.“Even somebody who has a great family and loves the holidays who makes it through the New Year can hit January and find that they can get depressed, because now they are coming off the high and rush of the holiday season, and there’s nothing really else to look forward to,” she said. “That’s why we encourage people to start checking in with people—especially those with mental illness—in November and continue on through January.”
As the early darkness persists, by January it can become tiresome, she said.
“That really affects moods,” she said. “We know that lack of sunlight will severely impact an individual’s overall mental health. It can be a very hard time.”
Checking in with those who could be struggling with mental health issues is crucial, even if it’s just a text, phone call, or card.
Changes in communication patterns can be an indicator that there is a shift in mood, she said.
Disruptions in Routine
Jeremy Blair, CEO of WellStone, a northern Alabama community health center serving Madison and Coleman counties, echoed Galliher when he said the facility’s busiest times are after Christmas and the New Year, in the first week of January.“A person’s routine is disrupted in a lot of different ways, which leads to depression, anxiety, and intrusive thoughts creeping in when people are more isolated,” Blair said.
Humans, being creatures of routine, can face interruptions in their regular patterns that in turn lead to depression and anxiety, even after January.
February brings Valentine’s Day, a holiday celebrating romantic love that many do not have, he said, leaving them to confront this reality amid its commercialized insistence on having a companion.
For high schoolers, Blair said depression and anxiety can increase in summertime. Suddenly, teenagers are cast out of their sense of purpose and into more freedom, which brings about a variety of responses.
More Open Discussion of Mental Health
A significant change in the narrative around mental health came in 2020 when a global shift in routine caused by the pandemic forced the average person to confront psychological problems that might have been masked by years of socialization that came to a halt with the lockdowns.“We were shown that we can all have mental health struggles at some point in our lives,” Blair said. “People who never dreamed of dealing with any kind of mental health issues found themselves facing a range of issues during 2020. So, I think in some ways, the stigma around mental health dissipated during that time.”
‘988’ and Crisis Care Clinics
Alabama has seen two new developments to meet the demand of mental health challenges that allow for a direct line to treatment, bypassing a long wait in an emergency room.“We have the 988 national suicide hotline that one can call if you are having a medical emergency, and you can speak to a mental health professional,” Galliher said.
In October 2020, the National Suicide Hotline Designation Act was signed into law, incorporating 988 as the new Lifeline and Veterans Crisis Line number, the FCC said.
“In 2020 alone, the U.S. had one death by suicide about every 11 minutes—and for people aged 10–34 years, suicide is a leading cause of death,” the FCC said.
Though there had been a 1-800 national suicide hotline, it didn’t meet the emergency demand that 911 does, Galliher said.
If someone were to call 911 for a mental health crisis, dispatch would send an emergency responder and police. From there, the person could end up in an emergency room with a lengthy wait, or officers would have to come up with charges that kept the person in custody until they could be seen by a professional, Galliher said.
“Now, all you have to do is dial 988 and it connects you immediately to a mental health professional in your region,” Galliher said. “If I’m on the phone with someone and I don’t feel like the situation is deescalating and I need more support, then I could call 911 and have law enforcement go out there while still on the phone with that person.”
That’s where the crisis care clinic comes in, Galliher said.
“Now, with crisis care centers, they can be taken to the closest one where they can immediately be seen by a mental health professional instead of taking the person to a holding cell or an emergency room where they had to wait for hours,” Galliher said.
Though not new to the world of mental health, crisis care centers are new to the southern regions of the United States, she said.
Meeting Immediate Needs
Crisis care centers, open 24 hours a day, are designed to take in people for 23 hours or less, where they can stay on temporary observation beds, Galliher said.“You have individuals who maybe had too much to drink, and they have become depressed and are contemplating suicide,” she said. “This is a place they can come and usually after sobering up they can address their substance use.”
People who are having psychotic episodes can find refuge in crisis care clinics where they can be evaluated and prescribed medication while being monitored, she said.
“After the 23 hours, if they still need treatment, they can move over to the extended observation unit,” she said. “At JBS, we have 32 temporary observation beds, which are recliners, and then we have 16 extended observation beds with an average length of stay at five to seven days.”
‘That’s Not Who They Are’
In addition to checking in on people, Galliher said that taking shame out of the picture of mental illness is a step toward helping those through while making it easier for them to openly share about it.“There’s no shame if someone has cancer,” she said. “We just want them to get better, which is why language is very important here.”
For example, someone may have cancer, she said, but that cancer doesn’t define that person.
“They are individuals dealing with cancer,” she said. “It’s the same with an individual with schizophrenia or one who is dealing with depression.”
A person isn’t “a schizophrenic,” she said, but one who is dealing with schizophrenia.
By rephrasing how society labels someone who is struggling in this way, it can bring back into the picture who they were before the mental illness, she explained.
“Mental illness has been stigmatized for many years and there’s been so much shame in saying, ‘Hey, I’m having these feelings and thoughts,’” Galliher said. “People have been labeled quote-unquote ‘crazy,’ but that’s not who they are.”
