Last Christmas was the first Keith Franzese spent without his mom.
He said the lasagna didn't taste the same. The table was quieter. He put up the decorations that had always delighted her — a beloved fake tree, stockings ripe for filling — but he was heartbroken she wouldn't see them again.
"I have two kids, 11 and 9, and they bring up my spirits, but in the back of my mind there's always this feeling that one person is missing," said Franzese, whose mother Kathryn died at 71 from complications of a stroke. He anticipates the same void heading into the holidays this year.
A barrage of media insists this is the happiest time of year. But for many it's not.
The "holiday blues" — feelings of loneliness, loss or isolation that psychologists say can heighten during the holidays — affect people with our without mental health disorders. It can be brought on by grief or illness, spurred by the loss of a job or the end of a relationship, and compounded by the stress and pressure of the holidays.
"Holidays are a great example of expectations exceeding reality for most people," said Ken Duckworth, medical director at the National Alliance on Mental Illness. "I encourage people to reduce their media dose if they're sensitive to this idea of mismatch between reality and fantasy."
Duckworth says idealized images sold to people about what the holidays look like, and how they should feel, do not always align with family dynamics, the circumstances of people's lives or the other stressors they may face. Not everyone can afford to put presents under the tree. Many families don't have all the people they love reunited around the fire.
Tricia Heinz says it's devastating to see the disconnect between her own life and the media's steady stream of family togetherness. This is Heinz's second Christmas post-divorce. She said the end of her marriage completely changed the holidays for her and her two kids, one in high school and the other in college. Where there was one holiday, now there are two, and neither feels complete.
"Most of the year I can forget, but at Christmas, it's unavoidable," she said. "Mistletoe, those damned Hallmark movies, and even commercials make me cry. [It] may sound silly, but it’s real."
Heinz said what was once a joyful family event now feels perfunctory, as if they are all going through motions.
"That moment that used to be magical on Christmas morning is quiet, solemn, and everyone feels something nobody can quite articulate," she said.
Have a plan for dealing with grief
For those experiencing fresh grief, holidays can be particularly difficult. Data from the CDC shows people have a greater chance of dying in December or January than any other time of the year. Last year, more than a quarter million Americans died in December; for those families, this holiday season is marked with loss.
"This is almost a universal human heartache — your first Thanksgiving, your first Christmas, your first whatever your holiday is without your family member can be the hardest day," Duckworth said. "Whether you have a psychiatric vulnerability or not, the question is, 'who do you surround yourself with to help you cope with that?'"
Duckworth lost his sister five years ago, and says he's been intentional about staying in close touch with her children on holidays.
"Maybe it's just a text, maybe it's a phone call, but it kind of keeps your spirit alive. It makes you feel less alone," he said.
The holiday suicide myth
While the "holiday blues" are real, they do not lead to increased suicides, despite the link made in "It's a Wonderful Life." Suicide rates are historically low in December, according to data from the Centers for Disease Control and Prevention (CDC), and highest in the spring and summer. News media perpetuates the myth. During last year's holiday season, two-thirds of news stories (including local news) that wrote about suicides during the holidays drew incorrect connections between the two, according to an analysis released this month by the Annenberg Public Policy Center at the University of Pennsylvania, which has performed the tracking since 1999.
"For someone in a suicide crisis during the holidays, reading that information might make suicide seem more acceptable because others are more likely to be turning to it. ... It’s not a message that should be promoted," said Dan Romer, research director of the Annenberg Public Policy Center.
Experts don't know for sure why suicides fall around the holidays, but there are some studies that suggest meteorological conditions may be a factor. Suicides tend to rise in conjunction with warmer weather. Psychologist Deborah Serani, a professor at Adelphi University in New York, says many people experience a "depressive calm" in the winter, where a person is too fatigued to act on a suicidal urge. When spring arrives, the warmth leads to an "energized despair" which may prompt action.
Serani says suicide rates may also drop around the holidays because people with depression may feel more supported in the presence of family and close friends.
Whether you're suffering from a mental health condition or not, experts say there are ways all of us can cope with the anxiety the holidays may bring:
Think carefully before breaking up with your therapist
If you see a mental health care provider, the holidays are not the best time to stop or change care.
"Make sure you follow your treatment plan for keeping depressive symptoms at bay," Serani said. "Don't miss psychotherapy sessions, remember to take medication, and practice good self-care, like eating healthfully and keeping a structured sleeping schedule. Exercise and getting sunlight — be it outdoors or in a pool of indoor sunlight — also help your well-being."
Don't isolate
If you find yourself feeling sad or overwhelmed, isolating is not the answer. Try to stay connected to the people who are part of your support system.
If you're a serious introvert, consider limiting your time at the office party rather than avoiding it completely. You don't necessarily have to RSVP yes to every holiday party, but you should say yes to that lunch invitation from a good friend.
If you can't see people in person who are part of your support system, call or text them.
Make a safety plan
If you have a mental health condition or you struggle with suicidal thoughts, it's good to have a safety plan in place.
"If you begin to feel suicidal, these will be the steps you and others take to keep you safe," Serani said. "This includes knowing which mental health professionals to call, which hospitals, if necessary, to use, which family members and friends to ask for assistance ... and knowing exactly how this process will unfold."
Have realistic expectations
Psychologists say it's important to remember that what you see on social media and ads is polished and curated, not real life. Feelings about the holidays will inevitably vary from person to person or even from year to year. Try not to put undue pressure on yourself.
"If my sister was alive I would enjoy the holidays a lot more, and that's a humbling reality," Duckworth said. "I don't tell people to have a wonderful holiday. ... Have a reasonable one."