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By Jane Elliott
Health reporter, BBC News
Hospital often see admissions increase in the New Year
As millions of Britons prepare for the festive season, for a minority fun and laughter is the last thing on their minds.
For some people with mental health problems, the season of jollity is so stressful it can tip them over the edge.
Psychiatrists report an increase in admissions in the immediate aftermath of the holiday period.
For John, who does not want his full name revealed, the whole festive season is mired in miserable memories, including of an unhappy childhood and of a suicide attempt.
Stress
The build-up to Christmas usually starts in September for John - and its effect lasts until early February.
During this time his depression and mental illness always get worse.
"I have schizophrenia and schizophrenia affective disorder and although I have to battle with severe mental illness all year round, Christmas is more unbearable because of memories of abuse by a parent," said John.
For a three-week period over Christmas and the New Year, John needs to be sedated to minimise the risk to himself.
I can feel my anxiety levels starting to rise, which increases the risk to my personal safety
John
"I am a suicide risk at other times, but at Christmas the risk is greater and as it approaches I can feel my anxiety levels starting to rise, which increases the risk to my personal safety.
"Christmas causes major distress for many people like myself.
"Not only is most of the country engaged in jollity and festive cheer, but the country also seems to go into total shut-down mode.
"Services and drop-in centres close, friends and people around you tend to go incommunicado and spend time with family, and the psychiatric wards take on a very different feel, as doctors and nurses try to send all those who can go home home, making them even more difficult places to be.
"The worst times that I have had in hospital have been those in and around Christmas and the New Year because there is virtually no-one there."
Tense
Another person who has had a problem with Christmas is Edward Jones, 58, from Somerset.
Edward has schizophrenia, as did his mother, and he said this has made for very difficult Christmases in the past.
"Christmas with my mother invited to the extended family get together was a bit tense.
"Finally, when the kids were about two and four, my ex-wife's grandmother put in a request that my mother not be invited to these events in future, because of her laconic, non-participative behaviour being an 'embarrassment'.
"I acceded to the request because I wanted the kids to get as much exposure to their great-grandmother as possible.
"However, I was deeply hurt and offended.
"Thereafter, I used to go and see my mother alone on Christmas Eve - a very tense and intense meeting in her flat over the far side of town in premises that felt like a replica of those of Miss Haversham in Great Expectations.
"Once the Christmas Eve event was over, Christmases were OK except for my inner sadness at my mother's exclusion, even though we didn't get along at all.
"Looking back, it must be a common dilemma of many friends and relatives of those with schizophrenia; hopefully less so with current progress in education and media focus."
This year Edward plans to spend Christmas alone, reminiscing on memories of his son who was killed in a car crash last year.
"I have set Christmas Day aside as a cry day, that does not mean I will cry, but I could.
"It is a time to reflect."
Hospitals
Dr Mike Isaac, consultant psychiatrist at south London's Maudsley hospital, said it was a fact that for mentally ill people, like Edward and John, Christmas can prove extremely stressful.
"I think that part of the problem with Christmas is that there is nothing they can do about it.
"Christmas is just there. Also it falls on one of the shortest days of the year, which can affect some people."
[Christmas] is the time when lots of places used by people with mental health problems close their doors and many do not open them again until January
Dr Mike Isaac
Dr Isaac said psychiatric hospitals regularly see an influx of patients in January, patients for whom the stress of the festive period has proved too much.
"January is one of the busiest times for admissions.
"Another problem about Christmas is it is the time when lots of places, used by people with mental health problems close their doors and many do not open them again until January."
Dr Isaac said there was a slight increase noted among suicide levels.
He added that other religious festivals such as Diwali and Eiid do not have the same impact on stress levels.
"Everything does not shut-down in the country for these the same way as it does for Christmas," he said.
Isolation
Paul Corry, Rethink's director of public affairs said: "Christmas can be a difficult time of year for everyone and be fraught with tensions that exacerbate existing mental health problems.
"People with severe mental illness can become very isolated if their usual support services shut down over the holiday period.
"What helps is having access to the right kind of help, such as seeing a GP or therapist, early on."
Anyone needing help over the Christmas period can call the Samaritans on 08457 90 90 90.
Health reporter, BBC News
Hospital often see admissions increase in the New Year
As millions of Britons prepare for the festive season, for a minority fun and laughter is the last thing on their minds.
For some people with mental health problems, the season of jollity is so stressful it can tip them over the edge.
Psychiatrists report an increase in admissions in the immediate aftermath of the holiday period.
For John, who does not want his full name revealed, the whole festive season is mired in miserable memories, including of an unhappy childhood and of a suicide attempt.
Stress
The build-up to Christmas usually starts in September for John - and its effect lasts until early February.
During this time his depression and mental illness always get worse.
"I have schizophrenia and schizophrenia affective disorder and although I have to battle with severe mental illness all year round, Christmas is more unbearable because of memories of abuse by a parent," said John.
For a three-week period over Christmas and the New Year, John needs to be sedated to minimise the risk to himself.
I can feel my anxiety levels starting to rise, which increases the risk to my personal safety
John
"I am a suicide risk at other times, but at Christmas the risk is greater and as it approaches I can feel my anxiety levels starting to rise, which increases the risk to my personal safety.
"Christmas causes major distress for many people like myself.
"Not only is most of the country engaged in jollity and festive cheer, but the country also seems to go into total shut-down mode.
"Services and drop-in centres close, friends and people around you tend to go incommunicado and spend time with family, and the psychiatric wards take on a very different feel, as doctors and nurses try to send all those who can go home home, making them even more difficult places to be.
"The worst times that I have had in hospital have been those in and around Christmas and the New Year because there is virtually no-one there."
Tense
Another person who has had a problem with Christmas is Edward Jones, 58, from Somerset.
Edward has schizophrenia, as did his mother, and he said this has made for very difficult Christmases in the past.
"Christmas with my mother invited to the extended family get together was a bit tense.
"Finally, when the kids were about two and four, my ex-wife's grandmother put in a request that my mother not be invited to these events in future, because of her laconic, non-participative behaviour being an 'embarrassment'.
"I acceded to the request because I wanted the kids to get as much exposure to their great-grandmother as possible.
"However, I was deeply hurt and offended.
"Thereafter, I used to go and see my mother alone on Christmas Eve - a very tense and intense meeting in her flat over the far side of town in premises that felt like a replica of those of Miss Haversham in Great Expectations.
"Once the Christmas Eve event was over, Christmases were OK except for my inner sadness at my mother's exclusion, even though we didn't get along at all.
"Looking back, it must be a common dilemma of many friends and relatives of those with schizophrenia; hopefully less so with current progress in education and media focus."
This year Edward plans to spend Christmas alone, reminiscing on memories of his son who was killed in a car crash last year.
"I have set Christmas Day aside as a cry day, that does not mean I will cry, but I could.
"It is a time to reflect."
Hospitals
Dr Mike Isaac, consultant psychiatrist at south London's Maudsley hospital, said it was a fact that for mentally ill people, like Edward and John, Christmas can prove extremely stressful.
"I think that part of the problem with Christmas is that there is nothing they can do about it.
"Christmas is just there. Also it falls on one of the shortest days of the year, which can affect some people."
[Christmas] is the time when lots of places used by people with mental health problems close their doors and many do not open them again until January
Dr Mike Isaac
Dr Isaac said psychiatric hospitals regularly see an influx of patients in January, patients for whom the stress of the festive period has proved too much.
"January is one of the busiest times for admissions.
"Another problem about Christmas is it is the time when lots of places, used by people with mental health problems close their doors and many do not open them again until January."
Dr Isaac said there was a slight increase noted among suicide levels.
He added that other religious festivals such as Diwali and Eiid do not have the same impact on stress levels.
"Everything does not shut-down in the country for these the same way as it does for Christmas," he said.
Isolation
Paul Corry, Rethink's director of public affairs said: "Christmas can be a difficult time of year for everyone and be fraught with tensions that exacerbate existing mental health problems.
"People with severe mental illness can become very isolated if their usual support services shut down over the holiday period.
"What helps is having access to the right kind of help, such as seeing a GP or therapist, early on."
Anyone needing help over the Christmas period can call the Samaritans on 08457 90 90 90.