It was Christmas Eve when George Bailey stared into the black depths of the river beneath the bridge in Bedford Falls, convinced that the world would be better off without him. That scene from the 1946 movie classic "It's a Wonderful Life" could well have given birth to the media myth that Christmas is a trigger for increased suicides and episodes of depression.
It is a baseless notion, according to a body of published studies by statisticians who have examined hundreds of thousands of suicides in the United States and around the world. The number of suicides goes down, not up, over the holiday season, by as much as 40 percent.
During the season of good cheer, there are certainly those whose blue mood stands in stark contrast to the season's bright lights and festivities. But pointing to the Christmas season as a cause of increased depression and risk for suicide is wrong, says Dan Romer, director of the Annenberg Adolescent Risk Communication Institute at the University of Pennsylvania.
"Holiday blues?" says Dr. Eric Caine, co-director of the center for the study and prevention of suicide at the University of Rochester Medical Center in New York. "I'm not sure. I just know I get a lot fewer admissions (to the psychiatric ward) over the holidays."
In one of the most thorough examinations of what researchers call acts of deliberate self-harm, which can be an indication of depression, Helen Bergen, research scientist at the University of Oxford, found that Christmas, for most people, is protective.
Bergen and colleagues reached this conclusion after examining emergency room admission records of 19,346 people in England and looking at daily rates of self-induced injury from 1976 to 2003.
Drug or alcohol overdoses, self-poisoning with gas or other harmful substances and self-inflicted injuries - with or without the deliberate intention to die - all decreased from average levels during the week of Dec. 19-26, Bergen and colleagues found, and these lowered levels held through New Year's Day.
The decrease in rates of self-inflicted damage before, on and immediately after Christmas and into the New Year was found regardless of age, family connections or social isolation, the researchers reported in the September issue of the journal Social Science & Medicine.
Even people with family relationship problems were less inclined to attempt to hurt themselves during the holidays. "These findings are contrary to the popular view that Christmas is a time of stress and arguments," Bergen says. Perhaps, she says, problems within the nuclear family ease up instead of intensify when the extended family is around.
Another possible reason depression and suicide rates fall this time of year is that the season, more than other times, is one of giving. "People tend to reach out over the holidays," says Dr. Douglas Jacobs, a psychiatrist at Harvard Medical School. Elderly people in nursing homes might suddenly get visitors. People who haven't heard from friends all year might get a card or a phone call.
It's only in the last year that the majority of news stories reflected the fact versus the myth about seasonal suicide rates, says Romer, who since 2000 has been tracking trends in media interpretations of the link between holidays and suicide. In a national search of news stories linking the holidays with suicide, he says, 9 percent of news organizations supported the myth in 2006, compared with 57 percent in 2005 and 77 percent in 1999.
This is not to say that the holidays are easy for everyone. "Some people have unreasonable expectations - the holidays have to be happy," says Dr. Ian Cook, director of the depression research program at the University of California, Los Angeles. If in-laws are sniping at you about your home, your food and your lifestyle; your 2-year-old has already broken his new toys and is wailing; and your sister's teenage daughter is sulking in the family room, happiness can be a tall order.
Others are reminded of losses at holiday time. Some churches have started offering a special service - more somber and reflective than joyful - on Dec. 21, often the darkest day of the year, or on Christmas Eve.
"The holidays put on us an expectation for a certain set of feelings," says the Rev. Larry Rice, pastor at the St. Thomas More Newman Center at Ohio State University, which will be celebrating a "Blue Christmas" Roman Catholic Mass on Christmas Eve. "Everyone around them seems joyful, and they're not feeling that."
Ryan Warne-McGraw, associate pastor at the Good Shepherd Lutheran Church in Irvine, Calif., said his church would hold its Blue Christmas service Thursday. Last year's service was a hit, he said, an acknowledgment that traditional services can be hard on widows, widowers, divorcees or people who have lost jobs or loved ones. "Not everyone wants to come and sing Christmas carols," he says.
It's that kind of cultural reaction - an extra dose of caring - that probably adds to the psychological protection of a season that seems to insist on happiness. No matter how bad it may seem, holiday rituals add up to more good than bad, buffering adults and children against depression and anxiety.
Barbara Fiese, chairwoman of psychology at Syracuse University, reviewed 32 studies done over 50 years and concluded that holiday family rituals may be annoying, but they're good for us. People with strong family routines and rituals at holiday time reported more marital satisfaction, better academic achievement among children and better overall health among family members, she found. Even in families in which there has been a divorce, the continuation of family rituals improves the children's ability to adapt and increases their stability.
"Each family defines its own rituals," she says. "It can be things as simple as unpacking a particular ornament or menorah, or cooking a dish that's been passed down for generations.... It provides an emotional connection, a symbolic bonding."
Certainly, many people feel alone during the holidays. But, Caine of the University of Rochester asks, "If you banned all holidays, do you think people would feel happier or sadder? If they were really bad for us, do you think they'd have been around for so long?"
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