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Getting through the holidays: a time of anticipation or anxiety?

The annual stretch of holidays from Thanksgiving through New Year’s Day typically brings a range of emotions when it comes to gathering with family and friends. Some people aren’t excited, rather, they are exhausted with the prospect of “spreading holiday cheer.” They may have a sense of dread, which makes them wonder why they can’t relax and enjoy the holidays.Gingerbread man cookie with broken leg and surprised face, illustrating how some may face increased social anxiety around holidays

They are far from alone.

Mental health professionals say anxiety is often at its peak this time of year. Starting with the traditional Thanksgiving feast, people who suffer from social anxiety disorder face a burden that their family members might not understand or appreciate.

“There’s this idea that holiday gatherings with family are supposed to be joyful and stress-free,” Ken Duckworth, MD, medical director of the National Alliance on Mental Illness (NAMI), said in an interview noted on the NAMI website. “That’s not the case. Family relationships are complicated.”

What causes anxiety around family gatherings?

The holiday season creates expectations that family members get together and enjoy each other’s company. Whether Thanksgiving, Christmas, Hanukkah, Kwanzaa, New Year’s or another day or days of celebration, family traditions can run deep, making it seem unacceptable to avoid the event – or even to appear down or anxious while there.

Every family, of course, is different. And each social setting is different.Family with balloons in front of their faces, demonstrating how some may feel anxious when getting together at social gatherings

When families get together, there could be sadness over a loved one who passed away since the last gathering, apprehension over bringing a new spouse or partner into the fold, fear of getting drawn into arguments over politics or culture, anxiety associated with discussing personal matters, or feelings of being judged and compared to others in the family.

For some, these feelings are passing and don’t stand in the way of the joy of getting together. But people suffering from social anxiety might be filled with dread over the prospect of a holiday gathering where others seem to be enjoying themselves.

The National Institute of Mental Health (NIMH), defines social anxiety disorder as an “intense, persistent fear of being watched and judged by others.” People with the disorder can start to worry about a social event weeks before it occurs, the NIMH notes. They might also decide to avoid places or events in order to mitigate their anxiety.

The NIMH says that while risk for social anxiety disorder may run in families, the exact causes aren’t known. Anxiety and fear stem from several parts of the brain, researchers have found, and genetics influences how these areas of the brain function.

Licensed mental health professionals can help determine a diagnosis of social anxiety disorder and provide treatments that may help. Common treatments may include psychotherapy, medications, and/or participation in a support group, the NIMH says.

The key to coping: plan ahead

If you have an unusually high level of anxiety about gathering with family this holiday season, it’s helpful to plan ahead. Mental health professionals recommend developing a list of topics you’d like to talk about. You can rely on these to gently change the subject if you find yourself in an uncomfortable conversation with family members.

Another coping mechanism is to plan a temporary escape, such as a quiet place in the house or gathering spot where you can be alone for a moment.

It’s important to recognize – and give yourself grace when doing so – that it might be best to say “no” to some gatherings and activities.

The word “no” repeated on a black background showing the importance of declining invitations where it may impact your mental health

“We can all benefit by enjoying moments that bring meaning and belonging, but those times are different for each of us,” Rebecca W. Brendel, MD, JD, president of the American Psychiatric Association, said in an news release. “It’s also okay to opt out of some or all events if they bring more stress or distress than joy. There is no one right way to spend the holiday time of year.”

If you feel you could be suffering from social anxiety during the holidays, talk with your healthcare provider, who can determine whether you need to be evaluated by a mental health clinician for further treatment.

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For more information about this and other topics, please visit:

Happy(er) Holidays

The most wonderful time of the year?

5 tips for easing the post-holiday blues

Our articles are for informational purposes only and are reviewed by our Medical Information team, which includes PharmDs, MDs, and PhDs. Do not make any changes to your current medications or dosing without consulting your healthcare provider.

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