holiday health problems essay

• Mental Health

The Inevitable Difficulty of Being Chronically Ill During the Holidays

When I pack my bags to go to my in-laws' house for Christmas, I have to bring an entire bag of medication. There are migraine meds, thyroid meds, anti-anxiety meds , antidepressants, anti-nausea tablets, pain meds, and rescue meds, among others. There's my weekly pill organizer and ice packs and sleeping mask and earplugs.

It's not just the packing process — everything is more complicated with a chronic illness , and holidays are no exception. In my experience, a chronically ill body is a body that functions best when it rigidly adheres to schedule and routine. To say I am a creature of habit is a great understatement. I thrive under a strict routine, and habits are guardrails on the highway of my illnesses. My body functions best when I go to sleep by 10 p.m. and eat the same things at the same time (relying on "safe foods" that I know won't trigger my symptoms, like oatmeal in the morning and an egg sandwich for lunch). It's not just a preference — I notice that my migraines flare when I wait too long to eat or I don't get enough sleep.

And what are the holidays if not a break in routine? They simply aren't a time for rigid schedules for most people. I dream of being able to stay up late into the night talking with friends without worrying that a migraine will greet me in the morning. I would love to drink a few glasses of red wine without the knowledge that it will spark a pain flare. I want to go with the flow and be able to hang out with family that I don't get to spend nearly enough time with outside of the holidays.

I dream of not living like this.

But that's not how it is. If I want to control my illnesses in a meaningful way, I have to prepare and abide by a schedule and skip things I would prefer to indulge in. Right now, I'm planning a birthday party for my husband (whose birthday is on Christmas!), and we're trying to figure out what time we should have friends meet us. I want to do it late enough that everyone has had dinner and seen their families for the day, but early enough that I'm not exhausted and out of spoons by the time we start the festivities. We have a family event before the birthday party, and I wish I were the kind of person who could do two outings in a row without worrying that I'll be dry-swallowing Tylenol and chugging espresso in between them — but I'm not.

So what does this mean? It means that I already know I'll spend the day resting before the family event and the birthday party, and I'll make sure I sleep in the next day. I'll be especially careful to drink enough water and eat enough food that day to control my symptoms further, and I'll keep a rescue migraine med in my purse in case it all becomes too much.

I dream of not living like this. Life in a chronically ill body feels like what I imagine it would be like to be a wild animal trapped in a cage. If I could, I would stay up late watching movies with my in-laws, and we would drink wine and eat dark chocolate, and the price I paid for those indulgences wouldn't be pain. But the truth is this: I know my body, and I know what is waiting for me if I don't prepare. I know I will be left in a dark room with a sweating ice pack held to my throbbing head. It will hurt to chew and blink and stand up to make my way to the bathroom; the sound of the thoughts in my head will be too loud. The only thing I will want to do is sleep, and when that comes, it will be fitful and full of dreams. When the pain finally leaves, I will be exhausted, hungover past anything I've ever managed to reap from drinking.

I know this isn't how other people live their lives. I know they aren't beholden to the whims of their bodies the same way I am, and in my worst moments, this realization leaves me achingly jealous.

And yet even in a life with this much pain, I'm lucky.

And yet even in a life with this much pain, I'm lucky. I've been with my husband for almost 10 years, since I was 21, and I've known his family for nearly as long. They have seen me battle thyroid cancer and migraines and a traumatic brain injury; they know what my body needs, and more than that, I feel free to allow myself to take what I need in front of them. If I disappear from dinner, they know I'm taking a rest, and they hope I'll be back, but they won't judge me if I just go to sleep instead. They know that each night, before we go to bed, my husband will fill up my ice pack, and my mother-in-law makes sure she buys extra bags of ice if we're running low. When we go somewhere, they make sure I always have a way to leave if my symptoms become overwhelming. In short, they give me the space to manage my illnesses the best I can. I'm grateful for that every day — I know that there are many in the chronically ill community who deal with the added pressure of unsupportive family members.

Holidays are a break, but a life with a chronic illness is a life without breaks. How I wish it were otherwise. In the meantime, I'll make sure all my medications are refilled and packed, and I'll thank my family for understanding my limits, and I'll make sure there's room in the car for my bag of meds and supplies. This is the truth of a chronically ill body and the fight to live alongside it instead of in opposition to it.

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Mental Health and the Holiday Blues

Posted on November 19, 2014

Arlington, Va. —High expectations, loneliness and stress can lead to the “Holiday Blues” during the season from Thanksgiving to New Year’s. In most cases symptoms are temporary, but they can be serious if they last for more than two weeks, leading to clinical anxiety and/or depression.

According to a recent survey, the National Alliance on Mental Illness (NAMI) reports that approximately 24% of people with a diagnosed mental illness find that the holidays make their condition “a lot” worse and 40% “somewhat” worse.”

Approximately 300 individuals participated in the survey, Nov. 13-18, 2014, with 292 answering the specific question. Others detailed experiences.

“For many people the holiday season is not always the most wonderful time of the year” said NAMI medical director Ken Duckworth. “What the survey shows is a tremendous need for people to reach out and watch out for each other in keeping with the spirit of the season.”

“The holiday season beams a spotlight on everything that is difficult about living with depression,” said a Massachusetts woman who responded to the survey. “The pressure to be joyful and social is tenfold.”

Approximately 755 of overall respondents reported that the holidays contribute to feeling sad or dissatisfied and 68% financially strained. 66% have experienced have loneliness, 63% too much pressure and 57% unrealistic expectations. 55% found themselves remembering happier times in the past contrasting with the present, while 50% were unable to be with loved ones.

NAMI offers information about holiday blues at: www.nami.org/newsroom

Key points include:

• Holiday blues are different from mental illness, but short-term mental health problems must be taken seriously. They can lead to clinical anxiety and depression.
• People already living with mental illness are often affected by the holiday blues. Individuals, families and friends should know symptoms and watch out for each other.
• There are many ways to avoid or minimize holiday blues.
• Alcohol is a depressant. Don’t drink when feeling stressed or down.
• Local NAMI affiliates can be a source of support.
• It’s a myth that suicides increase during the holidays, but suicide risks are always serious.
• Children and teens get the blues too. The highest rate for child psychiatric hospitalizations occurs in winter.

For tips on avoiding holiday blues, see www.nami.org/holidayblues

“Be patient. Keep expectations low. Inform family in advance of your limits,” said one survey respondent.

“If holidays were a special time in the past and you try to recreate a time long gone, you are setting yourself up for sadness,” said another. “Create new memories. Have some fun.”

NAMI is the nation's largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. 

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NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264 , text “helpline” to 62640 , or chat online. In a crisis, call or text 988 (24/7).

Essay: Stress, depression and the holidays — how to cope this season

Everyone feels blue or sad sometimes, especially these days with the weather getting colder and darker and the stress of the holidays right around the corner.

These feelings can be short-lived and pass within a couple of days. Unfortunately, due to the increased isolation and financial pressures, many of us are facing more serious mental health issues such as depression.

Depression can interfere with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness. People often give you advice to “just get over it” or “pull yourself up by your bootstraps.”

There are several types of depression. Seasonal affective disorder, a type of depression, is most common in areas of the country that do not get a lot of sunlight during parts of the year.

Adjustment disorder with depressive symptoms is also quite common now as a result of people struggling with the changes brought about by COVID-19 and its impact on our daily living.

There are many people with a depressive illness that do not seek help but most people with depression can get better with treatment.

Medications, psychotherapies and other methods can effectively treat people with depression. If you are experiencing any symptoms of depression such as trouble sleeping, trouble eating, extreme sadness, loss of interest in things, feeling hopeless or helpless and you would like help, there are many places to turn. You can talk to your primary care provider about how you are feeling and he or she can help you negotiate getting the services that will help.

Mental health clinics typically house providers, such as psychiatrists, psychologists, social workers or mental health counselors. There are also private mental health practitioners and clinics as well as employee assistance programs that can be accessed through your place of employment. Often the first few visits to an employee assistance program is free of charge.

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Sometimes people experiencing depression and other mental illnesses feel there is no place to turn and begin to look at harming themselves as an option. If you are thinking about harming yourself, or know someone who is, tell someone who can help immediately.

Do not leave your friend or relative alone, and do not isolate yourself.

Call your doctor.

Call 911 or go to a hospital emergency room to get immediate help, or ask a friend or family member to help you do these things.

Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor. suicidepreventionlifeline.org

Call the Mobile Crisis Assessment Team 315-732-MCAT (6228).

When you face a stressful event or major life change, you can take some steps to care for your emotional well-being.

Do what works for you. For example, you can:

• Talk things over with supports (family and friends)

• Try to keep eating a healthy diet

• Stick to a regular sleep routine

• Get regular physical activity

• Engage in a hobby you enjoy

• Find a support group geared toward your situation

• Find support from a faith community

If you use these kinds of self-care steps but they don't seem to be helping, be sure to talk to your doctor.

Most people find treatment helpful, and they often require treatment only briefly. However, others may benefit from longer treatment.

For additional resources visit: nimh.nih.gov

Jodi Kapes is the director of behavioral health at Mohawk Valley Health System in Utica.

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Expert Commentary

Seasonal holiday injuries: A research roundup

Holidays are a time for celebration, but also a source of injuries. Several research studies examine both common and uncommon types and sources of seasonal holiday injuries, which usually peak on the week after Thanksgiving and continue until the end of the year.

Republish this article

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License .

by Naseem S. Miller, The Journalist's Resource December 20, 2023

This <a target="_blank" href="https://journalistsresource.org/home/seasonal-holiday-injuries-a-research-roundup/">article</a> first appeared on <a target="_blank" href="https://journalistsresource.org">The Journalist's Resource</a> and is republished here under a Creative Commons license.<img src="https://journalistsresource.org/wp-content/uploads/2020/11/cropped-jr-favicon-150x150.png" style="width:1em;height:1em;margin-left:10px;">

Winter holidays bring celebrations, family traditions, light decorations, special foods and delicacies, and indoor and outdoor activities.

But they can also bring injuries and health problems. Research shows a range of injuries in kids and adults stemming from swallowing Christmas ornaments and decorations, falling from a ladder when putting up lights — or falling from Santa’s lap , suffering burns from touching the candles on a menorah or from biting into a hot deep-fried donut. In some, binging on alcoholic drinks can induce atrial fibrillation, leading to a condition known as “holiday heart syndrome.”

Each year, nearly 18,400 people visit emergency rooms because of accidents with Christmas decorations, according to USAFacts , a non-profit organization that provides U.S. data and reports, using data from the Consumer Product Safety Commission. The peak of those injuries is usually the Sunday after Thanksgiving.

To be sure, compared with other holidays such as Memorial Day, Fourth of July and Halloween, Christmas has a lower number of injuries, a 2010 study found . But seasonal holiday injuries and health issues make headlines each year.

Earlier this month, a Michigan woman suffered significant burns after her robe caught fire at a church’s Christmas event, reported Hometown Life , a Gannett-owned publication. “Someone put a candle in the wrong place,” the fire chief told the news outlet. A 9-year-old boy suffered injuries after falling from a float in the West Alabama Christmas Parade, according to WVUA 23 News . And ABC News ran an explainer about holiday heart syndrome.

For journalists looking to inform their audiences about health-related holiday topics, we’ve gathered several studies. They’re listed in order of publication date.

Research roundup

Enjoy the Holiday Spirit, Not the Holiday Heart Ali Syed, Benjamin D. Seadler, David L. Joyce. The Journal of Thoracic and Cardiovascular Surgery, January 2023.

Alcohol is typically part of holiday celebrations and gatherings in Western society. Short-term alcohol use in excess and binge drinking are linked with memory loss, impaired judgment, unintentional injury, violence and driving under the influence.

But a less commonly known consequence of binge drinking is alcohol-induced atrial arrhythmia, known as “Holiday Heart Syndrome,” which was first described in the 1970s, the authors write. (In the United States, 5% to 10% of new atrial fibrillation diagnoses are related to alcohol abuse.)

Symptoms include palpitations, shortness of breath, anxiety, weakness and chest pain.

The authors note that the exact biochemistry of the syndrome is unknown, but the correlation between atrial fibrillation and binge drinking is “undeniable.”

Avoiding A Crisis at Christmas: A Systematic Review of Adverse Health Effects of ‘Chrishaps’ Caused by Traditional Hazard Sources and COVID-19 Ursula Wild, David M. Shaw, Thomas C. Erren. Australian and New Zealand Journal of Public Health, February 2022.

This study aims to find out “which hazards have been scientifically associated with old Christmas essentials such as decoration, gifts, menus, and Santa himself, as well as new challenges associated with COVID‐19?”

The authors examined the findings of 30 studies, most of which were case reports or retrospective analyses, which are types of studies that examine data collected in the past.

The various hazards of Christmas included allergic reactions to poinsettias, Christmas trees and candles; swallowing of Christmas decorations; and falling from ladders, roofs and furniture. In one case , a patient had a supposed case of cyanosis — a condition where the skin, lips and nails turn blue — after receiving a blue bed linen as a Christmas gift.

Christmas dinners can also pose risks, such as higher cholesterol levels and weight gain, the authors write. Also, “two other risks from eating were documented: abdominal pain after eating without chewing and eating a piece of Christmas cake together with a plastic robin ,” which was part of the cake decoration, they write.

Pediatric Ingestions of Christmas Past, Present, and Future: A Review of Holiday Trends, 1997 to 2015 Patrick T. Reeves, Jayasree Krishnamurthy, Eric A. Pasman and Cade M. Nylund. Clinical Pediatrics, February 2019.

The authors use National Electronic Injury Surveillance System data from 1997 to 2015, focusing exclusively on cases of children, up to 17 years old, who went to an emergency department due to ingesting Christmas decorations, including ornaments, bells and candles during December and January.

There were an estimated 22,224 such cases over the period studied. Children aged 2 and younger accounted for 84% of the cases. Almost 96% were either treated and released or examined and released without treatment.

The peak of such injuries occurred during the Christmas week.

 “Future advocacy efforts might focus on improving social awareness, parental education, or even federal oversight with regard to these possibly dangerous decorations,” the authors write.

“Oh the Weather Outside is Frightful”: Severe Injury Secondary to Falls While Installing Residential Christmas Lights Michael R. Driedger, et al. Injury, January 2016.

The study examines the health outcomes of 40 patients in Canada who were admitted to a level 1 trauma center from 2002 to 2012 with severe injuries suffered due to falling while installing Christmas lights. The researchers found this activity can result in life-altering injuries.

In total, 95% of the patients were men with a mean age of 55. Most of the falls (65%) were from ladders and 30% of the patients fell from a roof.

The most common injury was to the head and torso. About 43% of the patients had spine injuries.

“Given the heights associated with this activity, as well as the often hazardous weather conditions, adherence to safety precautions is essential,” the authors write.

Seasonal Foreign Bodies: The Dangers of Winter Holiday Ornamentation Andrew T. Trout and Alexander J. Towbin. Pediatric Radiology, October 2014.

Children can suffer minor or severe injuries if they swallow winter holiday decorations and ornaments. These injuries mostly occur in children under 5.

In this “pictorial essay,” the authors provide radiology images of a wide range of holiday ornaments they’ve seen in children, including whole glass baubles, large and small, metal hooks used to hang ornaments on trees, small plastic ornaments, individual Christmas lights and Hanukkah decorations, including spinning tops and foil-wrapped coins.

Radiologists play a key role in identifying these foreign bodies in children, the authors write.

“Around the winter holidays, ornaments and decorations can become a source of foreign bodies for pediatric patients, and familiarity with the appearance of these seasonal foreign bodies can be helpful in their identification,” they write.

Jewish Holidays and Their Associated Medical Risks Jacob Urkin and Sody Naimer. Journal of Community Health, June 2014.

This study summarizes the findings from the existing literature regarding the health hazards related to celebrating Jewish holidays, including Rosh Hashana, Yom Kippur, Passover, Sukkot, Purim and Hanukkah.

The authors highlight several injuries related to Hanukkah, which lasts eight days — starting in late November or in December — and is observed by lighting candles on a candelabrum called a menorah.

“Most of the injuries in Hanukkah are related to burns in children who were carelessly handling lighted candles,” the authors note.

Children often receive foil-wrapped chocolate coins, or gelt, during Hanukkah. Another source of injury is children ingesting the foil covering gelt.

The most popular sweet during Hanukkah — deep-fried donuts called sufganiyot — can be a source of burns in the mouth.

“We assume that the reason for these injuries is that the fluid cream, jam or caramel at the center of the pastry tends to heat much quicker than the surrounding baked dough, especially when heated in the microwave oven. Then, without sensing its extreme heat at the center, the hungry subject will bite into burning hot fluid,” the authors write.

Epidemiology of Pediatric Holiday-Related Injuries Presenting to U.S. Emergency Departments Anthony D’Ippolito, Christy L. Collins and R. Dawn Comstock. Pediatrics, May 2010.

The study investigates eight major holidays in the U.S. and finds that among children younger than 19, approximately 500,000 holiday-related injuries were treated at emergency departments between 1997 and 2006.

Labor Day, Memorial Day, Fourth of July and Halloween were the holidays with the highest number of injuries per year overall. Christmas, in fact, had the least number of injuries.

Among the study’s other findings:

• Overall, boys sustained 62% of the injuries.
• Nearly 30% of injuries were in children younger than 5.
• The most common injuries were cuts, bruises, fractures and sprains.
• Nearly 66% of the cuts were to the face.
• The greatest proportion of deaths occurred around the Fourth of July and New Year’s.

“Parents should closely supervise children who are younger than 5 years on Thanksgiving and Christmas when the proportions of injuries were significantly greater among these younger children compared with the other age groups,” the authors write. “On New Year’s, those aged 15 to 19 years had a significantly greater proportion of injuries compared with all other holidays.”

The BMJ Christmas issue

The BMJ, a prestigious medical journal, has a well-established annual Christmas issue that includes a mix of light-hearted features and peer-reviewed research. Below are highlights from this year’s issue:

• One study makes the case for the Barbie doll to expand her range of medical and scientific professions.
• Another study draws a link between a new Doctor Who episode shown during the holidays, especially Christmas Day, and lower death rates in the following year across the UK.
• To the relief of coffee drinkers, a study finds that coffee machines are not responsible for spreading disease in hospitals.
• A small study finds putting a chair beside a patient’s bed in the hospital room nudged physicians to sit during the visit, which in turn resulted in higher patient satisfaction.
• If you’re a fan of the Great British Baking Show, you’ll appreciate this study, which examines the health benefits and harms of Christmas recipes on the show. Results: you can have your cake and eat it too.
• And if you’re popping the cork on a sparkling wine bottle on New Year’s Eve, be careful, because cork eye injuries can be significant, according to this study . It takes 0.05 seconds for the cork to travel from the bottle to your eye, the authors write. They also share a useful guide for opening a bottle of sparkling wine.

About The Author

Naseem S. Miller

Holiday Blues: Why Christmas Causes Stress

Here are four tension-producing holiday roles. do any of them apply to you.

Posted December 8, 2021 | Reviewed by Ekua Hagan

• The holidays are a time of hope and joy—and of social tension.
• People experience holiday stress for different reasons, ranging from being over-responsible to feeling obligated.
• Instead of renouncing seasonal festivities, it's wise to be selective about social involvements and develop one's own ways to support others.

As the name suggests, religious holidays were once holy days, focused on honoring God. So oriented, local communities set aside their customary responsibilities to work and government; collectively, they assembled, prayed, and feasted. Both as individuals and as families, people took stock of who they had been—and who they should be.

All of us know that the modern world has transformed those celebrations. Holidays, even those with profound religious meanings, have broadened their scope to include many different activities and relationships, some explicitly commercial. Christmas, in particular, has become a time to go and do. People rush about buying presents, cleaning and decorating houses, making travel arrangements, and preparing elaborate meals. There are parties to host and attend, some with persons one rarely sees socially, indeed hasn’t seen since the holiday events of the preceding year. Everyone is to look their best and to adopt their most cheerful demeanor; achieving this may require trips to the salon and department store.

The online world both assists and documents these exploits. How we are celebrating Christmas—in words and images—is December’s primetime show in our ongoing broadcasts of personal and family advancement.

To be sure, there are people who see the Christmas season as an opportunity to reaffirm their faith and who stand apart from the hubbub. Many more increase their commitments to charity. However, most of us, I would venture, find ourselves caught up in the public expectation to be festive, or merry. Christmas, as expressed now, is a time to build and consolidate relationships with family, and with an ever-widening circle of friends and associates. Courtesies extended at this time of year—perhaps an invitation to one’s home or a nice gift or tip—are meant to “count,” that is, to reinforce social standing in the months ahead. If earlier celebrations honored God, now we honor one another.

It may be, as the song has it, that Christmas is “the most wonderful time of the year.” But that hectic festivity may also be the circumstance for unwanted stress , anxiety , and even depression . Not everyone has “the Christmas spirit,” and even those who do commonly find that the potential joy of the season somehow eludes their grasp.

In that light, consider four different roles people play in the creation and management of festivity. Each role, I argue, poses problems of its own sort and can be a source of stress.

The controller

Certain people have very clear ideas, perhaps based on fond memories of childhood , about Christmas celebrations. They have the will, resources, and organizational ability to realize these visions, even if that means doing most of the work themselves. As they see it, meals and decorations should happen in a certain way; certain people (and not others) should be present at important events; there should be rules about gifts and other social courtesies.

One might simply thank controllers for their contributions, as they free others from some of the heavy work of planning and executing these occasions. However, social life is more complicated than that. When one person has too much control, others are unable to implement their own visions or even to make what they consider useful contributions. To that extent, the festive event loses its qualities of camaraderie, spontaneity, surprise, and fun. Indeed, who wants to have their festivity managed?

Controllers may respond that they take this role because others are less interested in the (proper) sequence of events and less able to direct them. The cost of this attitude is that others may resent their bossiness. Alternative, differently styled activities may not occur. Commonly, controllers find themselves overwhelmed with all the preparations and executions. This pressure to perform increases as cultural platforms like magazines, websites, and social media ratchet up standards for the “perfect” Christmas. In past, controllers could compare their productions to those of a competitive friend, family member, or neighbor down the street. Now, they take on Martha Stewart, HGTV, and the Food Network.

The outsider

Quite different is the circumstance of the isolate or non-participant. Many people live alone with few resources and social contacts. Christmas for them may feature the companionship of a beloved pet or a similarly situated friend who drops by. A few will go to a community center for a meal. At any rate, their holiday observance will not resemble the essentially upper-middle-class model supplied by media.

Others stand apart from the public celebrations by choice. Some are quiet, introverted people who simply do not enjoy prolonged or raucous gatherings. A subset of these oppose the public celebrations, with all their glitter and waste, on intellectual and moral terms. What society needs now, or so their thinking goes, is well-considered and compassionate policy, not aimless revelry.

Non-Christians, such as Jews and Muslims, also find themselves marginalized by the dominant pattern. As parents, they must explain to their children why “we” don’t celebrate in the way “they” do and why “our” traditions receive less attention than “theirs.”

Consider a final group, for whom Christmas is bittersweet. The noisy gatherings make them remember better times when they shared the companionship of now-departed loved ones. They attend the scheduled gatherings, perhaps smiling and laughing ; but their hearts are elsewhere.

The trapped

A third category I call the “trapped.” Such people do not want to be involved in many of the proceedings, but they feel should or even must. Attendance, or so it seems, is obligatory.

In that regard, most of us can recite instances of social occasions we haven’t wanted to attend. There is the official party at work. (“These people are more colleagues than friends. Don’t I see them enough?”) What about that neighborhood gathering? (“I know I should go but I really don’t want to know those people more than I do now.”). Some events obligate us because the hosts are friends and because we’ve gone there for several years now. (“Yes, but we’ve socialized with these folks at two parties already this month. Can’t we give it a rest?”). Be clear that most of these occasions are not just a matter of showing up and staying for a few minutes. Gifts for the host as well as food and beverages are part of the offing.

More important are gatherings with family. Frequently that means exposure to relatives of many different sorts. Long-simmering disagreements may boil over; attendees may revert to childhood roles. Think also of the pressure felt by adult children to travel to their parents’ homes for Christmas even when significant distances are involved. This pressure intensifies when there are grandchildren, especially a first grandchild. Imagine the difficulties of blended families, which may have four sets of grandparents to satisfy. Of course, people want—and have a right—to see their loved ones. But who envies a family traveling across the country with young children in winter?

The overcommitted

Whatever our attitudes toward the holiday season, most of us sense limitations of time and energy. Rare is the person who has an extended December vacation. Purchasing, decorating, cooking, and wrapping presents must occur outside of regular working hours. Other domestic responsibilities continue apace.

There is also the matter of finances. Christmas preparations are expensive; so is travel. Debt piles up and, indeed, may linger well into the following year.

Commonly, people eat and drink excessively during the holidays. Alcoholic tendencies may find their outlet. Like financial issues, those overages have consequences for rest-of-year behavior. Returning to normalcy is difficult.

More than anything perhaps, there is the emotional investment of the season. Much of this is a wonderful thing, a mix of hope and love. Still, tension builds as the big day approaches. (“Will meals turn out? Can we get there in time? Will people like their presents? Is this outfit all right?”). Such anxieties are natural enough; but the effects can be cumulative, especially when they combine with sleep deprivation, financial worries, poor eating habits, and concerns about social flare-ups.

The four roles I’ve described generate distinctive tensions and require distinctive responses. However, all those “holiday blues” center on the challenges of interacting with different kinds of people. In its current form, Christmas represents a time when we should express our good wishes for all. Sharing meals and gifts—and being pleasant to one another—are elements of this; any disgruntlement should not overwhelm that kindly spirit. Instead of renouncing one’s connections to others at this time of year, perhaps the wiser course is to think hard about the kinds and levels of social involvement we can endure, to approach holiday activities selectively, and to find one’s own ways to demonstrate caring for others. Most people are clear enough about what—and who—really matters to them. Christmas is a chance to implement that vision.

Thomas Henricks, Ph.D., is Danieley Professor of Sociology and Distinguished University Professor at Elon University.

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Why Holidays are Important for our Mental and Physical Health

Everyone gets excited at the thought of a holiday, be it a sunshine escape to Spain, a winter break in Italy or an indulgent retreat in the Maldives, nobody’s going to refuse a break from the UK weather, are they? Although you might not need persuading when it comes to booking a wellness retreat , we’re looking into the reasons as to why holidays are important for our mental and physical health, and how an escape from your usual routine could be a wellbeing boosting experience that will solve your problems.

Studies have shown that holidaymakers can reap the benefits of a holiday on a physical, mental, and emotional level, with changes to blood pressure, stress levels, energy levels, sleep quality and emotional stability all being noticed. With just one of these benefits your overall physical and mental wellbeing can be significantly improved, and tailoring your trip to your emotional and physiological needs can boost your health even further.

Here are some key benefits of holidaying for your mental and physical health:

Reduced stress

Going on wellness holiday gives you the chance to step back from any responsibilities, obligations, and problems you have at home or work, and taking a break from these sources of anxiety has been proven to drastically reduce stress levels. By separating yourself from situations and places you normally associate with stress and distracting yourself, you’re reducing the process of rumination (the tendency to focus on thoughts causing us stress) and giving your mind other things to focus on – e.g. an activity you enjoy or a place you love - and this can even last for a few weeks after you leave your holiday. These feelings of enjoyment and comfort will replace the feelings of anxiety and reduce your production of cortisol, the stress hormone, which can improve your mood and fertility as well as reducing the risk of indigestion, weight gain and heart attack. 

Taking time off to go on a de-stress holiday will allow you to relax and reset, and as you give your mind and body a break, you will continue to reap the health benefits even after you’ve returned home.

Decreased blood pressure

As you reduce your stress levels on holiday, your blood pressure also decreases, and in turn, so does the risk of heart disease and diabetes. You don’t need to travel far and wide to get your wellness holiday fix, even a quick staycation in the UK could reduce your blood pressure, whether it’s through dampening mental and physical tension by relaxing and recuperating, or through being active with activities or exercise classes.

Improved physical health

Staying physically fit and healthy doesn’t have to mean going to the gym five times a week, it can merely be a few hours of activity per day, and what better place to do so than a fitness holiday where you can hike, bike, swim or surf, or even try out a brand-new sport like paddle boarding, windsurfing or kayaking. Doing even one of these things will improve your physical health as you could lose weight, build muscle, strengthen your heart and decrease your blood pressure, and you never know, you might just find yourself a nice new hobby. 

You don’t even have to be moving to reap the physical benefits of a holiday, just stepping away from the UK and escaping to the sunshine can give you that much-needed Vitamin D which is fantastic for your bones, teeth, and muscles.

Improved sleep quality

Leaving your worries at home and indulging in a holiday gives your mind the relaxing and peaceful break it needs to slip into deeper and longer sleep habits. Whether you live in a bustling city or a quaint village, jetting off on holiday can relieve any pressures from home as you let yourself be pampered with treatments, activities, and delicious meals. Letting go of your responsibilities can be hard, but as you reduce your stress you will ease your mind, and with that comes deep sleep and sweet dreams. For those suffering from sleep disorders or insomnia, a sleep enhancement holiday focuses solely on improving the quality of your sleep, identifying and analysing sources of anxiety and helping you settle into a regular and fulfilling sleep pattern.

Improved emotional health

There’s no denying that just the thought of a break is enough to boost anyone’s mood, so it should come as no surprise that actually going on holiday is proven to radically improve your mental health. Not only does it remove you from stressful and mentally draining situations, but it provides the perfect distraction from potentially damaging and persistent thoughts and results in reduced feelings of anxiety and depression.

The emotional health benefits of holidaying begin from the moment you book the holiday, as even having something to look forward to can boost your mood and mentality. But once you’re away your health improves even further, with better sleep quality leading to increased energy levels and an enhanced mood, as well as endorphins from exercising and activities providing a natural and effective anti-stress treatment.

It is hard to not let the dreary English weather get you down, and taking some time away on an emotional healing holiday to the sunshine can help to alleviate symptoms of S.A.D (seasonal affective disorder), with only a little amount of sun improving your mood and physical health to no end.

Improves productivity

Taking time away from work can refresh and reboot your mentality and allow you to approach tasks and problems with a different mindset. If your mind is exhausted it will struggle to come up with creative and innovative ideas, but going on holiday can boost our ability to adapt our thinking to face new and unexpected conditions in our environment. So, although walking away from a challenging task might seem like a step backwards, taking a break to step away from the task, learn about new cultures and experience new places could be just the thing you need to move forward.

A yoga or meditation retreat is the perfect opportunity to reset your mind and explore your creativity and expressiveness, both of which are essential to productivity and success both at home and at work.

Prolonged life span

The collective result of a reduction of your blood pressure and stress levels, and consequent decrease in risk of heart disease and diabetes, can increase your lifespan with studies showing that holidaymakers can live longer and healthier lives.

Life satisfaction

Combine all of these benefits; decreased blood pressure, stress levels, risk of disease, increased energy levels, better sleep quality, improved physical health, emotional health and boosted productivity, and the end result is an improved life satisfaction. Whether you’re relaxing by the pool, learning to scuba dive, or exploring the natural world by bike, horse, or foot, having a break is beneficial in a number of ways. Taking yourself off, giving your mind and body some TLC and experiencing new things will let you make memories that will last a lifetime whilst simultaneously boosting your mental and physical health.

Talk to one of our Travel Specialists on or contact us  here  to discuss tailor-making your perfect wellness holiday .

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Tess Holliday: I was as shocked as everyone when I learned I had anorexia

I started using food to cope after my mother was shot when I was 10 years old. 

I remember my aunt gave me a bowl of soup and I put a whole pack of crackers in the soup, little by little, and I remember how it made me feel. I started overeating. Even though I’m from the South, where larger-bodied individuals are more common than in some other parts of the country, my family was critical of what I ate. I started hiding food. As I got older, I struggled with anorexia . I didn’t know that’s what it was until last year — but for over 10 years, I have restricted food. 

That means I don’t eat — or when I do eat, it’s very little. Or sometimes it’s one large meal a day. My dietician, Anna Sweeney , first brought it to my attention. She told me, “I’m not licensed to diagnose you, but if I could, I would diagnose you with anorexia nervosa .”

When she said anorexia, I laughed. I thought, “Do you see how fat I am? There’s no way that word could ever be attached to someone my size.” She referred me to a psychologist, who confirmed the diagnosis. 

When she said anorexia, I laughed.

Tess Holliday

When I shared that I had anorexia on social media last year, it blew up. I posted it on a whim, sitting on my bed where I’m sitting now. I just needed to talk about it. That’s how I’ve always operated. I have always been as transparent and honest as I’m able to in hopes that it will help someone else feel less alone. My manager said, “Why didn’t you tell me first?” I didn’t think it would be that big of a deal. But I had no idea how broken the eating disorder community is. I had no idea how few resources there are for people like me.

People said I was lying. There are people who believe I was saying this to get attention. I’ve had some people say, “You’re doing this to stay relevant.” I laugh because I know it’s untrue, but it’s so indicative of what a large problem this is. I feel grateful that I’m tough enough to talk about this, but I’ve since taken a lot of steps backwards in my recovery. I’ve regressed. I haven’t eaten today. It’s 11 o’clock and I’ve had two sips of coffee, and I feel sick. This has been extremely hard on my mental and physical health. 

I chose to share my diagnosis because it’s not just about a desire for thinness. I’m not restricting because I want to be thin. I’ve just done this for so long. I wish I could tell you that I’m good at feeding my body, but I’m not. I tell myself, “Oh, I’ll eat later,” but I didn’t realize that by not eating, I was starving my body. Your body just holds onto whatever food it can because it doesn’t know when you’re going to feed it again.

I still struggle with wrapping my head around, “How can I be in a fat body and be starving?” Then I realized that bodies of all sizes and shapes starve. ( Editor's note: It is a myth that anorexia only occurs in patients who have extremely low body weights. Atypical anorexia nervosa is a restrictive eating disorder that occurs in patients whose body weight is at or above normal, and experts say it is under-recognized. )

So many people who are in larger bodies have messaged me and said, “I never thought I restricted until you started talking about this.” It’s been very empowering, but it’s also made me incredibly sad. To get a diagnosis when there is so much weight bias and stigma in the medical industry is difficult. It’s tough when you hear the word anorexia and it’s only equated with one kind of image. It’s detrimental to so many people, including myself. 

Recovery for me is messy. It’s lonely. It’s hard to deal with something for which there isn’t enough support. Having a diagnosis has been liberating and it has made me feel less alone, but the confused look on people’s faces when I say anorexia or the stares I get if it comes up in conversation — that’s hard. 

I remind myself that my feelings are valid. I go to therapy . Talking about it has helped. I surround myself with people who can gently say, “Have you eaten today?” or, “Let’s have a protein shake." I make sure I have things in my house that are easy to grab and eat. Moving my body makes it easier for me to feed myself because it makes it harder to ignore the feelings of hunger. 

There is no space for people who are in larger bodies to ever exist in the world where we aren’t being told that we need to lose weight.

There is no space for people who are in larger bodies to ever exist in the world where we aren’t being told that we need to lose weight or change our bodies. January is an extremely hard time because it starts with the diet talk and the “new year, new you” messaging. Then it migrates into getting your body ready for summer. It never ends, and fat people are more aware of this messaging than anyone because it is shouted at us from the moment we present as fat in the world. 

For folks who claim they actually care about fat bodies and plus-size people and want to “help” us, the way you can help us is by supporting our mental health, and by understanding that there are so many people struggling with what I’m struggling with, but they don’t know it, and they can’t name it, and they can’t get a diagnosis, because our system has never been set up to support folks in larger bodies. 

And to people who are struggling, I say to find support. One of the bright spots that has come from COVID-19 has been increased access to mental health professionals online. I found someone to talk to through just Googling someone in my area. I literally would not have been able to do any of this if I didn’t have that help. 

As told to Rheana Murray 

If you’re struggling with an eating disorder and need help, information or resources, visit  the NEDA website  or call 1-800-931-2237.

12 Ways to Have a Healthy Holiday Season

November 27, 2019

Brighten the holidays by making your health and safety a priority. Take steps to keep you and your loved ones safe and healthy—and ready to enjoy the holidays.

• Wash hands often to help prevent the spread of germs. It’s flu season. Wash your hands with soap and clean running water for at least 20 seconds.
• Bundle up to stay dry and warm. Wear appropriate outdoor clothing: light, warm layers, gloves, hats, scarves, and waterproof boots.
• Manage stress. Give yourself a break if you feel stressed out, overwhelmed, and out of control. Some of the best ways to manage stress are to find support, connect socially, and get plenty of sleep.
• Don’t drink and drive or let others drink and drive. Whenever anyone drives drunk, they put everyone on the road in danger. Choose not to drink and drive and help others do the same.
• Be smoke-free. Avoid smoking and secondhand smoke. Smokers have greater health risks because of their tobacco use, but nonsmokers also are at risk when exposed to tobacco smoke.
• Fasten seat belts while driving or riding in a motor vehicle. Always buckle your children in the car using a child safety seat, booster seat, or seat belt according to their height, weight, and age. Buckle up every time, no matter how short the trip and encourage passengers to do the same.
• Get exams and screenings. Ask your health care provider what exams you need and when to get them. Update your personal and family history.
• Get your vaccinations. Vaccinations help prevent diseases and save lives. Everyone 6 months and older should get a flu vaccine each year.
• Monitor children. Keep potentially dangerous toys, food, drinks, household items, and other objects out of children’s reach. Protect them from drowning, burns, falls, and other potential accidents.
• Practice fire safety. Most residential fires occur during the winter months, so don’t leave fireplaces, space heaters, food cooking on stoves, or candles unattended. Have an emergency plan and practice it regularly.
• Prepare food safely. Remember these simple steps: Wash hands and surfaces often, avoid cross-contamination, cook foods to proper temperatures and refrigerate foods promptly.
• Eat healthy, stay active. Eat fruits and vegetables which pack nutrients and help lower the risk for certain diseases. Limit your portion sizes and foods high in fat, salt, and sugar. Also, be active for at least 2½ hours a week and help kids and teens be active for at least 1 hour a day.

Be inspired to stay in the spirit of good health! Listen to The 12 Ways to Health Holiday Song or a holiday health podcast .

• Holiday Health and Safety Tips
• Mall Walking this Winter
• Twelve Holiday Health and Safety Tips Podcast (2007) [PODCAST – 3:40 minutes]
• Holiday Food Safety During Pregnancy
• Gather and Share Your Family Health History
• Get Your Flu Vaccine: Stay Healthy This Flu Season!
• Managing Diabetes During the Holidays
• Pregnancy and Flu
• Go Green for the Holidays
• Stay Safe and Healthy in Winter
• Lead Hazards in Some Holiday Toys

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Home — Essay Samples — Life — Thanksgiving — My Favorite Holidays

My Favorite Holidays

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Published: Mar 20, 2024

Words: 747 | Pages: 2 | 4 min read

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Introduction, thanksgiving.

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Essay on Health for Students and Children

500+ words essay on health.

Essay on Health: Health was earlier said to be the ability of the body functioning well. However, as time evolved, the definition of health also evolved. It cannot be stressed enough that health is the primary thing after which everything else follows. When you maintain good health , everything else falls into place.

Similarly, maintaining good health is dependent on a lot of factors. It ranges from the air you breathe to the type of people you choose to spend your time with. Health has a lot of components that carry equal importance. If even one of them is missing, a person cannot be completely healthy.

Constituents of Good Health

First, we have our physical health. This means being fit physically and in the absence of any kind of disease or illness . When you have good physical health, you will have a longer life span. One may maintain their physical health by having a balanced diet . Do not miss out on the essential nutrients; take each of them in appropriate quantities.

Secondly, you must exercise daily. It may be for ten minutes only but never miss it. It will help your body maintain physical fitness. Moreover, do not consume junk food all the time. Do not smoke or drink as it has serious harmful consequences. Lastly, try to take adequate sleep regularly instead of using your phone.

Next, we talk about our mental health . Mental health refers to the psychological and emotional well-being of a person. The mental health of a person impacts their feelings and way of handling situations. We must maintain our mental health by being positive and meditating.

Subsequently, social health and cognitive health are equally important for the overall well-being of a person. A person can maintain their social health when they effectively communicate well with others. Moreover, when a person us friendly and attends social gatherings, he will definitely have good social health. Similarly, our cognitive health refers to performing mental processes effectively. To do that well, one must always eat healthily and play brain games like Chess, puzzles and more to sharpen the brain.

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Physical Health Alone is Not Everything

There is this stigma that surrounds mental health. People do not take mental illnesses seriously. To be completely fit, one must also be mentally fit. When people completely discredit mental illnesses, it creates a negative impact.

For instance, you never tell a person with cancer to get over it and that it’s all in their head in comparison to someone dealing with depression . Similarly, we should treat mental health the same as physical health.

Parents always take care of their children’s physical needs. They feed them with nutritious foods and always dress up their wounds immediately. However, they fail to notice the deteriorating mental health of their child. Mostly so, because they do not give it that much importance. It is due to a lack of awareness amongst people. Even amongst adults, you never know what a person is going through mentally.

Thus, we need to be able to recognize the signs of mental illnesses . A laughing person does not equal a happy person. We must not consider mental illnesses as a taboo and give it the attention it deserves to save people’s lives.

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Walmart to close health clinics in latest blow to retail healthcare.

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Walmart is closing its Walmart Health centers and virtual care business, saying it doesn't see a ... [+] sustainable business model, the company disclosed Tuesday. The move means 51 Walmart Health primary care clinics in five states will close in the next three months. Also closing is Walmart's virtual healthcare business.

Walmart is closing its Walmart Health centers and virtual care business, saying it doesn’t see a sustainable business model in primary care.

It’s the latest blow to the retail health clinic model, with the retail giant saying it will close its 51 Walmart Healt centers in five states and Walmart Health Virtual Care , which is the retailer’s telehealth business. The centers will close in the next 30 to 90 days, the company confirmed Tuesday.

Walmart didn’t disclose how much the shutdown will cost the company, which spent tens of millions of dollars over the last five years opening primary care centers that were typically more than 5,000 square feet in size and included an array of primary care services, dental and mental healthcare as well as X-rays, immunizations, and chronic condition management.

“The decision to close all 51 health centers across five states and shut down the virtual care offering was not easy,” Walmart said in a blog post on the company’s website. “We understand this change affects lives – the patients who receive care, the associates and providers who deliver care and the communities who supported us along the way. This is a difficult decision, and like others, the challenging reimbursement environment and escalating operating costs create a lack of profitability that make the care business unsustainable for us at this time.”

Just one month ago, Walmart said it planned to add 22 new locations in 2024, deepening its presence in Texas while opening new sites in Missouri. A sixth market, Arizona, was expected to see an expansion in 2025 where the company doesn’t yet operate Walmart Health facilities.

But Walmart executives said the business environment became increasingly more difficult to recruit healthcare professionals and physicians amid a U.S. healthcare staffing crisis and a tight labor market.

Best Short-Term Health Insurance Companies Of 2022

Best health insurance companies of 2022.

Other operators of primary care clinics are also facing staffing issues. For example, physician-owned primary care practices are still reeling from a loss of support staff since the beginning of the pandemic, down 40% per doctor since 2019, according to a report last year from the Medical Group Management Association.

Physician-owned practices had just 3.0 support staff per full-time equivalent physician in 2022 compared to 5.08 per doctor in 2019 as the Covid-19 pandemic and the so-called “great resignation” took their toll on doctor practices across the country. The MGMA study is a snapshot into the labor problems in healthcare, which has been hit hard by the ongoing economic trend of workers quitting their jobs, though studies show healthcare, education and hospitality industries have been hit the hardest. And Walmart Health executives found that the company isn’t immune from the healthcare staffing and labor crisis hitting employers.

Walmart’s decision to close its health centers and virtual care comes as Amazon grows its One Medical Clinics into new markets and CVS Health, which spent $10 billion last year to buy Oak Street health centers for seniors, adds to its portfolio of medical care provider operations with clinics that treat patients covered by Medicare and privatized Medicare Advantage.

But Walgreens, which made a multibillion-dollar investment in doctor-staffed clinic operator VillageMD, has struggled somewhat by expanding too fast and being unable to fill patient panels in certain markets it is now exiting. Walgreens last month reported a loss of nearly $6 billion in its second quarter due largely to the loss in value of its VillageMD investment.

In Walmart’s case, the retailer said it will now take what the company has learned and focus on “trusted health and wellness services across the country through our nearly 4,600 Pharmacies and more than 3,000 Vision Centers. For 40 years, we have provided these high quality, accessible and affordable points of care that are integral to their respective communities.”

The decision disclosed Tuesday comes five years after Walmart opened the first 10,000-square-foot Walmart Health facility that opened in Dallas, Georgia, where Walmart shoppers and patients in the community had reportedly taken to the concept and convinced Walmart executives to forge ahead. The newer Walmart Health centers are about 5,400 square feet, located inside Walmart Supercenters and featured Walmart Health’s full suite of health services, the company said. The range of services included primary care, dental care, behavioral health, labs and X-ray and Walmart Health Virtual Care telehealth services.

It’s possible that some physicians, dentists and other providers could remain inside the stores if they, for example, negotiate a partnership with a local hospital or health system. The medical care providers inside Walmarts are independent and generally have contracts to provide care outside of Walmart Health Centers as well, according to sources close to Walmart.

“Today and in the coming days, we are focused on continuity of care for patients and providing impacted associates with respect and assistance as we begin the closing process of the health care centers,” Walmart said in its blog post. “The associates and providers have made an incredible difference for their patients and communities, and they are a priority: all associates are eligible to transfer to any other Walmart or Sam’s Club location” and “all associates will be paid for 90 days, unless they transfer to another location during that time or leave the company.”

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Victorian state budget 2024: airport train delayed and sick leave for casuals scrapped in bid to rein in debt

Government to also provide $400 for each public school student as Tim Pallas hands down his 10th state budget

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The Victorian government will delay construction of the long-awaited Melbourne airport rail by at least four years, postpone key election promises and scrap its lauded paid sick leave scheme for casuals in an effort to bring its growing debt under control.

The Victorian treasurer, Tim Pallas, said he has been forced to make “sensible and disciplined decisions” to combat the state’s “two big problems” of high inflation and workforce shortages in his 10th budget, handed down on Tuesday.

This includes putting off the Melbourne airport rail by at least four years and increasing several taxes.

“We need to be realistic about the project and its timeline,” Pallas said of the rail project in his budget speech to parliament.

“[It] is now at least four years delayed.”

In 2020, the state and federal government each committed $5bn to the Melbourne airport rail. But Victoria has been locked in a dispute with the airport’s operators , who have insisted on constructing a costlier underground station.

Pallas said the federal government had only “recently” appointed an independent mediator to work through the issue, while the airport “has not indicated it is prepared to drop its demands for compensation and an underground station”.

“Believe me, we are not doing either of those things,” the treasurer told reporters. “So we’re at a standoff and I think we need to recognise that ending that standoff will take some time.”

A Melbourne Airport spokesperson said the government had rejected a 2019 offer, as part of a consortium, to invest $7bn in an underground airport station and express tracks from Sunshine. But a government spokesperson said the proposal would have been a “terrible deal” for Victorian commuters and taxpayers, by privatising a proposed Geelong fast rail line for 40 years.

Pallas said putting off the project allowed the state to “get on with delivering other projects”. However, the government’s total spend on infrastructure will decline from a peak of $24bn in 2023-24 to $15.6bn at the end of the forward estimates.

The government’s Suburban Rail Loop will also be affected, with the completion date for early works on the eastern section pushed back from mid-2025 to early 2026.

Meanwhile, plans for a medical precinct in North Melbourne have also been scrapped due to “electromagnetic interference” from the new Arden train station. The government will instead expand the Royal Melbourne and Royal Women’s hospitals, allocating $2.3bn to this work.

Pallas said the expanded rollout of free kinder and the mental health and wellbeing local hubs – both key commitments at the 2022 election – will go ahead “gradually”, due to workforce shortages.

While no new taxes have been announced, there will be increases to the waste and fire services levies, which will reap $423m and $591m, respectively.

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However, a standalone tax exemption for land used to provide social and emergency housing will be introduced.

Pallas said the budget was “firmly focused on the things that matter to families”, with the introduction of a $400 payment for every child at government schools, totalling $287m.

The homebuyer fund , a shared-equity scheme to help people buy homes, has also been extended for one year – before the commonwealth establishes a national scheme – costing $700m.

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The budget shows Victoria’s net debt will reach $135.9bn by the end of June and is expected to keep growing across the forward estimates, reaching $156.2bn in 2024-25 and $187.8bn in 2027-28 – or 25.1% of the state’s economy.

Pallas said this represents a “fall” in the ratio of net debt to gross state product (GSP) for the first time since 2017, however the state’s proportion of debt is still much higher than other states. By 2027-28, interest payments on state debt are forecast to total $9.38bn – or $26m a day.

This year’s deficit has also increased from $3.5bn in the December budget update to $4.6bn. The forecast deficit for 2024-25 has also increased to $2.2bn from $1bn.

The state will then build to a surplus of $1.5bn in 2025-26, $1.6bn in 2026-27 and $1.9bn in 2027-28.

As part of efforts to stabilise debt, Pallas has also cut initiatives introduced during the Covid pandemic, saying they are “no longer needed as we move into a new phase”.

This includes an Australian-first sick pay guarantee, which provided casual workers with five days a year of sick or carer’s pay at the national minimum wage. Under the previous premier, Daniel Andrews, there were plans to make the scheme ongoing .

The scrapping of the scheme is included in $1.79bn “savings and efficiencies”

About $11bn has been allocated to the health system and $1bn to build 16 more schools.

Businesses groups said the budget was modest and welcomed the decision not to impose new taxes or levies on the private sector. But Luke Hilakari, secretary of Victorian Trades Hall, said it was a “very difficult” budget for casual workers.

The opposition leader, John Pesutto, said the budget had failed to drastically change the financial direction of the state or provide enough cost-of-living relief.

The Greens leader, Ellen Sandell, described the scrapping of the North Melbourne medical precinct as a “shemozzle”.

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Analysis In its 2024 budget, the Victorian government forgets debt, dreams big and crosses its fingers

There's a clear and simple message you get from reading the Victorian government's budget papers : don't panic.

Sure, there's a few numbers that will widen your eyes.

Money the government gets in (revenue) for the next financial year is $96.1 billion, which is less than projected it will spend (expenses) of $98.3 billion.

And yes, debt is $156.2 billion rising to $187.8 billion by 2027-28 – which by that time will be 25 per cent of the value of all the goods and services produced in the state in a year (called gross state product or GSP).

And OK, that means a daily interest bill on the debt of about $15 million, climbing to more than $25 million a day by 2027.

But why worry? This is Victoria. Get with the program.

That program — if you buy into the government's vision — is a rapidly-growing population that will buy property, find employment and get around on mega-transport projects due to open just before the next state election.

There are schools, tunnels, hospitals and roads to service this swelling growth, as Melbourne (where the vast majority of Victorians live) becomes the nation's largest city, overtaking a waterside resort for squillionaires to the north that also houses normal people.

All that needs to happen is for employment to stay strong, inflation and construction costs to keep moderating, interest rates to go no higher, workers to find housing that is being built at a far slower rate than people are moving here and a few other "risk factors".

Fingers crossed, eh?

The problems

With the immense debt and still unfunded mega-projects like a circular underground railway (the Suburban Rail Loop) about to start digging, you would expect a state government 2.5-years from an election would raise money and cut costs — hard.

There's a bit of that, but not much. It's more Facebook Marketplace than selling a kidney.

The government is making extra cash by:

• Shifting commercial and industrial properties from a stamp duty (cost when sold) system to one that kicks in 10 years after the sale and is then annual.
• People dumping stuff at the tip will pay more, bringing it into line with fees for New South Wales and South Australia.
• Lifting the Fire Services Levy from where it started a decade ago to a higher level.

The savings are also pretty minimal. There's things like ending the Sick Pay Guarantee, a COVID-era pilot of paying sick leave to casuals. With a more "worker friendly" regime in power federally (the government's words) the pilot is over for now.

The Jacinta Allan-led government will also trim in costs by:

• Ending some COVID-era employment.
• Reducing office space as work-from-home and those reduced numbers impact the desks required. 
• Trimming in a program to expand state-funded pharmacy and care clinics.
• Making the money for Breakthrough Victoria, which funds speculative start-up tech businesses, stretch for 15-years rather than the original 10-years it was meant to.

It's not exactly ring all the alarms stuff is it? That's because they're not worried.

Get with the program and all cost is an investment. Public sector wages help pump private sector ones. Infrastructure unlocks value.

Remember the daily cost of that interest bill? Treasurer Tim Pallas calculates it as "1/4000th of one per cent of the economy" – an infinitesimal smidge of nothingness compared to the riches that await Victorians … if it all works out.

And there's a surprising group helping them get there.

Opposing forces

At the end of 2022 Victorians went to the polls.

After the painful repeated lockdowns in Melbourne — and with the exploding cost of keeping the state alive barely covered by a federal government accused of a lack of interest or care in the plight of the southern mainland state — there were a lot of predictions about the fate of the then eight-year-old government.

Plenty of interstate commentators had written Dan Andrews' political obituary, based on his bombastic personality, COVID-era decisions and ballooning debt.

But at the election the government didn't lose seats. It gained them.

By the time the next election rolls around Liberal-National opposition will have been in power for just four years between 1999 and 2026.

Some could say their show of unity, policy ideas and the cut-through they are making with the Victorian public show a resolute commitment to remaining in opposition.

What even is money?

Underpinning all of this are a few things that might not seem obvious.

One is the immense employment that's been delivered by infrastructure programs, public sector growth and things like "free TAFE".

Another is that the government has literally built credibility by starting and finishing big projects — new schools and hospitals, the removal of scores of level crossings — sprinkled in every corner of the state.

Adding to it is that COVID changed what people think about government, debt, and the role of the state in guiding the economy — we're seeing that federally too, as taxpayers invest billions in specific companies and industries.

If you think any government is going to leave the future to the invisible hand of the free market, you haven't been paying attention. That's gone.

A final element is that there's not a compelling competing vision about Victoria's growth and how it is being dealt with.

People can be unhappy about the untold millions spent on infrastructure, but when a new five-station underground rail line opens under the central business district next year, I don't expect a protest march out the front about the cost.

More likely is that people will use it, love it and ask a pressing question: When will there be one where I live?

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David Wallace-Wells

Are smartphones driving our teens to depression.

By David Wallace-Wells

Opinion Writer

Here is a story. In 2007, Apple released the iPhone, initiating the smartphone revolution that would quickly transform the world. In 2010, it added a front-facing camera, helping shift the social-media landscape toward images, especially selfies. Partly as a result, in the five years that followed, the nature of childhood and especially adolescence was fundamentally changed — a “great rewiring,” in the words of the social psychologist Jonathan Haidt — such that between 2010 and 2015 mental health and well-being plummeted and suffering and despair exploded, particularly among teenage girls.

For young women, rates of hospitalization for nonfatal self-harm in the United States, which had bottomed out in 2009, started to rise again, according to data reported to the C.D.C., taking a leap beginning in 2012 and another beginning in 2016, and producing , over about a decade, an alarming 48 percent increase in such emergency room visits among American girls ages 15 to 19 and a shocking 188 percent increase among girls ages 10 to14.

Here is another story. In 2011, as part of the rollout of the Affordable Care Act, the Department of Health and Human Services issued a new set of guidelines that recommended that teenage girls should be screened annually for depression by their primary care physicians and that same year required that insurance providers cover such screenings in full. In 2015, H.H.S. finally mandated a coding change, proposed by the World Health Organization almost two decades before, that required hospitals to record whether an injury was self-inflicted or accidental — and which seemingly overnight nearly doubled rates for self-harm across all demographic groups. Soon thereafter, the coding of suicidal ideation was also updated. The effect of these bureaucratic changes on hospitalization data presumably varied from place to place. But in one place where it has been studied systematically, New Jersey, where 90 percent of children had health coverage even before the A.C.A., researchers have found that the changes explain nearly all of the state’s apparent upward trend in suicide-related hospital visits, turning what were “essentially flat” trendlines into something that looked like a youth mental health “crisis.”

Could both of these stories be partially true? Of course: Emotional distress among teenagers may be genuinely growing while simultaneous bureaucratic and cultural changes — more focus on mental health, destigmatization, growing comfort with therapy and medication — exaggerate the underlying trends. (This is what Adriana Corredor-Waldron, a co-author of the New Jersey study, believes — that suicidal behavior is distressingly high among teenagers in the United States and that many of our conventional measures are not very reliable to assess changes in suicidal behavior over time.) But over the past several years, Americans worrying over the well-being of teenagers have heard much less about that second story, which emphasizes changes in the broader culture of mental illness, screening guidelines and treatment, than the first one, which suggests smartphones and social-media use explain a whole raft of concerns about the well-being of the country’s youth.

When the smartphone thesis first came to prominence more than six years ago, advanced by Haidt’s sometime collaborator Jean Twenge, there was a fair amount of skepticism from scientists and social scientists and other commentators: Were teenagers really suffering that much? they asked. How much in this messy world could you pin on one piece of technology anyway? But some things have changed since then, including the conventional liberal perspective on the virtues of Big Tech, and, in the past few years, as more data has rolled in and more red flags have been raised about American teenagers — about the culture of college campuses, about the political hopelessness or neuroticism or radicalism or fatalism of teenagers, about a growing political gender divide, about how often they socialize or drink or have sex — a two-part conventional wisdom has taken hold across the pundit class. First, that American teenagers are experiencing a mental health crisis; second, that it is the fault of phones.

“Smartphones and social media are destroying children’s mental health,” the Financial Times declared last spring. This spring, Haidt’s new book on the subject, The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness, debuted at the top of the New York Times best-seller list. In its review of the book, The Guardian described the smartphone as “a pocket full of poison,” and in an essay , The New Yorker accepted as a given that Gen Z was in the midst of a “mental health emergency” and that “social media is bad for young people.” “Parents could see their phone-obsessed children changing and succumbing to distress,” The Wall Street Journal reflected . “Now we know the true horror of what happened.”

But, well, do we? Over the past five years, “Is it the phones?” has become “It’s probably the phones,” particularly among an anxious older generation processing bleak-looking charts of teenage mental health on social media as they are scrolling on their own phones. But however much we may think we know about how corrosive screen time is to mental health, the data looks murkier and more ambiguous than the headlines suggest — or than our own private anxieties, as parents and smartphone addicts, seem to tell us.

What do we really know about the state of mental health among teenagers today? Suicide offers the most concrete measure of emotional distress, and rates among American teenagers ages 15 to 19 have indeed risen over the past decade or so, to about 11.8 deaths per 100,000 in 2021 from about 7.5 deaths per 100,000 in 2009. But the American suicide epidemic is not confined to teenagers. In 2022, the rate had increased roughly as much since 2000 for the country as a whole, suggesting a national story both broader and more complicated than one focused on the emotional vulnerabilities of teenagers to Instagram. And among the teenagers of other rich countries, there is essentially no sign of a similar pattern. As Max Roser of Our World in Data recently documented , suicide rates among older teenagers and young adults have held roughly steady or declined over the same time period in France, Spain, Italy, Austria, Germany, Greece, Poland, Norway and Belgium. In Sweden there were only very small increases.

Is there a stronger distress signal in the data for young women? Yes, somewhat. According to an international analysis by The Economist, suicide rates among young women in 17 wealthy countries have grown since 2003, by about 17 percent, to a 2020 rate of 3.5 suicides per 100,000 people. The rate among young women has always been low, compared with other groups, and among the countries in the Economist data set, the rate among male teenagers, which has hardly grown at all, remains almost twice as high. Among men in their 50s, the rate is more than seven times as high.

In some countries, we see concerning signs of convergence by gender and age, with suicide rates among young women growing closer to other demographic groups. But the pattern, across countries, is quite varied. In Denmark, where smartphone penetration was the highest in the world in 2017, rates of hospitalization for self-harm among 10- to 19-year-olds fell by more than 40 percent between 2008 and 2016. In Germany, there are today barely one-quarter as many suicides among women between 15 and 20 as there were in the early 1980s, and the number has been remarkably flat for more than two decades. In the United States, suicide rates for young men are still three and a half times as high as for young women, the recent increases have been larger in absolute terms among young men than among young women, and suicide rates for all teenagers have been gradually declining since 2018. In 2022, the latest year for which C.D.C. data is available, suicide declined by 18 percent for Americans ages 10 to 14 and 9 percent for those ages 15 to 24.

None of this is to say that everything is fine — that the kids are perfectly all right, that there is no sign at all of worsening mental health among teenagers, or that there isn’t something significant and even potentially damaging about smartphone use and social media. Phones have changed us, and are still changing us, as anyone using one or observing the world through them knows well. But are they generating an obvious mental health crisis?

The picture that emerges from the suicide data is mixed and complicated to parse. Suicide is the hardest-to-dispute measure of despair, but not the most capacious. But while rates of depression and anxiety have grown strikingly for teenagers in certain parts of the world, including the U.S., it’s tricky to disentangle those increases from growing mental-health awareness and destigmatization, and attempts to measure the phenomenon in different ways can yield very different results.

According to data Haidt uses, from the U.S. National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration, the percent of teenage girls reporting major depressive episodes in the last year grew by about 50 percent between 2005 and 2017, for instance, during which time the share of teenage boys reporting the same grew by roughly 75 percent from a lower level. But in a biannual C.D.C. survey of teenage mental health, the share of teenagers reporting that they had been persistently sad for a period of at least two weeks in the past year grew from only 28.5 percent in 2005 to 31.5 percent in 2017. Two different surveys tracked exactly the same period, and one showed an enormous increase in depression while the other showed almost no change at all.

And if the rise of mood disorders were a straightforward effect of the smartphone, you’d expect to see it everywhere smartphones were, and, as with suicide, you don’t. In Britain, the share of young people who reported “feeling down” or experiencing depression grew from 31 percent in 2012 to 38 percent on the eve of the pandemic and to 41 percent in 2021. That is significant, though by other measures British teenagers appear, if more depressed than they were in the 2000s, not much more depressed than they were in the 1990s.

Overall, when you dig into the country-by-country data, many places seem to be registering increases in depression among teenagers, particularly among the countries of Western Europe and North America. But the trends are hard to disentangle from changes in diagnostic patterns and the medicalization of sadness, as Lucy Foulkes has argued , and the picture varies considerably from country to country. In Canada , for instance, surveys of teenagers’ well-being show a significant decline between 2015 and 2021, particularly among young women; in South Korea rates of depressive episodes among teenagers fell by 35 percent between 2006 and 2018.

Because much of our sense of teenage well-being comes from self-reported surveys, when you ask questions in different ways, the answers vary enormously. Haidt likes to cite data collected as part of an international standardized test program called PISA, which adds a few questions about loneliness at school to its sections covering progress in math, science and reading, and has found a pattern of increasing loneliness over the past decade. But according to the World Happiness Report , life satisfaction among those ages 15 to 24 around the world has been improving pretty steadily since 2013, with more significant gains among women, as the smartphone completed its global takeover, with a slight dip during the first two years of the pandemic. An international review published in 2020, examining more than 900,000 adolescents in 36 countries, showed no change in life satisfaction between 2002 and 2018.

“It doesn’t look like there’s one big uniform thing happening to people’s mental health,” said Andrew Przybylski, a professor at Oxford. “In some particular places, there are some measures moving in the wrong direction. But if I had to describe the global trend over the last decade, I would say there is no uniform trend showing a global crisis, and, where things are getting worse for teenagers, no evidence that it is the result of the spread of technology.”

If Haidt is the public face of worry about teenagers and phones, Przybylski is probably the most prominent skeptic of the thesis. Others include Amy Orben, at the University of Cambridge, who in January told The Guardian, “I think the concern about phones as a singular entity are overblown”; Chris Ferguson, at Stetson University, who is about to publish a new meta-analysis showing no relationship between smartphone use and well-being; and Candice Odgers, of the University of California, Irvine, who published a much-debated review of Haidt in Nature, in which she declared “the book’s repeated suggestion that digital technologies are rewiring our children’s brains and causing an epidemic of mental illness is not supported by science.”

Does that overstate the case? In a technical sense, I think, no: There may be some concerning changes in the underlying incidence of certain mood disorders among American teenagers over the past couple of decades, but they are hard to separate from changing methods of measuring and addressing mental health and mental illness. There isn’t great data on international trends in teenage suicide — but in those places with good reporting, the rates are generally not worsening — and the trends around anxiety, depression and well-being are ambiguous elsewhere in the world. And the association of those local increases with the rise of the smartphone, while now almost conventional wisdom among people like me, is, among specialists, very much a contested claim. Indeed, even Haidt, who has also emphasized broader changes to the culture of childhood , estimated that social media use is responsible for only about 10 percent to 15 percent of the variation in teenage well-being — which would be a significant correlation, given the complexities of adolescent life and of social science, but is also a much more measured estimate than you tend to see in headlines trumpeting the connection. And many others have arrived at much smaller estimates still.

But this all also raises the complicated question of what exactly we mean by “science,” in the context of social phenomena like these, and what standard of evidence we should be applying when asking whether something qualifies as a “crisis” or “emergency” and what we know about what may have caused it. There is a reason we rarely reduce broad social changes to monocausal explanations, whether we’re talking about the rapid decline of teenage pregnancy in the 2000s, or the spike in youth suicide in the late ’80s and early 1990s, or the rise in crime that began in the 1960s: Lives are far too complex to easily reduce to the influence of single factors, whether the factor is a recession or political conditions or, for that matter, climate breakdown.

To me, the number of places where rates of depression among teenagers are markedly on the rise is a legitimate cause for concern. But it is also worth remembering that, for instance, between the mid-1990s and the mid-2000s, diagnoses of American youth for bipolar disorder grew about 40-fold , and it is hard to find anyone who believes that change was a true reflection of underlying incidence. And when we find ourselves panicking over charts showing rapid increases in, say, the number of British girls who say they’re often unhappy or feel they are a failure, it’s worth keeping in mind that the charts were probably zoomed in to emphasize the spike, and the increase is only from about 5 percent of teenagers to about 10 percent in the first case, or from about 15 percent to about 20 percent in the second. It may also be the case, as Orben has emphasized , that smartphones and social media may be problematic for some teenagers without doing emotional damage to a majority of them. That’s not to say that in taking in the full scope of the problem, there is nothing there. But overall it is probably less than meets the eye.

If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

Further reading (and listening):

On Jonathan Haidt’s After Babel Substack , a series of admirable responses to critics of “The Anxious Generation” and the smartphone thesis by Haidt, his lead researcher Zach Rausch, and his sometime collaborator Jean Twenge.

In Vox, Eric Levitz weighs the body of evidence for and against the thesis.

Tom Chivers and Stuart Ritchie deliver a useful overview of the evidence and its limitations on the Studies Show podcast.

Five experts review the evidence for the smartphone hypothesis in The Guardian.

A Substack survey of “diagnostic inflation” and teenage mental health.