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It won’t be a “lockdown Christmas” like last year, but this year’s holiday season continues to bear the scars of COVID-19.

Mental health professionals know that the last 20 months have been difficult times for people dealing with loss and grief. The holiday season can normally be difficult for people dealing with mental health issues. Add the pandemic into the mix and the holidays can become a major struggle.

“The unexpected changes, life-changing losses, social restrictions, constant barrage of news, and uncertainty about when the pandemic will end have contributed to a dramatic increase in anxiety and depression,” said Trinity Health licensed professional clinical counselor Virginia Dohms, LPC, LPCC. “As we continue to face the challenges of COVID-19, with continued spread of the disease and increase in death, the associated grief and fear is a reality impacting every home.”

The US Census Bureau, in collaboration with five federal agencies, launched its Household Pulse Survey to produce data on the social and economic impacts of COVID-19 on American households. The results, published by the Centers for Disease Control and Prevention, show that a significant percentage of Americans have experienced mental health challenges during the pandemic. Throughout the period of August 2020 to February 2021, the percentage of adults with symptoms of an anxiety or depressive disorder increased from 36.4% to 41.5%, with the largest increase occurring among those in the 18-29 age group. Statistics on children’s mental health were harder to verify because of a smaller sample size, but the Morgan Stanley Alliance for Children’s Mental Health reports a similar trend, with 37% of teens saying that their mental health has worsened during the pandemic.

With that backdrop comes the holidays – a time that can heighten feelings of loneliness and despair, with each person reacting differently.

“Along with increase in the mental health challenges, comes the rise in alcohol and substance use, forms of abuse, tech addictions, lack of motivation for daily activities of life, and suicidal ideations,” Dohms said. “Children struggle with additional behavioral challenges such as acting out, isolation, gaming addictions, and physical ailments. The 1800-plus deaths in North Dakota alone have touched every home and community. If you or a family member is experiencing symptoms – you are not alone.”

Dohms notes that people generally can and do recover, thanks in part to resilience. “More than ever it is important to remember that resilience is not just about ‘bouncing back,’ it can also be about incredible personal growth and development,” she emphasizes. “Austrian neurologist, psychiatrist, philosopher, author, and Holocaust survivor Viktor Frankl observed that a sense of meaning and purpose is the greatest predictor of survival. Mourning the loss of a loved one takes time, but it can be a catalyst for a renewed sense of meaning and purpose to life.”

Dohms offers these suggestions for someone struggling with grief:

1. Healing is best done in relationships. Resist the urge to isolate. This is the time to reconnect with friends and family. Talk about your loved one to recall what happened and remember that person.

2. Identify and accept your feelings. It is normal to experience a wide range of emotions including sadness, anger, numbness, confusion, anxiety, and exhaustion. Avoid alcohol and substance use during this time, as self-medicating interrupts and delays the healing process.

3. Take care of yourself and your family by intentionally returning to healthy eating, exercise, and sleep patterns. Check in with other family members to see how they are doing.

4. Remember and celebrate the lives of your loved ones. Find ways to mark their memory through rituals of remembrance such as preparing a meal of their favorite food, setting the table with an empty chair to honor them, journaling, or telling some favorite stories. What you choose is up to you, providing it honors the special person and feels right to you.

Other reflections from Dohms: the personal experience of grieving is processed in the context of multiple secondary losses that may include loss of part of self, change in family structure, loss of a desired lifestyle, a fading of one’s hopes and dreams, and even social changes. Additionally, beliefs from the past can keep us stuck in unhealthy thinking styles. Well-meaning phrases that keep people stuck include “time heals all wounds,” “pull yourself up by the bootstraps,” “boys don’t cry,” “go to your room if you are sad,” “food will make you feel better,” “stay busy and don’t think about it.” When an individual is grieving, automatic thoughts contributing to prolonged distress can be difficult to identify and change.

At what point should people reach out for support and perhaps seek professional counseling? “There is no shame in reaching out for help if a person feels stuck in feelings of depression hopelessness, helplessness, bitterness, or anger,” Dohms states. “Individuals with severe or complicated grief can benefit from talking to a professional counselor trained in grief therapy. There is hope for a meaningful and even joyful life ahead.”