Christmas time challenges for kids with common mental health conditions

shutterstock_343761578Kids with common mental health conditions react to the holidays very differently than do adults. Today, we’ll look at three struggles common during Christmas break amongst the kids and families served by our practice and suggest practical strategies for parents and caregivers to minimize the impact of the holidays upon their kids.

Problem: Kids who are anxious and/or struggle with obsessive thinking don’t do well with down time over the Christmas break.

Solution: Busy is better!

This is the single biggest factor contributing to kids landing in our office during the Christmas season. Kids prone to sadness, irritability or obsessive thinking cope by distracting themselves with schoolwork or activities that occupy their minds while filling lots of time. When the normal school routine (accompanied by lots of homework and and extracurricular activities) comes to a screeching halt in late December, it’s not unusual for kids who dwell or ruminate on bothersome thoughts to become intensely more angry or irritable.

Parents of kids prone to perseveration, rumination or obsessive thinking can proactively address this problem by keeping their child or teen busy over the break. If they’re old enough, volunteer opportunities through churches and non-profits are plentiful at this time of year. Parents might consider making plans for family activities likely to keep their child mentally engaged…trips to art museums, science museums, the movies, concerts, plays and outdoor sports may all be welcome diversions.  This strategy may also be helpful during the first two weeks after school lets out for the summer, before camps open and summer-long activities begin.

Problem: Kids who struggle with emotional self-regulation, social anxiety or sensory processing often experience challenges at large gatherings with extended family during the Christmas season.

Solution: Parents must be careful to manage their expectations…and the expectations of family members when kids have neuropsychiatric conditions.

Some kids have more difficulty masking their disappointment over gifts than others. Emotional self-regulation is one of the executive functions that mature more slowly in kids with common mental health disorders. The picture with Santa isn’t worth it if your painfully shy kid is going to melt down at the prospect of sitting on his lap. A child with sensory issues may find the prospect of hugging Aunt Betty as downright aversive, even if she doesn’t smell of alcohol and cigarette smoke.

To the extent possible, the holidays represent an opportunity for parents to educate relatives about the nature of their child’s condition and interaction strategies likely to produce pleasant memories for all.

Problem: With the excitement of the season and changes in routine that occur during the Christmas season, many kids with common mental health conditions experience difficulty with self-control.

Solution: Parents and caregivers need to be very intentional in attempting to maintain some structure during a very busy holiday season.

As a general rule of thumb, kids who struggle with disruptive behavior disorders (ADHD, Oppositional Defiant Disorder) are capable of controlling their behavior and managing their emotions – but they need to devote much more mental effort to maintaining control than another child of the same age without the condition.

I’d define “structure” as clear and predictable rules, expectations and routines for task completion and interpersonal relationships. “Structure” allows kids to devote mental resources and energy to maintaining self-control instead of expending their available cognitive capacity processing the stimulation in their environment.

Let’s apply this concept to the holidays…For kids who struggle with self-control, their risk for disruptive behavior is reduced when they can fall back upon predictable and familiar routines. As the environment becomes increasingly chaotic and their daily schedule more disorganized and unpredictable, their capacity for maintaining self-control is diminished. Reestablishing routines as the resumption of school approaches is also important. Kids  often need a week or more to settle back into their school routines after two weeks of excitement and sleep deprivation.

image_ChristmasFamilyIn summary, three practical strategies will help many kids with common mental health conditions and their families to better experience the peace and joy associated with the Christmas season!

  • Busy is better for kids who think too much
  • Managing behavioral expectations for family gatherings outside the child’s usual routine
  • Intentionality in maintaining as much structure and routine as possible


shutterstock_118324816Key Ministry has put together a resource page for pastors, church staff, volunteers and parents with interest in the subject of depression in children and teens. Available on the resource page are…

  • Links to all the posts from our recent blog series on depression
  • Links to other outstanding blog posts on the topic from leaders in the disability ministry community
  • Links to educational resources on the web, including excellent resources from the American Academy of Child and Adolescent Psychiatry (AACAP), a parent medication guide, and excellent information from Mental Health Grace Alliance.


About Dr. G

Dr. Stephen Grcevich serves as President and Founder of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland (Family Center by the Falls), and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health. His blog for Key Ministry, was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
This entry was posted in ADHD, Anxiety Disorders, Families, Hidden Disabilities, Key Ministry, Strategies and tagged , , , , , , , , , , , , . Bookmark the permalink.

3 Responses to Christmas time challenges for kids with common mental health conditions

  1. May we share your blog on our blog, giving you credit? This may help our foster families this Christmas.
    Brandy from the Bair Foundation national office


  2. Melissa Baker says:

    Thank you


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