Holidays spark rise in emergency room visits, ER physician says

While it is true that suicide rates are actually lower at the holidays compared with other times of the year, these weeks can be very lonely for those with nowhere to go and no one to turn to. As a result, the hospital emergency department sees an increase in visits from people who have engaged in potentially self-destructive or depressive behavior.

"For those who have no support system, no friends, family, loved ones or even co-workers, the holidays can prove very deadly," said Mark DeSilva, MD, Emergency Department, Gottlieb Memorial Hospital, part of the Loyola University Health System. "Everywhere there are signs of gatherings, gift exchanges, happiness and love. If you are not experiencing what the rest of the world is enjoying, it is very bitter." Often there are signs that a person may be feeling overwhelmed. And there are opportunities to intervene.

Here are Dr. DeSilva's five tips to identify individuals who may be vulnerable during the holidays:

Isolated behavior – "Most people are busy going to social gatherings, shopping, attending events and connecting with friends," DeSilva said. "Look for those who shun social interaction or who consistently do not attend events that they say they will."

• Angry mood – "The person expresses sarcasm, unhappiness or criticism of others' joy in the season and is consistently pessimistic," he said.
• Alcohol or drug excess – "Beer or cocktails, readily available throughout the holidays, or illegal drugs, are overindulged to numb the pain the individual is feeling and offer an escape from reality," DeSilva said.
• Frequently missing from work/social activities – "Facing others who are happy and bright is often too difficult for those feeling the holiday blues," DeSilva said. "They may be consistently absent or very late to work or no-shows at anticipated social engagements."
• Excessive sleeping – "Depression often takes the guise of extreme fatigue or tiredness. The body shuts down to form an escape from the everyday world," DeSilva said.

If you see signs of extreme behavior in a friend, family member or acquaintance, act immediately. "Talk to the individual and talk to them about the behavior that you are seeing and offer to help," DeSilva said. "There are social services, community groups, churches and other programs that can intervene."

DeSilva routinely has seen increases in emergency room patients during the many years he has worked at Gottlieb, a community hospital based in the western suburbs. "The holidays bring out desperate behavior in unstable individuals and they frequently end up in the ED as a medical emergency."

The aftereffects of the last recession also have contributed to depression and engagement in risky behavior.

"Loss of a job or the unavailability of extra money for presents for loved ones can lead to low self-esteem and contribute to the person making poor choices," DeSilva said. "By recognizing when a person is in trouble, and speaking out, you may not only save them a trip to the ED, but also save a life."