To the best of my knowledge, there is no study which observes the influence of the holiday season (Christmas and New Year) on non-suicidal self-injury. The closest we have are studies on “deliberate self-harm”, a broad term which refers to any type of self-inflicted injury or poisoning irrespective of the motive. This includes self-injury but also suicidal behaviors. The population observed in these studies are patients of the emergency services, which are not wholly representative of those who self-injure. Indeed, it seems fair to assume that the self-harm cases included in these studies are predominantly suicidal behaviors, as non-suicidal self-injury rarely leads to hospital presentation.
Rates
In the days preceding Christmas and on Christmas day, emergency services face a lower rate of presentations for deliberate self-harm than usual1, 2, 3, 4. One possible explanation is that people may benefit from the increased social contact during Christmas, as family tend to visit and stay over the course of several days1, 5. In contrast, a higher risk of deliberate self-harm has been observed after New Year1, 4, perhaps because unlike at Christmas, friends visit more briefly on New Year’s eve1. Interestingly, only those under 25 show a reduction of hospital presentation in the days preceding both Christmas and New Year1.
Another possible theory to explain the rise in presentations for deliberate self-harm after New Year is the “broken promise”.
The “broken promise” effect
For some desperate and depressed people, events commonly associated with happiness, such as the weekend or holidays, might give hope in feeling better and therefore lead them to postpone self-harming behaviors. However, after those specific moments pass and fail to bring improvement, frustration and disappointment can result in self-harm. This theory is known as the “broken promise” effect. This might explain, for example, why suicides tend to occur more frequently on monday and tuesday and rarely during the weekend1, 2, 5.
Alcohol
While the rate of presentations for deliberate self-harm is lower, alcohol could still remain a contributing factor. There is a higher rate of alcohol-related fatalities during the holiday season3 and self-harm presentations during the Christmas period are more likely to involve alcohol5.
Conclusion
It’s important to keep in mind that these findings don’t strictly apply to non-suicidal self-injury, but instead relate to presentations for any non-lethal self-harm at emergency services, that we can assume to be predominantly suicidal behaviors. More research is needed to investigate the effects of the festive season on non-suicidal injury. However, due to the predominantly private nature of the behavior, and the possible difficulties in finding people to join research during the busy festive season, it’s not surprising that such research has not been performed yet.
If you found this article interesting and would like to learn more about how self-harm varies throughout seasons, I’ve also covered self-harm during the summer and during autumn and school months.
References
[1] Bergen, H., & Hawton, K. (2007). Variation in deliberate self-harm around Christmas and New Year. Social Science & Medicine, 65(5), 855-867. https://doi.org/10.1016/j.socscimed.2007.04.004
[2] Blenkiron, P. (2003). The timing of deliberate self harm behaviour. Irish journal of psychological medicine, 20(4), 126-131. https://doi.org/10.1017/s079096670000793x
[3] Sansone, R. A., & Sansone, L. A. (2011). The Christmas Effect on Psychopathology. Innovation in Clinical Neuroscience, 8(12), 10-13. http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3257984/
[4] Schneider, E., Liwinski, T., Imfeld, L., Lang, U. E., & Brühl, A. B. (2023). Who is afraid of Christmas? The effect of Christmas and Easter holidays on psychiatric hospitalizations and emergencies—Systematic review and single center experience from 2012 to 2021. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2022.1049935
[5] Griffin, E., Dillon, C. B., O’Regan, G., Corcoran, P., Perry, I. J., & Arensman, E. (2017). The paradox of public holidays: Hospital-treated self-harm and associated factors. Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2017.04.058
Exploring self-harm 