Top tips for looking after your mental health at Christmas

Dr Nihara Krause
Consultant Clinical Psychologist


Social Anxiety


Christmas, with all its various social occasions, can be a nightmare for people with social anxiety. Try and face your anxiety by deciding to go, but chose your challenge – start with a small social event, work up to a bigger one.


1. Give yourself some time to get ready – do something relaxing beforehand such as have a bath, watch some TV

2. Arrive at the party before it gets too busy – get there on time or even a little early

3. Prepare some topics you might like to talk about before the party, practice some lines in front of a mirror – sounds daft but it helps to be more fluent

4. Give yourself the opportunity to have a break if it becomes too much – go somewhere quiet, do some breathing, visualise a confident you and go back and face your fear

5. Know in advance when you would like to leave

6. Don’t ‘ self-medicate’ with alcohol – it might initially relax but it will generally add to more anxiety


Eating Disorders


Christmas with its focus on eating and plenty of treats can be very challenging if you have an eating disorder. For those with anorexia nervosa, it can be frightening to think of facing so much food and for those with bulimia nervosa a fear of how to regulate eating.


1. Plan what you think you are going to eat before you go or else eat before you go – stick to your meal plan if you are following one. On the other hand, it can also be a great opportunity to try something new

2. Don’t skip meals during the day in order to cope with going out – this will make you hungrier when you are out and more likely to be out of control

3. Be as honest as you can with family and friends. Make sure they can provide something you can eat

4. Learn how to relax before you join social situations which involve food so that you know what to do to relax when you are in them

5. Have a ready prepared answer for anyone who might comment on your weight, shape or the amount of food you are eating

6. Don’t starve in order to eat at Christmas




When you are depressed it’s difficult to find the energy or the motivation to do anything. It’s also easy to feel lonely in your sadness when all around you are making merry.


1. Attend Christmas gatherings and take away the pressure you might place on yourself to be the life and soul of the party

2. Give yourself the option of being a listener rather than a contributor

3. Do some extra regular exercise to help reduce lethargy – walking is great

4. Try not to self-medicate with alcohol. This only serves to further depression

5. Take steps to make an effort with your appearance – self-care can help to temporarily alleviate mood

6. Try and connect with people who support and care for you




If you have an addiction or are in recovery, the Christmas period with its surpluses can provide temptations that are hard to resist.


1. Keep your schedule of abstinence. If you think there is a risk of lapsing back into alcohol or drug misuse then perhaps don’t attend certain places or events or be with certain groups of people who you know can be triggers

2. Challenge ‘I deserve it’ type thinking that encourages drinking or drug use

3. Practice saying ‘no’ and make sure you say this in situations where you need to in order to protect yourself

4. At a party try and join people who are non-drinkers. If you have a friend who is a non-drinker attending the party, pre-arrange to go to the party together

5. Make a plan to leave early – the later you stay, the higher the likelihood of being tempted


International Men’s Day

November the 19th is International Men’s Day

12.5% males in the UK suffer from one of the common mental ill-health conditions (Men’s Health Forum, 2016). However, the presentation of mental health problems in males is often under-diagnosed, with many men not seeking help in the first place. Traditional treatments such as talking therapies are also not always favoured by men. It is therefore true to say that the field of male mental health needs more investigation and understanding.

The types of problems are fairly gender specific. Some male mental health facts include:

  • Over three-quarters of those who take their own lives are male and suicide is the highest cause of death in males under the age of 35 (ONS, 2016)
  • Men are nearly three times more likely than women to become alcohol dependent (8.7% of men are alcohol dependent compared to 3.3% of women) (Health and Social Care Information Centre, 2017)
  • Men are three times more likely than women to report frequent drug use (4.2% and 1.4% respectively). 
Whilst more than two thirds of drug-related deaths occur in men. (Public Health England, 2017)
  • Men have measurably lower access to the social support of friends, relatives and the community
  • Boys present with all the same types of difficulties as men. Anxiety and depression are the most commonly occurring, together with behavioural disorders and substance abuse conditions. Whilst a quarter of the eating disorder population are boys, this group can often pose a considerable challenge in terms of identification and recovery. The incidence of psychosis is higher in males

We need to do whatever we can to encourage boys and men to address their mental health and wellbeing. Having a warm, open relationship with parents is the first building block. Finding a way to connect so that some sort of discussion can take place is another. Having an activity to focus on is often helpful as is a mentoring model of having an older sibling or a peer to support. Traditional models of mental health care with their heavy and often implicit reliance on help-seeking and face-to-face encounters involving emotional disclosure are more likely to present barriers to boys and men and its important for mental health professionals to draw upon scientific evidence to provide more effective treatments that engage males to live happier lives.


Health and Social Care Information Centre,2017 Statistics on Alcohol, England, 2016, HSCIC and ONS
Office of National Statistics, Britain, 2016 Suicides in Great Britain
Mens Health Forum Website,
Public Health England (2017) Adult Substance Misuse Statistics From the National Drug Treatment Monitoring System, April 2016 to March 2017

Dr Nihara Krause
Consultant Clinical Psychologist
Founder and CEO stem4

Local Charities Day and stem4

Our aim at stem4 is to support teenage mental health, raise awareness, build resilience and encourage early intervention.

Founding stem4

I founded stem4 in 2011, after the death of a 16-year-old who had anorexia nervosa and whose school I became involved with in my clinical capacity. Since then we have extended our scope to work not only with students, parents and teachers but to provide information to school nurses and GPs in four specific areas of mental health commonly affecting teenagers – eating disorders, anxiety & depression, self-harm and addiction. We also advise on ways to enhance well-being and emotional resilience.

Increasing demand

Talks are offered in conference format by mental health professionals and our ambassadors all have lived experience of dealing with mental health issues. We offer these conferences to students, parents, teachers, school nurses and GPs and we have had very positive feedback. We use feedback from our student conferences to help us develop our education offers, and they also promote a cascade effect through students delivering school assemblies as well as providing ideas that have helped us create a ‘school mental health toolkit’. Due to increasing demand, and because of our commitment to offer our services to schools that can’t access information about mental health as easily, we have produced a series of educational videos so that all schools can access this information.

Taking advantage of technology

As a clinician specialising in this field, I was really excited to be able to design and develop an app to help people manage their urge to self-harm. Since the launch of Calm Harm in 2015, it has been downloaded over 55,000 times. The app was developed with young people who provided their views on the design and on the tasks and a new version was released in April 2017. It is now available on NHS Choices.

Local Charities Day 2017

The contribution made by small local mental health charities such as stem4 is vital in complementing the work carried out by statutory organisations, as we can tailor our work to local people. Celebrating the work of local charities on this day is important because of the recognition it gives in helping promote our work, gives us the energy to keep up our fundraising efforts and also encourages linking up with other charities.

A message we pick up constantly from the children and young people we work with, as well as their families, is the importance of connection. We are celebrating Local Communities Day this year by promoting ‘Connect4 stem4’ – encouraging young people, their families and work organisations to spend 4, 14 or 40 minutes carrying out a fun activity whilst sharing something important about themselves.

Dr Nihara Krause
Consultant Clinical Psychologist
Founder and CEO stem4

Making Some Time to Talk on World Mental Health Day

On World Mental Health Day, when we are reminded of the importance of looking after our mental health, what can we all collectively do that’s helpful? My recommendation as a Consultant Clinical Psychologist and CEO of stem4 would be to recommend making some time to talk today. Talk the good old-fashioned way using words, face to face, expressing thoughts, emotions and intentions – being listened to and being heard. Our speedy modern communication through social media, text and email can’t surpassed what some people may see as a time consuming and sometimes painful process, especially if talking isn’t practiced or words are not your forte

Robert Frost in his poem ‘Time to Talk’ says

‘When a friend calls me from the road

And slows his horse to a meaning walk,

I don’t stand still and look around

On all the hills I hadn’t hoed,..’

Talking is probably one of the most under rated human abilities and the most often practiced one. Mothers talk to their babies from the time they are born (and even when they are in utero) initiating the process of bonding through creating a pathway through words to emotional connection. It is one of our oldest forms of love.

Talking helps to clarify your thoughts, to pay attention to things and to get a different perspective or to get a handle on what may be churning inside. It substantiates our experiences and memories. It helps you to connect to others and to sometimes release an internal pressure such as anger or sadness.

As William Blake in ‘A Poison Tree’ says

‘I was angry with my friend:

I told my wrath, my wrath did end.‘

Talking forms the basis of psychological treatment and at a time when children and young people’s mental ill health is at an all time high, how do we encourage talk, particularly in boys and men?

The statistics on mental health problems indicate a heavier bias towards boys. In children aged 5-10 years, 5.10% boys present with mental health problems in comparison with girls and in children aged 11-15 years, 12.8% comprise of boys whilst 9.5% are girls (National Statistics online, 2004).

The types of difficulties boys present with include a higher rate of behavioural and developmental problems such as conduct disorders and autistic spectrum disorders and in the older group, a higher proportion of alcohol and drug misuse, bipolar disorder and schizophrenia. Statistics also indicate that suicide in more common in young men under the age of 35.

And yet, far less boys admit to experiencing emotional difficulties and attendance figures to G.P’s indicate that more girls and women seek help. In a ‘man-up’ culture, where expressing vulnerability is seen to be negative, encouraging boys and young men to admit to mental health difficulties remains a challenge. Education plays a huge role in enabling discussion, discouraging ‘banter’ and bringing about an attitude change. Promoting and supporting fathers to instigate discussion about concerns and worries is another.

In an age when self-harm predominates as way in which 1 in 12 children in the UK non verbally communicate their stress and distress, surely we need to provide them with verbal tools which will enable them to begin a process of change and healing? So let’s celebrate positive mental health today and spread the word – let’s make a special effort to talk.


Dr Nihara Krause, Consultant Clinical Psychologist

CEO stem4