The true spirit of Christmas

At this time of year there is an expectation (sometimes unspoken) for us all to be merry. With the prospect of a few days' holiday, some time spent with loved ones and at least one cracking meal, perhaps this is fair. For many this expectation can prove to be too much.

"A wise man has something to say; a fool has to say something." BA Baracus (Mr T)

As I sit writing this, there are 28 shopping days to Christmas. As we live in a 24/7 world where we can shop online at any time of the day or night, this tells you precious little. But suffice it to say that the festive season is nearly upon us.

At this time of year there is an expectation (sometimes unspoken) for us all to be merry. With the prospect of a few days' holiday, some time spent with loved ones and at least one cracking meal, perhaps this is fair. For many this expectation can prove to be too much. Christmas can serve as a reminder of particularly painful times, an anniversary of bereavement or just a reminder of those no longer there to share the Christmas meal. For others the universal goodwill only acts as a stark contrast to how they feel, accentuating their depression. Knowing that many will be joyfully reunited with their families and friends may make others feel even more alone. For these reasons there is something of an urban legend that this time of year always tops the charts for most suicides. In fact research shows us that suicides and deliberate self-harm attempts decrease in the run-up to Christmas Day. There is an increase in events related to those with chronic alcohol misuse problems around New Year, but otherwise no significant change. Perhaps this reflects the success of care planning and available support services - a cause for self-congratulation amongst the negative media stories. What do you think?

Christmas will also bring the usual glut of patients with coughs and colds that 'need sorting out' before the holiday, along with other unrealistic expectations. I just hope that I will have enough reserves to listen patiently to those who need a sympathetic ear, reassure appropriately (and with no loss of temper) those who think I have a magic wand and still have enough energy to buy presents, send cards and cook a bigger than usual lunch. Each year I think how much more in the true spirit of Christmas I would be if I volunteered at a local shelter - although I doubt my husband or boys would agree. The years I spent in hospital medicine where I seemed inevitably to be working over the Christmas period, were despite the granny dumping and the less-than-amusing drunks, very satisfying. Perhaps I've just grown older and look back with rose-tinted glasses. No doubt those who still work in that environment will correct me and I'm sure 20 years have changed everything hugely. However, no matter where you work, at Christmas we will need to deal with other people's stress as well as our own. Dust off your smile and your coping mechanisms. Good luck.

In the last month we have updated the following articles on Psoriasis following NICE guidance published at the beginning of November: Chronic plaque psoriasis P+ (PIL also updated), Psoriatic nail disease PIL, Psoriatic nail disease P+ and Psoriatic arthritis. We have also responded to the Department of Health's decision to routinely vaccinate babies against rotavirus (PIL also updated) and updated immunisation schedules.