You are not the only one dreading it. Nearly half of US adults say they worry about missing someone over the holidays, and the research has some specific things to say about which days tend to be hard.
The invitations have started. Someone has asked what you are doing this year, in a careful voice, and you do not know. You do not know whether you want the whole thing to happen exactly as it always has, or whether that would be unbearable.
Two things are worth knowing before you decide anything. You are in very ordinary company. And some of what you have been told about grief is wrong in ways that make this harder.
Close to half say they are worried about it. In the American Psychiatric Association's Healthy Minds poll, fielded in early November 2025 among 2,203 US adults, 48 percent said they were worried about missing someone or grief. That was the most common worry measured, ahead of affording gifts at 46 percent, challenging family dynamics at 32 percent and loneliness at 31 percent. Forty-one percent expected more holiday stress than the year before.
The same poll found something worth holding onto: 44 percent said the holidays have a positive effect on their mental health, against 21 percent who said negative, and 61 percent named seeing family and friends as what they most looked forward to. You can miss someone badly and still enjoy parts of the day.
Around significant dates, yes. Around December specifically, the evidence is less clear than the cliché.
A 2025 systematic review of 58 articles concluded that the literature supports the phenomenon of a bereavement anniversary reaction. But the most careful prospective test is worth looking at closely. Researchers followed 210 widowed people and 87 matched married people. In the first six months, those interviewed within 30 days of their late spouse's birthday reported significantly higher despair, anxiety and depressive symptoms. January showed elevations across nearly every measure. June, wedding season, raised yearning and despair. December showed no significant rise, though this was one small study, so it does not prove December is easy. At 18 months the pattern was no longer detected.
The honest version of the claim, then, is that early grief intensifies around dates that mattered to that particular relationship, and which dates those are is personal. For some people that is Christmas morning. For others it is a Tuesday in February that nobody else has marked, or the first time the weather turns and you reach for the phone.
The National Cancer Institute describes what this feels like as grief bursts: short periods, roughly 20 to 30 minutes, of very intense distress, often set off by reminders, with painful feelings coming and going rather than being constant. That is a useful thing to know in advance of a long lunch.
For a first holiday season, intense grief is common, and there is a specific reason a diagnosis does not fit yet.
Prolonged grief disorder was added to the DSM-5-TR in March 2022. For adults, the criteria require that the death occurred at least a year ago, alongside intense yearning or preoccupation most of the day nearly every day for at least a month and at least three of eight further symptoms. If your loss is more recent than that, the diagnosis does not apply to you by definition. The American Psychiatric Association estimates that 4 to 15 percent of bereaved adults go on to experience prolonged grief disorder, and a meta-analysis of 14 studies put the pooled figure at 9.8 percent.
Which means most bereaved adults do not develop it. Grief can still be painful and disruptive without meeting a diagnosis, and that alone is reason enough to ask for support if you want it.
Set them down. The stage model has not held up, and researchers have been unusually blunt about it. Margaret Stroebe, Henk Schut and Kathrin Boerner argued in 2017 that science and practice seem deeply stuck in stage theory, that health-care professionals continue to prescribe stages, and that the expectation that bereaved persons will, even should, go through stages of grieving can be harmful to those who do not.
Even the study most often cited as supporting the stages complicates them. Tracking 233 bereaved people over two years, it found the responses peaked in the expected order on average across the group, but acceptance was the most frequently endorsed item throughout and yearning, not anger or depression, dominated from 1 to 24 months. An average across a group is not a march that each person makes through five rooms.
What has held up is the dual process model, supported in a systematic review of 22 studies: people oscillate between loss-oriented coping and the practical business of rebuilding a life, moving back and forth rather than progressing. That is why you can laugh at dinner and cry in the car on the way home and neither one is a relapse or a breakthrough. We wrote about this at more length in Why Grief Comes in Waves Instead of Neat Stages.
Trajectory research says something similar about the overall shape. Following 282 people bereaved of a spouse over two years, the largest group by far took a resilient course, with smaller groups improving gradually and a small minority worsening.
The Hospice Foundation of America offers a three-word framework. Choose: decide what activities you want to be part of, who you want to be with, and what you want to do. Communicate: tell people your choices, because grief responses differ and nobody can read your mind in a kitchen full of people. Compromise: there is no right or wrong way to grieve, so leave room for other family members needing something different from what you need.
Memorial Sloan Kettering's patient guidance adds a few concrete moves. Decide in advance whether to keep existing traditions or create new ones, with no obligation either way. Tell people what you need even when it feels hard. Mark the person deliberately if you want to, through something private or something shared. And postpone major life decisions, which is worth knowing if a house or a job is currently looking like an answer.
The Mayo Clinic's guidance on anniversary reactions suits the Valley, where the holidays mean relatives flying in and a calendar that fills fast: expect the reaction rather than being ambushed by it, plan to be with people at the times you know will be hardest, reminisce on purpose rather than only by accident, and allow yourself both the sadness and the enjoyment.
One thing to decide before you walk in: your exit. Not as a failure plan. As the thing that lets you say yes to the first hour.
This deserves a straight answer rather than an advertisement, and the research draws a clear line.
Grief counseling offered broadly to everyone who has lost someone has shown mixed results. A meta-analysis of 14 randomized trials found no significant difference for preventive interventions, and a significant benefit for treatment aimed at people whose grief had already become complicated. A later meta-analysis of 31 trials found modest overall effects, larger where participants started with high symptom levels. The National Cancer Institute states plainly that researchers disagree about whether credible evidence on the efficacy of grief counseling exists, and notes that most bereaved people adapt without professional help.
So you do not need therapy to get through a first holiday season, and you also do not have to wait until things are severe to ask for support. The evidence is strongest for people whose grief is not moving at all, months in, or who cannot look after themselves, or who have stopped letting anyone near them.
One myth worth setting down: suicide rates are not highest during the holidays. Using 2024 federal data, December had the lowest average daily suicide rate of any month in the US.
If you want someone outside the family to think this season through with you, that is a reasonable use of a few sessions, and it does not commit you to anything longer.
The Healing Effect works with clients across Arizona, in person and by telehealth for clients located in the state. You can read more on our grief and loss page, or get in touch through our contact form. If the shape of your grief has surprised you, When Grief Doesn't Look the Way You Expected may be the more useful place to start.
And you are allowed to do less this year than you have ever done. Nobody who loves you is keeping score, and the ones who are can be disappointed.
In person or by telehealth, for clients located in Arizona.
Partly because reminders are everywhere and partly because the calendar forces decisions you would rather not make. Research supports the existence of bereavement anniversary reactions, and the National Cancer Institute describes grief bursts of roughly 20 to 30 minutes of intense distress triggered by reminders such as major holidays. One careful prospective study found distress rose around a late spouse's birthday and in January, with no significant rise in December, which suggests the dates that hurt are often specific to the relationship. It was a small study, so it does not prove December is easy.
There is no set period, and most people adapt gradually without professional help. Prolonged grief disorder, added to the DSM-5-TR in 2022, requires for adults that the death occurred at least a year ago plus intense yearning or preoccupation nearly every day for at least a month and three of eight further symptoms. The American Psychiatric Association estimates 4 to 15 percent of bereaved adults experience it, and a meta-analysis put the pooled figure near 10 percent.
Not as a sequence people pass through. Researchers have argued the stage model lacks empirical support and that expecting bereaved people to move through stages can harm those who do not. The better supported account is the dual process model, in which people oscillate between grieving and rebuilding rather than progressing through phases.
Either, and you are allowed to decide late. Memorial Sloan Kettering's guidance says plainly that there is no right or wrong way to respond to these particular days and advises doing what feels most comfortable. The Hospice Foundation of America's three Cs are to choose what you take part in, communicate those choices to others, and compromise where family members need different things.
It depends who is receiving it, and you do not have to wait until grief is severe to ask. A meta-analysis of 14 randomized trials found that preventive grief interventions offered to bereaved people generally showed no significant benefit, while treatment aimed at people whose grief had become complicated showed a clear one. A later meta-analysis of 31 trials found modest overall effects that were larger where people began with higher symptom levels.
Sources:
American Psychiatric Association. Healthy Minds Poll news release, November 18, 2025 (48 percent worried about missing someone or grief; 46 percent affording or finding gifts; 32 percent challenging family dynamics; 31 percent loneliness; 41 percent anticipating more stress than the prior year; 44 percent positive and 21 percent negative effect on mental health; 61 percent looking forward to seeing family and friends). Fielded by Morning Consult November 4 to 5, 2025 among 2,203 US adults; no margin of error published.
Leaune E, Lau-Tai P, Pitman A. The phenomenon of bereavement anniversary reactions: An integrative systematic review. Death Studies. 2025 (58 articles; the literature supports the phenomenon of a bereavement anniversary reaction).
Carr D, Sonnega J, Nesse RM, House JS. Do special occasions trigger psychological distress among older bereaved spouses? An empirical assessment of clinical wisdom. The Journals of Gerontology Series B. 2014;69B(1):113 to 122 (210 widowed people and 87 matched married controls; elevated despair, anxiety and depressive symptoms within 30 days of the late spouse's birthday in the first six months; January and June elevations; no significant elevation in December, in a small sample; the pattern not detected at 18 months).
National Cancer Institute. Grief, Bereavement, and Coping With Loss (PDQ), Patient Version, updated February 2025, and Health Professional Version, updated June 2024 (grief bursts of roughly 20 to 30 minutes; pangs as reactions to reminders including major holidays and the anniversary of the death; painful feelings coming and going rather than being constant; researchers disagree about whether credible evidence on the efficacy of grief counseling exists; most bereaved people adapting without professional intervention).
American Psychiatric Association. Prolonged Grief Disorder, patient-facing criteria summary (loss at least a year ago for adults; yearning or preoccupation most of the day nearly every day for at least a month; at least three of eight further symptoms; an estimated 4 to 15 percent of bereaved adults).
Lundorff M, Holmgren H, Zachariae R, Farver-Vestergaard I, O'Connor M. Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. Journal of Affective Disorders. 2017;212:138 to 149 (pooled prevalence of 9.8 percent across 14 studies of adults bereaved by non-violent causes).
Stroebe M, Schut H, Boerner K. Cautioning Health-Care Professionals: Bereaved Persons Are Misguided Through the Stages of Grief. OMEGA Journal of Death and Dying. 2017;74(4):455 to 473 (science and practice deeply stuck in stage theory; professionals continuing to prescribe stages; the expectation of going through stages as potentially harmful to those who do not).
Maciejewski PK, Zhang B, Block SD, Prigerson HG. An Empirical Examination of the Stage Theory of Grief. JAMA. 2007;297(7):716 to 723 (233 bereaved individuals; grief indicators peaking in the hypothesized order on average; acceptance the most frequently endorsed item and yearning the dominant negative grief indicator from 1 to 24 months post loss).
Fiore J. A Systematic Review of the Dual Process Model of Coping With Bereavement (1999 to 2016). OMEGA Journal of Death and Dying. 2021;84(2):414 to 458 (22 studies; the model accurately represents the bereavement experience; oscillation between loss-oriented and restoration-oriented coping).
Bonanno GA, Malgaroli M. Trajectories of grief: Comparing symptoms from the DSM-5 and ICD-11 diagnoses. Depression and Anxiety. 2020;37(1) (282 people bereaved of a spouse, interviewed at 3, 14 and 25 months; a resilient trajectory accounting for the majority, with smaller improving groups and a small worsening minority).
Wittouck C, Van Autreve S, De Jaegere E, Portzky G, van Heeringen K. The prevention and treatment of complicated grief: a meta-analysis. Clinical Psychology Review. 2011;31(1):69 to 78 (14 randomized trials, 1,655 participants; preventive interventions showing no significant difference from control, standardized mean difference of minus 0.03 post-intervention; treatment interventions significant at minus 0.53 post-intervention and minus 1.38 at follow-up).
Johannsen M, Damholdt MF, Zachariae R, Lundorff M, Farver-Vestergaard I, O'Connor M. Psychological interventions for grief in adults: A systematic review and meta-analysis of randomized controlled trials. Journal of Affective Disorders. 2019;253:69 to 86 (31 trials; Hedges g of 0.41 post-intervention and 0.45 at follow-up, 0.31 adjusted for publication bias; baseline symptom severity a significant moderator).
Doka KJ. Three Cs for Coping with Grief. Hospice Foundation of America, December 2014 (choose, communicate, compromise; there is no right or wrong way to grieve).
Memorial Sloan Kettering Cancer Center. Coping With the Death of a Loved One, patient education, updated May 2026 (keeping or creating traditions, with no right or wrong way to respond to particular days; communicating what you need; rituals of remembrance; delaying major life decisions).
Mayo Clinic Staff. Grief: Coping with reminders after a loss. Mayo Clinic News Network, December 2020 (anniversary reactions as a normal part of grieving; being prepared and expecting them; planning to be with people at high-risk times; deliberate reminiscing; creating a ritual).
Annenberg Public Policy Center, University of Pennsylvania. Lowest Suicide Rate Is in December but Some in Media Still Promote Holiday-Suicide Myth, December 2025 (using 2024 federal data, December ranked 12th of 12 months in average daily suicide rate, with August highest).
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