In the classic Christmas film It's a Wonderful Life, a despondent George Bailey, convinced that his life isn't worth living, prepares to leap off a bridge into the chilly waters below.
The notion that the joy others are experiencing during the holidays drives home the hopelessness in those who are not joyous - because of depression, loneliness, heartbreak, physical illness or financial woes - is well-ingrained in society.
It is widely assumed that those teetering on the brink, like George Bailey, are driven over the edge and that, at this time of year, suicides increase dramatically.
This is a myth. Research shows that suicide rates consistently drop during the holidays.
In a recent edition of the journal Social Science & Medicine, Helen Bergen and colleagues at the Centre for Suicide Research at Oxford University in England showed that during the holiday period, Dec. 16 to Jan. 6, suicide rates dropped a whopping 30 to 40 per cent.
Examining hospital admission data for more than 25 years in England, the researchers found that "acts of deliberate self-harm" dropped across demographic groups - young people, older people, those who were married, those with their families and those who were alone. (The only exception during the holidays was New Year's Day, when suicides among young men spiked, particularly for those who drank excessively.)
Recent research from the journal Psychiatry Research found a similar trend in Switzerland over a 30-year period.
Wulf Rössler and colleagues at the research unit for clinical and societal psychiatry at the Psychiatric University Hospital in Zurich found there was a steady decline in suicides throughout the last weeks of the year, with a low on Christmas Day.
After the new year and a return to routine, there was a sharp upswing in men's suicide rates and a slow, steady resumption of suicide among women.
Canada is no different. In 1994, Ronald Dyck of the University of Alberta (now with Alberta Health and Wellness) showed that suicide rates in Canada actually peak in August and bottom out in September. December and the Christmas period come in around the lower end.
So why do suicide rates fall during the holidays? Do the troubled, like George Bailey, actually have guardian angels?
In a sense, they do.
Scientific research repeatedly points to the importance of social networks and the value of the age-old medicines called friendship and belonging. (Other socio-economic determinants of health such as income and housing help too, but they are not the stuff of Hollywood.)
The gathering of friends and family, despite the stress it sometimes causes, generally has a positive effect. Holiday rituals are good for the soul and may offer a buffer against depression and suicide.
Of course, we should not lose sight of the fact that the vast majority of suicides result from underlying mental illness. Severe depression, anxiety, schizophrenia and the like cannot magically be cured by Christmas cheer.
But suicide is rarely a spontaneous act, and, in the severely depressed, suicidal thoughts can gnaw away at a person.
Breaking that cycle can help put into perspective the emotional pain that accompanies mental illness, or distract from the external events that often trigger suicide such as job loss, financial woes, failing an exam, the breakup of a relationship or the loss of a loved one.
Taking the time and effort to visit your grandmother in a nursing home, having dinner with a widowed aunt or patching things up with an estranged family member really can make a difference. So, too, can reaching out to a lonely neighbour, or even a phone call or card to someone with whom you have lost touch. (The free flow of alcohol at this time of year, on the other hand, has a deleterious effect. Alcohol causes untold damage to those suffering depression, and drinking is a leading suicide trigger.)
There is also increased awareness and availability of safety nets during the holidays. Food banks, shelters, churches, synagogues and other community-based programs step up their efforts during this time of year, and individuals in our self-centred world may momentarily reach out to the needy rather than avert their eyes.
Still, suicide remains a scourge in modern society. In Canada, an average 10 people a day take their own lives, fluctuations notwithstanding.
It is, in many ways, heartwarming that the numbers drop during the Christmas season. But it is merely a seasonal variation and should not mask the horror of the bottom line: thousands upon thousands of lost lives each year.
The question we need to ask ourselves is: How can we extend these protective benefits of Christmas?
Those who suffer from mental illness - so many of them isolated, lonely and painfully alone - need tidings of comfort and joy (as well as social and medical services) year-round, not merely during Advent.
If we cannot deliver A Wonderful Life to all in modern society, we should at least strive to provide everyone with a fighting chance for one.
André Picard