Volume 195 - Issue 11
The humbug syndrome
Author: Katrina J R Watson
Med J Aust 2011; 195 (11): 711. || doi: 10.5694/mja11.11405
Published online: 12 December 2011
Published online: 12 December 2011
A new twist to an old Christmas problem
In the past three decades of medical practice, there has been an increasing prevalence of a peculiarly Australian seasonal syndrome. The condition appears to affect a large segment of the population, and it appears that doctors may be particularly vulnerable.
Symptoms usually commence in October, and escalate during November. They include irritability, anxiety and a feeling of dread, sometimes precipitated by hearing certain choral music. Typical behaviours include the purchasing of inordinate quantities of food, or standing in an apparently dissociated trance-like state in front of Christmas card stands. During December, there may be lavish preparation of seasonally inappropriate dishes and consumption of large amounts of alcohol. In the advanced stages there is extreme fatigue and emotional lability.
Sufferers describe feelings of overwhelming competing responsibilities, particularly if they are parents. They feel they have to provide presents and joy, and cope with the end of the academic year; they feel obliged to attend multiple functions, including break-ups for school and parties for work. Some describe feelings of shock when they realise their children have finished school for the year. On top of this there is preparation for the long summer holiday, with packing up and cancellation of milk and newspapers. Bizarre behaviours include assembling and disassembling Christmas trees in short periods of time, or wandering around a garden with a hose, tearfully farewelling plants.
A forme fruste of the syndrome is an urge to make cakes or puddings. Signs of this variant include large quantities of dried fruit sitting on the kitchen bench for weeks. This appears to be a form of compensatory behaviour, particularly in mothers, in an effort to regain control.
The illness seems to be less severe in the northern hemisphere; parents there can concentrate solely on Christmas, because end-of-school festivities happen in June. Additionally, in North America, the Thanksgiving festival relieves the pressure of Christmas celebrations.
In Australia, the symptoms often continue to increase until the Christmas dinner, when the combination of high ambient temperatures and certain ingredients can precipitate a crisis.
Observational studies suggest that medical practitioners can be particularly severely affected. Doctors report additional pressures during this period, including hundreds of patients needing urgent appointments before Christmas, and describe the atmosphere in their clinical practices as one of “impending Armageddon”.
These behaviours appear to be compensatory responses to a syndrome first described in an 1843 publication of Dickens.1 In this case report, the sufferer, ES, is described as “a squeezing, wrenching, grasping, scraping, clutching, covetous old sinner”; a miserly, usurious wretch. Most, if not all, affected individuals are aware of this paper, and express a strong desire to avoid being likened to ES.
A contemporary reinterpretation of the original article is warranted. ES suffered multiple losses as a child and young man, including the loss of both parents and a sister, and a rejection by his fiancée. His “Bah, humbug!” was an expression of emotional deprivation. Despite this, ES responded to the cognitive behavioural therapy interventions administered by the Spirits of Christmas. In fact, ES became humane and kind, and gave a salary raise to his needy employee, Bob Cratchit. ES did not, however, overcompensate with manic forms of indiscriminate gift-giving, nor did he become profligate with food and wine. ES actually remained totally abstinent from alcohol of all sorts, and he subsequently became happy, and “as good a friend, as good a master, and as good a man, as the good old city knew, or any other good old city, town, or borough, in the good old world”.
It is therefore recommended that sufferers of this syndrome emulate, rather than avoid, Scrooge-like behaviour, and that they be good friends, good masters and good men and women not just at Christmas, but all year round; and be generous to those who need it most. “Bah, humbug!” may be just the remedy for the humbug syndrome.
Competing interests
The author discloses her recent purchases of large quantities of dried fruit.
References
- Dickens C. A Christmas Carol. London: Chapman and Hall, 1843. 0_BEBFHJIC