Contrary to popular belief, suicides don’t happen more often during the holidays. But this time of year is still challenging for both patients and providers. The never-ending to-do lists, the pressure to see family who hurt our mental health, and the constant temptation to overeat and drink can make it hard to get out of bed.

Because the challenges of the holiday season are so rampant, providers should take time to check in with patients about their coping abilities, says Pam Greene, Ph.D., RN, assistant professor at the College of Nursing and Health Sciences at Texas A&M University, Corpus Christi, and member of the American Psychiatric Nurses Association (APNA).

“If people have competing needs, and they have depression and anxiety, during the holidays, it can escalate,” she explains.

What’s more, your efforts may have a more lasting impact during the end of the year. Why? Dr. Greene says mental health providers tend to have fewer appointments and could more easily squeeze in a referral.

Here are some ways to get the conversation started.

“The holidays can be challenging. How are you doing with everything?”

Dr. Greene frequently uses this as an opener with patients, especially with those who’ve had a challenging year. This encourages them to speak candidly about what’s bothering them and allows you to provide guidance as necessary.

“I know you worked on your weight loss this year, and I want to help you not slip into old patterns.”

For this strategy, weight loss is just an example. You can use any health initiative a patient has taken recently. This allows you to provide specific strategies to help the individual plan. For example, suggest they treat Christmas buffets as a sampler rather than a whole meal.

“You seem slightly off today. You’re not talking much, and that’s unusual.”

This is a good opening for a patient feeling down or anxious. It shows that you understand them as an individual and you’re paying attention. The key here, Dr. Greene says, is to be direct. Say precisely what you’re noticing and your worries as a healthcare provider.

“I just want to make sure you’re not slipping through the cracks in the busyness of this time of year.”

Again, letting a patient know that you notice their needs will help them open up. This can also be an excellent transition to discussing New Year’s resolutions. Starting them a few weeks early can help patients regain control, Dr. Green advises.

“Who do you most enjoy spending time with? Have you made plans to spend time with that person?”

The holidays come with plenty of social obligations, which can cause people to de-prioritize the people they see often who are beneficial for their mental health. “We want to encourage people to stick to the parts of the holidays that are keeping in their values,” Dr. Greene explains.

“What has happened most recently with the holidays that you’ve felt good about?”

Sometimes, no matter how many Christmas banners declaring “Joy to the World” you drive past, you can’t get that warm, fuzzy feeling—but encouraging struggling patients to focus on how they’ve helped someone important to them can.

“What have you accomplished so far this season?”

Nothing cuts through the overwhelming sense that you’re a failure, like thinking through what you’ve gotten done. This question provides a small dose of empowerment that can last for weeks.

If the responses to these questions give you pause, Dr. Greene reminds fellow providers to conduct a mental-health screening. If the patient’s baselines are elevated, it might be time for a referral.

Asking personal questions during a time of year when we’re all struggling can seem daunting, but the goal, Dr. Greene says, is simple: “Give patients permission to manage their own lives.”