3 winter habits that push patients over the edge—and what you can do about it
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Dysregulation in the dopamine system can lead to frantic attempts to regulate dopamine activity through different means.
—Joseph R. Volpicelli, MD, PhD
The holidays may be over, but winter’s health risks are just getting started. As patients continue traveling, shopping, and gathering indoors, clinicians often see a predictable—and preventable—spike in physical and mental health issues.
From impulse-driven behaviors and substance relapse to cold-related cardiac events and injuries, winter quietly amplifies vulnerabilities that many patients manage the rest of the year. Stress, disrupted routines, social isolation, and environmental hazards converge, creating a seasonal perfect storm that shows up in exam rooms nationwide. Here’s what physicians should be watching for—and why these winter-specific risks deserve closer attention.
1. Compulsive shopping
Though we don’t have hard data showing impulse shopping spikes around the holidays, it’s well known that many compulsory behaviors increase this time of year—and those behaviors tend to run together.
“People who struggle with compulsive shopping often also have compulsive eating, compulsive exercise, excessive gambling, or other behavioral compulsions,” says Joseph R. Volpicelli, MD, PhD, the executive director at the Institute of Addiction Medicine.
According to Dr. Volpicelli, these behaviors are likely fueled by a dopamine mechanism. “Dysregulation in the dopamine system can lead to frantic attempts to regulate dopamine activity through different means,” says Dr. Volpicelli.
Nona Kocher, MD, a board-certified psychiatrist in Miami, says the holiday season heightens emotional intensity—stress, loneliness, nostalgia, family dynamics, and grief—while also disrupting sleep and routines.
“Combined with constant marketing, social pressure, and easy access to quick rewards, this lowers impulse control and makes dopamine-seeking behaviors more likely,” Dr. Kocher says.
Though spending is common during the holiday season, roughly 5% of the population struggles with a shopping disorder. [] “Doctors should screen for red flags, including concealment of purchases, regret and shame after spending, relationship strain over money, and escalating debt,” advises Dr. Volpicelli.
2. Substance misuse and relapse
Also common around the holidays is drug and alcohol use. According to Dr. Volpicelli, people may be reminded of past years when they celebrated with alcohol and repeatedly find themselves in social situations centered around alcohol. As cravings intensify, a person's typical defenses may weaken. Stress, poor sleep, and social isolation can further erode resistance, adds Dr. Volpicelli.
“The holidays don’t create these patterns—they expose coping strategies, and compulsive reward-seeking is often a signal that deeper emotional needs aren’t being met,” says Dr. Kocher.
Dr. Volpicelli hopes doctors recognize that people with a history of substance use disorder are particularly vulnerable during the holidays and through the winter. Doctors can help their patients anticipate high-risk situations and have a game plan in place. The goal isn't perfection,” Dr. Volpicelli says, “it's strategy and support.”
3. Wintertime injuries and accidents
‘Tis the season of snow, frigid temperatures, and icy roads—and, with that, a spike in injuries and accidents. [] According to the Department of Transportation, 24% of weather-related car crashes occur on snowy, slushy, or icy roads, and 15% take place when it snows or sleets. []
Physicians also see injuries spike off the roads. For example, cold temperatures and shoveling snow can increase the risk of a heart attack, according to the American Heart Association. [] []
“Cold weather causes vasoconstriction, which is when the blood vessels tighten—called constriction—and get smaller, which makes our blood pressure go up,” says Marianne Matzo, PhD, APRN-CNP, AOCNP-Emeritus, FPCN, FAAN, a certified advanced nurse practitioner, adjunct professor in gerontology in the School of Integrative and Professional Studies at the University of Maryland Global Campus, and host of the podcast Everyone Dies.
“Too much exertion, especially when you are not used to strenuous exercise, that occurs too quickly, can trigger a heart attack, especially in the cold,” she adds.
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