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Monday, December 12, 2016
Ask the Doctor: Holiday Stress Strategies
EPRINT: Permission BP Hope Magazine
Enjoy the gift of peace and health through careful planning ahead, avoiding triggers, and monitoring your mood before, during, and after this year’s holiday season.
By Melvin G. McInnis, MD
With the holidays approaching, there is a childlike anticipation of good times: the parties, the jingle in the malls, the shopping, the food, and—my favorite—snow. But challenges abound. Routines are out the window. Sleep is disturbed. Alcohol flows. The treats brought into the office are just so tempting … Living with bipolar during the holidays is often not easy.
What is it about the holidays that makes this such a difficult time?
There are two main challenges I see my patients struggling with around this time of year: One is impulsivity—the tendency to do things on the spur of the moment, often with limited regard for consequences; even when manic or depressive syndrome is not present, sometimes sub-syndromal or mild symptoms persist and drive actions. The second is reactivity—the tendency to respond with extreme intensity to external stimuli; good things take one “over the top” and bad things do the polar opposite.
What can I do to stay well yet still have some fun?
First and foremost: prioritize your health. Avoid changing your medications without talking to your health-care provider, and contact him or her right away if you feel a change in mood coming on.
Plan, prioritize, and avoid impulsive activity (this includes spending!). If there are things that can be done in advance, do them. Gifts? Create a shopping list and a budget and stick to it—don’t procrastinate and then panic and overspend at the last minute. A whole new outfit? Fine if you can afford it—but even an inexpensive new scarf, tie, or earrings may be enough of a treat to satisfy that “something new” urge.
Can you recommend some survival strategies?
Plan for minimizing a reactive response by using the following tips:
Plan for fun events. Look your best—it feels good! Think carefully about what you actually prefer to do, and whose company you truly desire. Identify the “required” duties and plan to seek common ground in the conversations, avoiding controversial topics that invariably lead to arguments. Compliment your host and family. Ask about the kids. Smile.
Don’t overdo it. Carve out personal time for yourself. If you need a break, say so: “I really need an hour or so on my own to recharge.” Have a rational reason handy for declining or leaving an event early; discuss your strategy for extricating yourself, if needed, with a trusted family member.
Have a “Go To” list of activities that relax you, such as movies, music, or a book. Find a new coffee shop in another neighborhood. It is often restful to sit and relax in a calm, neutral environment after a stimulating activity.
Tell your family and friends how much they mean to you. Find a new board game to play with a willing child, and play it over and over (and again) with him or her. You are making memories!
Once the holidays are over, now what?
After the holidays, many feel a sense of letdown. Credit card statements start appearing, the grim reality of winter sets in, life feels flat and stale, somehow a few extra pounds have found their way to your bathroom scale … It can be hard to know if one is headed for a full-blown depressive episode or just a few difficult days.
Develop a post-holiday strategy, and talk it through with a close friend or family member. Do they think you are getting depressed? Invite them to go with you to your health-care provider.
It is a good idea to have an appointment scheduled for soon after the holidays, simply to review how you are doing, identify needs for the current month and year, and set some new goals. If you did overdo it, forgive yourself and take the appropriate steps to move forward.
Melvin G. McInnis, MD, FRCPsych, is Thomas B. and Nancy Upjohn Woodworth Professor of Bipolar Disorder and Depression and professor of psychiatry in the Department of Psychiatry, University of Michigan School of Medicine. He is also principal investigator of the Heinz C. Prechter Bipolar Research Fund and associate director of the University of Michigan Depression Center.