Culture in Mind

Mental health, culture, and ethnicity

Happy Holidays? Why Not?

The holidays dont have to make you feel nuttier than fruitcake.

Thanksgiving has passed and the madness that is Black Friday is already a memory. One down, more to go: Christmas, Hanukkah and Kwaanzaa and let's not forget the New Year. 

It's the holiday season which fills some with anticipation and excitement and others with dread. The non-denominational, celebrated-by-all-Americans Thanksgiving has passed. Family came over, food got consumed, old arguments got revived, secrets got revealed, and love is everywhere. Or not. Then there is the shopping onslaught that has already begun with tales of midnight openings and desperate measures to get the season's best prices.

Now along comes Kwanzaa, Christmas, and Hannukah and of course you need to get tickets to the Nutcracker and the party-of-the-year (and not sure if that's the last year or the next. And the right outfit for it all. It's enough to drive anyone loony.

And it does.

Depression, anxiety and mania increase in frequency and intensity during the holidays and suicide rates increase too.

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Oooh not so happy a holiday for everyone is it? But what is it about the holidays that get us all crazy??

Well, first there are the expectations. People have high (or low) expectations about the Thanksgiving dinner. Who will come? Who do you wish wouldn't come. Who brings what and where shall it be? Can you afford to go or does it mean going into debt even more? Before November starts, the anxiety and conflict can begin. And it's 8 weeks through to the New Year's Eve kiss which officially ends the holiday season. (Did I just put  more pressure on?!!) Of course, it's not just me and you but Hollywood has a slew of films all lined up to give you just one more 'standard' of what the holidays should look like.

When Thanksgiving arrives, some families have a wonderful time. And I have no data to say whether it's most families or the relative few but from my experience, Thanksgiving comes with family drama. It is often the only time that some family members get to see each other and lots of unsaid stuff gets said.

As for Christmas, Kwanzaa and Hannukah.... buying yourself something can mean hours in the store or online, so buying a gift for others can make you crazy. How long shall the list be? Who only gets a card? (My strategy is to buy everyone a mastercard or visa logo gift card, wrap it in a box and get it all over with; but i'm just a bit pragmatic).

Then there are the parties.... Eating all this food doesn't help when you're trying to figure out what to wear (that you can fit into) to meet your boss, your partner's boss or your partner's family. The holiday season is one long performance with the accompanying stage fright: we are not quite ourselves and we sort of don't really want to be. We want to drink but not too much. We are wearing the shoes that kill our feet. And with all this social life, work is still as busy as ever.

So with all that going on, why wouldn't we get more than a little off-kilter? But before the onlsaught begins, here are a few tips to keep you calm and centered with a smirk on your face while everyone else looks like you did last year.

So what to do?

1. You can't please everyone so you please yourself. Decide early on where you are going and plan what you will wear or bring. Make a short gift list of people who are very special to you. Or decide if you want not to give gifts at all. Make it about what you can realistically do instead of what everyone wants/expects you to do. Do what takes care of you and let the rest of them eat (fruit)cake

2. Sleep. Much of the challenge of the holidays is the onslaught of social activities that leave us sleep-deprived. And anxiety/depression/stress also reduce our ability to sleep. Sleep deprivation increases the likelihood of irritability, getting physically ill (because of suppressed immunity) anxiety, depression and triggers mental illness in people who are vulnerable or already have a mental illness. Keep to a bedtime routine and set a time to leave the party and stick to it. And shut down the party at your house when it's your bedtime. When in doubt, revert to #1 on this one. Give yourself a pass on New Year's Eve or Christmas Eve or whatever your religious culture requires. The National Institutes of Mental Health offers a guide to sleep which is available here: www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.pdf

3. Make a budget. And stick to it. Be realistic. No point setting a high budget that is out of line for your fiscal resources. If you really want to have fun at Christmas, being creative and finding a really meaningful but inexpensive gift can mean the difference between a near-panic attack every time you put something in your literal or virtual shopping cart and anxiety that lasts all year when the bills just keep coming. Bring your hobby into play if you can. If you are not the creative type then think of coupons. For example, if you have friends with children you like, give them coupons for babysitting, I promise, there is nothing more valuable to parents than some time together. If you have the kindof friends that really need nothing then make a donation to their favorite charity. One of my favorites is heifer.org where you can choose to give a poor family some animals, like cows or goats, that gives them health and some income and provides sustainable income for a family and community.

4. Plan ahead. Try and arrange to meet your friends in the daytime or early afternoon so that #2 stays on track. Avoid malls and instead wander art galleries, museums, or enjoy the beauty of nature's winter gifts. A walk in the fresh air with great company hits all the buttons for mental well-being. And if you go to a party, remember there is no minimum time to be there. Show your face, check-in with a friend and off you go. If you are divorced, and share child custody, then work out the details and let go of any conflict if there is any. You are already divorced, why keep fightin??

5. Enjoy your drink and eat. But take it easy. (And its best for sleep, health and mental clarity if you eliminate the alcohol altogether). Our bodies let us know when we are having too much. When you feel full, stop. Ask for half of everything offered to you. Cut it in half. Share it with a friend. Have a half glass of wine instead of a full one. This is not about weight, it's about the hangover, the loss of control (drinking and driving, sexual interludes you can't remember etc), the upset stomachs etc. In public health our mantra is: Prevention is better than cure so if you really want to take the best care of you limit your alcohol intake to no more than one drink per event. Dilute your wine with sparkly beverages and make a spritzer. Deliberately half your shot or double your mixer. Taste a lot but don't eat a lot. Denial isn't fun so indulge but skip the greed option.

6. Start early. Planning. Buying. Planning outfits etc. Buy some index cards and write down your plans so you have something to refer to when things get a little crazy. (And they will). This way as the anxiety ramps up, you can sit in calm as the chaos swirls around you. If possible, start before Thanksgiving. Once Thanksgiving arrives you're not early anymore so you've got two weeks.

7. Be physically active. Do something. Anything. Walking requires comfortable shoes and clothes. That's it. You can do situps and pushups during the commercials of your favorite TV show. Take dance lessons show you can show off at your holiday parties. To keep the calm on track take some yoga or Pilates so you'll look great in your outfit and be the model of calm.

8. Breathe deeply. Whenever you can. Whenever you feel like it is getting to be too much. If breathing deeply is not working and a little stretch is not cutting it, then cut out. Leave. Take a walk. Return if you're up to it or off to bed you go.

9. Seek out help if you need it. Talk to loved ones if you're feeling overwhelmed or seek out professional help if you need to. There is no shame in seeking out a professional when the brain screams "enough". The previous tips were meant to avoid that but your brain may have ideas of its own. 

I have no magical "ten ways to..." But if I think of anything more or you send me your tips, then I'll keep this list going.

The goal is not to survive the holidays but to enjoy the holidays. Hope I didn't raise your expectations too high :).

Ruth C. White, Ph.D., M.S.W., and M.P.H., is the author of Bipolar 101 and is an associate clinical professor at the School of Social Work at the University of Southern California. 

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