The holidays can be a joy-filled season, but they can also be stressful and especially challenging for those impacted by mental illness.

A NAMI study showed that 64% of people with mental illness report holidays make their conditions worse. “For many people the holiday season is not always the most wonderful time of the year,” said NAMI medical director Ken Duckworth (in an interview before the pandemic). For individuals and families coping with mental health challenges, the holiday season can be a lonely or stressful time, filled with anxiety and/or depression. If you’re living with a mental health condition, stress can also contribute to worsening symptoms. Examples: in schizophrenia, it can encourage hallucinations and delusions; in bipolar disorder, it can trigger episodes of both mania and depression. The COVID-19 crisis has made maintaining mental health more challenging for so many.

Here are some suggestions for how you can reduce stress and maintain good mental health during the holiday season:

• Take steps to stay safe. As COVID-19 continues to pose a severe risk to communities, California’s Public Health Department and the Centers for Disease Control (CDC) have released guidelines for holiday gatherings. The safest way to gather is to spend time with people living in the same household or to gather virtually. For those planning to gather with others, follow these guidelines:

• • Limit the number of people and households. Gatherings of more than 3 households are prohibited in California; this includes everyone present, including hosts and guests. The smaller the number of people, the safer.
  • Gather outdoors.
  • Don’t attend gatherings if you feel sick.
  • Don’t attend gatherings if you are in a high-risk group.
  • Practice physical distancing and hand hygiene at gatherings.
  • Wear a face covering and keep your mask in a safe place when eating or drinking.
  • Keep gatherings short: 2 hours or less.
  • Frequently wash hands and surfaces.
  • More on the California State guidelines for holiday gatherings and guidelines for celebrating safely and preventing the spread of COVID-19 (CDC)
• Accept your needs. Be kind to yourself! Put your own mental and physical well-being first. Recognize what your triggers are to help you prepare for stressful situations. Is shopping for holiday gifts too stressful for you? What is making you feel physically and mentally agitated? Once you know this, you can take steps to avoid or cope with stress.
• Write a gratitude list and offer thanks. As we near the end of the year, it’s a good time to reflect back on what you are grateful for, then thank those who have supported you. Gratitude has been shown to improve mental health. 2020 has been an especially challenging year for us all. In the midst of it all, is there something or someone for whom you are grateful?
• Manage your time and don’t try to do too much. Prioritizing your time and activities can help you use your time well. Making a day-to-day schedule helps ensure you don’t feel overwhelmed by everyday tasks and deadlines. It’s okay to say no to plans that don’t fit into your schedule or make you feel good.
• Be realistic. Even pre-pandemic, the happy lives of the people shown in those holiday commercials are fictional. We all have struggles one time or another and it’s not realistic to expect otherwise. Sometimes, it’s simply not possible to find the perfect gift or have a peaceful time with family. (Yes, even Zoom family gatherings can be stressful!)
• Set boundaries. Family dynamics can be complex. Acknowledge them and accept that you can only control your role. If you need to, find ways to limit your exposure.
• Practice relaxation. Deep breathing, meditation and progressive muscle relaxation are good ways to calm yourself. Taking a break to refocus can have benefits beyond the immediate moment.
• Exercise daily. Schedule time to walk outside, bike or join a dance class. Whatever you do, make sure it’s fun. Daily exercise naturally produces stress-relieving hormones in your body and improves your overall physical health. More on the benefits of movement.
• Set aside time for yourself and prioritize self-care. Schedule time for activities that make you feel good. It might be reading a book, going to the movies, getting a massage, listening to music you love, or taking your dog for a walk. It’s okay to prioritize alone time you need to recharge. More on self-care.
• Eat well. With dinners, parties, and cookie trays at every turn, our eating habits are challenged during the holiday season. Try to maintain a healthy diet through it all. Eating unprocessed foods, like whole grains, vegetables, and fresh fruit is the foundation for a healthy body and mind. Eating well can also help stabilize your mood.
• Get enough sleep. Symptoms of some mental health conditions, like mania in bipolar disorder, can be triggered by getting too little sleep. More on getting good sleep.
• Avoid alcohol and drugs. They don’t actually reduce stress: in fact, they often worsen it. If you’re struggling with substance abuse, educate yourself and get help.
• Spend time in nature. Studies show that time in nature reduces stress. (More on the mental health benefits of nature.) Need to break away from family during a holiday gathering? Talk a walk in a local park.
• Volunteer. The act of volunteering can provide a great source of comfort. By helping people who are not as fortunate, you can also feel less lonely or isolated and more connected to your community. You can find out if there is a safe way to volunteer in your community.
• Find support. Whether it’s with friends, family, a counselor or a support group, airing out and talking can help. Consider attending a free support group provided by your local NAMI California affiliate. If you or someone you love is experiencing a crisis, you can call the National Suicide Prevention Line at 1-800-273-8255; use the Crisis Text Line by texting NAMI to 741-741 to connect with a trained crisis counselor for free, 24/7 crisis support via text message; or call the NAMI Helpline at 1-800-950-NAMI (6264) M–F, 7 a.m.–3 p.m. PT for free mental health info, referrals and support.
• Keep up or seek therapy. If you’re feeling overwhelmed, it may be time to share with your mental health professional. They can help you pinpoint specific events that trigger you and help you create an action plan to change them. If you’re already seeing a therapist, keep it up.

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More on the subject:

How to Deal with Negative Holiday Emotions (NAMI)

Mental Health and the Holiday Blues (NAMI)

Beat Back the Holiday Blues (NAMI)

9 Keys to a Resilient Holiday (Psychology Today)

COVID-19 stress isn’t taking a break for the holidays: How experts say you should cope (USA Today)

How To Manage Depression in Yourself, Family Members During The Holidays (Long Island Press)

‘Throw Out the Rulebook’ To Get Through Pandemic Holidays, A Therapist Says (NPR’s Life Kit)