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Ask a Doc: Handling Holiday Stress

Editor's Update: This article was first published December 12, 2015. It was most recently reviewed and updated November 3, 2022.

In our Ask a Doc series, we sit down with physicians and other clinical experts, including those at Allegheny Health Network (AHN), for a chat on an important health topic. In this edition, we’re talking holiday stress with Dr. Betsy Blazek-O'Neill, a physician in AHN's Center for Complementary and Integrative Health program.

It’s been said that one of the surest signs that you’re officially a grownup, or in the process of becoming one, is that you become a Santa Claus to your family and friends.

Give yourself the gift of cuddling a kitty (or petting a pooch). It’s a great way to reduce stress during the holidays — or any time of year.

Give yourself the gift of cuddling a kitty (or petting a pooch). It’s a great way to reduce stress during the holidays — or any time of year.

Along with that, sadly, is another sign that you’re officially a grownup: A lot more stress starts to rear its ugly head around this time of year. Now that I’m a married fellow who owns a home, drives a station wagon and is a “kitty dad” to my calico cat, Cally, as well as a “doting uncle” to several younger family members, I can certainly relate: being one of my family’s Santa Clauses has its stressful moments.

Dr. Betsy Blazek-O'Neill is one of our resident stress management gurus, and I asked her some questions about holiday stress, in particular.

The causes of holiday stress

Bryce Walat: Why are the holidays such a stressful time?

Dr. Betsy Blazek-O’Neill: There are several reasons why the holidays are so stressful. For one thing, we’re up against unrealistic expectations and idealized images of what the holidays are supposed to be. Those expectations come not only from our own selves and our families and friends, but also from society as a whole. It’s no secret that the holidays are heavily commercialized, and that we’re led to believe that it’s all about having the right stuff.

Here’s an example of what I’m talking about: I got a catalog in the mail for a company that sells holiday decorations. In this catalog, there were centerpieces that cost $275. That’s only the tip of the iceberg: There were wreaths, garlands and trees for sale that cost hundreds, even thousands, of dollars. The implication here was that having the “perfect” holiday home meant spending a lot of money on expensive decorations like these.

Those unrealistic expectations also involve how people are supposed to feel and act. We expect everyone to be nothing but happy and on their best behavior, and everyone to get along. Holidays bring up a lot of family issues, like unresolved grief, conflict and other painful feelings.

Another big reason is that the holidays disrupt our routines. We eat and drink foods and beverages we don’t usually eat and drink at other times of the year. We do activities we usually don’t do at other times of the year. We spend a lot of time with people we typically don’t interact with at other times of the year, and we tend to make more tasks for ourselves like shopping, cooking, etc., that can cut into things that are important for our physical and mental health like eating right, getting enough sleep, exercising or just relaxing.

Finally, finances are a major factor. Even if you’re no Clark W. Griswold, people still have expectations of what a typical holiday should look like and may expect more from you than you can realistically afford. What’s more, they may make assumptions, not knowing what your financial situation looks like, and may interpret any attempts to economize as being stingy.

Sticking to a healthy routine

Bryce Walat: Speaking of routines, how can people stick to their routines and healthy habits?

Dr. Betsy Blazek-O’Neill: Different things work for different people. Find a plan that works for you and stick to it.

When it comes to food and drink, it’s OK to indulge — within reason. After all, the holidays only come once a year. The problem is when you let things get out of hand and let unhealthy habits crowd out healthy habits.

Some people, for instance, eat nothing all day before a big dinner, which is…not a good idea. Have a normal breakfast and lunch. Eat regular meals and drink water so you’re not famished or thirsty, and don’t drink alcohol on an empty stomach.

At potlucks and buffets, start with some of the healthy options first, like vegetables, salads, fruit or nuts. Once you’ve filled up on the healthier foods, go back for small amounts of the less healthy stuff. It’s also better to put food on a plate and sit down to eat, instead of standing next to the snacks and grazing repeatedly. If you’re contributing to a potluck, bring a healthy dish to share.

Of course, if you have any chronic conditions, such as diabetes or food allergies, you need to follow your doctor’s recommendations no matter what the season.

As far as exercise is concerned, you need to schedule workouts just like you’d schedule any other activity. Include your friends and family in your workout routines, too.

You can use a holiday meal as an incentive for exercise that day. If you know you will probably eat more than usual at a holiday dinner, go for a walk or jog earlier in the day to burn off some calories. Instead of sitting around while you wait for the turkey to be ready, head outside for a family football game. That way, you may feel a little more like you have “earned” the extra calories and experience less guilt. A walk is also a nice interlude between a heavy holiday meal and the dessert course.

Managing different types of holiday stress

Bryce Walat: The holidays can mean coping with both major stressors, like the family and financial pressures you mentioned, and minor annoyances, such as bigger crowds and more traffic at the mall. Which of these are more of a problem?

Woman sitting by tree with tangled lights.

Dr. Betsy Blazek-O’Neill: The most truthful answer I can give you is this: It depends on a lot of things. We each have our own unique coping styles and emotional baggage that affect how we respond to stress. What really matters is how you feel. Stress is a matter of perspective. What may seem like a big deal to you may not be for me, and vice versa.

You bring up a good point about major stressors: The holidays can really magnify any significant losses or traumatic events you’ve experienced. For example, if you lost a loved one this year, you may be spending the holidays alone, or you may be reminded of the things you used to do with the one you lost that you won’t be able to do.

That’s why it’s important to know and respect your situation and others’ situations so you can avoid pressing any hot buttons that could trigger bad feelings.

Bryce Walat: What are some signs that you’re being overwhelmed by holiday stress?

Dr. Betsy Blazek-O’Neill: Managing stress is all about balance and moderation. You know you’re being overwhelmed when you start going to extremes. If you’re eating or drinking too much (or you’ve lost your appetite), if you’re losing sleep (or feeling sleepy a lot), or if you’re feeling any intense negative feelings that are keeping you from meeting your work or family obligations, you’ve reached an unhealthy point.

I can’t tell you enough how important this is: If you’re having any problems with alcohol or any other substance, seek professional help. If you or a loved one feels suicidal or homicidal, call 911 or go to an emergency room.

Practical tips for dealing with holiday stress

Bryce Walat: So, what are some practical tips you can give to help reduce holiday stress?

Dr. Betsy Blazek-O’Neill: The most important thing you can do is nip those unrealistic expectations in the bud. Discussing expectations, obligations and even family traditions can be helpful. I come from a big family, and over the years we’ve changed our gift-giving practices to minimize both the financial and hassle-factor impacts.

At first, my siblings and I would pick names so we were buying one sibling a present, and then gifts for our parents. Once we all had kids, we decided to just get gifts for the kids and our parents. As the kids have gotten older, we tend to just send money gifts to the kids, as teenagers usually prefer to pick out their own items. And more recently, more of us are making charitable donations in my parents’ names, which is great for both parties. My parents don’t need any more stuff and appreciate the gesture — we pick charities that they care about. The donations are easy to make online from any location, since the six of us kids live all over the world. And of course, the world is a better place for the donations made. That seems a little more in line with what the holidays are supposed to be about, right?

Also, remember that it’s OK to say no, and it’s OK to ask for help when you need it. It’s also OK to outsource some of those holiday tasks.

Bryce Walat: Any parting words of advice you’d give?

Dr. Betsy Blazek-O’Neill: Think about your true intentions when you’re planning your holiday. What’s your ultimate goal: Do you want to have a good time and make lasting, fond memories, or are you too focused on impressing others or “keeping up with the Joneses”? We have a deep need to connect with people and be together. That’s what the holidays are really about. You don’t need a $275 centerpiece, or any other expensive stuff, to do that.

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