Managing Stress at the Holidays

Home for the holidays! Friends, family, good times, and good food: What could be better? For some, it’s their favorite time of the year, but if you live with chronic pain, just the thought of the holidays and all that’s involved may be overwhelming, evoking worry, additional pain, and stress.

In truth, the holidays can be both mentally and physically stressful for everyone. Getting everything done the way we want to do it is challenging. For those with chronic pain, the holidays can certainly increase stress, but they can also provide opportunities for creativity, flexibility, and change. Improving your life skills, confidence, and ability to change can be rewarding. Pain, while uncomfortable, can provide the stimulus you need to change in ways that can improve your life at the holidays and throughout the year.

It’s most important to take care of yourself throughout the holidays to reduce both mental and physical stress and subsequent pain, making these important days and their many activities the best they can be.

We know mental stress can add to and actually cause physical pain. Worry can lead to tight muscles, headaches, and fatigue, which can also add to pain. So, in addition to dealing with physical pain, the challenge is to be aware of your mental stress levels. Managing mental stress may be a key toward reducing pain.

Mental stress can happen without your even realizing it. Just as a scary movie can lead you to tighten your muscles in fear, stress and pain can creep up on you due to your thoughts. Before and at the holidays, simply thinking about how you will get everything done, preparing for guests, driving to or from or even hosting an event, and wrapping all the gifts you bought can lead to and cause more stress and pain.

Luckily, stress and the pain it may cause can often be managed. Strategies include being aware of how and what you are thinking, avoiding catastrophizing, using relaxation techniques, and initiating the four Ps along with good self-care techniques. These strategies start with managing our mental stress and thinking, and in the end they impact physical stress and pain as well.

What Are You Thinking About?

Staying aware of your thinking is so important, and knowing we have the opportunity to control and choose what we think is critical. Some people naturally think about positive things. Others lean the other way, worrying and lamenting about their misfortune. Remind yourself that everyone has problems, that you are doing your best, and that many things in your life are good. These thoughts can help reverse the negative thinking that can add to stress and pain. If you find yourself thinking negatively or in ways that could add to your stress, try to think of more positive things. When life seems to be giving you lemons instead of lemonade, the only thing you can control is your thoughts about the situation and your body’s reaction to it. Easier said than done, you might say. Just know that practice does help.

An example of negative holiday thinking could go something like this: “If I just didn’t have all this pain, I would be more fun, and people would like to spend more time with me. Holidays are awful, and it will be an awful day.” A more positive self-statement might be: “I know my family understands that I have been having a lot of pain lately. They love me and will understand. If they don’t stay a long time, perhaps we can see each other the next day. It will be fun to be together.”

Avoid Catastrophizing

Catastrophizing is another way of thinking that can bring on stress and pain. An example of catastrophizing is when you say to yourself, “I am not feeling good today. Everyone is coming for dinner. I probably will have to call the doctor, maybe cancel the dinner, and go to the emergency room. Maybe I am having a bad flare-up. I’m going to ruin everything.”

Catastrophizing takes us quickly from one thought to another, all in a negative direction. In this situation, an extra rest and extra pain medication ordered by your doctor ahead of time might help you feel better. Remember, taking one day at a time can reduce the stress. And who knows? Maybe your holiday dinner will be wonderful.

Using Relaxation Techniques

Relaxation techniques can reduce stress and pain. Begin by taking a few minutes to sit quietly, removing yourself from others, and resting on your bed or recliner. Learn deep breathing, meditation, guided imagery, and how to relax tight muscles through biofeedback; this allows the mind and body to do the opposite of what stressful thoughts induce.

As the mind clears itself of stressful thoughts and concentrates on letting tight muscles relax, the entire body can become rested and rejuvenated in as little as five to 10 minutes. Guided imagery helps the mind visit calming places such as a stream or beautiful mountaintop, usually by listening to a recording that helps you visualize the sight. Your breathing can slow, your muscles can relax, and pain can diminish. Plan for 20 minutes of relaxation exercises before guests arrive, or take a few minutes while your visitors are present. Remember you have to allow your body to relax.

Stress-reduction tips

Use the following tips, including the four Ps (problem-solving, planning, prioritizing, and pacing), to reduce both mental and physical stress.

Problem-solving is an active way of reducing mental and physical stress. Start with an assessment of past holidays, your current health issues, and other influencing factors such as budget, help, and time. Include what you need to do to get ready for the holidays. By examining the to-do list and identifying potential problems or difficulties, one can then develop solutions. For example, if you are worried about cooking a large holiday meal, try easy-to-cook recipes early to be sure they taste good, or ask others to bring hors d’oeuvres, dessert, or sides.

When listing the problems that cause your stress, remember to be specific. An example might be, “I didn’t have enough time to wrap my presents,” or “I was exhausted halfway through dinner and couldn’t help with the dishes.” A non-specific problem might be stated as, “I felt awful all day long” or “I didn’t like the gifts I gave people.” Non-specific problems are too broad and make listing solutions difficult. A better way to state these issues might be, “It was difficult to get up early on Christmas morning because I was so stiff” or “I had a hard time thinking of gifts last year.” Make sure the solutions you chose are as easy as possible.

Planning, prioritizing, and pacing strategies are additional ways of helping make holiday chores more manageable. Priority setting simply means doing what in your opinion is most important or what needs to be done earlier rather than later. Make a dessert or clean two or three days before the holiday, for example. Planning means figuring out what the holiday activities might be for each day or weekend, making to-do lists, or buying supplies weeks in advance. Pacing means not rushing, doing a little bit every day, using all your energy wisely, not working too quickly, and not using your energy on non-essential chores or activities.

Holiday activities that usually impact both mental and physical stress include but are not limited to cleaning, cleaning up, decorating, holiday correspondence, vacation alternatives, holding an event, home projects, meal shopping and preparation, overnight guests, social events, shopping for gifts, and wrapping. Using the four Ps will help develop new, less stressful ways of getting the activities accomplished.

Cleaning. As the days come closer, cleaning the entire house to perfection may be too difficult. This is where priority setting and pacing strategies can be used. If you decide to clean the house yourself, do a little at a time and leave the rooms you will be using last. Guest bedrooms might be cleaned a week ahead of time. Sheets can be changed right after the last guest stayed in the room. Save kitchen cleaning for the end. If you’re not able to tidy up the house, hire a cleaning service or ask a neighbor to help.

Cleaning up. After dinner is a great time to sit and relax. Most family and friends enjoy chatting during clean-up activities and find doing this chore easy. Find a comfortable chair and enjoy a job well done. Sit close by and help coach your wonderful helpers and thank them. OK, you may feel a little guilty. Remind yourself that you have certainly done your share and that rest is now a priority. If necessary, the clean up can be accomplished the next day.

Decorations. Inside and outside decorations are always a challenge. Many people choose to make decorating outside their first priority, using items that will last for two to four weeks such as evergreens or reusable materials. Much of the outside work can be done shortly after Thanksgiving. Plan to start early, keep your decorations simple, and be sure to ask for help. Or hang decorations that require less effort. If you ask others to help, make sure to keep their schedules in mind and ask early. Here are examples of a decoration game plan.

  • Perhaps you have always put up a recently cut Christmas tree. An alternative, though hard to accept, might be to purchase an artificial tree, as long as you have a place to store it that is easily accessible.
  • If you are determined to have a recently cut tree, consider a small one that can sit on a table. It will be less difficult to purchase, transport, mount, and decorate.
  • Ask your family to help mount and decorate your tree. The task will be more fun with cookies, cider, music, and an invite at a convenient time for them.
  • Pay a teen to decorate. It can be good for you and the young person as well.

Any change from the usual means you have kept your priorities in mind and developed an alternative plan, perhaps by using a problem-solving approach of coming up with several different ideas and choosing the best. If you’ve always had lots of decorations, perhaps this is the year to display fewer. You could give decorations you no longer want to family or friends or donate them to charity. (Make sure to keep a list for tax time in the spring.)

Holding an event. If your pain becomes an issue near or at the holiday event, you may want to give a heads-up to a family member or close friend. You might say, “My fibromyalgia has been flaring up lately with all the preparations for the holiday. I may need a little extra help on Christmas Day.” Or you might have to ask your spouse to greet people at the door and hang up their coats so you can concentrate on the kitchen activities. Remember, if you need to ask for help, your request can allow someone else to feel good about supporting you.

If possible, rest before the event, and make sure you take your pain medication before guests arrive. Sit and chat with someone during the event. Most people who live with chronic pain have learned that it’s best to slow down before getting overtired and feeling a lot of pain. Plan to rest the next day.

Holiday correspondence. If you send greeting cards or letters, plan to accomplish the task early to avoid more stress. Make mid-fall your goal to print labels, buy stamps, purchase cards, and write and print a letter. Set a date for mailing, such as the day after Thanksgiving. If this is too much effort, make calls or send a note via email. Or send a Happy New Year’s greetings in January.

Holiday vacation alternatives. If your pain forces you to curtail your usual holiday activities at home, consider alternatives. Someone else in your family could host dinner, you could have a meal catered, or you could go out to eat. Or the holiday may be a good time to take a vacation such as a cruise to give the family a holiday to remember.

Home projects. Of course, we all want our homes to be in the best shape possible when guests arrive. Rooms might need paint, a bathroom renovating, a new chair bought or an old one recovered, rugs cleaned, and closets and cabinets sorted. It’s important to set priorities. Starting early and knowing when to stop are of utmost importance. Make a list and set a date for each item you feel needs to be done. Remember, projects often take longer than expected. Decide if you need to do the task versus just wanting the task done. As the holiday gets closer, you may need to re-evaluate what’s a need and what’s a want.

Meals. Food is an important part of every holiday, but if you live with pain, it can be overwhelming to shop for groceries, carry them in the house, and cook a big meal. You may need to revise traditions. If you’re hosting a dinner, ask your guests to bring one or two items, or ask a family member to coordinate the meal. Choose recipes that can be prepared ahead of time, are easy, or if you are trying a new one, try it early and make sure it is easy and doable. Make meal time a group effort. Involve your kids or grandkids. Set the dinner table and get your platters out early. Ask for help lifting a heavy dish out of the oven. Prioritize and plan to do everything possible in advance.

Overnight guests. You can make beds and clean bathrooms and bedrooms well before guests arrive. Find out early if they have any special needs and what they like for breakfast. If you do not feel up to having guests, perhaps a relative or friend who lives nearby will host them. Limit the number of days overnight guests will stay, and do not feel you have to entertain them if you don’t feel up to it.

Social engagements. As if accomplishing all of your holiday commitments at home isn’t enough, attending other social engagements can be overwhelming if you live with pain. But if you’re physically able to accept an invitation, consider it a gift. Healthy relationships are keys to good health, and a lack of social support may lead to increased disability, flare-ups, and pain. Even if you can only attend a party for an hour or two, it may be worthwhile. Consider resting before and after the event. The holidays are the time to enjoy people’s company.

Shopping for gifts. If chronic pain limits your ability to shop in stores or malls, then shop online or ask a friend or relative to help. Or chose small stores with short walks to parking lots. And of course, if you plan ahead, you can shop for holiday gifts year-round. If you don’t know what to buy, then consider gift cards, or surprise someone with a check tucked somewhere on the Christmas tree.

Wrapping. Be sure to have paper, ribbon, scissors, tape, and gift bags ready to go. Buy gift cards early. Not everything needs to be wrapped. A present hunt can be lots of fun for grandkids. If you’re giving a lot of gifts, wrap a small amount each day to use your energy a little at a time. Finally, shop at stores that offer free gift wrapping.

Taking Care of Yourself

During the holidays, take care of yourself, get plenty of rest, take your medications faithfully, and spread out your favorite events and activities. Relax whenever you can and use hot or cold treatments for sore muscles.

And be kind to yourself. It’s OK to revise a family tradition or two to reduce your stress and pain. Although it may seem undesirable, difficult, or overwhelming, having chronic pain may be the opportunity to try something new. Reducing mental and physical stress should make your holiday season as pleasurable as it can be.

Want to learn more about feeling good for the holidays? Read “Managing the Holidays With Chronic Pain.”

Wendy McBrair has spent 35 years as a health-care professional in rheumatology, orthopedics, and osteoporosis, specializing in patient and community service, patient education, and advocacy.

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