Turkey, Travel, and Triggers: Managing Bipolar Relapse Risks During the Holidays

The holidays can be delightful. Catching up with family you barely get to see, enjoying some delicious family recipes, and being back home. But they can also be overwhelming and stressful. Many people run into similar issues, including:

• Listening to your father-in-law tell painful jokes, then having to offer the obligatory, “haha good one”. 
• Literally everyone talking all at once. You somehow manage to hear every conversation while retaining none of the information because your brain is on noise-overload.
• Everyone’s “favorite” Drunk Uncle (trademark pending) making an appearance, and informing you of yet another conspiracy theory (but don’t worry he’s got a plan). 
• Intrusive questions being asked and boundaries being crossed. No, I’m not dating anyone. Yes, still.
• Somehow you fall into old (and potentially toxic) family dynamics, and revert to emotional responses you haven’t exhibited since you were 15 years old. Well, not out loud, anyways

If you have bipolar disorder, your emotional volume might already feel turned up. Add in family history, drama, and expectations, and it can get overwhelming fast. It’s like a pressure cooker being turned up to ten. How are you supposed to survive the holidays with minimal damage? 

• Have a get-away plan. Before dinner, pick a place you can escape to – a bedroom, the porch, even the bathroom for a few minutes. Know that you are allowed to step away when you feel tensions rising.
• Use short-yet-clear phrases when setting boundaries. Simple lines like “I’d rather not talk about that right now” or “Let’s change the subject” are enough. You don’t owe others a detailed explanation of your mental health history; “no, thanks” is enough.
• Set a timer. It’s ok to make an appearance, make some small talk, eat, and still leave early. It doesn’t make you a terrible person for knowing (and enforcing) your time limits. Whether it be an all-day event or a two-hour visit, you get to decide what is realistic for you.

Feeling drained, irritable, or even tearful after a long visit with family does NOT mean you’re ungrateful or a failure. Emotions have their place, and it’s ok to feel sad when you think you should be joyful, or stressed when you think you should be grateful. You’re a human who had an emotionally heavy day; be gracious with yourself.

Emotions are difficult during the holidays, and nothing makes tensions rise quite like unrealistic expectations. Many people feel like they “should” be enjoying the festivities, and end up feeling guilty because they’re stressed. There’s an unspoken pressure (or sometimes spoken, depending on your family) to be happy, gracious, and generous during the season. These expectations may include:

• Spending money you don’t have on gifts and travel.
• Meeting work deadlines before everyone leaves the office, so you can fully relax during your time off.
• Spending an equal amount of time with every family member, which can be really difficult when your father-in-law is STILL telling painfully, unfunny jokes.
• Proving to everyone on social media that you have a perfect family, by trying to take a photo with a less-than-perfect family. 

This pressure often heightens underlying feelings of inadequacy, resulting in shame and disappointment. For someone with bipolar disorder, this stress is not just unpleasant, it can be debilitating. You may experience: 

• Difficulty sleeping because your brain won’t chill out
• Having big ideas or plans that you either start and never finish, or don’t start at all
• Feeling physically weighed down, as if someone put you in slow-motion

While some of these feelings may be perceived as no big deal, they can also be an indication that your bipolar symptoms are escalating. Not in a “drop everything and panic” type of way, but in a “I need to show myself some compassion and patience” way. If you’re noticing overwhelming feelings or worsening symptoms, you may try:

• Pare down your to-do list. Take the most important things to prioritize, and be aware and accepting of the outcomes of the others. If it works out, great. If it doesn’t, that’s okay too.
• Confide in someone you trust. Let them know that this time of year is especially difficult, and ask if they can offer patience and support. Sometimes, just verbalizing your concerns can be a big weight off of your shoulders.
• Set small, realistic goals. Instead of “I will be happy and present at every event,” try “I will check in with myself before and after each event and adjust if needed.”

You are not a bad human being for having limits. In fact, you’re a responsible person for recognizing your boundaries and preparing for mood shifts. Allow yourself the same compassion and patience you would offer your dearest friend. After all, you deserve gentle, loving kindness. Even if you slip up sometimes.

The holiday mindset often sounds like “come on, ‘tis the season!” And it’s so easy when everyone around you is drinking too. Besides, as long as you’re not as bad as Drunk Uncle™ , who cares. 

But some patterns can hit harder if you live with bipolar disorder. Alcohol can mess with sleep, meds, and mood. It may be relaxing in the moment, but it can have long-term effects that you have to deal with later. Ultimately, you get to decide what feels safe for you – that could be none, a very small amount, or something in between. Late nights might be fun at first, but several nights in a row with short sleep can push you toward mania or deepen a depressive slump. Even overdoing sugar, caffeine, or constant stimulation can keep your body revved up when what you really need is to calm down. It may feel impossible to manage it all, but you can participate safely with a few self-limits:

• Set a bedtime and try to respect it. Then, set a REAL bedtime to commit to, because sometimes we just need one more episode of The Office before counting sheep
• If you do choose to drink, sip slowly, and drink plenty of water during. And trust me, eat a nourishing meal beforehand. You’ll thank me later.

Remember that you can partake in the festivities without drinking. Fuzzy socks, a fun board game, and quality company will keep you feeling spirited.

“Hope for the best, prepare for the worst”. Yeah, I’ve heard it too. While the saying seems bleak, there are definitely benefits in having a disaster plan. Things to include in your “toolkit” might be: 

• Your favorite (and trustworthy) Emotional Support Human™
• People you can text when you need a quick reminder of your worth
• Someone who knows you well, who knows when something is off, and is comfortable telling you, “Hey, I’m a little worried. Are you doing ok?”
• Professional support in the form of a therapist or counselor
• A preparation session with your therapist before the gathering
• A follow up appointment to help you debrief the events (let’s be honest; there might be a lot to unpack)
• Grounding techniques to slow your heart rate during distressing moments
• A calming music playlist to help you relax
• A notebook where you can dump ALL your thoughts without fear of judgement from others
• An exit strategy, including a reason and transportation, in case the family gathering doesn’t go as planned
• Allowing yourself permission (without judgement or shame!) to cancel or reschedule if you become overwhelmed

Most importantly in your toolkit, try swapping the question, “what should I do?” with “what’s actually going to help me?”. Reframing your mindset to show yourself patience and compassion can make a world of difference during emotionally-heated moments.

Even with the most thorough preparation and support, things may get difficult. You may notice:

• Racing thoughts, risky behavior, or feeling wired and invincible
• Deep hopelessness, numbness, or thoughts that life is not worth it
• Urges to hurt yourself or a sense that you do not want to be here

If you start experiencing these feelings, you deserve to reach out for additional support. This may include calling your therapist, confiding in a trusted friend, seeking intensive mental health treatments, or utilizing crisis resources or emergency services if you’re in immediate danger. 

Asking for help is not an admission of failure. Managing your mental health is just that: management. There’s ups and downs in your healing journey, and you deserve to experience those moments without shame or judgement. 

The holidays tend to magnify everything – the good, the painful, the unresolved. You might feel joy and grief in the same afternoon. These emotions don’t determine your worth or value, and you deserve to feel all your emotions without shame or judgement. Take time to not only practice self-care, but also show yourself compassion. This may include:

• Enjoying a warm bath or a shower
• Reading a book or journaling
• Speaking verbal affirmations to yourself

There’s really no “right” way to experience the holidays. It’s okay to not have a great time, all the time. In fact, it’s ok to be sad, stressed, or overwhelmed. Remember to take it one step at a time, checking yourself with authenticity.