To print: Select File and then Print from your browser's menu
Handling Holiday Stress
‘Tis the season to be jolly? Jolly well sick of the holidays, perhaps. After decking the halls, braving the malls, and baking 12 dozen cookies she shouldn’t even eat, Marcia, for one, is always too tired and cranky to enjoy the big day much. To make matters worse, the combination of too little rest and too much stress often sends her blood glucose soaring out of control. It’s enough to turn a sweet-tempered lady into a first-class Scrooge.
Marcia isn’t the first to succumb to the five-week stress-fest that runs from the Thanksgiving turkey to the New Year’s hangover. According to a 1996 Prevention Magazine and Dateline NBC poll, 41% of those surveyed found the holidays somewhat or very stressful, ranking them right up there on the stress scale with asking the boss for a raise.
Just how stressful can celebration be? A 1999 study published in the American Heart Association journal Circulation found that the number of deaths from cardiac events increased sharply starting around Thanksgiving and rose steadily until shortly after New Year’s Day, when the number dropped off again. Previously, researchers who had noticed similar trends often attributed the increase to the cold weather. However, the death records analyzed for this study came from sunny Southern California, so it seemed more likely that the holidays themselves were to blame. It appeared that for some people, at least, the prolonged stress and overindulgence in food and alcohol during this season could be a fatal combination.
For most people with diabetes, the more likely consequence of seasonal stress is out-of-control blood glucose levels. Stress may affect blood glucose levels in two ways. First, the circumstances causing the stress may distract people so that they neglect to follow their usual self-care regimen. Second, the body reacts to stress by releasing hormones that prompt secretion of glucose from the liver. In people with Type 2 diabetes, most of whose bodies still make insulin, stress can also block the release of insulin from the pancreas, leaving the extra glucose circulating in the blood. Many studies have found that psychological as well as physical stress can raise blood glucose levels in people with Type 2 diabetes. The effects are more mixed in those with Type 1. Most people with Type 1 diabetes say stress drives their blood glucose level up, but some say that it brings the level down. In either case, the result of stress can be sudden fluctuations in blood glucose levels, which can drain you of energy and make it harder to handle the holidays.
Sometimes people set themselves up for disappointment by trying to live out unfulfilled childhood fantasies. Some people feel that they missed out on the holiday fun as children — for example, because their family couldn’t afford many gifts or because special occasions were marred by an alcoholic or absent parent. As adults, they may go overboard trying to make up for the disappointment. At the other extreme, there are some who grew up in affluent circumstances, who feel inadequate because they can’t give their own family the same kind of lavish treats they had as children.
Then there are the unrealistic images we cherish of the picture-perfect, Norman Rockwell holiday scene: a smiling, joyful family gathered around a beautifully set table loaded with delectable food. In real life, the scene may look quite different: The baby is crying, the older children are making a mess of the table, the turkey is dry, and the rolls are burned to a crisp. The women look frazzled, and the men are arguing about the ball game. The fact is, festivities rarely go as planned, and with such idyllic models in mind, it’s no wonder folks often feel a painful gap between the holiday they think they ought to have and the one they actually experience.
Often, overblown holiday expectations materialize in bloated gift lists. Gifts are meant to be trinkets symbolizing affection. In our consumer-oriented society, however, the tradition of gift-giving has been taken to excess. As a result, pre-holiday gift shopping — and post-holiday bill paying — have become dreadful ordeals for many people. One recent survey, which polled a random sample of 625 American employees, found that the most frequently cited sources of holiday stress or anxiety were shopping, lack of time to get everything done, and expenses.
The irony is that costly gifts frequently mean more to the giver than to the receiver. This is most obvious with children, who may be quite satisfied with one or two gifts, but who tend to become overwhelmed or demanding when given 20 new toys in one day. The truth is, everyone is apt to be overstimulated by the materialistic frenzy leading up to the holidays. For children and adults alike, the big buildup can lead to a huge letdown afterward.
Every family seems to have an Uncle Phil who tells loud, off-color jokes, an Aunt Ethel who asks too many nosy questions, or a Cousin Lily who always gets drunk and weepy. People tend to cling to an unreasonable hope that their motley collection of relatives will somehow morph into a fantasy family — at least for one meal. When this transformation fails to happen, they may end up feeling cheated, exhausted, or believing that they have failed in some way.
For those who play host, any family tensions are compounded by the extra work and minor irritations that go along with having other people in their home. For the out-of-town guest, delayed flights and crowded highways are just the start. It can be hard to keep holiday spirits high while sleeping on an air mattress on someone else’s den floor, sharing a bathroom with six other people, and trying to adapt to a different schedule or to a different time zone.
Then there are the diabetes police — those well-meaning family members who can’t resist issuing dire warnings to stay away from the cookies. They only want to help, but their hovering concern can quickly start to feel oppressive, and their intimate health questions can begin to seem intrusive.
For some people, of course, the problem with holidays is not too much family life, but not enough. Loneliness and grief are felt particularly acutely at this time of year. When a loved one is missing, an empty seat at the table can be a painful reminder of good times shared in the past. Forcing an air of festivity and ignoring the loss for the sake of the occasion can create a sense of unreality that just makes things worse.
Holiday survival guide
Once you’ve pinpointed the problems, ask yourself what your true priorities are. Often the pleasures of the season can be dampened by seeming obligations. Do you really want to make the annual trek to your parents’ house, or would you rather take your spouse on a ski trip this year? Do you really want to go to eight different parties, or would you rather limit your socializing to informal get-togethers at your closest friends’ homes? Is elaborate decoration a pleasure or a chore? Are home-cooked feasts enjoyable or exhausting? Instead of acting on “shoulds” and “oughts” this year, plan to do things that bring you and your loved ones genuine satisfaction.
Make sure your plans are grounded in reality. Your holiday doesn’t have to be a picture-perfect experience or a commercial wonderland to be emotionally satisfying and spiritually meaningful. It simply has to be right for you. Take into account your personality, budget, schedule, and family situation, and set a standard that you can live up to. The following tips can help you to keep your expectations realistic and your stress levels lower as the holidays approach.
Make a list, and check it twice. Chances are, you will still want to buy at least some gifts, and you may have other expenses for decorating and entertaining. If so, it helps to draw up a shopping list, setting an upper spending limit for each item. Then shop early and stick to your budget, rather than rushing around making last-minute impulse purchases. Shopping online or from a catalogue is a good strategy for avoiding the crowds and reducing hassle. No matter where you shop, don’t forget that a sale isn’t necessarily a bargain if you buy something you didn’t intend to.
If your number one holiday stressor is last-minute madness, learn to budget your time well. In early November, start a two-column master list of holiday-related tasks. In the first column, write each task, and in the second column, write the date by which it needs to be done. As you think of new chores, add them to the list. Begin with the tasks that have the earliest deadlines and allot about 30 minutes per day or a couple of hours per week for these chores. Break up large projects into smaller chunks that fit into your schedule. For example, instead of writing 25 cards in one sitting, try writing one or two a day. Rather than shopping for everyone at once, you might decide to look for just two special gifts a week.
Allow ample time for rest, self-care, and relationships. It’s easy to let your schedule get so hectic that you become tired and run down. It’s also tempting to let your normal diet plan, exercise program, or blood glucose monitoring routine slide when you’re this busy or offered holiday treats everywhere you go. Resist the urge to overdo or overindulge. Instead, set aside at least 20 minutes each day for simply relaxing. Go for a walk, listen to music, read a good book, or take a long bath — whatever is soothing and restful for you. Talking to a supportive friend and sharing a laugh with a loved one is sure to conjure up some holiday cheer.
Home for the holidays
While you’re in charge of your own behavior, there’s only so much you can do to influence the actions of others. Maybe you’re dreading the holidays because it’s become an annual tradition for one particular relative to dissect your lifestyle along with the turkey. You can try to avoid this person, and you can enlist others to steer the conversation onto safer ground. You can even suggest that this relative not be invited to certain family gatherings. Ultimately, though, you may find yourself outnumbered and on your own. If you anticipate that things might get sticky despite your best efforts, have a Plan B ready. Come in your own car so that you can leave when you want to, or, if you’re visiting from out of town, stay in a motel so that you have a haven to retreat to if necessary.
Take a break from overnight guests. Even when a family normally gets along, staying in close quarters for a few days can make anyone irritable. Find ways to give yourself — and everyone else — some breathing space. If you’re the host, make some time to be alone, even if it’s just to go to the grocery store or walk the dog. If you’re the guest, consider renting a car or taking a stroll so that you can get out from underfoot for a few hours. Also, don’t hesitate to take a break from socializing and pitch in with the cooking, cleaning, and child care. Chances are, your host needs all the help he or she can get.
Plan ahead for diabetes dilemmas. If questions about your health get too persistent or personal, be ready to redirect the conversation politely but firmly. If your host asks for guidance on what you can eat, be prepared to suggest a few simple ways that he or she can work around your diet without adjusting the whole menu. Offer to provide dishes you know you can eat, and be sure to bring along your own snacks, just in case. Since overindulging in food or alcohol can have a negative impact on your blood glucose levels that will only increase any distress you feel, you may want to meet with your health-care provider or registered dietitian for support and suggestions for sticking to your meal plan over the holidays.
Finally, don’t downplay real grief. If you’ve recently lost a loved one, you and your family may feel the loss especially intensely during the holiday get-togethers. Pretending that the grief doesn’t exist will only make things worse. Different people have different ways of coping with loss, however. Some choose to restructure their holiday experience, by doing something novel or traveling to a new location. Others take the opposite approach, displaying the missing loved one’s picture at traditional gatherings or making it a point to sing the person’s favorite song. There is no right or wrong way to handle grief. Do what feels right to you, and respect others’ ways of grieving as well.
Toward holiday cheer
The holidays are also a good time to expand your definition of family, particularly if distance separates you from your relatives. Reach out to others you know who may be in the same boat. Invite a coworker or neighbor over for dinner or to watch a holiday movie. Or share your caring by volunteering at a homeless shelter or charity organization.
Relaxation techniques, such as meditation, may help combat stress-induced fluctuations in blood glucose and make for happier holidays. Although research has produced some conflicting results, a study published in the journal Diabetes Care in January 2002 found that participation in a stress management program had clinically significant benefits for people with Type 2 diabetes. At the end of a one-year follow-up period, research participants who were trained in several stress management techniques had about a 0.5% drop in HbA1c levels, a reduction that has been associated with a significant decrease in the risk of microvascular (small blood vessel) complications.
Whether you’re navigating a crowded mall or a tense dinner conversation, one relaxation technique to try is a simple breathing exercise. To do this, take a long, deep breath in, counting slowly to five in your head as you inhale. Then exhale, counting slowly down from five to one. Repeat this exercise several times. As you finish, notice how your mind and body feel. Are you calmer or more at peace?
It’s important to note that while stress can be managed, depression doesn’t go away with deep breathing alone. If you have been feeling despondent or hopeless for several weeks, or you have noticed a change in sleeping or eating patterns, speak with a health-care professional. He or she can give you the appropriate examination and treatment to help you get back on your feet again.
Yes, Virginia, there is a sanity clause
Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.