Dealing with PTSD over the holidays

Holiday seasons like Christmas, Easter, Eid, Hanukkah, Kwanzaa (or even just birthdays) are supposed to be a time of happiness, cheer and get-togethers, but for many people with PTSD or C-PTSD, it can be a stressful and unhappy time as it’s also full of loud, busy and overstimulating events. Meeting new people, parties and family events all add to the sense you have to behave in a certain manner (i.e. forget your worries and feel festive). Add to that, for some people, it’s the very friends or family members that they’re expected to see during this time that may have caused their trauma in the first place through abuse, neglect and/or estrangement for example.

Putting on a ‘smiley mask’ can just add to feeling of guilt, panic, shame and fear. You might feel anger and guilt because you find it hard to truly embrace the season… everyone should be ‘jolly’ at Christmas, and excited for the New Year, right?

If you stop to think about it, the time of year or the expectations of other people can’t dictate your mood or the level of your emotional and mental health. Putting  decorations up is not a magic fix for trauma and a Bank Holiday Monday is not a signal for your PTSD or C-PTSD to ‘take a day off’. In fact, having your normal routine disrupted and no work to distract you can be destabilising.

So, the first step in coping with PTSD or C-PTSD during seasonal ‘high days and holidays’ is to accept that you may not approach these occasions the same way others do. Or indeed, the same way as you did before your traumatic experience.

Give yourself permission to understand the recovery process from PTSD or C-PTSD, rather than kicking yourself for not being festive enough!

So why can holidays cause added pressure for people with PTSD?

There are a variety of reasons why someone with PTSD or C-PTSD might struggle more over the holidays, but understanding and accepting them may help you to relieve some of the guilt, added pressure and expectations – as you’re not alone in feeling this way!

• Hypervigilance can be especially problematic to manage when you are in social situations that involve sudden loud noises or strangers who get ‘up close and personal’. Choose only manageable social interactions, and excuse yourself as soon as your anxiety level rises.
• This time of year is also an ‘unforgiving battleground to the many who struggle with food, disordered eating, and/or addictions’.
• You may have to face immediate or extended family or locations that were the cause or source of your trauma.
• A disrupted routine may remove coping strategies if you find comfort in routine. 
• Time with friends/family you don’t see very often may bring reminders of the past which may be difficult for you
• A sense of obligation to visit with unsupportive or toxic family or friends who may not understand or accept your diagnosis and so you feel an expectation to ‘hide’ your condition.
• Expectations for social gatherings are higher than the rest of the year. This is especially true for Christmas and birthdays when there’s a tendency to believe everyone should join in with social gatherings. Even though individuals with PTSD or C-PTSD may find hustle, bustle and noise triggering and unpleasant.
• Many people with PTSD and C-PTSD are also ‘grappling with chronic physical health issues, too . They’re going to be in pain, sick or exhaustion — wanting to engage, but unable’ and this can cause deep sadness and regret at missed opportunities.
• Domestic violence figures increase over Christmas, which could create flashbacks for some people with PTSD or C-PTSD and add to levels of depression over the festive period.
• New Year can make you think about the troubles you faced in the past 12 months, and the battles ahead of you. There could be dates you personally find a struggle too, such as milestones connected to your trauma, or anniversaries linked to private grief.

Being lonely in a crowd… or at home

Even people who don’t have PTSD or C-PTSD can find certain times of year depressing and isolating. However, post-traumatic stress can certainly increase the potential for some calendar dates to create dips in your mental health – so how can you help yourself (or a loved one) during any holiday seasons? Here are some tips that might work for you:

Plan ahead: It’s vital to plan ahead for potential low points in the season and put into place activities you find distracting, calming and enjoyable. ‘List what kinds of things you’re going to do for yourself before the important moments to ensure you are prepared to go in to any stressful environment much less vulnerable, steady and even confident. Describe the things you’re going to do during the event to make sure you’re staying grounded, level and calm. Then, be incredibly specific about what you’re going to do after to decompress and unwind, and then [most importantly!] what you’ll do for self-care.  This is called a “Before/During/After Plan” or BDA. You can make one for every significant challenge or phase of the holiday season: phone calls and planning stages, declining an invite, food prep, the gathering, specific traditions you know may be emotional, etc.’

Say no: If parties, dinners and crowds of people make you unable to cope – feel free to say no to invitations that will add to this stress and anxiety. Offer alternative meeting places with friends, or simply say ‘no thank you’. Do what is best for you, set your boundaries and remember you can’t keep everyone happy.

Have an ‘exit strategy’: ‘You are not obligated to do anything you don’t want to or do it for longer than you desire. You do not have to feel guilty. You don’t owe anyone an explanation for why you are leaving, where you’re going, or why you want to ‘go so soon’, but having your ‘escape plan’ mapped out may just give you a sense of peace, even if you don’t use it. ‘I need to get the last bus home’, or ‘I need to drop some shopping into my neighbour on the way home’ are pre-planned ideas that you can have tucked away if you’re not enjoying yourself as much as you’d like. Also,’take breaks. Leave the room. Take a walk outside. Sit in peace in a bedroom or unoccupied room for a moment. Those 15 minute breathers will do you and your nervous system wonders before returning to the festivities — even if you don’t think you need it yet.’

Don’t think too far ahead: While planning ahead can be helpful, sometimes thinking about a social situation can bring on more anxiety than it deserves. Try to stay in the moment, enjoy getting dressed up and ready to go out, or at the very least, give yourself extra time to stop, breathe deeply and be in the moment before you step through the door.

Let your loved ones know: Let your close circle know that you expect to face a tough few days so they can adjust their responses and check in on you in a way you find helpful. ‘Make it a point to fill them in on what’s going on and what’s worrying you. Plan to connect with them even if for just 5 or 10 minutes before/after holiday gatherings. We know that many therapists aren’t available during holiday weeks, so touching base with friends and family that you know have your back can help you feel less stranded or as if you’ve been abandoned in your weakest moments.’

Create New Traditions: You could create new, relaxing traditions or other annual milestones. So, instead of a big family dinner involving social stress, opt for a walk on a beach with a flask of hot chocolate and some snacks! You could invite a special someone to watch a film with you, quietly on a sofa, or cook an intimate dinner to thank people who have supported your PTSD and C-PTSD recovery.

Stay Grounded:  ‘Remaining grounded is your first and strongest line of defence to any of the things you’ll face during the holidays.  If you aren’t grounded, none of your coping skills will be as effective. Keep textured items in your pockets, bags, and/or car. Carry a notecard on you or in your phone that can remind you of the date, that you’re safe and an adult now, as well as any other orienting details that are important to you. Keep your feet on the floor whenever you can. Try to refrain from staring off or zoning out when things get too dull (or too heated). Keep your phone on you to play music or engage in interactive apps whenever you feel yourself drifting. Look around the room – take note of all the pretty things that catch your eye as you look about. Talk or engage with someone if you can; vocalise in some way when you’re alone. Step out and wash your hands or face in cool water. Go outside for a bit to reinvigorate yourself with fresh air or cold temperatures.  Anything you can to stay present in the here and now!’ says the wonderful blog Beauty after Bruises.

Don’t forget to look after yourself: ‘It sounds painfully simple, but it’s so easy to forget. Take your medications. Eat well. Stay hydrated. Force yourself to rest your body and mind even if you cannot sleep. Don’t neglect your physical health. These things are as much your foundation as being grounded is. Forgetting any of these basic needs can make you more vulnerable to symptoms, which can lead to a full unravelling later.’

Let yourself feel the feelings you need to: ‘It seems counterintuitive to lead yourself into painful emotions, but it makes them far less likely to bubble up just as you’re getting comfortable or having a good time. Let yourself be sad. Let yourself be angry. Let yourself mourn lost holidays or entire childhoods of happy memories. Allow yourself to be upset by all that your traumatic experiences robbed you of or made more difficult than it ever needed to be. Take a moment to be angry about neglectful and/or dismissive family/friends who won’t support you the way you deserve to be supported. Once you’ve given yourself a moment to feel these feelings, your mind will feel freer to let go and enjoy the holidays, less determined to remind you how it’s really, really hurt by everything associated with them, afraid you’ll forget it still needs healing.’

Limit alcohol intake: ‘The holidays don’t make this super easy for those who like to partake, but any level of intoxication can make traumatic material just a trigger away from flooding you. …and leaves you quite defenceless against it, too. Try to be extra responsible during the rough moments – even if your whole body’s zinging or feels like you’re going to burst. Going for another drink to drown it out or feel calmer actually increases your vulnerability for it all to come crashing down — both inside your mind and possibly in your behaviour. For those of you who struggle with moderating your alcohol consumption or need to steer clear entirely, try recruiting a trusted loved one to help keep you accountable and to feel less isolated amidst the temptation.’

Breathe: ‘Again, it sounds so simple, but you’ll be amazed by how often the times you’re completely overwhelmed you’re actually holding your breath. Take several deep, cleansing breaths each time you feel your tension meter rising.’

The trick is to create ways to mark seasonal milestones in a controllable, calm setting that manages your symptoms. That could even involve crafting your own meaningful rituals and letting everyone else know it’s okay to do the traditional stuff without you.

The best way to get through annual occasions

It really all comes down to this. ‘The holidays are hard. For everyone. Yes, even those who seem to have it all together. It is never going to be perfect. You’re likely going to make mistakes, have bad days, be a little short with someone you love, or have a day where you aren’t the most patient. You may stumble, or even completely fall apart. While we hope that doesn’t happen, it’s okay if it does. Life is a process, and every year is different. None of us get it right every time, or even most of the time. The best and only thing to do after something goes wrong is to practice some self-kindness. Cut yourself some slack and remind yourself that now, if any a time, is the time you need comfort the most…especially from yourself. Be gentle. If you wouldn’t tell one of your friends they were stupid or bad for making the exact same mistake, then you aren’t either. Breathe. It’s okay. You are going to be okay.’

If you need more ideas of positive activities and therapies for PTSD, please check out the other articles on our blog, information about treatments, or resources about other activities and therapies that can help ease symptoms.