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The holidays can be fun and exciting, but you know they can also be cause for stress and anxiety. Besides the flurry of gift shopping and holiday events, there are the usual illnesses we spread in winter, families struggling with more significant illnesses and financial stressors, as well as ongoing family drama.
We want to feel our best when getting together with family and friends, so I asked CNN wellness expert Dr. Leana Wen to share some advice. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore’s health commissioner.
CNN: Why does it seem like so many people are feeling stressed and fatigued before the holidays?
Dr. Leana Wen: One reason is simply logistical stress. People who are traveling or hosting others in their home may be worried about how much they have to plan. Those with school-age kids may need childcare once school is out. A lot of people have time off for the holidays, but many don’t, and they may be thinking about how they can get their work done while taking care of their family. For many, financial stress factors here, too, with the added monetary pressures around gift giving and hosting.
Another reason is relational stress. Holidays are a time when people see family members with whom they may have had disagreements or even past trauma. They could anticipate uncomfortable conversations and start approaching gatherings with dread.
Along those lines, holidays often trigger underlying behavioral health issues. The stress of holidays could exacerbate existing anxiety. People with depression and who have experienced the loss of a loved one may feel the loss more acutely over the holidays. And individuals with alcohol use disorder may experience added difficulty during this period due to stress and to being in settings where alcohol use is prevalent.
CNN: If someone is feeling especially run-down, what should they be sure to do?
Wen: The first thing I do is to try to identify the cause. Is there something you can pinpoint that explains feeling run-down? For example, perhaps you have had trouble sleeping recently. That could explain why you are especially tired. Maybe you are recovering from a respiratory illness. Even a mild bout of the common cold could lead to people feeling exhausted. If the lack of light in the winter makes you feel blue, could you have seasonal affective disorder?
If the cause isn’t immediately clear or doesn’t entirely explain how you are feeling, I would suggest making an appointment to see a primary care provider. It’s important to rule out ongoing medical causes. For example, anemia or hypothyroidism can lead to fatigue. These conditions need to be diagnosed and the cause identified and treated. It’s also always a good idea to screen for depression and anxiety. These common conditions often go undiagnosed, but effective treatments are available.
If no clear medical issues explain your symptoms, you and your provider can start looking at lifestyle factors. How has your sleep been — if it’s not been good, has it always been this way or has something recently changed? A sleep evaluation may be worthwhile, as obstructive sleep apnea could certainly lead to fatigue (in addition to a host of other medical problems). Has your consumption of alcohol, cannabis, cigarettes or other substances changed? Have you been especially stressed at work or faced difficult personal situations?
CNN: What kinds of symptoms should prompt someone to seek relief for stress?
Wen: Stress is a normal physiological response in which our bodies release hormones that lead to effects such as faster heartbeat, increased blood pressure and higher blood sugar levels.
In the short term, stress responses aren’t a problem and can even help people be more efficient. The problem is if the stress response is continuous. People can develop mental health problems and physical manifestations such as headaches, back pain, abdominal cramping, heart palpitations and trouble concentrating. If someone develops these symptoms, they should consider taking action to try to reduce their stress level.
CNN: What can help relieve stress and that feeling of being run-down?
Wen: Recently, you and I discussed the benefits of “forest bathing,” a practice that started in Japan that involves being immersed in nature and is associated with lowering anxiety, improving mood and sleep, reducing blood pressure and helping with other stress responses. Everyone can try this activity — you don’t have to go a forest, as even a neighborhood park or somewhere with at least a few trees can qualify as forest bathing.
Exercise, whether outdoors or indoors, also helps to reduce stress. Physical activity reduces stress hormones while boosting endorphins, which improves feelings of well-being. And making sure to get enough sleep is essential for everyone.
Beyond that, the activities and methods that work best are specific to the individual. A recent survey found that 46% of Americans reported less alone time during the holidays. This may be a relief for some people who want to be around others, but others may need to carve out some alone time for themselves. The other side of this are people who anticipate being alone over the holidays but wish to be around others. Consider spending more time with your friends or trying volunteer activities if you want to be around other people.
Some people swear by practices like yoga and mindfulness meditation. That’s terrific; they should work to incorporate these into their schedule. Those who haven’t done it as much can still try these practices, starting with deep breathing exercises and chair yoga.
It’s just as important to talk about the things to avoid as it is to discuss what to do. Some people may turn to alcohol, cigarettes and other substances to make themselves feel better. This may be a temporary salve, but they do not solve underlying problems like depression and anxiety, and chronic substance use can lead to other health problems.
CNN: What other strategies can help people feel better in time for the holidays?
Wen: First, identify what activities and interactions are causing you the most anxiety. Are there ways you could reduce these activities or mitigate the interactions? If what’s causing you stress is logistical, could it help to make a list and prioritize the tasks to make the tasks more manageable? Could you ask others for help so you’re not the one doing all the work?
Oppositely, think about all the things you are looking forward to over the holiday. Here, too, making a list can help. The activities could be as basic as watching the snow fall or as monumental as meeting a new grandchild. Referring to this list also can help to make us excited — rather than tired — for the holidays.
