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Health Talk: Stress and the Holidays
Hosted by Abigail Trafford
Washington Post Health Editor

Tuesday, December 21, 2 p.m. EST
Abigail Trafford
Abigail Trafford

The holiday season is a time for celebration, family and love. It can also be a time of stress. How can you effectively deal with the holiday craziness?

Dr. Carol Goldberg, a clinical psychologist specializing in stress management, health and motivation, was our guest for this week's "Health Talk."

Please read the transcript below.

Abigail Trafford: Hello everybody. I suppose you're all calm and relaxed these days. You've finished all your shopping, and you're just enjoying yourself with all the holiday parties, the visits with relatives. . . . But maybe you're getting a little stressed out. . . or feeling sad. For a lot of people this time of year is hard. Dr. Carol Goldberg is an expert on holiday stress and holiday blues. Send us your questions and comments.

Abigail Trafford: Dr. Goldberg, welcome to Health Talk! We're in the midst of the holiday season. My two grandchildren are in the house and it's just the most wonderful visit. It's also incredibly stressfull. Soon we'll have four generations in the house. Everyone is tired. Tempers get short. We immediately say to each other: holiday stress. Well, what is holiday stress? What turns holiday stress into a psychological or medical problem?

Dr. Carol Goldberg: Stress is our reaction to pressures and demands. Holidays bring lots of pressures and demands. Holiday stress becomes a problem when we overtax our ability to handle pressures. Then stress can make us anxious, depressed, and at risk for illnesses from the common cold to heart attacks, strokes, and even death. In addition to lowering immunity to illnesses, stress causes inefficiency and accidents.

Abigail Trafford: What are the main symptoms of holiday stress?

Dr. Carol Goldberg: Emotional suffering, including anxiety and depression. Difficulty sleeping. Catching colds and flu. Heart attacks, strokes, and death.

Bethesda, MD: Do you have any tips specific to pregnant women over the holidays? I'd like to make sure I don't get too busy, stressed, etc. especially since I'll be in the midst of lots of relatives and friends who have not yet seen the new, pregnant me...

Dr. Carol Goldberg: To begin with, women experience more stress than men. As you pointed out, pregnant women are adjusting to their new appearance, to reactions from relatives and friends, and to plans for being a mother. Added to that, women often have the major responsiblity for holidays. For instance, despite all of the progress toward equality women have made, they still do most of the preparations for holiday gifts and celebrations. I'm glad you are trying not to exhaust yourself by not getting too busy. It is important to get enough sleep, to eat healthfully, and to get appropriate exercise. Holiday preparations will be easier if you make lists of chores geographically.

Abigail Trafford: The Surgeon General's Report on Mental Illness pointed out that mental disorders are very common, especially depression and anxiety. Can the holidays trigger episodes of depression or anxiety in people who are vulnerable? What are the ways to prevent this?

Dr. Carol Goldberg: Holidays can trigger episodes of depression and anxiety in those who are vulnerable. Getting enough sleep, eating properly, and exercising regularly are protectors against stress. Since there is less light during the holiday season in the northern hemisphere, those prone to SAD (seasonal affective disorder) might explore with their health care providers whether light therapy would help prevent depression. Try not to feel guilty about not doing as much holiday preparation as you would like. Instead of feeling guilty if you overeat, try eating less and exercising more to compensate after the holidays.

Rockville, MD: Could you say some wise words about Holiday overeating and overdrinking? They seem to be significant signs of stress in many of us.

Dr. Carol Goldberg: Considerate hosts should have healthy, low fat, low calorie foods available. For instance, raw veggies, fruit, and sugar free beverages are recommended. Hosts should not pressure guests to eat or drink alcohol. A good way to avoid overeating and overdrinking is to drink several glasses of water prior to going to a party. Remember to exercise.

Abigail Trafford: Long ago I made a rule for the holidays. Every day I would take a bubble bath. The greatest benefit was to have some time to myself. How important is it for people--especially women who are "doing" everything--to get time by themselves?

Dr. Carol Goldberg: Time for yourself is extremely important. I recommend people schedule an hour a day for themselves...to exercise, do meditation or other relaxation techniques, and whatever they find relaxes them. Your bubble bath is a great idea since it gets you away from chores and relaxes your muscles.

Abigail Trafford: What can people do to relieve stress?

Dr. Carol Goldberg: The answer to the last question included some tips, such as exercise and bubble baths. In additon, to relieve holiday stress, plan well so you do not feel overwhelmed. For instance, make a list of chores, the estimated time for each, and add in extra time for unforeseen delays. Say "no" to unnecessary busy work and to unwanted party invitations. When people feel rushed, the first things they neglect are sleep, excercise, and healthy foods. Do not neglect to get enough sleep, exercise, and healthy foods.

Abigail Trafford: It's fine to say do exercise to reduce stress, but who has time? And how can you eat less, when it's non-stop socializing? I woke up this morning and put myself on a diet for today and tomorrow, because I've already eaten too much. What about just letting things go until the new year and then get back on track. Would that be less stressful?

Dr. Carol Goldberg: Create time. For example, setting priorities, being organized, and saying "no" can help you find time. You can eat less by drinking several glasses of water prior to going to a party. Grazing, that is tasting rather than eating hugh amounts of foods, can help. As for postponing dieting, do what works best for you. Starting a strict diet durig the holidays is not recommended. However, most people would find it overwhelming to have to take off a big weight gain after the holidays and do better limiting amounts rather than depriving themselves during the holidays.

Bethesda, MD: My 8-month old daughter has been in the hospital for more than six weeks recovering from complications related to her heart surgery. As you can probably guess, this has been an extremely stressful time for our family - particularly for my three year-old, who wonders why mommy and daddy have to go away so often. -One of us spends each night at the hospital.- How do we make the burden easier for him?

Abigail Trafford: I'm so sorry. This is a really difficult situation--no matter what time of year. Dr. Goldberg, how can they make the burden easier on their 3-year old son--and on them, too?

Dr. Carol Goldberg: I'm sorry about your family's stress. Your three year old might find his stress more bearable if friends and relatives can spend time him. There are some good books that could help explain family illness at his level of comprehension. Best wishes for your daughter's recovery.

Washington, DC: I love the holidays. I get such an emotional lift at this time of year. But now, with all my coworkers and friends whining constantly about their high stress levels, I'm starting to feel guilty. Is there something wrong with me?

Abigail Trafford: You're the kind of person we stressed-out folks count on at this time of year. Dr. Goldberg, what's the secret?

Dr. Carol Goldberg: No, there's nothing wrong with you. You are the enviable person who has what others want for the holidays...a lift. Perhaps you could explain how you deal so well with the holidays. I would guess you have excellent ways to organize your life, set priorities, and have realistic expectations. Maybe you also have a wonderful perspective and do not let little things bother you.

Fairfax, VA: Dr. Goldberg:
I think that I've learned a long time ago that too many folks try to relive a "perfect" holiday season, with the "perfect" present, "perfect" family gatherings, etc., when in reality, very few of us could make the blanket statement that most holiday seasons from the past were perfect. The card companies also successfully promote this, with their idyllic and festive winter scenes, all of which hardly reflect the hustle and bustle we all experience. Society today says that we must all have the perfect holiday experience, so we build up false expectations, costing stress and leading to disappointment. Then, quick as a wink, it's time to stop "celebrating", -as if we ever really did- and make a mad dash to buy Valentine's Day cards. Do you think that this has gotten especially worse over the years?

Dr. Carol Goldberg: Yes, I think holiday stress is worsening. First of all, people have more stress than their ancestors did. Most women work out of the home. There are longer commutes. Thus, people should have realistic expectations and not try to duplicate grandma's celebrations. It is fine to have guests share in preparations, buy prepared food, and if you can afford it hire help. Restaurant celebrations also are acceptable. Most of all, do not expect perfection. Holidays will not be perfect and will not solve your problems. Just enjoy them for what they are.

Abigail Trafford: There's always talk that suicides increase during this time of year--but that's a myth. The statistics show no such increase. Yet, suicide is always a risk. It's a leading cause of death in the U.S. Many more people die of suicide than homicide, for example. What are the warning signs that someone may be at risk of suicide?

Dr. Carol Goldberg: The warning signs for suicide are depression (prolonged feelings of being sad and hopeless), poor self-care (not eating, not sleeping, neglecting personal hygiene), giving away prized possessions, talking about wanting to die, and not going for help. Depression is very treatable with psychotherpy, medications, and even light therapy. Be sure to go to a licensed professional, such as a psychologist, psychiatrist, social worker, or psychiatric nurse.

Rockville, MD: Is there a way to prevent an attack of flu during this season?

Abigail Trafford: And what role does stress play in the development of flu? Does stress make you more vulnerable to flu?

Dr. Carol Goldberg: Stress makes you more vulnerable to all types of illnesses. If you sleep sufficiently, eat well, and exercise, you lower your chances of getting sick. Socialization is important. People who have good relationships with others handle stress better and have better resistance to illnesses. Even having a pet helps.
As protection specifically against the flu, health practitioners recommend an annual flu vaccine just prior to the onset of the flu season.

Arlington, VA: Please--holiday stress is an oxymoron. People bring it on themselves. I have absolutely no sympathy. I planned ahead, shopped early -and mostly on the Internet-, baked, decorated and got my cards out. What's the big deal? Calm down, enjoy your family and friends and stop making such a big deal out of everything. It's not the end of the world if you can't find a bow to perfectly match your wrapping paper, or if you forget to buy a gift for your boss.

Abigail Trafford: I'm with you--except that I haven't got my cards out. (I only send cards to people out of town. And I save cards from previous years to decorate the house. That makes me feel ahead of schedule.)Dr. Goldberg--your thoughts on this Tough Holiday Love approach?

Dr. Carol Goldberg: Congratulations! It sounds like you are doing all the right things to prevent your stress. Let's also be tolerant and helpful to those who do not have your organizational skills and perspective.

Washington, DC: sometimes I just get the urge to leave town over the holidays to avoid all the wackiness. Is that a reasonable response to holiday stress, or does it sound completely selfish?

Dr. Carol Goldberg: Holiday stress is not geographically limited. Perhaps getting away is escaping from obligations tied to home.

I can't imagine where you could go to get away from holiday stress. But if you figure it out, have a great trip.

Gaithersburg, MD: How can holiday stress be handled in families where there is disagreement over how the holidays should be observed, in terms of gift-giving, visiting vs. staying home, religious vs. secular?

Dr. Carol Goldberg: Discuss the type of celebrations you want with those who will be spending the holidays with you. You might be surprised to find not everyone wants turkey on Thanksgiving, Christmas Dinner at home, or to watch the bowl games on New Year's Day. It might be the time to start a new tradition. Family conflicts are not limited to observances. Sibling rivalry, parental control issues, and competition are intensified at family gatherings. My advice is to try to avoid conflicts with parents, siblings, and ex-spouses. It is easier if you remember you only have to be tolerant for a short time.

Columbia, MD: Would you say a word about family conflicts that arise during the holidays over differing religious traditions and practices?

Dr. Carol Goldberg: With the increasing number of intermarried families, this is a big source of stress. It would be good to ask participants how they want to celebrate. Some may want to attend both the lighting of the Channuka menorah and the Christmas tree. Others may want to only participate in their own religious practices. Businesses should arrange for equal inclusion or equal exclusion for decorations and celebrations for all religions of their workers.

Abigail Trafford: Dr. Goldberg. Holidays are "family time." But the majority of families in the U.S. don't fit the stereotype of the perfect nuclear family. What is the stress for families that have gone through divorce or death and are reconstituted? How can these families manage the stress?

Dr. Carol Goldberg: Sure, there is no longer a stereotypic family. There can be big conflicts about where the children of divorced families spend holidays. Asking the children to choose puts them in a difficult position and should be avoided. If geographically possible, one solution is to have the children spend equal time with both families. For instance, the children can go to one family for Christmas Eve and the other for Christmas Day. Or the children can go to one family for the entree and the other family for the dessert. Ex-spouses can avoid a lot of conflicts from ex-in-laws ("I told you never to marry him") by picking up the children at a neutral place.

Abigail Trafford: It's so hard to avoid family conflicts. I remember long ago when my family went to visit my grandmother. My parents had a slogan: PAP for peace at any price. But this was very stressful. (I adored my grandmother and didn't see what the problem was.) How do you avoid conflicts with parents siblings and spouses, ex and otherwise? And if you avoid them (peace at any price) is that in the end more stressful?

Dr. Carol Goldberg: Conflicts often arise when adult children visit their parents. For instance, grandparents may want to tell their children how to raise the grandchildren or be more indulgent than the parents want for their children. A solution would be for grandparents not to intrude.

Another scenario affecting adult children is when they bring their live-in boyfriend or girlfriend to their parents' home for the holidays. A solution is to repsect parents' right to feel comfortable in their own homes and abide by their truf rules. After all, it is only for a day or two.

Try to minimize sibling rivalry by realizing it is only for a short time.

Somewhere, USA: I suspect that no matter how stressful this season is for most of us, it is more stressful for the homeless and the least fortunate people in our community. During the holidays, I try not to walk by beggers without at least making eye contact and usually giving them a dollar. It doesn't help the big social problems, but it makes them and me feel a little better.

Abigail Trafford: The holidays SHOULD be about giving to others, and giving people hope and caring. Dr. Goldberg, talk a little bit about how the benefit--the joy--of giving goes both ways for the giver and the receiver. What is the psychological dynamic here?

Dr. Carol Goldberg: Interestingly, those who volunteer not only help those who are in need but also benefit themselves. Volunteers are healthier, happier, and more resistant to stress. A wonderful way to help those in need is to volunteer at a soup kitchen or to visit those in hospitals and nursing homes on the holidays.

Washington, DC: Are there any special signs to be aware of in older people experiencing holiday stress? (I'm talking geriatric.) What are some ways we can help our parents and older friends come through the holidays with less stress?

Dr. Carol Goldberg: It's nice to see your cconcern. Be there for them, just as they were there for you when you needed them in the past. Be alert to signs of depression. Most of them have suffered losses, including of spouses, siblings, and close friends. Holidays are particularly lonesome for them. Try to be with them and take their lead. If they want to talk about their losses, listen. If they want to escape from discussing those they miss, let them.

My bottom line advice is not to inflate holidays with perfectionistic preparations and expectations. You have asked wonderful questions. I hope my answers help you have more enjoyable and less stressful holidays.

Abigail Trafford: Thank you Dr. Goldberg so much. I hope that you and everybody in Health Talk Land have a wonderful holiday season. For all the stress, it's a special time of year when we take stock and let people know how much we care about them. Join us again next week when we look at what lies ahead for health in the new century. The genetics revolution promises to rewrite the script of what we can expect from the medical community--and ourselves. Our guest will be genemeister Francis S. Collins, who heads the National Human Genome Research Institute at the National Institutes of Health. Talk to you all then.

© Copyright 1999 The Washington Post Company

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