Coping with Post-Traumatic Stress Disorder Over the Holidays

The Holidays.  Some people love this time of year and for some it induces flashbacks of trauma and grief, making it the most difficult time of year.  An estimated 70 percent of adults in the United States have experienced a traumatic event at least once in their lives and may have acute stress disorder from it.  Acute stress disorder will usually heal after 6 months from the trauma.  Not all people do and up to 20% of these people go on to develop post-traumatic stress disorder, or PTSD.  An estimated 5 percent of Americans—more than 13 million people—have PTSD at any given time.

According to the National Center for PTSD, about seven or eight of every 100 people will experience PTSD at some point in their lives. Women are more likely to develop PTSD than men. Some traumas may put an individual at a higher risk and biological factors like genes may make some people more likely to develop PTSD than others.  Anyone is susceptible to developing PTSD: Military veterans, victims of crime, foster children, someone who loses a loved one, people involved in natural disasters, accidents or events.  If you suspect you or a loved one may have PTSD, you can be screen and diagnosed by a licensed therapist or medical professional and should not be left untreated.  The sooner you seek help for it, the sooner you can begin your path to healing.

The holidays may trigger someone with PTSD in different ways.  For example, someone that has been traumatized by a family member, forced attendance to gather with family can cause extreme triggers and anxiety.   Different trauma histories will entail different triggers and where someone is in their recovery also has an impact.  During the holidays there are more family gatherings and events  and we may find ourselves around those who were in some way involved in the trauma or are unsupportive or toxic and do not consider your emotional and mental well-being.

Unhappy memories are common triggers for PTSD. Memories from holidays in abusive or a neglectful environment holidays spent in isolation due to hyper vigilance, addiction, or being in treatment.  Also holidays spent away from loved ones whether due to deaths, abandonment, distance, or situation can trigger those with PTSD.

Life changes and reflections may be another trigger. Throughout the year, there have most likely been ups and downs, and major changes have occurred. Many with PTSD have difficulties with change in general, and if any major losses or changes have happened throughout the year, the holidays are the time to "reflect upon the year". This often brings up feelings of grieving and loss, sadness and a longing for "the way things were".   When we look back the year during the holidays, it also brings to light that which has not changed or goals unmet a feeling of regret and failure can accompany this reflection.

The holidays are portrayed as a time for families and friends to join together - reunite, reconnect, re-establish relationships. It is often in the movies that we see reconciliations and folks who have severed ties reconnect "in the holiday spirit." We often place these expectations on ourselves during the holidays in hopes of making things better and have lower defenses in thinking others may feel the same way and end up disappointed. 

Financial concerns often arise during the holidays, with an increase in event attendance, grocery budgets, travel expenses, and gift buying.  This causes even more stress to try and “keep up appearances”.  When we do this, it creates an unhealthy thought in our mind that we are not good enough as we are and depression begins taking hold.

For some, coping with PTSD may cause unhealthy behaviors such as substance abuse, eating disorders, risky and hazardous behaviors.  Not taking time for self-care or failing to utilize coping techniques may cause a relapse.

So what can you do to make your holidays less triggering and more enjoyable?  Whether you have PTSD, acute stress disorder, or finding yourself more anxious, depressed, or stressed than usual, here are some tips:

1. Say “no” to invitations to events or places you feel are a current trigger for you.  It is perfectly acceptable for you to put your mental and emotional well-being first.  In fact, it should be a priority. Set boundaries and stick to them.  You matter.  You are allowed to set boundaries for yourself, say no, change your mind, and make choices that honor you. 
2. Start a new tradition.  Don’t feel you have to do the same old traditions each year, particularly if they cause hurtful feelings or memories to resurface. Start a tradition that celebrates the holidays that gives you something to look forward to.
3. Keep your expectations realistic. Don’t expect the joyous outcome of old conflicts and trauma you see in the movies when being around friends and family.  Not everyone will treat you the way you treat them or be in the same mindset. As the saying goes, “expect nothing and accept everything”. High expectations often lead to more stress and disappointment.
4. Plan ahead!  One of the best strategies to prevent a disaster is to plan ahead in the most detailed way possible.  List what kinds of things you're going to do before to make sure you go in to any stressful event confidently and steadily.  Describe the things you're going to do for yourself during to make sure you're grounded and calm.  Then, be very specific about what you're going to do after to decompress and unwind, and then what you'll do for self-care.
5. Communicate with yourself:  Acknowledge the difficult, painful, scary, or triggering things that you're going to be facing. Acknowledging and validating what is painful about these holidays will make you less likely to be blindsided by traumatic holiday celebration if you encounters a trigger you never saw coming.
6. Allow yourself to grieve.  It seems counter-intuitive to lead yourself into painful emotions, but it makes them far less likely to bubble up like a shaken soda bottle just as you're getting comfortable or having a good time.  Let yourself be sad.  Let yourself be angry.  Let yourself grieve lost holidays or entire childhoods of happy memories.  Allow yourself be upset about what your traumatic experiences have robbed you of or made more difficult.  Take a moment to be angry about neglectful and/or dismissive family and friends who don’t support you the way you deserve to be supported.  Once you've given yourself a moment to feel these things, your mind will feel freer to enjoy the holidays and less determined to remind you that it was really, really hurt by all that's associated with them.
7. Have an exit strategy.  If you’re in a situation where you feel uncomfortable or have a trigger know it is okay to leave. A friend to call, a place to go, and literally- where the exit is if you’re attending an event in a place you’re unfamiliar with.
8. Know your support system.  C.  Keep a list of hotlines, counselors, and loved ones you can contact if things get overwhelming or you need someone to talk to.   Plan to connect with them at some point around events or gathering, as touching base with friends and family that have your back can help you feel less stranded or as if you've been abandoned in your weakest moments.
9. Conquering loneliness.  Many of these tips revolve around gatherings with others.  But for some, much of the holiday season is actually spent alone (either by choice or circumstance).  Since loneliness can breed all sorts of darkness in the mind, plan your own holiday time for you.  Make the day a day that you treat yourself like you never do.  Watch movies, take a long and relaxing bath, turn your music up and dance silly, catch up on your Netflix queue, read a book, make yourself a fantastic meal, celebrate yourself and how far you’ve come.  Practice self-care and pamper yourself in a way that honors you. You deserve it!
10.  Last, but not least: Be kind to yourself.  Holidays can be hard for everyone; you’re not alone in that. Even those individuals that seem to have it all together struggle at times.  There might be some mistakes, a bad mood or bad day, a stumble or a fall.  It’s okay. You’re human.  Each mistake is a learning experience on what works and what doesn’t.  How we talk to ourselves become our inner voice that can turn into depression, unhealthy thoughts and behaviors.  Give yourself a break for not knowing what you didn’t before and kudos for learning and becoming better.  Take deep breaths, ground yourself, and remind yourself you are worthy of kindness.

Remember the words of Michelle Rosethal, “Trauma creates change you don’t choose. Healing is about creating change you do choose”.  The holidays don’t have to be a time of dread. The more you plan and prepare, the safer you’ll feel and be able to enjoy however you celebrate.