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Bipolar Disorder: Handling the Holidays

With a little planning you can avoid holiday depression, anxiety, and mania -- and enjoy the season.
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WebMD Feature

The holidays can be a tricky for anyone. But people with bipolar disorder may anticipate November and December holidays with real dread -- and depression.

"The holidays can be very hard for people with bipolar disorder," says Raymond L. Crowel, PsyD, vice president for mental health and substance abuse services at the National Mental Health Association. You'll probably face loads of possible triggers: relatives, stress, exhaustion, and the temptation to overindulge, to name a few. Slipping into a mood swing may be much easier than usual.

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So what should someone with bipolar disorder do when the holidays roll around? Be a Scrooge and opt out? Hibernate?

You don't have to do either. WebMD talked to experts about how people with bipolar disorder can weather the holidays -- with tips on avoiding depression and mood swings, planning, enjoying the season, and more.

Bipolar Disorder: Why the Holidays Can Be Hard

Experts say many things come together to make the holidays tough for people with bipolar disorder, including:

  • Disrupted schedules. "The biggest single problem with the holidays for people with bipolar disorder is that they take them out of their routine," says Ellen Frank, PhD, director of the depression and manic depression prevention program at the University of Pittsburgh's Western Psychiatric Institute and Clinic.

    Studies show that people with bipolar disorder do best when they're on a schedule -- getting up, eating, exercising, and going to bed at roughly the same time each day. Even the loss of just one night of sleep can trigger a mood swing. But during the holidays -- when you may be traveling across time zones, partying, or staying up until the wee hours -- it's all too easy to get off track.

  • Over-stimulation. Shopping, decorating, and preparing for the holidays can leave you excited and anxious. Some family reunions aren't always happy. Any excess stimulation can trigger a swing toward holiday depression or mania.

  • Shorter days and longer nights. Some people with bipolar disorder find their mood swings are related to the seasons. Depression is more common in the fall and winter in the northern hemisphere, says Michael E. Thase, MD, professor of psychiatry at the University of Pittsburgh Medical Center.

  • Holiday "cheer". The holidays are a time when excessive drinking is often tolerated, even encouraged. Though unwinding with alcohol can be tempting, it can be bad for people with bipolar disorder. Not only can it interfere with medicine, it may also ruin sleep and make you more prone to mood swings.

  • Excessive spending. It's the season when it seems everyone is running up their credit cards. If you have a history of excessive spending and grandiose gift-giving during hypomanic or manic episodes, you are clearly at risk.

  • Missing your medication. When you're busy, it's easy to forget about your medication. You may even feel tempted to skip a few doses on purpose: it might make it easier to tolerate alcohol, or being a little hypomanic may give you the energy to get errands done. But when you have bipolar disorder skipping your medication is always risky, since it makes your mood less stable.

  • Believing the hype. We all know how we're supposed to feel at the holidays: brimming with joy, good will, and love. But a lot of us don't really feel that way. Being depressed during the holidays can really make you feel out of step, which adds to feelings of isolation.

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