What can we do to help our patients?

By MARY-CATHERINE SEGOTA, Psy.D.

The COVID pandemic has pushed most people to reexamine their lives on some level- their priorities, how they live, and what they want for themselves. No one could have anticipated the length the pandemic would last, and it certainly has caused significant stress in how we live, love, and how we spend time together. Last year brought about a holiday season with isolation, social distancing, and skipping many holiday traditions. While there have been shifts in the pandemic, some continue to live in isolation, while some have re-emerged with cautious optimism, and others returned to pre-pandemic behaviors. Thinking it through wherever someone falls in this continuum will help ensure the happiest and safest holiday season possible.  

For many, last year's celebrations were conducted with only immediate family present or by zoom, and the season held difficulty and uncertainty for everyone. This year, it is essential to recognize that everyone is in a different stage of coping with the pandemic. Many children have returned to in-person schooling, while some have maintained distance learning. Adults are either juggling work from home or having returned to the office. Different geographical locations continue to have different rules in place regarding masks. It is essential to consider all of these factors in making plans, the most important of which is recognizing and respecting induvial autonomy and community differences regarding pandemic management.

As healthcare professionals, you are in the front line of dealing with individuals at all stages of pandemic management. It is crucial for those who remain isolated to review their coping strategies and ability to handle the separation from others. In social isolation, there is a greater chance of depression and anxiety during holiday time.

It is crucial for those who have begun to re-emerge from social isolation with caution to acknowledge the stress they may experience in straddling two worlds, between self-protection and the desire to connect with others and experiences in person. With that, internal conflict may emerge with increased depression and anxiety as they face these new changes. Those who have returned to pre-pandemic behaviors may experience conflict with others in their immediate community and the world. Regardless of an individual's perspective and stage of pandemic management, increased stress, depression, and anxiety are continually a risk. 

What can we do to help our patients manage the holidays in this new world?

Embrace change: Change is inevitable, and how one manages change determines how one is affected emotionally. Resisting change leads to increased frustration and angst and leads to disappointment. Accepting change leads to happier, peaceful experiences.

Plan: When making plans, it is essential to communicate with all involved regarding expectations and interactions. Asking questions is key: How comfortable are you in gathering together? What are your expectations about the size of the group? What is your preference regarding masking? What are ways to incorporate favorite family traditions with the current limitations? Is a hybrid approach possible (both in-person and those participating through video conferencing)? Will several smaller social events be a better fit, rather than one large get-together?

Be respectful of individual differences and acknowledge your own needs.

It is essential to create a holiday experience where you feel safe. In doing so, recognize that others may not share the same beliefs or values. Communication is key. Decide what is important to you and communicate that information before and at the time of arrival. For example, if the get-together will occur outside, it is essential to share that so guests can dress accordingly. If you want everyone in masks, include that in the reminder, and have a basket of masks available at the entrance. Remember that each guest may be at a different stage of pandemic management, and for some, this event may be their first time leaving their home. 

Holidays can trigger stress, anxiety, and depression. The pandemic adds another layer. When you have identified that one of your patients may be experiencing stress, anxiety, or depression, it is essential to address this and offer the following – emphasizing that self-care is the priority:

1. Acknowledge feelings. If someone close to you has recently died or you can't be with loved ones, realize that it's normal to feel sadness, and it's OK to cry or express your feelings.
2. Reach out. If you feel lonely, seek out community, religious, or other social events. Volunteering your time to help others is an excellent way to lift your spirits.
3. Be realistic. The holidays don't have to be perfect. As families change and grow, choose some traditions to hold on to that can be adapted to the current climate and create new ones. 
4. Set aside differences. Try to accept people as they are, even if they don't live up to all of your expectations. Acknowledge the bridges that connect different beliefs or values.
5. Acknowledge financial limitations. Stick to a budget. Before you go shopping, decide how much you can afford. Consider making personalized homemade gifts.
6. Focus on giving. Data supports the old saying, "It's better to give than to receive." Sponsor a family, donate to a worthy cause, or give your time to volunteer in the community. Despite avoiding large gatherings and social distancing practices, there are plenty of ways to get involved in your community if you seek them out. 
7. Reach out to those who are more isolated. Try to think of family, friends, and neighbors who might have less local social support and offer to include them in festivities or drop something off at their door. Make an art project to give them or invite them to participate in a socially distant outdoor activity. 

8. Plan your preparation. Set specific days for shopping, baking, visiting, and other activities. Plan menus and make shopping lists to avoid last-minute scrambling—line up help for party prep and cleanup.
9. Learn to say NO. Saying yes when you say NO can build resentment and overwhelm. 
10. Don't abandon healthy habits. Overindulgence adds to stress and guilt.

Have a healthy snack before holiday parties to reduce eating sweets, cheese, or drinks.

Get plenty of sleep. Incorporate regular physical activity into each day by taking a walk with the family.

11. Practice mindfulness. Sit and recognize the world around you: the sounds, sights, and smells you might typically ignore. Mindfulness helps our brains reset and keeps us feeling well.
12. Take a breather. Spend 15 minutes alone each day without distractions to clear your mind, slow your breathing, and restore inner calm. Take a walk, listen to music, get a massage or read a book.
13. Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last, talk to your doctor or call a counselor.

This holiday season brings different challenges than the last. The pandemic has sustained longer than anticipated, and each individual is at a different stage of pandemic management. Many of us will face increased stress, anxiety, and depression this holiday season, and intervention is critical. Acknowledging these issues, planning, and focusing on things in one's control, ensures a more successful holiday experience.

With a doctorate in clinical psychology and over 20 years of experience in the field, Dr. Mary-Catherine Segota has conducted university-based behavioral medicine research, acted as a consultant to professionals and organizations, and worked with a diverse number of psychological and medical conditions. By identifying unique needs, the source of distress, and what’s perpetuating the problem, she will help develop the tools to overcome seemingly insurmountable circumstances. Visit www.CounselingResourceServices.com