This Is Why Anxiety & Depression Get Worse Over The Holidays — And Here's How To Cope

While the winter holidays hold fond memories of family gatherings and giant dinners for plenty of folks, they're also one of the biggest stressors people face all year. In fact, 64 percent of people say their mental health stress level increases exponentially around this time of year, as psychiatrist Monika Roots, Vice President of Health Services and Senior Medical Director of Behavioral Health at Teladoc, tells Bustle. There is also evidence to suggest depression and suicide rates rise in December, which is why it's so important to prepare for a dip in your mental health during the holidays.

Roots says it's normal to feel more anxiety during the holidays, but that practicing a few key coping strategies is vital to keeping that stress from overloading you. "[The holidays are] a little bit of mass chaos, there's a lot of people, there's a lot of emotion, there's a lot of anxiety, and that's the time where it's the most crucial to be able to not just get help when you need it," Roots explains. "If we think about diagnosable conditions, about one in five have an anxiety disorder, but I usually think about it like, 100 percent of us have anxiety during the holidays."

According to a 2016 index put together by Orbitz, 72 percent of Americans travel between Thanksgiving and New Year's. The anxiety of traveling and being out of one's normal environment, coupled with being pushed outside your comfort zone and possibly pushed into conflict with family members, can be exactly the kind of holiday cocktail you don't want to enjoy. Plus there are dozens of smaller stresses: Worry over selecting the right gifts, preparing all or part of a family meal, or possibly dealing with emotions of having lost a loved one during the year, when their absence from a family gathering is most greatly felt.

Roots says mitigating the negative effects all these various holiday stressors can have on you involves a few key behaviors, including proactively taking time for mental de-stressing. That means taking moments of quiet for yourself, to focus on your own well-being.

You should also stick to your routine as much as possible, especially when it comes to sleep. "I really think about sleep as the building blocks for your whole mental health and well-being," Roots says. "If we can't sleep, then we start to eat more, we can't focus, we say things we maybe don't mean, the chaos seems more, and the anxiety goes way up."

People in general have poor sleep hygiene, even outside of the holidays, Roots says. And once you're in a cycle of sleep-related bad behavior or anxiety, it can be hard to break free. "We might be on our phone until two minutes before we want to go to bed, [and] many of us clock-watch all night, which means that you're just looking at the clock and you're saying, 'Okay, if I fall asleep now I'll get five hours. If I fall asleep now, I'll get four hours,'" Roots says. "It's the worst thing that you can do, because [...] you're training your brain to be anxious in bed."

Because stress is a common cause of insomnia, it's especially important to pay attention to these bad sleep habits during the holidays. If you're struggling to fall asleep or catch yourself clock-watching, the best thing you can do is get out of bed, Roots says. "After ten or fifteen minutes, if you don't fall asleep, get out of bed, go to a different room," she explains. "Grab the most boring textbook you still have from school, start reading it, and when you're bone-tired, go back to bed."

Aside from getting seven to nine hours of quality sleep, you should focus on setting boundaries, Roots says. She adds that this is a good strategy for people who may be afraid of facing conflict with family members who have different viewpoints or who may not approve of your viewpoints. Knowing where your boundaries are and practicing mental de-stressing can be a huge help for conflict-laden situations, Roots says.

"It’s really important to know what discussion topics will make you more or less anxious," she tells Bustle. "[If] you’re getting really stressed or really anxious, is [the conversation] really worth it? Is this maybe a good time to walk out of the room and connect with someone else that you can have a really good conversation with? Is that the time to take the five-minute break and, you know, go get some water and take a walk outside, maybe walk somebody’s dog?"

For these types of situations, it's also helpful for folks to chat with someone who has an objective viewpoint, Roots says. This can be a mental health provider like your regular therapist, if you have one, and it's also part of the services Teladoc offers.

"[You might need] therapy where it’s helping you go to the grocery store so you can buy that food for the holiday dinner and they can walk you through the stress," she says. Mental health care is wholly unique, Roots says, and should be treated as such. "Being able to seek care is really personal. It can’t just be one-size-fits-all," she adds.

Ultimately, Roots says, you can only truly manage yourself. While the holidays may feel wildly out of control, maintaining your own mental health should be a top priority, and everything else can take a backseat.

"[Realize] where your power is," Roots says. "Which is really being able to manage and work through your own reaction to things and people."

And if everything becomes too much, there's absolutely no shame in withdrawing from a situation and reaching out to your support system of family and friends, or to a mental health professional. This season is all about kindness, and it's important to remember to treat yourself with same kindness you give the people you love most.