MS and Stress: Managing the Holidays

Stress is a normal part of life for many people. For some, holidays can be especially stressful because of gift buying, traveling, and making holiday dinners. If you have multiple sclerosis, the stress of the holidays can be compounded by managing your illness on top of everything else. 

Living with MS is not only a physical hurdle, but the effort it takes to manage the illness can increase your stress levels. During the holidays, you might feel like you need to explain your condition and request certain accommodations for traveling, dinner parties, or other holiday events. This can get emotionally exhausting, and you might feel yourself getting anxious whenever you have to socialize. There is also the stress of adapting to new symptoms as the disease progresses and the unpredictable nature of MS.  

Studies have shown that stressful life events are associated with a significant increase in the risk of MS exacerbations. The impact can last weeks or months after the onset of the stressor. For example, if you have MS and you lose your job or have concerns about paying hospital bills, you may notice that your flare-ups are more frequent or worse months after the event has passed.  

Long-term or continuous stress can also trigger MS relapse in people with relapsing-remitting multiple sclerosis (RRMS). This type of MS is defined as MS in which patients have relapses and periods of stability between relapses. Continuous stress keeps your body on high alert, causing further inflammation in the body. But it can also suppress your immune system and make it harder to fight off infections or other illnesses that can make your MS symptoms worse.  

It’s not just negative stressful life events that can cause MS exacerbations. Even positive or happy life events such as the birth of a child or a wedding can increase the chances of a relapse. 

Although there isn’t any evidence that stress is a cause for MS, many patients with MS report that stress triggers their symptoms or causes a relapse. If stress makes your symptoms worse, it’s important to do your best to reduce your stress during the holidays. Here are a few ways to keep your stress levels down this holiday season.  

Identify your stressors 

Before you can take steps to manage your stress, you first need to identify your stressors. There may be a lot of them and that’s OK. It’s important to be honest with yourself about people or situations that raise your stress levels so you can minimize those interactions as much as possible.  

Christmass shoppingIf you know being in crowds makes you feel anxious, try to plan your shopping for off-peak days and hours. Don’t wait until the last minute when there are bound to be lots of other shoppers. You can also shop online instead of in stores. In addition to crowds, if noise is a stressor for you, you might want to consider using noise-canceling headphones while you’re out. You can play music to help keep you calm, just be sure to pay attention to your surroundings.  

If you have to go out of town for the holidays, try to travel during days and times that won’t be as busy. Holiday travel will likely look different this year compared to previous years because of the pandemic and more people working from home. Instead of traveling one or two days before and after the holiday, you might want to consider leaving a couple of days earlier if your schedule is flexible.  

It’s OK if you can’t identify all of your different stressors at first, one or two stressors is a good place to start. You can take action to reduce the stressors you are aware of and adjust as new ones arise.  

Establish clear boundaries 

The holidays are a wonderful time to visit friends and family. However, there may be some interactions you would prefer to avoid. If there are people who are difficult for you to be around, it can easily send your stress levels through the roof. This can have a cascading effect as you might indulge in unhealthy behaviors to cope with that stress, such as drinking too much alcohol, isolating, or neglecting your health.  

Try to limit your interactions with people who make you feel stressed out. This can be easier said than done, and it can be difficult to do this in a way that doesn’t come off as rude. Communicate with friends and family about who is expected to be at certain events so you can plan accordingly. You don’t have to say that you are trying to avoid someone, but you can make plans to leave the event early to avoid confrontation. 

Remember, you are allowed to say no to anything that makes you uncomfortable or that you know will be difficult for you to manage. You don’t have to accept every invitation or go to every dinner. Find your comfort zone and stick to it.  

Set a budget 

The holidays can quickly drain your bank account if you’re not careful. If you have a lot of people to buy gifts for, it can be easy to spend a lot of money without realizing it. You don’t have to go broke trying to please everyone. Set an overall budget and a budget per person and stick to it as close as possible. Shop around to see if you can find a better deal somewhere else and take advantage of discounts. 

You might want to consider the “four gift rule” to figure out what to buy the people on your list: 

  1. Something they want  
  2. Something they need 
  3. Something to wear 
  4. Something to read
Christmas presents under tree
Photo credit: James E. Petts

Following these suggestions can help you narrow down your shopping list and buy meaningful or useful gifts. A lot of times, we try to surprise people with things we think they’ll like, only for that item to be regifted later. You can avoid the possibility of that happening by asking your loved ones what they want.  

Another way to save some money on gifts is to make handmade gifts. If you do any kind of crafting, such as knitting or jewelry making, you can give friends and family something you have made especially for them. Not only is this easier on your wallet, but it’s more personal than something store-bought. 

Make a list  

The holidays can get very busy, and it can be easy to get overwhelmed by all of the different things you need to do. Make a list to keep track of all of your obligations, such as events and appointments. Try to give yourself enough time between events to allow your body to rest. You don’t want to burn yourself out by running around and not taking a break.  

As you’re making your list, make a note of where you might need extra support. Delegating some tasks can be helpful for keeping your stress levels down. For example, if you have to cook a meal, can you enlist family members to help you out with the cooking or grocery shopping? If you have to travel, is there someone you can hitch a ride with?  

You use the notes and calendar features on your phone to keep track of your obligations. Many of these apps have the option of sharing them with another person. You might want to consider sharing with a friend or family member as an added precaution. 

It can also be helpful to rank the items on your list by priority. What are the events or tasks that are the most important? Which ones are the least important? Organizing your list this way can help you focus on the things you really want to do, which can also help alleviate stress. As always, prioritize spending time with the people you really enjoy being around. 

Set realistic expectations 

There can be a lot of pressure during the holidays to “go big or go home.” But when you’re living with MS, your symptoms can make even seemingly simple tasks difficult.  

Similar to setting clear boundaries, it’s also important to set realistic expectations about what you can and can’t do during the holiday season. If you usually put together a huge dinner spread, you might need to consider paring it down in order to manage your stress and MS symptoms.  

You also want to be realistic about how many events you can attend during this season. If you’ve made a list and ranked it in order of importance, this can be helpful for managing your time and knowing how much you are able to handle without getting stressed out.  

Be sure to communicate with friends and family about what you are and are not able to do. That way, you don’t have to feel bad about leaving an event early or skipping it entirely. Keeping your friends and family in the loop can help relieve some of the stress you might feel about your different obligations. They can act as an ally and help back you up in situations where you might feel uncomfortable speaking up for yourself.  

Resist the urge to overeat 

One of the best parts of the holidays is all the delicious foods there are to eat. If you keep to a strict diet throughout the year, eating foods that aren’t part of your regular diet can cause stress on your body. While it’s easy to be tempted into overindulging during the holidays, overeating or eating too many of the wrong foods can quickly lead to feeling guilty and stressed out.  

Holiday meal
Photo credit: Zeetz Jones

The holidays often involve foods that can make MS worse. Inflammatory foods like gluten, sugar, and certain fats can trigger a flare-up. Though some foods may not inherently have inflammatory properties, preparations can. For example, lean meats like turkey are generally safe to eat. However, they are often prepared with lots of butter or oil, which can cause inflammation and make symptoms worse. To help keep stress to a minimum, try asking friends to prepare chronic illness-friendly foods or prepare your own meals. 

It’s equally as important not to overeat. You can resist the urge to overeat by choosing smaller portions and eating slowly. It helps to be realistic about your appetite and how much you can actually eat in one sitting. Before you pile your plate up high, try to think about how much you eat during a normal meal. This can help prevent you from taking more food than you actually need. 

It takes approximately 20 minutes from the time you start eating for your brain to realize you’re full. Although this amount of time is based on several different factors, it can be a good rule of thumb to curb overeating. You don’t have to watch the clock to know when 20 minutes have passed, but it can be helpful to be aware of how your stomach and body feel to know when to stop.  

Simplify meals and cleanup  

If you’re hosting a holiday dinner, you might need to cook a large amount of food and make it presentable. But the end result of all of that cooking is a huge pile of dishes that will have to be washed at the end of the night. Since MS can have symptoms like fatigue, spasticity, and numbness or tingling, it can be difficult and tiring to get through the cleaning-up process. 

Many people like to use their good China or dinnerware during the holidays. But decorative plates, bowls, napkins, and cups can look just as nice at the dinner table. This also helps simplify the cleanup process after the meal is finished. You can also use disposable serving bowls and flatware. 

Remember that you don’t have to take on all of the cooking and cleaning yourself. If you have friends or family members who are able and willing, ask them for help. You can also turn your meal into a potluck and ask guests to bring a dish. This way, you don’t have to do all of the cooking yourself and, as a bonus, your guests will bring their dishes home with them at the end of the night.  

Give yourself grace 

As you go through the holidays while managing your MS symptoms, it’s important to remember to give yourself grace. That means not being too hard on yourself if you are unable to do certain things, or if you find yourself doing things you don’t usually do. You don’t need to feel guilty if you do overeat one day, or if you stay later at an event that you planned to leave early.  

Remember that you are human and you are going to make some mistakes. The important thing is not to dwell on them. Overthinking what you could have done differently can cause you unnecessary stress and anxiety during an already stressful time.  

Take time during the holidays for yourself. Whether it’s adding an extra day to your travel itinerary to rest and recover or taking short breaks during the day to recharge, it’s important to check in with and center yourself.  

Ask yourself how you are feeling, if you’re staying hydrated, or if you’re getting enough rest. Make sure to talk to yourself the way you would talk to a loved one. Keep your self-talk positive. Try saying things like, “I did my best today, and my best is good enough” as a reminder. If you’re having a hard time giving yourself grace, talk to a supportive friend or family member. They may see things you didn’t notice, and they can give you a pep talk if you need it.  

Find the support you need 

The holiday season can be tough for anyone, but for people with MS, it can be even more difficult. If you are struggling with managing your stress this holiday season, know that you’re not alone. At PatientsLikeMe, there are over 75,000 members who are also living with MS and learning how to manage their stress and other symptoms. Join the conversation today to get the support you need to make it through the holidays. 

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