When I heard that my daughter would be home for Christmas, I felt more scared than joyful. She had just entered a partial hospitalization program at an eating disorder treatment center. The past few months had felt like walking through a blizzard - I could barely see straight and I didn’t know where we were going or how to get there. Of course I wanted my daughter to be with us on Christmas. But I dreaded the overwhelming work of the feeding her according to the strict, nutritionist-mandated food plan, which she resisted in the same way that she kicked and screamed about getting vaccines as a toddler. How could we enjoy the beauty of Christmas carols, the peace of a Christmas Eve service, the excitement of seeing family, when depression paralyzed her?
Fast forward two years. During a visit to my dad’s home over Thanksgiving, I noticed the subtle signs of my daughter’s bulimic tendencies cropping up. Cookie jar raided, seeing her pick at meals, the fact that she took a pass (more than once) on a family activity to hole up in the guest bedroom. It didn’t turn into a full relapse, but it was enough to stir up anxiety in my gut.
Why Holidays Can Be Tough for Teens with Mental Health Challenges
At first, it seemed counterintuitive. Shouldn’t the holidays be a reprieve from my daughter’s mental health challenges? After all, there’s no academic pressure, she has time to relax with loved ones, she’s getting and giving presents and eating delicious meals. After all the time (and money) I’m putting into making this holiday special for her and her siblings, shouldn’t that mean that they are all happy and content?
Now I understand. The holidays are full of both joy and a kind of hectic chaos, which disrupt the predictable routine that grounds teens with mental health issues. Overstimulation, even for good reasons such as gatherings of loved ones, beautiful meals, gift-giving, and a full schedule of fun activities, can be stressful. In addition, it can be harder to connect with a support network during the holidays, as therapists may take vacation time, support groups might pause, and friends are less available due to travel or family obligations. On the other hand, when holiday expectations fall short, when family members fight, when the usual patterns of sleeping and eating are thrown off, or when there is too much unstructured time, teens who already struggle with depression, anxiety, or eating disorders may feel worse.
When my kid is struggling, it also affects me. At times, I’ve been overly focused on her well-being, unable to enjoy a holiday when she’s depressed. Even though I’ve learned the practice of detachment to create some emotional space between us, it’s still not easy. Plus, there’s the reality that Ellie’s mental health challenges affect her siblings, which means more stress and more conversations. When we’re with extended family, I face other challenges in helping my daughter manage her needs within a bigger group while trying to be present to grandparents, aunts, and cousins who may not know or understand. So I have my own stress around mental health challenges during the holidays.
What Practices Can Help
As a fellow mom on the journey, here are a few ideas I’ve learned, which I’ll be practicing myself this holiday season.
Reset Expectations
In hindsight, I realize that changing expectations could have made previous holidays much easier. Unconsciously, I expected my daughter to act like a neurotypical kid without mental health challenges. That wasn’t fair. I tried to convince her and myself that she could participate to a level that was beyond her limits (hello, control tendencies!).
This year, I’m asking myself, What are our family’s priorities? What are our values, versus what others might expect of us? How can I partner with my daughter to make a plan that works for both of us? I want to be clear about which family activities are essential and where she can take a pass. In our situation, I expect my daughter to be present to a visit with her cousins and grandparents for gift exchanges and a dinner, but I understand that during a 6 hour visit, she might need to take a half hour to herself. I offered to host this 13-person gathering in part because I know that my daughter will be less prone to anxiety in our home and she can take a breather in her bedroom rather than someone else’s bathroom. For our immediate family’s Christmas Day, I expect our daughter to participate fully in our immediate family’s holiday meals, gift-exchanges and board games, but I know she will need to rest by mid-afternoon. Knowing that ahead of time frees me from frustration and power struggles. Maybe I’ll need a break myself!
Resetting expectations means setting boundaries and saying no when needed. It means accepting our limits. It means becoming aware of my own needs, not just my daughter’s. It means letting my daughter know that we will participate in an activity even if she doesn’t. It gives all of us the freedom to define our own definition of a satisfying holiday.Make Space
In the midst of holiday busyness, I am prone to forget to make space for myself, my feelings, my body, my breath. Because her emotional and physical conditions force her to move at a slower pace, my daughter is a wonderful teacher. Here’s a list of the self-care practices that I love for myself and our family during the holidays, which can help with everyone’s well-being.
Outdoor walks on a sunny, cold day
Down time for rest, play, reading, meandering
Prayer, meditation, reflection & gratitude
Noticing and honoring feelings
Restful breaks, maybe a nap
Meaningful connections (even brief) with husband, friends, parents, kids
Checking in with my daughter about how she’s doing
Helping each other laugh by finding humor in any situation
Dog snuggles and human hugs
Reach out for Support
I’ve learned the hard way that our need for support doesn’t take a break during the holidays! Even though it’s not always convenient, whenever possible, we make sure that our daughter can continue meeting with her therapist and nutritionist during the holidays, if they are available. The hassle of finding ways to make those appointments work, despite family visits and fun adventures, is always worth the value of keeping our daughter grounded. In the same way, I find time to reach out to my own support network during the holidays, sneaking out on an early morning walk for a phone call or delaying family breakfast preparations so I can squeeze in a support group meeting on Zoom. Those connections can be the difference between a day stuck in emotion mind versus wise mind, to use DBT terminology. In the hardest moments, when our daughter has slipped back into a dark place, we have learned not to hesitate to reach out to a doctor, a psychiatrist, a therapist or even the ER, for help, regardless of the holiday.
Affirm & Accept
This year, I’m using the last few days of December to reflect, to learn, to evaluate. What did I accomplish this year? What would I do differently in the future? In the same way, I can consider: what’s happened in our family this year? What progress did we make, even if it felt painful and circular? How have my kids grown? What have I learned and how have I grown as a parent?
Taking time to reflect can help us focus on what is, rather than where we fall short. It’s tempting for me to compare myself and our family to others. But that tendency prevents me from noticing the beauty in front of me. Especially in parenting a teen with mental health concerns, it’s easy to be frustrated and discouraged. But what if we change our perspective to see how far our children have come? And what if we communicate our affirmation to our teens, who are already probably down on themselves?
This Christmas, I want to give my daughter the gift of affirmation. A friend challenged me to write down my own best qualities and read it to myself. I can do something similar for my daughter. For instance, my daughter tried college and dropped out because of health concerns, which has been very painful. During the holidays, I’d like to tell her how proud I am of her for focusing on her health, for learning to navigate the medical system, for her maturity in moving forward with community college. I want to tell her how impressed I am of her for how she’s managing her eating disorder recovery, how excited I am to see her joy at pursuing creative hobbies like baking bread, how proud I am to see her commitment to therapy in the past three years. Accepting what is and naming the good might be just as meaningful as a wrapped gift under a tree.Have a Plan
If I took away just one idea from my daughter’s seven months in a treatment center, it was this: failing to plan means planning to fail. Every time Ellie faced a new challenge, such as her first day at home during partial hospitalization, stepping down to a lower level of treatment, or going back to school, her therapist would sit her down to write a plan. When she left for college, I found one of those plans in a dresser drawer, wrinkled and torn and faded but still in circulation.
Our plans always included a few key elements:Potential triggers (such as events, situations, people that might create stress)
Ellie’s typical reactions to those triggers (feelings, anxiety, unhealthy urges)
Ellie’s preferred activities to help herself calm down and where or how she could do them, both at home or away from home
People she would reach out to for help
An example of Ellie’s plan today might be:
Ellie likes her cousins but she gets overwhelmed by how loud and active they are, especially after several days at Grandma’s. She is extra sensitive to sensory stimulation.
She feels very anxious and angry. Without support, she might binge on cookies to calm down. Or she might have an anxiety meltdown later.
Healthy choices: she could take some time alone and listen to an audiobook. She could use the Calm Harm app on her phone. It would also help to snuggle with the dog.
Talking with mom or her boyfriend helps - both are good listeners - or her therapist.
Whatever practices you use, I hope you have a peaceful holiday. Even if your holiday feels a little bit better than last year - more loving, serene, joyful, kind - please celebrate that as progress! I’m going to do the same.
I’d love to hear what has worked for you in loving someone with mental health concerns over the holidays. What are your best tips?