Since her diagnosis with bipolar disorder, Amy Pilkington has had more than her share of holiday crises. Over the years she has learned how to cope with the stress—and risks—of the holiday season.


January and February have always been the hardest time of the year for me to manage my symptoms, which can range from severe depression to mania. One year was particularly difficult, however. My father passed away on New Year's Day in 2008.

He was very ill throughout the holidays and we all knew his death was imminent. As the eldest child, I took on all the funeral planning and felt I had to be the rock for everyone else. I completely ignored my own needs because I thought I had to be strong for the rest of the family.

It all blew up in my face. By mid-January, I was having bouts of psychosis that included hearing my father's voice urging me to kill myself. I hadn't allowed myself to grieve for him, and I was also overwhelmed by the hustle and bustle of the holidays. While trying to be there for others, I had inadvertently set myself up for disaster.

Since then, the holiday season tends to make me anxious. I'm working on putting myself first, but I have a habit of doing the exact opposite—and its a habit that's proving hard to break.

I've learned that the crowds, family functions, and last-minute shopping can spell trouble, but I also know there are steps I can take to reduce anxiety and keep my sanity in the midst of all the madness.

I've found the most important thing is to plan ahead. Regardless of how hard you try to avoid it, you will inevitably be faced with stressful situations. Try these six strategies to get through the holidays in one piece.

Know your limits

My husband has a very large family. His father had more than 10 siblings, and more than 100 people attend the family Christmas celebration each year. There are so many of them that I still can't keep count.

Being in the middle of that many people is way too much for me to deal with. I can handle a dozen relatives at a time for a short while, but even the thought of being in a crowd of 100 makes me want to scream. I don't like crowds and I can take only so much before I start to crack.

A few years ago I decided that I'd no longer attend the big celebration, and I usually opt for the smaller gatherings instead. Large get-togethers are sometimes unavoidable during the holidays, however, and I've been forced to find ways to deal with the fear and anxiety they provoke. During family functions, it's not unusual to see me heading for the door. Sometimes it helps to find a quiet spot outside and spend a few minutes away from the crowds. Enjoying a little quiet time often allows me to get through the day without a manic meltdown.

Leaving a party altogether is a last resort, but there are times when my efforts to cope with the stress just don't help. When you go to a holiday gathering, you should always have an exit strategy. Be prepared with an excuse in case you need to make a hasty exit. Making up excuses isn't really possible once I'm beyond the point of rational thinking, so having an excuse before I reach that point comes in handy. Sometimes just knowing that you have a way out of a situation before it turns bad can help lessen your anxiety.

Don't overschedule

Holiday parties, parades, and banquets can pile up quickly and overload your frazzled nerves. There are always so many events to attend, but I pick and choose a few and forgo the rest. Sometimes it's necessary to avoid certain places or people. If I know I'll be uncomfortable in a situation, I politely decline the invitation. Some people don't understand this, but I think it's better for them to be upset because I didn't attend than to be upset because I had a major meltdown and ruined the festivities for everyone.

I especially try to avoid attending events several days in a row. I give myself a day or two to relax before tackling the crowds again. I need all of my energy to cope with one event at a time, and if I become overloaded with obligations then I won't be able to function. One event at a time is hard enough. If you know you have to face it again tomorrow, you'll spend the entire time worrying about both events and end up miserable.

Skip the holiday toasts

I have never been more than a social drinker, and now I refrain from drinking altogether. Some time ago I started to notice that even though I'm in a jolly mood if I have a few drinks, I'll have fits of rage for several days afterward. My medication stops working and it takes a few days for it to straighten out.

If the people around you are drinking, it can be very easy to consume a bit too much alcohol. Alcohol may seem like a good way to take the edge off, but it can make matters worse. Clouding your judgment and losing your inhibitions is a recipe for disaster. Also, if you take prescription medication, alcohol may interfere with its ability to work properly. A few hours of pleasure aren't worth a week of pain.

Ask for help with holiday errands

Thousands of frenzied shoppers can make holiday gift buying unbearable. I do as much of my shopping online as I possibly can. If I need items from a local store, I make a list and send my husband to pick them up. Occasionally I'll brave the crowds, but I never enter stores during the last-minute shopping rush.

Don't forget your meds

I never have a problem remembering my medication–—unless I change my routine. My schedule goes out the window during the holiday season, and my medications slip my mind from time to time. Missing even a single dose can wreak havoc and make me want to retreat to my room and stay there.

Don't get so caught up in holiday celebrations that you forget to take your medication. Without it, you may be headed for disaster. Ask a friend or family member to remind you when it's time to take your medication.

Don't ignore the warning signs

It's easy to let things slide during the holidays, but if you allow stress to keep building, it will get the best of you in the end. By the time February arrives, I am usually at such a low point that hospitalization is considered.

Don't put off asking for help until you feel you're reaching your breaking point. Ask for help at the first sign of distress, and call your doctor if necessary. It may be difficult to contact your doctor over the holidays, so be sure to ask for an emergency contact ahead of time.

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter