So here we are wrapping up 2011. If you believe the TV commercials, movies and all the rest, celebrating the New Year is the best party of the year, one that everyone wants to attend. But surely not everyone can always be in the frame of mind for a party on December 31. I wondered about those who have to cope with a mental illness and those who care for someone with a mental illness. Surely it can’t be easy for them.

So I posed some questions about this to some Menninger clinicians, and thought I’d share their answers with you. Here they are:

What advice would you give someone currently struggling with a mental illness to help them through New Year’s Eve celebrations?

Thomas E. Ellis, PsyD, ABPP: Keep in mind that most New Year’s resolutions are a waste of time and good intentions, because they are too darned hard and doomed to fail. But here’s one worth considering: To spend a little time each day cultivating kindness and compassion toward yourself. Remember the reverse golden rule: Treat yourself as you would hope to treat others. There are lots of ways of doing this, from meditation that focuses on self-nurturing thoughts to engaging in acts of kindness toward yourself. When was the last time you treated yourself to a funny movie?

Elizabeth C. Cantini, MSN, RN, Professionals in Crisis Program:

1. Sometimes a smaller group with warm and close friends can be safer and more rewarding to bring in the New Year. 
2. Try not to get caught up in the hype and mindset of partying with everyone looking so happy and fulfilled. Everyone has challenges and difficulties to face in life.
3. Celebrating New Years can be fun and meaningful with sparkling grape juice and other beverages without ETOH (regardless of what commercials advertise).
4. Fun can be within reach while maintaining good judgment and discretion.
5. Remember to regulate emotions before, during and after New Year’s.
6. Role play before being around friends if social anxiety is an issue.
7. Keep in mind that everyone needs friendship and affirmation.
8. It is a myth that everyone has to stay up until midnight!
9. Call, contact or visit someone less fortunate.
10. It’s fun to talk about everyone’s goals and New Year’s resolutions.

Dee Henderson, MSN, RN-BC, Comprehensive Psychiatric and Stabilization Program:

For those struggling with a mental illness, some coping strategies for the New Year’s holiday include:

• Stay close to friends or family that understand.
• Take medications as prescribed.
• Get adequate sleep.
• Relax by listening to favorite music or doing other activities that relax you.
• Make realistic resolutions.
• Allow yourself to grieve losses of this year.
• Don’t dwell on the negative.
• Be gentle with yourself.

 Chris B. Webb, CPRP, MT-BC, Rehabilitation Services:

• Refer to your wellness and recovery plan if you have one. If you don’t have one, start one.
• Spend New Year’s Eve with supportive friends and family.
• Spend New Year’s Eve at a place of worship.
• Attend small parties if you are triggered by crowds and loud music/noise.
• Ask how they would like to spend New Year’s Eve that will allow them to enjoy themselves without feeling overwhelmed or triggered.

Frances Fisher, CPRP, MT-BC, Rehabilitation Services: Someone living with a mental illness may view not view the coming of the New Year as a new beginning but rather as just more of the same old struggle. Life is not filled with possibilities; only the hopeless feeling of impossibilities and limitations. These feelings may be exacerbated on a day that is exclusively devoted to the celebration of ringing in this New Year. To this person who is struggling, I would say: Step back from the hype of New Year’s Eve and consider that EVERY day is a new day whether it feels like it or not. Know that recovery from mental illness is real and a possibility for your life.

What advice would you give someone with a friend or family member who has a mental illness to help them through New Year’s Eve?

Chris B. Webb, CPRP, MT-BC:

• Ask them how they would like to celebrate it.
• Ask how they would like to be supported.
• Host a healthy and supportive NYE party with soft drinks, play games, share highlights of the past year or best and worst of the last year and expectations of the New Year.

 Dee Henderson, MSN, RN-BC:

For families trying to support a loved one with a mental illness at New Year’s, some strategies include:

• Reach out to those who are alone or vulnerable.
• Encourage honesty in how they are feeling.
• Let them know you truly care about them.
• Support ways of celebrating that are low-key.
• Don’t compare this holiday with previous ones.
• Focus on the positives.
• Allow them to process feelings with you.

'Tis the season

This time of year creates different reactions in people. Most of us are blessed to have family and friends with whom to share the holidays, and are able to celebrate all the things for which we are thankful. It is a joyful time: We travel to be with people we miss and share traditions of food, song, decorations, lights, games and warm interactions. To most of us, it is a festival for the senses and a time we look forward to every year.

Unfortunately, not all people will feel that way. Some are alone, depressed, fearful and in need. For them, the holidays bring thoughts of what their lives lack, which can make their emotional distress worse. Travel challenges can trigger panic disorders and destabilize bipolar disorders. Eating disorders can be triggered by holiday foods and the pressure to indulge in them. Alcohol is free-flowing in some settings, and those challenged with addiction have additional pressure with which to contend. People may feel forced to be with individuals they may avoid the rest of the year, and old issues can arise, increasing the stress. Expectations run high, and disillusionment fuels conflicts. Even under the best of circumstances, the holidays are stressful, and stress can precipitate underlying depression and anxiety.

Some surveys indicate that not only do many people suffer from depression during the holidays, some experience distress to the extent that they cannot partake in the season’s activities at all, increasing their sense of isolation and exacerbating existing mental illness. At worst, the depression is severe enough to generate feelings of hopelessness and thoughts of suicide.

The positive news is that support from loved ones and treatment by mental healthcare professionals can help individuals cope with depression, anxiety and other mental illnesses, both during the holidays and when the regular routine resumes.

As you count your blessings this holiday season, consider giving to non-profit organizations that support those with mental health issues in gratitude for the health your family enjoys or maybe the help these organizations provide for someone you care about. 

Have a safe, happy and blessed holiday season!

Editor’s note: Many wonderful non-profits treat individuals with mental illness, do research into the nature of mental illlness and help families cope with the effects of mental illness. These organizations work at the national, regional and local levels to alleviate suffering and offer hope. Many, including The Menninger Clinic and The Gathering Place, Menninger’s psychosocial clubhouse, send out year-end appeals. Others, including the National Alliance on Mental Illness and Mental Health America, urge their web visitors to support their work. To find other mental health non-profits in need of your support this holiday season, a quick Google search will lead you to them. 

Each year, along with my greetings of the season to friends and associates, I share a summary of significant events occurring in my life that year. And I conclude with some general thoughts about the state of the world. My closing thought this year prompted quite a few responses. My words:

Divisive political rhetoric and shrill negative commentary continue. Many people, preoccupied with real and imagined threats, manifest the attitude: “Don’t confuse me with the facts; my mind’s made up!” As I urged last year, let us work to open minds, reject simplistic polarization, engage in a more tempered discussion of the world around us, focus on constructive options in life and recognize that most people want to be good and do well.

One friend responded, “I wish that your closing paragraph were blanketed on every Op Ed page all across America!!!” And one of my children’s former teachers wrote:

You are certainly a kind man who looks at the world with views of working together to find common ground in solving problems. Who is listening? It seems there is less of everything we wish for: Peace and Love, but there’s always Hope and our Faith on which to rely. May they eventually bring us closer to the Peace and Love we so desire. You have done much in support of your beliefs and your words inspire me to do more in my own small way.

Right vs. wrong

My message reflected a continued concern about the profound split that seems to be evident in our country. A “right” way and a “wrong” way are reflected in the media on most every issue, with a remarkable difference as to which is the “right” and the “wrong” way. It depends on who’s expressing the opinion! All too often, opinions with a less than substantial basis on verified information are presented as “fact.” And those who have a differing opinion are demonized and devalued.

Public officials seeking political acceptance will say what they think people want to hear, rather than the way things really are. More than 30 years ago, I gave a speech entitled: “Tell it like it is! The H… you say!” Because most people don’t really want to hear it like it is. They want to hear it like they want it to be! Underlying this wish is a host of insecurities and deep-seated prejudices that unconsciously bias how we perceive the world and how we respond to what we are experiencing. If we are hurting and distracted, it is hard to tune into complicated explanations.

But our world is complicated, and there are few if any simplistic solutions. We do have some basic needs in common, as articulated in Maslow’s hierarchy of human needs: (1) basic physiological needs; (2) safety; (3) love, affection and belonging; (4) esteem; and (5) self-actualization. If we are threatened in our capacity to achieve our more basic needs, it is hard to focus on the higher levels of achievement. And it is easy to look for scapegoats on whom we can blame our, and the world’s, shortcomings.

What we need

So what’s to be done? We all need to respect disagreement and examine its value. We should examine differences, and rather than close our minds and focus on the negative, we should search for points of commonality that can bring us together. We must find ways to assuage so much hate and enhance our capacity to respect one another. We should search for ways to make our lives and our world better. We have to do less talking and more listening.

And keep in mind the “Serenity Prayer:”  God, please grant me the serenity to accept the things I cannot change; the courage to change the things I can; and the wisdom to know the difference.

Not everyone enjoys the holiday season as much as Snoopy and friends.

We have all likely walked through a shopping mall or grocery store this time of year and hearing the familiar jingle “Tis the season to be jolly, fa la la la la, la la la la” piping through overhead speakers. If we are excited about the holidays and their promise of time spent with loved ones, such melodies can lift our spirits and kindle warm memories. Sadly, not all share such fondness for the holiday season.

Many who struggle with mental illness feel left out of the advertised frivolity, thus exacerbating the stigma they already feel. One of the difficulties they wrestle with is the discrepancy between the ubiquitous external symbols of joy, peace and happiness—such as the peppy holiday jingles found on TV commercials and in grocery stores—and the internal experience of melancholy. For many, especially those who do not find comfort in their connections with family, the holidays are yet again another reminder of an aching gap between lived experience and the pleasures commonly associated with the winter holiday season.

What patients have taught me

In my work with patients, I have learned well the struggles of the season. The fault lines of broken or strained relationships are revealed more clearly with the increased attention paid to families. Those who have lost parents, siblings or who are otherwise estranged from families or spouses can feel the heart wrenching awareness of loss and absence.

From this I have learned two valuable lessons. First, the emotional pain stirred up is not only painful—it is harder to bear in isolation. Alone with painful experience, it is harder to gain perspective. We can feel like the only ones struggling and that no one can relate. This sense of disconnection can fuel shame—the painful sense that we are defective and do not belong—and once caught in a shame spiral, we are prone to retreat further, becoming more depressed in the process.

The second lesson closely follows the first. If isolation and aloneness, coupled with nearly unbearable pain, makes matters worse during the holidays, there is a way out. It is through finding connection and understanding. It is through learning to be vulnerable enough, with the right people, to let them know of our struggle. The number one healing influence I hear from patients every day is the power of connection, usually with peers they can relate to and who understand their plight. Individuals who felt utterly alone and unable to relate discover that their pain is not so uncommon and that there are others who have felt like them. Sharing the burden helps lift its crushing effects and rekindles a sense of belonging.

Getting through

Not everyone reading this post is in a hospital with peers who might be able to offer support this holiday season. Can anything be learned from those currently hospitalized that might apply to you? Yes, I believe so. Find a source of connection. Look in your newspaper for support groups, or talk to your psychiatrist, your therapist, your sponsor, a friend, or a spiritual leader about what the holiday season is really like for you.

There is no need to try and pass off the holiday season as something it isn’t, but at the same time, you don’t need to go through it and only experience misery. It is okay to struggle and find parts of it painful, while being out in the world and living your life anyway—but make sure to do it by relating with others who can understand and empathize with what you are up against. This will help buffer you through a season that is perhaps not so jolly … but can be lived with dignity and supportive connections with others.