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The 12 Steps of Christmas

“My name is Sarah and I am a Holiday-holic”.

Yes, I love the holidays. In fact, I probably love them too much. I am so emotionally over-invested that I sometimes get overwhelmed, creating a horrible disconnect between the fantasy and the reality.

The truth is that I have gone through the same cycle of manic hyper-anticipation and inevitable anticlimax so many times that I have finally come to embrace the wisdom of AA:

"I have had to admit that I am powerless over Christmas and it is unmanageable for me"

The emotional pressure, temptation to spend too much, drink too much, exposure to toxic family members, other peoples' expectations (or my distorted perceptions of them) - the list of triggers and stressors just go on and on. More and more we are coming to understand the huge role that stress plays in bipolar disorder. Given how stressed out most folks can get around the holidays, it is no surprise that people with bipolar disorder can find this time of year extremely challenging.

A couple of years ago things got so bad that I actually took an unscheduled vacation in early December because I recognized that my Christmas shopping was starting to spin out of control and I needed a "pattern interrupt" to stop me developing a full blown mania.

Now I have finally wised up to the perils of the holiday season and am able to enjoy an authentic, appropriate, joyous experience with my family and friends.

Here are a dozen strategies I have developed to make sure I enjoy the holidays and stay well - my 12 Steps of Christmas:

1. Stick to your regular sleep/wake routine each day.

2. Stick to your medication regime.

3. Make plans with your doctor ahead of time about what changes you will make in your meds if you start to become depressed or manic.

4. Heck - make plans about everything! Uncertainty is a huge stressor at the best of times so have as much predictability as possible. In particular, decide potentially difficult things like time spent with in-laws, your financial budget, and what social functions you will attend well in advance. Make sure you and your loved ones are in agreement and are aware of your plans.

5. Keep up your mood charting and include a special section on holiday triggers, danger signs and preventative strategies in your treatment plan. This is how my spouse and I identified that my mood was building up towards mania and why we decided to take a few days off somewhere quiet, getting centered instead of shopping and spending.

6. Do not over schedule. It is tempting to try and visit with all of your friends and family, but if anything you need to schedule in downtime and avoid burnout. Be selective.

7. Avoid the "disease to please" by promising things that will be difficult for you to deliver and cause you problems further on down the road. This can be anything from promising children expensive gifts to promising your sister-in-law you don't get along with that you will come stay for Thanksgiving.

8. Have a gift list and a budget and STICK TO IT! Sanity check your budget and gifts with your spouse, or a trusted friend or counselor. There are many reasons why we may overspend at Christmas - obvious ones like manic grandiosity, and more subtle reasons such as trying to compensate for what we put loved ones through with our illness. Just remember that for the folks who love you, there is no gift you can give that matters as much to them as you staying well.

9. Practice sobriety. This may mean abstaining from alcohol if you have substance abuse problems, or only eating one piece of pie if you are trying to manage weight gain as a side effect from bipolar medication. Or it may mean spending quality time with your family instead of frantically cooking, decorating, shopping - whatever - we are all different, but in our heart of hearts we usually know our own personal demons.

10. Do not isolate. Some of us are estranged from family and risk being lonely over the holidays instead of over-committed. In this situation, accept invitations and stay engaged with the world around you. Again, talk to your therapist or other supporters and make plans well ahead of time.

11. Enjoy yourself! Make sure your holiday plans are manageable but still fun. Each year I do 3 things without fail: 1. Attend a specifically Christmas event (this year is Handel’s “Messiah”); 2. Buy MYSELF a Christmas treat (this year it will be a Wii Plus Fitness bundle); 3. Make amends with someone I have done wrong by (this year it has been my stepson who endured years of my buying inappropriately lavish gifts when he was little and then suffering my moods when his response to things he never asked for and was emotionally overwhelmed by did not live up to my fantasies).

12. Remember the reason for the season. Regardless of your particular personal faith, focus on whatever is spiritually uplifting and sacred to you

AA’s 12 steps work miracles because the steps are all grounded in the principle of always practicing rigorous honesty. For someone with bipolar disorder, rigorous honesty requires that we prepare when well for the times when our mania and depression will distort our perceptions so much that we cannot be honest because reality is lost to us. I hit a turning point with my holiday overspending when I realized that spending more than I could afford was a form of deceit – that buying an over the top gift was not a message of love to the recipient but a lie to them. However, if I become manic this powerful insight will be lost to me, at least temporarily. My bipolar illness makes concepts like “willpower” and “choice” irrelevant once an episode takes hold. So I admit my powerlessness and focus on prevention instead. Please take a good look at the list above and consider what YOU can do to make these holidays a genuine celebration for you and your loved ones.

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