Insight into the true sources of holiday stress for women, and how to make it through the holiday season happier and healthier.

Behind the joy and beauty of the holidays is tremendous stress for women. Every year, between Thanksgiving and Christmas, women pour into our medical practice with physical manifestations of stress like heavy or irregular bleeding. Many feel depressed. Other women call in reporting that their menopause symptoms have roared back to life again — they have no idea why. And how many of us have friends or relatives who get sick every Christmas?

From the thousands of women whose lives I’ve shared as their healthcare practitioner, and from my own personal experience as a daughter, wife and mother, I’ve come to understand that holiday stress arises from our own personal histories. It’s as though we are scripted, both in our actions and our reactions.

Luckily, we all have the power to rewrite our inner holiday scripts, just as we have the choice to provide our bodies with additional support during this demanding time. I’d like to explain how.

The power of the past

Outwardly it may appear that we are all exposed to the same seasonal stress factors: overeating, overspending, drinking too much, holiday travel, staying up too late, and family dramas. But some of us sail through the holidays in good cheer and health while others just feel awful. Obviously external factors make up only part of the story.

Studies have proven without a doubt that past emotional experiences affect our health. This becomes more obvious during the holidays when so many of us try to incorporate family tradition — or lack of one — into our own holiday. Not only are we trying to stage a major production (often all by ourselves!) but we are unwittingly following a script, whether we like it or not. I came to understand this the Christmas after my mother died. Up until then, the holidays were just an exhausting, debilitating enterprise.

When my mother was a child, she moved around alot and never had any family Christmas traditions. Then as I grew up in Australia, I watched her drive herself wild each year, creating the perfect Christmas for all of us. She hand-made our gifts and painstakingly crafted realistic pine Christmas trees (which don’t grow in my native soil). We lived 30 minutes — by ferry — from the nearest town and still my mother managed to create a magical Christmas feast that must have taken several trips to supply. My memories of my father at this time were of the time he spent with us keeping us out of my mother’s hair.

I loved Christmas Day as a child — who wouldn’t? And Christmas to me was connected with my mother’s effort. So when I became a mother, guess what? I spent this time of year in a similar frenzy, spending every free moment recreating the legendary Christmases of my youth. I did it because I believed that was what a mother was supposed to do. By the time my family finally sat down to Christmas dinner, I felt so sick and exhausted I could barely pick up my fork. I was hesitant to admit how bad I felt because I never remembered my mother complaining.

The year after my mother died was the first year that my family and I celebrated our own version of Christmas. I chose to incorporate a few of my mother’s traditions, but we mostly forged our own. And you know what? It was fantastic!

I missed my mother, but I felt as if a 50-pound weight had been lifted from my chest. I didn’t have anything to prove anymore. Having my own Christmas did not weaken the memories of my mother or my childhood, but enhanced them. And, more importantly, my family came together on our own terms, in the present — not as a reflection of my past.

Redemption and co-dependency

How many of us avoid going to church or temple all year, only to show up on a high holy day like Christmas? One of the emotional pitfalls of the holidays we all tend to share is using the month between Thanksgiving and Christmas to redeem a year of disappointment or shortcomings.

We reach out with holiday cards to people whom we’ve ignored all year. We buy expensive gifts to show our loved ones how much we care. We bake cookies for the neighbors, make gingerbread houses with the kids, adorn our homes and entertain ferociously to make everything perfect for everybody.

In addition, we cram all this into 30 days without much help from others. It’s as if you’ve decided to stage an extravaganza for a large audience with only one stagehand — you!

Normally we would know instinctively to avoid such a production, but during the holidays we tend to get swept away. As keepers of our family and religious traditions, women often feel it is their sole responsibility to create an idealized holiday experience — and our culture perpetuates this role.

Since life isn’t perfect, this perfectionism is bound to disappoint us. And the sad part is that by doing it all alone, we end up feeling all alone. This can manifest itself as resentment and bitterness towards the very people for whom we are putting on the show.

Inherent in this is a kind of co-dependency — a sense that in some way we are responsible for everyone else’s happiness. Women are conditioned from birth to think of others before themselves. As a result we tend to lose sight in adulthood of where we end and our loved ones begin. This is why knowing yourself and asking for help when you need it is so important. Moreover, allowing others to help (even if they don’t do something the same way you would) paves the way for the holidays to become a time of happy collaboration. It allows your family and friends to give back to you in a meaningful way. The art of graciously receiving such a gift is a wonderful thing to learn to do — during holidays and at other times of the year.

Holiday depression

Death, divorce, absent loved ones, empty-nesting — these experiences create feelings of grief, sadness or loneliness that may seem out of place during the holidays. Most of us have had at least some happy holidays, and those tend to be the ones we long for when they’re gone.

It’s important to honor those feelings rather than trying to suppress or ignore them. Make time to remember lost or absent loved ones and enjoy fond memories. Trying to push those feelings away may lead to compensating behavior like eating or drinking too much.

We know that social support — family and community — is a crucial factor in long-term health. Women who have satisfying relationships have been shown to ward off chronic diseases better. Those positive connections support physical and psychological health in profound ways.

It stands to reason then that one way to protect ourselves from some of these feelings is to establish meaningful ways to connect with others. Luckily, the wonderful spiritual aspects of the holidays can provide many ways to step out into your larger community. So honor the lost or absent connections, but make new ones, too.

Emotions and stress

In my personal and professional experiences I have come to know, unwaveringly, that we have to look at a woman’s whole life picture to find the underlying causes of her health concerns. We simply cannot underestimate the importance of emotions and memories as a source of additional stress.

In the comprehensive Adverse Childhood Experiences (ACE) study, researchers found a direct correlation between emotional trauma in childhood and health problems in adulthood. The correlation was so strong that one of the authors observed that it called into question the conventional theory of disease.

Our bodies do not seem to differentiate between physical and emotional sources of stress. Both trigger a release of cortisol and adrenaline from the adrenal glands. Confirming what all of us have known instinctively for years, a 2004 study by scientists at UCSF documents the link between psychological stress and aging at the cellular level. Women who experience a lot of stress show measurable signs of premature aging: weaker immune systems, higher levels of free radicals and shortened telomeres (the caps of DNA at the ends of chromosomes that determine cell life). In the women with the greatest stress, their telomeres resembled those of someone ten years older than their chronological age!

Holiday stress and hormonal balance

Think of your hormonal balance like a teeter-totter: on one side are the demands you make on yourself, on the other are the support mechanisms you have in place. The stress of the holidays is like throwing a 100-pound weight on the demand side.

If you’re not yet familiar with the ways in which your body responds to hormonal imbalance, I encourage you to read about the symptoms of hormonal imbalance, then take our on-line hormonal health assessment to evaluate your own symptoms. You’ll see that when your hormones are out of balance, the effects are pervasive. Fortunately there is a lot you can do to restore hormonal balance, even during times of holiday stress. The first step is to identify the relevant factors that are affecting your own hormonal balance.

Sources of holiday stress — the demand side

In addition to the emotional factors we discussed above, some of the common external sources of stress that affect our hormones during the holidays are:

  • Poor nutrition: Holiday parties, office noshing, cookie-swaps, and gifts of sugary treats all contribute to a big spike in simple carbohydrate intake. This can throw our metabolism out of kilter and lead to intense mood swings, digestive upset, weight gain, and increased insulin insensitivity. Lots of women accumulate most of their adult weight gain during the holidays — a few pounds each year that they never lose.
  • Lack of sleep: Not getting enough sleep for an extended period of time (more than two days) sets up a vicious cycle that upsets our natural circadian rhythm. We stay up too late, then need caffeine or some other stimulant to wake up. This gives us a temporary boost that leads to a crash a few hours later, which makes us crave carbohydrates (or more caffeine) for energy. We feel better in the moment so we take on more activities, which keep us up too late yet again, and the whole cycle repeats itself.
  • Alcohol use: Indulging in some eggnog or champagne is a rite of the holidays. But we tend to overdo it. Wine, in particular, contains a lot of sugar. Alcohol is a depressant; it initially triggers a gush of serotonin that makes us feel happy and relaxed until the levels recede. This sets up another binge-and-crash cycle like the one we discussed above. Too much alcohol also dehydrates and inhibits healthy liver function — which in turn influences the production of cholesterol, the mother molecule for estrogen and progesterone.
  • Lack of exercise: Skipping your morning walk because you stayed up too late or passing on the gym to get some shopping done undermines a significant source of support for your body. At the very time when we most need to get, and stay, moving for added energy a lot of us put exercise on the back burner and rely on caffeine and sugar to keep us going.
  • Time/money management: In trying to make our inner holiday movie a reality, we tend to fill up all of our available time with errands and obligations. Some of us throw our budget to the wind. This kind of overload exhausts the adrenals by saturating our bodies with cortisol (they don’t know the difference between stress caused by a physical threat and stress caused by a massive holiday traffic jam or credit card bill). Extended exposure to cortisol affects insulin levels, exhausts the adrenals and impairs brain function.

Avoiding holiday stress — the supply side

So now that we know why our bodies are under such stress at this time of year, what can we do about it? Luckily, women have an enormous capacity to adapt and renew. Incorporating even a few of these suggestions into your holiday routine will help you feel better.

  • Examine your inner holiday “movie”. Think about what made your family traditions (or lack of them) so influential. Acknowledge their importance but try to single out certain experiences that mean the most to you and let others go.
  • Be present for your loved ones. Find a time when you can spend time with the most important people in your life. Maybe it is a holiday gift-wrapping party or a cookie-baking afternoon. Turn off the phone, put away the to-do list and have fun with the ones you love the most.
  • Delegate responsibility. Remember that this is supposed to be a time of joy — for you as well as your family. Instead of taking everything on yourself, ask others to do certain things. Include members of your family or friends in your tasks. This will show them that you want your holiday to be a joint effort and alleviate any feelings of resentment and anger.
  • Plan ahead. Shopping early, freezing meals, and wrapping presents ahead of time are all good ways to relieve pressure. If you accomplish the bulk of your holiday tasks early, you will be able to give your family and friends your time and attention.
  • Incorporate some of the spiritual aspects of the holidays into your life. Going to a local church or synagogue is one way of connecting to a larger sense of the holidays. Even if you aren’t religious, listening to a sermon, watching a holiday pageant, singing hymns or lighting candles can be a comforting way of opening yourself up to the more profound joys of the holidays.
  • Reach out to others. The best way to feel connected is to get connected. It is also good for you — now and beyond the holidays. Research indicates that caring for others physically activates hormones that alleviate stress — just don’t overdo it! Volunteering during the holidays at your local hospital, school, or shelter is a good way to make first steps into the larger community. Many hospitals ask for volunteers on the pediatric wards this time of year. Finding a way to be with children and share in their joy is a wonderful way to celebrate.
  • Communicate. If you are having a hard time or feel overwhelmed with other people’s expectations or the commercial aspects of the holidays, try to find someone to talk to. If you can’t turn to a friend or family member, there are many counselors and clergy people who are available for temporary counseling during the holidays.
  • Make time for yourself. Take 15 minutes each day to devote to yourself. Read a poem, take a bath, sit quietly, breathe and meditate, or do some simple stretches. In the midst of trying to please everyone else, take a moment to tune into your body and your emotions. Give yourself some well-deserved love and nurturing.
  • Eat well and often. While we aren’t asking you to deny yourself your favorite holiday treats, it’s a good idea to stock up on healthy choices in between. Don’t skip meals if you’ve overindulged the day before. Eat protein and a serving of vegetables or fruit at every meal and snack. Drink a lot of water to help your body detoxify. Remember that Christmas is only one day — you don’t need to go on a month-long celebration.
  • Take a complete multivitamin. This is especially important this time of year. For more on the enormous healthful effects of a well-rounded supplement, please see our articles on health and vitamins.
  • Set yourself a bedtime: Studies have shown that adults consistently need 7-9 hours of sleep for optimal brain function and mood regulation. If you know you are going to be out late, schedule an early night the next night. Or set a bedtime that you can stick to whenever you are home — regardless of what needs to be done.
  • Limit alcohol. If you are feeling symptoms of hormonal imbalance, try to reserve alcohol for very special occasions. Alternate an alcoholic drink with sparkling water at parties. Avoid eggnog, holiday punch, and champagne because of their high sugar content.
  • Get moving. Park your car a good distance from the mall entrance and walk. Take several trips back and forth to stow shopping bags and you will have accomplished a good portion of the recommended 30 minutes a day of activity for health. If you are currently exercising, make it a priority. Exercise is one of the best ways to fight stress by boosting metabolism, leveling out cortisol, and increasing endorphins.
  • Fight the urge to spend indiscriminately. Most likely the gifts you remember from your past were not the most expensive, but the most meaningful. If you don’t leave everything until the last minute you can take your time to create a unique handmade gift or treat. Or, shop wisely and purchase an item that truly reflects your relationship with, or the desires of, the recipient.

It’s all about how you feel

The key is to listen to your body and tune into your emotions, particularly when you are experiencing a period of increased external stress — like the holidays. Make sure to replenish your own cup before pouring out your largesse. If you feel happy and well while doing what you do, by all means pursue it with gusto. If you don’t feel good, you need to look beyond the surface to figure out why.

Obviously balance is a year-round goal; it’s just harder to maintain it through the holidays. If your holidays wipe you out, experiment with some of the things we’ve discussed. Enact a few changes and see if you feel better. Hopefully by the time Christmas day rolls around, you’ll be as cheerful and radiant as the lights on the tree.