Creating Happy Holidays

Coping with Stress and Chronic Pain during the Holiday Season

By Dr. Mark Skellie, Psy.D.

“Stress” is a term that is frequently used and sometimes overused by people, because we tend to live highly stressed lives. As defined by engineers, stress is pressure or tension from force applied to a solid object. Similarly, emotional or psychological stress is a state of mental strain resulting from unpleasant or highly demanding life circumstances. With this definition of stress, chronic pain fits the bill, as it is a very unpleasant problem that demands attention unlike many other things in a person’s life. When trying to manage stress related to chronic pain, it is helpful to fully understand this complex psychological phenomenon. Stress can be separated into three categories: the stressor, the stress response, and coping. Stressors, which are the triggers or sources of stress, can come in many forms. There are internal stressors, which can be psychological or physical. Internal psychological stressors are feelings such as guilt or shame, while internal physical stressors could be that dull ache you’ve been living with or an unexpected sharp pain. External stressors can come in the form of threats, demands, or the ways your pain makes your life narrower.

Stressors, which are the triggers or sources of stress, can come in many forms. There are internal stressors, which can be psychological or physical. Internal psychological stressors are feelings such as guilt or shame, while internal physical stressors could be that dull ache you’ve been living with or an unexpected sharp pain.

The stress response is how the body and mind react to the stressor. Physically, the nervous system winds us up in a complex hormonal and neurochemical dance called the “fight or flight response”. The stress response can cause a lot of symptoms, particularly when problems in life lead to a chronic stress response. Typical symptoms of the stress response are irritability, headaches, shaking or trembling, impatience, problems with appetite and/or digestion, chest pain, sweating, dizziness, emotional fatigue, concentration problems, increased blood pressure, decreased productivity, mild memory problems, confusion, unexplained aches and pains, and higher sensitivity to pain in general. For individuals who live with chronic pain, a vicious cycle often occurs over time, in which pain becomes a major trigger for the stress response, and the way the body responds to stress can make the pain even more challenging to live with. This in turn makes the pain even more stressful. But the good news is, the way you cope or react to both the stressor and the stress response makes all the difference.

Stress, Interrupted

When under stress, everybody does something to cope, or reduce the stressor’s impact on their life, by trying to eliminate the stressor or reduce the stress response in the body. There are both healthy and unhealthy coping strategies. Both of these may reduce the unpleasant symptoms of the stress response. However, while unhealthy coping, such as using alcohol or tobacco products may have long term negative consequences, healthy coping strategies have no long term negative consequences. Using healthy coping strategies, such as talking to a close friend or family member, laughing, exercising, doing an activity that you enjoy, playing with children, journaling about your thoughts and feelings, or carrying out relaxation techniques (see the Deep Breathing Exercise on page 12) allow you to get through difficult situations without letting stress build up or result in stress overload. Obviously, none of these strategies eliminate the source of stress, but they all work to reduce the stress response in the body.

During the holiday season, most people report that their stress levels actually increase, despite the fact that many people look forward to the holidays all year. Interestingly, women typically find the holiday season to be more stressful than men, likely because women traditionally shoulder a greater portion of the responsibility of preparing for the holiday celebrations.

The stressors of contemporary life tend to be complex, like chronic pain or financial troubles. Therefore, a tool box approach to coping with stress must be developed, by learning a variety of different strategies that work. Learning healthy coping strategies can dramatically improve your quality of life, while engaging in unhealthy coping strategies tends to start a spiral of negative behaviors or health consequences that can themselves become new sources of stress later.

Holiday Stress

The holiday season is a busy time for people in the United States. Just when you think your life is stressful enough, managing everyday stressors such as working long hours or accepting the fact that pain makes you unable to work, caring for aging parents, and paying the bills, the holidays arrive, adding an additional layer of stressors. Depending on how well you cope with stress, the added responsibilities of the holidays can have a long-lasting impact on your body and mind. During the holiday season, most people report that their stress levels actually increase, despite the fact that many people look forward to the holidays all year. Interestingly, women typically find the holiday season to be more stressful than men, likely because women traditionally shoulder a greater portion of the responsibility of preparing for the holiday celebrations. Also, individuals with fewer financial resources tend to find the holidays to be a source of stress due to the commercialism and expense related to gift giving, as well as concerns that other family members may be judgmental if they do not buy expensive gifts. Another major source of holiday stress that many people do not expect is increased awareness of family members who are no longer a part of traditional holiday celebrations, whether it is because they have passed away, or simply moved a great distance. This can add to the already emotionally charged period and some people with unresolved grief may experience unexpected sadness. Another challenge of the holiday season is that many people fall into unhealthy coping strategies such as increased sedentary behavior, alcohol use, and comfort eating.

The good news is that the vast majority of Americans experience the holiday season as a time of happiness, love, and high spirits. Seeing distant family members and reconnecting with loved ones can be an amazing way to reduce stress. The best advice for balancing positive feelings and stressors over the holidays is to simply take time to savor the extra moments with family. If you allow yourself to focus on enjoying what you love about the holiday season, while sharing the burdens of planning and organizing celebrations, and not forgetting about your healthy coping strategies, this time of year can be one of the best times for families. In addition to practicing regular or newly-learned coping strategies, the holidays are a great time to focus on helping others. Participating in volunteer activities is a great healthy coping strategy that can reduce holiday stress. It doesn’t have to be anything formal, even the busiest person can take time to do simple and free things to help others, such as calling or visiting a lonely friend or family member who may not have the family support they need during this time of the year.