On Thanksgiving, after the dishes were done and the leftover turkey was put away, I, like many Americans, felt pleased and satisfied. I had enjoyed the yearly rite,= and was closer to my family for it. Also, I was just glad it was over.
I thought back to the rushed days before the holiday that are probably all too familiar to many of you: balancing work with festivity-planning, worrying about travel arrangements, prepping to make sure the meal was memorable, obsessing about how everyone would get along. It's true: even psychiatrists get stressed out this time of year.
Despite what Norman Rockwell, the greeting card companies and even our own gauzy memories would have us believe about the holidays, they can be very trying. It has become a fairly common lament, especially among busy parents, burdened by the often herculean efforts we undertake to plan memorable events, cook the perfect meal and provide our children with a magical experience -- not to speak of the gifts they desire. Kids don't get stressed out by holidays, we say -- kids love holidays.
Sadly, this is not always the case, and adults can do kids a big disservice by not recognizing the possibility of distress in children. The very things that make holidays exciting (and challenging) for adults -- a break in routine, travel, reuniting with seldom-seen friends and relatives -- can wreak havoc on the world of a child, particularly for an anxious child. And if a child or adolescent has a psychiatric disorder like depression, an anxiety disorder or ADHD -- and one in five children and teens do -- the holidays can be even more difficult. If left unaddressed, these holiday stresses can seriously undermine the pleasure the whole family takes in celebrating.
Empathy is a key part of the equation for helping a child through the season. Think about it: If you had social anxiety issues, would you like to be thrust into a gathering of near-strangers and expected to have a good time? Kids with social anxiety shouldn't be shielded from the events that trigger their anxiety -- they need to learn to manage their fears, but this is best done in controlled doses. It's important to keep your expectations for them realistic, let them know you are confident they can handle it, and coach friends or family members beforehand on how they can help. Otherwise, practice compassion with your child; while you don't want to insulate her from the objects of her unreasonable fears, you can't demand that she enjoy what she "should" enjoy.
A sense of not being in control can also be a significant stress for kids. As much as possible, include children in the planning of events and trips so they feel more comfortable and in charge. This is critically important for children who have high levels of anxiety, but can also help lower stress levels in any kid. Remember, a child's interest in novelty only goes so far, but he is always interested in knowing that a supportive, loving environment is available. If you plan together, he won't worry so much about the unsure future. By the same token, it's very important to maintain routines as much as possible going into the disruptive season. This extends to family holiday traditions, which can anchor kids in the swirl of events -- particularly if they feel a sense of ownership.
Of course, some things are beyond our control. One of the best ways to help your child handle holiday stress is to handle it well yourself. Modeling effective coping encourages good behavior and healthy attitudes in any young person, and is particularly important in children who react poorly to common life stresses, or who have a psychiatric disorder. Parents seem to realize this, but too often aren't careful enough in the behaviors they show their kids. A recent American Psychological Association study shows that while 69 percent of parents think they manage their own stress well enough that it has little or no impact on their children, 91 percent of kids say they can tell a parent is stressed -- and just 14 percent say parental stress doesn't bother them.
Finally, and most importantly, make sure that if your child does have a psychiatric disorder, he or she is getting the best care available, because treatment works -- and stress mixed with untreated mental illness is a dangerous recipe, not just during this season. Real psychiatric disorders don't disappear when the holiday is over.
In order to help kids deal constructively with the various stresses that pile up around the holidays, understand their limits, teach them about what really matters and model a reasonable response to the strains that cannot be avoided. This holiday season, everyone will feel better if you make sure your child has whatever help he or she needs, a realistic role in whatever celebrations you and your family enjoy and parents who aren't stretched to the breaking point. Don't give the unwanted gift of holiday stress.
Harold S. Koplewicz, M.D. is a leading child and adolescent psychiatrist and the president of the Child Mind Institute. For more on taking the stress out of parenting, go to www.childmind.org, which offers parenting advice and a wealth of information on childhood psychiatric and learning disorders.