How To Manage Co-Occurring Disorders On Christmas

Being in addiction recovery over the holiday season is hard enough without the added stress of managing a mental health condition.

People with a dual diagnosis have two disorders: a substance use disorder and a mental health disorder. But managing multiple conditions over Christmas is possible with the right tools.

A few of the commonly co-occurring disorders we’ll cover include:

• addiction and depression
• addiction and anxiety
• addiction and bipolar disorder
• addiction and personality disorders
• addiction and post-traumatic stress disorder (PTSD)

Managing Addiction And Depression On Christmas

If this is your first sober Christmas and you’re also dealing with symptoms of depression, you may be feeling an extra burden this time of year.

During Christmas time, people with depression and substance abuse problems may be dealing with issues such as:

• a lack of motivation to participate in holiday traditions, Christmas dinner, or socializing
• difficulty spending time with family members or sober friends
• symptoms of addiction and seasonal affective disorder from shorter, darker days
• grief over the loss of a loved one
• fatigue or a lack of sleep
• postpartum depression after giving birth

Here are a few practical ways you can manage depression and addiction symptoms during the Christmas period:

Find A Support Group On Christmas Day

There are many virtual and in-person support groups for people with co-occurring disorders, and specifically for people with depression and addiction.

Some peer-led recovery groups have marathon meetings on Christmas Day, such as 12-step Alcoholics Anonymous groups.

Other options include:

• support groups offered by your recovery program
• Women for Sobriety
• SMART Recovery groups

Use this time with peers to discuss anything that’s bothering you in relation to Christmas, potential triggers of the holiday, and get support on staying positive and mentally well.

Avoid Addiction And Mental Health Triggers

Recovering alcoholics and those overcoming drug addiction typically have a number of triggers, such as going to a certain place, witnessing an argument, or seeing extended family members.

If you have depression, you may have additional triggers that set off depressive symptoms or triggers that set off depressive and substance use responses.

Make a mental list of the triggers you know could arise and be prepared with ways to address them if they happen on Christmas Eve, New Year’s Eve, or another day during the season.

Volunteer On Christmas Day

Giving back has been found to improve physical and mental health, provide a sense of purpose, and increase social interaction for people with depression.

If you’re having a difficult time with motivation, finding a purpose for the season, or seeing past the hardships of Christmases past, push yourself to get out of the house and help others on Christmas Day.

Make Time For Physical Activity

Exercise has also been proven to ease the symptoms of both depression and addiction. Whether you’re withdrawing on Christmas and need some relief or you’ve been sober for a while, physical activity can help.

The Mayo Clinic explains that light exercise can release certain feel-good endorphins and other natural brain chemicals that can enhance your mood and mental health.

Try taking a short walk in the morning before you sit by the Christmas tree and open gifts. You can also take breaks during your family Christmas party, office party, or another event to get fresh air.

Managing Addiction And Anxiety On Christmas

This time of the year, stress may be at an all-time high, especially for someone in recovery from co-occurring anxiety and addiction.

For a person managing anxiety and a substance use disorder, reframing thoughts and paying attention to their body’s cues will be very important.

If you or your loved one are managing anxiety and addiction during the festive period, try some of these methods.

Practice Holistic Techniques

Common anxiety symptoms include feeling tense, headaches, sleeplessness or restlessness, shaking, shortness of breath, and other mental and physical manifestations.

Using holistic methods of addiction and mental health recovery, you can regain control over the cues your body is giving you.

You might try:

• a breathing exercise: common breathing techniques include box breathing, belly breathing, and roll breathing.
• meditation: Before any of the activities of Christmas Day begin, take some time to practice meditation. You can do self-guided meditation or find a free online class.
• mindfulness: This technique helps you to diffuse stressful circumstances or thoughts and live in the moment. You can do this by observing your surroundings, breathing, etc.

Create Space For Yourself

Part of why drug-free and alcohol-free Christmas celebrations can be so hard on those in recovery from anxiety and addiction is because that coping mechanism is removed.

Without using drugs, smoking, or drinking alcohol, it can feel overwhelming trying to navigate the holiday. This is why creating enough space for yourself to breathe is crucial.

Whether you’re hosting an event or attending one, be sure you have a strategy for getting space when you need it. This can help you to keep your emotions and stress under control.

Managing Addiction And Bipolar Disorder On Christmas

Bipolar disorder and addiction can cause extreme highs and lows, and involve opposite reactions depending on a person’s mood.

During a manic episode, a person with bipolar disorder might be over-the-top and excited about Christmas with an exaggerated sense of self-being and potentially poor decision-making.

However, if someone has a major depressive episode over Christmas, they might be hopeless, feel no pleasure in the festivities of the day, or even consider suicide.

Here are ways to help balance your mood on Christmas if you have an addiction and bipolar disorder:

Avoid Major Changes

Change can trigger substance cravings and relapse as well as mood swings for those with bipolar disorder and an addiction.

Do your best to maintain your daily routine, even on Christmas and New Year’s. Find a routine that works for you and stick with it.

It doesn’t have to look the same every day (for example, physical activity can mean a walk one day and weight lifting the next).

However, it should be routine enough to provide you with stability and predictability. This will help ease some of the triggers that can arise on Christmas.

Don’t Consume Mood-Altering Substances

In addition to avoiding drugs and alcohol on Christmas, you can also prevent major mood swings and relapse by avoiding substances like caffeine or excessive sugar.

You should try to keep a healthy diet and take only your prescribed dose of medications to keep your moods stable.

Managing Addiction And Personality Disorders On Christmas

Other commonly co-occurring disorders are addiction and personality disorders, which include a wide spectrum of illnesses.

Use some of the following tips to help you survive the Christmas season with addiction and a co-occurring personality disorder.

Limit Your Socialization

There’s typically pressure to spend time with family, attend holiday parties, and socialize with friends on Christmas. If this level of socialization is hard on you, it’s ok to politely decline.

Too much socialization or a triggering event among family and friends can send someone with a personality disorder into an unhealthy place, leading to relapse.

Participate in what you’re comfortable and willing to be a part of, then feel free to decline other invitations or leave early from a gathering that’s become overstimulating.

Have A Trusted Ally

Some people with substance use and personality disorders choose to keep their recovery and mental health concerns private.

If this is the case for you and you know that you’ll be around others who do not understand your situation, make sure you have at least one other person you can trust.

This person should be prepared to help you exit when appropriate, find space for rest, and address difficult conversations.

Managing Addiction And Post-Traumatic Stress Disorder On Christmas

Oftentimes, people don’t realize what a devastating and painful holiday Christmas can be for people who have an addiction and co-occurring PTSD.

Childhood trauma, memories of abusive partners, the death of a loved one, physical violence, emotional distress, and more can exacerbate the symptoms of substance use disorder and PTSD.

If you or your loved one are dealing with difficult memories this Christmas season, here are some tips that can help:

Make New Memories

For someone with PTSD and addiction, they might associate certain staples of the Christmas holiday — such as going shopping or putting up the Christmas tree — with traumatic experiences.

There’s no reason to continue old traditions that only bring pain. If you know that seeing a turkey at Christmas dinner is triggering because your father smashed it in a rage one year, don’t cook a turkey for tradition’s sake.

Instead, create new memories that are uniquely yours and untouched by trauma. Make a Christmas pasta dish or seafood feast, or skip the stress of preparing food and have pizza.

This is easier said than done, but you can try enlisting the support of your friends and family, those in your support network who know about your recovery and want to help.

Make Room For Self-Care

Christmas is a time of giving, but don’t forget to take care of yourself. In the frenzy of buying gifts and preparing for the day, you might lose sight of your mental health and recovery.

Here are some ideas to get you started if you’re recovering from addiction and PTSD this Christmas season:

• Don’t overdo it: Go to parties with loved ones and do the things you enjoy during Christmas, but be sure to listen to yourself when you need to take a break.
• Get the support of a service animal: A service animal can often identify the signs of mental and physical distress before you do.
• Surround yourself with good company: Spend Christmas with friends and family members who understand you, support your recovery, and leave a positive impact on you.
• Create boundaries with your loved ones: Your recovery is more important than pleasing others, so make sure you create boundaries that support your goals for healing.
• Find a PTSD and addiction support group: There are many support groups for veterans and those who have been through substance abuse and traumatic experiences.
• Maintain your physical health: Eating healthy and moving your body will help keep the chemicals in your brain balanced.
• Indulge in the things you enjoy: A healthy diet doesn’t mean you have to cut out all else. Enjoy holiday foods and participate in the aspects of the season you do enjoy.
• Keep yourself present: People with PTSD and addiction may struggle with dwelling on past experiences. Find a way to keep yourself grounded when those thoughts enter in.

Treatment Options For Co-Occurring Disorders

You can find treatment for co-occurring disorders at a dual diagnosis rehab center in your state.

These treatment programs typically combine methods such as holistic therapies, evidence-based treatments, behavioral therapies, and peer support.

Therapies used in dual diagnosis treatment may include:

• cognitive behavioral therapy (CBT)
• dialectical behavioral therapy (DBT)
• assertive community treatment (ACT)
• motivational interviewing
• trauma-informed care
• individual, family, and group therapy
• exposure therapy
• therapeutic communities

You may also be prescribed medications to help manage the symptoms of substance use and mental illness.

These programs aim to teach coping skills and treat the specific intersection of the two disorders, addressing how they relate to one another.

Find Treatment For Co-Occurring Disorders

If you or someone you love need more support managing co-occurring mental health and substance use disorders this Christmas, help is available.

Reach out to our helpline today and we’ll connect you with a treatment provider who can help.

Written by the Addiction Resource Editorial Staff