Getting Through the Holidays – A Patient’s Guide for Depression and Eating Disorders

Contributor: Cherie Massmann M.A, LPC, NCC of McCallum Place

Christmas giftsI ran a few shopping errands the other day in my neighborhood and was dumbfounded to see floor to ceiling holiday decorations – well, just about everywhere.

My soon to be 13 year old daughter voiced my own astonishment with this simple statement: “Already? Mom the decorations are up in the stores already! That is just crazy.”

While some might be ready to jump head first into the holiday season, I am all too aware of the impact that the holidays have on the many patients and families that I treat for depression and eating disorders at McCallum Place and Webster Wellness Professionals.

Holiday Challenges

The Thanksgiving and winter holiday decorations, songs and commercials suggest that merriness is on the horizon and good times are waiting to be had by all, right? Not so. For many people dealing with depression and eating disorders, it often is a time of worsening symptoms including increased anxiety, sadness and isolation.

One of the most challenging aspects of the holidays includes the presence of lots of festive food. Patients diagnosed with Anorexia Nervosa tend to feel overwhelmed and fearful of the highly calorically dense foods that are common at parties and holiday gatherings. They also find it difficult eating around other people.

Patients with Bulimia Nervosa might feel pressure to act normally around difficult food situations and this repression of emotions could lead to a worsening of binge and purge cycles. While patients diagnosed with Binge Eating Disorder tend to be preoccupied by the abundance of food and either overeat or use harsh rigid dieting rules to avoid eating in the moment.

Christmas snowmanNo matter what diagnosis one has – people with eating disorders tend to be so preoccupied by strong urges to calorie restrict, binge or purge that they are unable to engage fully with the people around them in a meaningful way.

This sense of isolation can make a patient feel much more depressed.

It is also important to note that many family holiday gatherings have strong undercurrents of interpersonal conflict. While the typical family member might find these disagreements annoying, our patients tend to really struggle in the face of family tension and may not have the skills needed to form appropriate boundaries with others.

Several years ago, when a patient I was treating was in the early stages of treatment for Binge Eating Disorder and heading into the holiday season, I joked that I should make her a button to wear that read, “I am being treated for an eating disorder. Please direct all questions about my weight, shape and eating to Cherie Massmann at Webster Wellness Professionals.”

We laughed about how nice it might be to not have to deal with these hard topics and then rolled up our sleeves and made a more realistic plan.

Here are just a few of the most helpful tips I have come across for dealing with the holiday season.

Tips for Patients

  1. Stay the Course. Stick to a meal plan or meal structure over the holidays. It is tempting to either eat less or more over the holidays. Sticking to your meal plan ensures that you are getting the consistent and adequate nutrients that you need. Adequate nutrition is the best foundation for emotional health.
  2. Talk About It. Be willing to talk about difficult feelings and admit when you are struggling. When you are honest about your experiences you might find that others have some of the same fears or challenges. It can help you feel less isolated.
  3. Don’t Go it Alone. Plan to invite supportive friends or family members to attend your therapy sessions prior to the start of holidays. Having an advocate or supportive person who understands what you are going through and knows what to expect is essential to navigating the holidays. It is also especially important to maintain regular therapy appointments throughout the holidays in order to get the professional support that you need.

Tips for Family Members

  1. Lake in FallCreate a Supportive Environment. Try to maintain normal structure or meal times for your loved one struggling with an eating disorder. Large holiday meals at unusual times such at 3:30pm can be difficult to navigate. Prepare your loved one for the holiday by sharing the guest list ahead of time and types of food that you are planning to serve.
  2. Focus on the Person, Not the Disorder. Ask your loved one, prior to any events, what they would find supportive or helpful. Try to limit questions about eating or treatment at social events or family gatherings. Avoid any weight or shape related comments (including well-meaning compliments such as: “Have you lost weight?” Or, “You look great! Have you put on some weight?”).
  3. Lower Your Expectations. For a loved one who is experiencing depression and/or an eating disorder, it may not be “the best holiday ever,” so don’t expect it to be. Battling these disorders are very draining. Anticipate that your loved one may or may not want to do all the things that you have “always” done in the past. Taking a more low key approach with appropriate down time or rest time is essential.

Community Discussion – Share your thoughts here!

What tools have you or your loved found to successfully help you navigate the holidays while in recovery from disordered eating?

About the author: Cherie Massmann, M.A, LPC, NCC earned her Master’s degree in Counseling from Webster University in St. Louis, Missouri in 1999. Ms. Massmann joined the Webster Wellness Professionals as a therapist for the Wellbody Weight Loss and Weight Management Program. She runs the groups for Wellbody and offers individual consultations for individuals working on achieving lasting, long-term healthy weight loss.

Ms. Massmann is a cognitive-behaviorally trained therapist with over 9 years of experience treating binge eating disorder, anorexia nervosa, and obesity in adults and adolescents as a staff therapist in the Departments of Psychiatry and Internal Medicine at Washington University School of Medicine. She has been part of several multi-center National Institute of Health grants including: the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY study) and the Comprehensive Maintenance Program to Achieve Sustained Success (COMPASS), a treatment of childhood obesity. She currently serves as a staff psychotherapist for the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE study) at Washington University School of Medicine.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 10, 2015
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