Christmas is a difficult time for many people. There are financial obligations, family obligation and often many end-of year events that lead up toward Christmas, increasing the feeling of time-pressure and burnout that may already be present.

One of the reasons Christmas time is particularly difficult for individuals with bipolar disorder or depression is the lack of structure that permeates holidays. For those with bipolar disorder, having a predictable structure, a routine, and goal-oriented tasks are known to be extremely helpful for stabilising moods and preventing relapses or spiralling out of control. When the usual work/school structure falls away and no preparations have been made for the holidays and how one will cope, symptoms such as depression, mania, high levels of anxiety and even suicidality can crop up.

Because structure is important for your mental-wellbeing, it is a good idea to begin planning your routine for the holidays now, before the open, lazy days are upon you. I suggest you make a calendar (or update your calendar) based on the following suggestions and the coping strategies you already use. Here are some questions to get you thinking about possible ways forward:

1. Is there a project you have been putting off that you can dedicate some time to each day? Schedule time to work on it into your calendar. This may be 2 hours daily, 30 minutes daily, or even 60 minutes every second or third day. Decide what you want to commit to and ensure that you have a regular entry for this activity in your calendar.
2. Are there Christmas gifts or cards that you can make instead of buy – saving you money and providing you with a meaningful activity at the same time?
3. Is there a friend or relative (or more than one) who you can meet with regularly, perhaps weekly for coffee or a walk, and schedule that meeting into your calendar? Alternatively, can you set up some meeting dates for during the holidays with various individuals?
4. Can you ensure that your exercise routine remains relatively structured despite the ambiguity of holiday days? (If you don’t have an exercise routine, now would be a good time to put one into practice. Begin with a walk every day – or as often as possible – if you are starting from scratch.) We know exercise has strong mood benefits and it is obviously also great for keeping in shape and general physical health. If you are taking a break from exercise for a while in the holidays, I encourage you to continue with a light form of exercise like walking in order to still gain the mood benefits.
5. Can you use social media and TV watching in an intentional manner: for example, as a reward for engaging in structured and meaningful activities, instead of opting for TV or Facebook in long, unregulated sessions? Too much social media is linked to depression and screen time easily sucks real time away. Because of this, one’s daily structure is disrupted and feelings associated with depression may emerge. This is true for most people, but those with bipolar disorder should be extra-aware of their screen time.
6. Are there decisions you need to make about Christmas itself – which events you will go to, which you won’t, which you’ll host, which you won’t? If you feel you need to avoid certain shops/malls (or even people!) on certain days (such as busy Christmas Eve), make note of that now and schedule accordingly.
7. Are you able to ensure that you have an exit strategy (such as taking your own car) for events that you are anxious about or hesitant to attend?
8. Can you plan some ‘me-time’ activities, scheduling in a few things that you really enjoy and that feed your soul? Ensure it is scheduled in your calendar because these are easily the first things to fall away when demands compete; if you have kids, can you find someone to help you by looking after them during the scheduled ‘me-time’? Fit your activity to your pocket: a walk on the beach is free!
9. Can you try keep to a regular sleep schedule, as much as is possible? This regularity is extremely helpful for maintaining a stable mood and sleep itself is revitalising and regenerating during times of wellness and ill health.
10. Can you avoid over-indulging with alcohol? Too much alcohol consumption will certainly affect the mood negatively and if coupled with lack of sleep and lack of structure, the outcome may be damaging.
11. Can you keep a journal, with as much or little detail as you like, in order to help track your thoughts, feelings, sleeping habits (monitoring that you are not losing sleep significantly) and general mood? This is also very helpful in the long-run, as you can reflect on your writings in the future and realise coping strategies, helpful activities or even triggers that you were not initially aware of.

I encourage you to begin working on a schedule that takes these questions into consideration. The holidays can be a happy, relaxing time but may need some extra thought and planning for those with bipolar disorder.

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