‘Tis the season to be jolly. The holiday season is traditionally a joyous occasion, a time of warm emotions when our thoughts turn toward gatherings of family and friends for the exchange of gifts, food, and companionship. However, there can be a flip-side to this holiday period. Many complain that the comfort and joy of the season can easily turn into a time of high stress filled with traffic jams, overspending, overindulging in alcohol and food, unmet emotional expectations, and weary irritability.
Is associating the holiday season with stress and unhealthy overindulgence just another example of Scrooge-like negativism? Or is there an empirically-based foundation for being cautious about exposure to unhealthy seasonal risks, especially for those individuals with heart disease. Let’s take a look.
A 2004 study reported in the respected journal Circulation throws some light on the issue. Researchers examined records for 53 million deaths from natural causes over a 26 year period and found that deaths from heart disease peak during December and January, with cardiac mortality spiking around Christmas Day and New Year’s Day. They concluded that there was evidence of multiple factors, including delay in seeking treatment, leading to what one authority, in a comment on this research, labeled the “Merry Christmas Coronary” and the “Happy New Year Heart Attack.”
Another example of suggestive research is a small but provocative case study reported in a recent issue of The Newsletter of the American Institute of Stress. The investigators found that purchasing six gifts in a store was associated with an anxiety-
driven doubling in heart rate from a resting 69 to a shopping 138 beats per minute, compared to purchasing the same items at home on the Internet which was associated with a steady heart rate of 65 to 67 beats per minute. Given our penchant for cleverly naming interesting medical malfunctions, before this holiday season is over a mischievous journalist writing about cardiac psychophysiology will likely discover the “Shop until you drop syndrome.”
Although epidemiological studies like the ones noted above as well as case studies are best used to suggest connections rather than to prove cause-and-effect, the studies reported above and similar studies certainly support the commonly reported personal experience of being “stressed-out” over the holidays, with its unhealthy emotional and behavioral consequences. Research strongly suggests that the dramatic behavior changes that characterize the holidays do affect morbidity and mortality.
Given that many of us including heart patients experience increased stress and unhealthy emotions and may indulge in unhealthy behaviors over the holidays, what can we do and advise others to do to better manage harried lives this season? Fortunately, we have available a panoply of effective strategies for coping with holiday stress and reducing unhealthy behaviors.
These strategies are as follows:
For Physical Health
• Keep doctor’s appointments. Because of time pressures over the holidays, many people reschedule medical appointments or delay seeking medical treatment even when symptomatic.
• Take medications as prescribed both at home and when traveling. Many individuals miss doses over the holidays.
• Limit alcohol consumption. Overindulgence can lead to a number of problems. In addition to the obvious behavioral consequences, a heart rhythm problem, sometimes called “Holiday Heart” can be triggered by drinking too much alcohol. And alcohol contains a lot of calories.
• Moderate food consumption. Adding pounds, developing heartburn, and unbalancing diets are all risks of immoderate eating.
• Maintain the usual exercise schedule. Exercise is a great stress management activity. Because of a perceived time-shortage over the holidays, shopping may unwisely be given priority over regular exercise. (Of course, for those not already exercising regularly, check with a physician first as beginning after the holidays may be a better fit.)
• Get sufficient sleep. Sleep deprivation is harmful at any time of the year.
For Psychological Health
• Take time to relax. If an individual has a regular relaxation technique such as meditation, continue to practice it. If not, practice a simple meditation technique by simply sitting or lying down, closing the eyes, and repeating a pleasant word or phrase over and over with each exhalation, for 10 to 20 minutes every day. And don’t overlook prayer, which has physiological as well as spiritual benefits.
• Stick to a budget to avoid increased anxiety over credit card debt and financial stressors.
• Ask for professional help if needed. Seasonal factors can contribute to biological depressions such as SAD and other psychological disorders exacerbating the usual stress.
• Let go of personal perfectionism. Finding the perfect gift or behaving perfectly is not essential to a happy holiday.
• Let go of relationship perfectionism. Accept the fact that relationships that were not perfect during the year, are not likely to improve under the pressures of Christmas.
• Have a hearty laugh. A good sense of humor is a wonderful stress management tool.
Remember that the holidays are much more than the giving and receiving of gifts. We often lose sight of the true meaning of these holidays. Overemphasis on the secular and commercial aspects of the holidays is the major culprit. Although it might seem trite, focusing on the true meaning of the holidays, namely bonding with friends and family and finding the spiritual meaning in the celebration, are likely to bring the greatest psychological and physical benefits, with reduced mortality and morbidity, along with happiness and spiritual well-being.
Dr. Scala has been selected a Castle Connolly 2015 “Top Doctor” by a physician-led team of researchers in the field of Cardiovascular Disease.
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