9 Things About Getting Through the Holidays Only People with Anxiety Understand

As the holidays approach—earlier and earlier each year, it seems—anxiety can begin to ramp up. That a serious issue for the 40 million Americans who suffer from an anxiety disorder, according to the Anxiety and Depression Association of America (ADAA).

“People who live with anxiety live in a state of what’s called anticipatory anxiety, where they are nervous about the ‘what ifs’ in life,” says Sanam Hafeez, PsyD, a New York-based psychologist and faculty member at Columbia University. “They may be able to function at a high level, and be very successful in careers and their personal lives, but the increased expectations of the holidays can leave those with anxiety feeling out of control.” Here’s what those managing anxiety want you to know about surviving the holiday season (and how you can help).

Being able to say “no” is crucial

This is arguably one of the biggest holiday stressors—that feeling that you have to do everything and be everything. Be honest with yourself about what you really want out of the season, so you can be your own holiday boss, suggests Dr. Hafeez. “If a long holiday list makes you nervous, start your holiday shopping in October so you can do it incrementally,” she says. “If big dinners are uncomfortable, plan an intimate get-together with a small group of people who understand your situation and can be a source of comfort instead. For those with anxiety, it comes down to picking and choosing what is manageable for you, and not biting off more than you can chew.” Most importantly, don’t feel guilty about it, which only makes you stress needlessly. While most stress is bad, there are types of stress that can be good.

Holidays can trigger stressful memories

Whether good or bad, memories of holidays past can be an anxiety trigger. “The anniversary reaction is a real thing, people do have them and can be pretty significant,” says Robert Hudak, MD, associate professor of psychiatry at the University of Pittsburgh. His advice for those entering a possibly anniversary-triggered reaction: Make a plan ahead of time for how you want your holiday to look, so you’re controlling the experience rather than have it control you. What’s more, you may feel more upset about your divorce or the sickness or loss of a loved one. Make sure you seek out the support you need from friends, family, a therapist, or support group. Here are more ways to cope with autumn anxiety to help get through the holiday season.

Expectations can run too high

Hosting a party? Attending one? Don’t set high expectations in either case—things will go wrong, someone will drop a glass, and there may be awkward silences, warn the experts at the ADAA—they point out that holiday gatherings are especially challenging for people with social anxiety disorder. It’s normal for things to go awry, and you can avoid feeling let down or getting trapped by anxiety by accepting this fact.

Making time for downtime

“It’s a societal expectation we have around the holidays, that we need to be around other people, but that can cause stress and anxiety for some,” says Dr. Hudak. Be honest about your need for alone time, and be understanding with loved ones who need the same, says Julian Brass, an anxiety coach based in Toronto, Canada, who chronicles his experience with anxiety in Own Your Anxiety: 99 Simple Ways to Channel Your Secret Edge. “If you’re going to a relative’s home for the holidays, for example, be honest by saying what you need upfront in order to ground you, whether it’s taking a walk or a drive on your own throughout the stay. People are often shocked to realize that once they simply open that conversation, that stigma about anxiety goes away,” he says.

Travel can be daunting

For those who battle agoraphobia or panic disorder, crowded airports and busy transit hubs can be a trigger, warns the ADAA. People with anxiety can head off trouble by confirming all schedules and travel details in advance, planning activities for the entire travel time, and brushing up on anxiety-relieving strategies like deep breathing exercises.

Sweating the small talk

Innocent questions such as “What are your plans for the holidays?” and “Have you gotten all your shopping done?” can set off an anxiety spiral. For those who have anxiety around these types of questions, realize that it’s okay to not have a perfect answer in place. “There’s absolutely nothing wrong with saying, ‘I have been working really hard and I’m looking forward to taking this time to chill out and unwind,” suggests Dr. Hafeez.

Maintaining a routine is key

Sticking to a routine is a good way for anyone to manage stress, but for those who live with anxiety, it can be especially vital. While some schedule shifts are inevitable during the festive season, it’s important for those with anxiety to keep as regular of a routine as possible. “Because there are more events associated with the holidays, and more meals, we’re generally sleeping less, eating more, exercising less, and drinking more alcohol, which is an anxiety storm waiting to happen for anyone,” says Brass. “Sure, you want to let yourself enjoy the holidays, but really be mindful at the same time of what you’re eating and drinking to ensure you’re not derailing yourself with the wrong choices because those with anxiety are especially prone to negative self-talk which can send you down a spiral.” If you’re worried about making time for exercise, discover six ways to sneak in a holiday workout.

The need for self-care

In the midst of the giving season, we sometimes forget about one important recipient: ourselves. Dr. Hafeez recommends taking some time for ourselves to give back to numero uno, which is an instant anxiety-reliever. “Buy yourself something and wrap it. Treat yourself to a lesson or spa treatment. You might even consider a staycation for a night or two in your own city. Anything that makes you feel special or pampered,” she says.

There will be a holiday weak spot

Whether it’s shipping gifts on time, figuring out what to get the boss for the holidays, or dealing with New Year’s party angst, there often is a moment when a person with anxiety will feel overwhelmed. “I advise people to pinpoint their biggest holiday stressor ahead of time, so they can take steps to manage it before it spirals out of control,” says Dr. Hudak. And keep these social-anxiety remedies in mind.

Finding a way to flip the “what if” script

A huge anxiety-provoker, says Dr. Hafeez, is the “what if” scenario: detailing ahead of time all the things that can go wrong before they happen—if they do happen at all, that is. Try switching your holiday script, suggests Brass. “Think about three things you’re grateful for during the holidays, really focus on them, and it will help you approach the aspects that do give you anxiety,” he says. “Yes, there’s more stress and anxiety this time of year, but there are also a lot of beautiful things happening.” Next, find out how to beat the post-holiday blues.