Family relationships can be marvelous or stressful — or both! And no other time of the year is family stress more evident than during the holidays. Guess what can cause IC flares? Stress. Then that flare leads to more stress as you try to navigate family gatherings while not feeling well. The cycle goes round and round. Even if you have a supportive and loving family, stress can still occur during the holidays as you manage your bladder in the midst of celebrating.

But not all hope is lost. No matter your family situation, there are some ways to help ease family stress and the risk of it causing an IC flare.

Understand the cause of holiday family stress.

Holiday family stress is a bit different than anytime family stress for a few reasons. First, family relationships are complicated because families tend to have roles assigned to some extent. Anything that breaks the mold can cause make the family feel unbalanced. But change is inevitable. We change as we age and encounter life experiences. We change as we learn to live a new normal with IC. And these things are brought to the forefront during holiday gatherings.(1)

During the holiday season, families also have expectations of how things will go and people will behave based on tradition and what the holidays are supposed to look like.(1) For example, maybe your family plays a football game together each Thanksgiving, but you’re not feeling well enough to play. That can add stress and guilt, even without family members saying a word. The other option is that in effort to not buck tradition, you decide to participate in the game and end up with a severe flare that lands you in bed for days afterward.

Finally, the pressure for perfect family holidays abounds throughout our culture as well. All types of media are full of happy families spending time together for the holidays. As a result, we often put stress on ourselves to attain that perfect holiday, which doesn’t actually exist. In fact, holidays can highlight how things have changed in negative ways, which creates more family stress. From losing a loved one to divorce to job loss to health problems, changes are usually more evident at holiday gatherings.(1)

Know your options for troubled relationships.

Some family stress can catch you off guard, but some relationships are obviously going to be an issue. You have three choices in dealing with difficult relationships. You can continue as is, try to change the other person or change yourself.(2) Think ahead of time about what you want to do and how you’ll handle the relationship. If you want to try and fix or improve the relationship, do your best to reach out to the person before the holiday gathering. Both of your stress levels will be lower than during the holiday gathering and the two of you will have a better chance to resolve the conflict on your own. Just remember that not everyone is open to fixing relationships or conflicts.(1)

No matter what, planning ahead is the best option. Planning ahead also keeps you from setting unrealistic expectations that this time the person will be different. Use your previous experiences to compose a list in your head of three things that are likely to occur.(2) Then think about how you will respond to them. You can talk with a friend and roleplay various ways conversations will go and your best response for them.(1)

Plan how to spend your time.

Think ahead of time about how much time you are going to spend at a holiday gathering. If you are attending with others, like a spouse, discuss ahead of time how long you want to be at the gathering and come to an agreement about what works best. You might consider coming up with a signal or way to let each other know when you’re ready to leave. For example, you might tell your husband you’ll pat him on the back if the gathering gets to be too much for you emotionally or physically — and vice versa!(3) Sometimes just knowing that you have a plan for when to leave or an option to leave early can make coping with family stress easier. It gives you perspective to know it won’t last forever.

Avoid hot button topics.

A great way to trigger family stress is by talking about controversial or hot button topics. Even within the same family, people often have differing opinions when it comes to hot button topics. Avoiding discussion about things like politics or religion is a good idea. If you find yourself in the midst of such a conversation, you can nicely put a stop to it by saying something like, “I love/respect you. Can we stop this conversation for now and talk about something else?”(3) Another great way to stop conversations you don’t want to have is to simply say something like, “That topic isn’t up for discussion, but I’d love to hear about how things are going with you.”

Talk with your family ahead of time.

Especially if this is your first holiday season with IC, you should consider talking with your family ahead of time about your needs. If you are going to someone else’s home for dinner, call them ahead of time to ask about food options or whatever you’ll need while you’re there. By letting your family know what you are able to do and what you need ahead of time, you can help set their expectations (as well as yours). And that results in less stress.(4)

That said, it is also up to you how much information you reveal about IC or any health issue you are managing. (Check out 10 Tips for Talking IC with Friends and Family for conversation suggestions.)

Beware of old behavior patterns.

Being around our families can change our behavior, and we can easily fall into old behavior patterns. And that can lead to more family stress. If you have an older sibling treating you like they did when you were 10, you might be inclined to react more like you did when you were 10. You can be proactive in curbing this behavior by planning activities and distractions that could disrupt old behavior patterns. Go for a walk together if you’re up to it, play a game or watch a movie.(5)

Set boundaries for toxic family members.

When a family member’s behavior goes beyond stressful to become toxic — such as the person is verbally abusive, manipulative or narcissistic — then set boundaries and stick to them. Protecting your mental health is important. You can choose to avoid the person or limit your time with them.(5) Don’t be afraid to seek professional help for managing these kinds of toxic relationships as well.

Allow yourself time to grieve.

Holidays can bring up many emotions, including grief. While this isn’t family stress caused by someone’s behavior, grief is still a huge source of stress. Whether it is your first holiday season without a loved one or your 10th, recognize your feelings of grief and give yourself permission to feel them. Consider talking about the person you’ve lost with your family so you can grieve together.(5)

Give yourself a break and some grace.

When family stress is getting to you, remove yourself from the situation and take a break. It’s OK to put yourself in “time out.”(1) Sometimes you just need time to regroup. If you can, slip away for 20 minutes of quiet time when you start feeling overwhelmed. As a natural born introvert, I’ve found another way to give myself a short break is by going to the restroom. And that’s when having IC comes in handy, because I usually have to go anyway! Take a few extra minutes in the bathroom to take some deep breaths, wash your hands with warm water and regroup before going back out into the group.

But also give yourself credit for what you are doing and recognize that you aren’t perfect, and that’s OK. Be as mindful as possible. If you are aware of how you’re feeling physically and emotionally, then you can take better care of yourself. Give yourself pep talks as needed to remind yourself that life is up and down. Just because you might be having a down moment doesn’t mean you’re stuck in that moment forever.(6)

Take time for gratitude.

We are more susceptible to stress when we are feeling depressed or anxious. And sometimes with IC or other chronic illnesses, it can be easy to focus on what we don’t have. Or with family, we can start focusing on what is going wrong. Throughout the holiday season (and year-round!), take time to think about for whom and what you’re grateful. Challenge yourself to write down three things each day or even make it a family activity and have everyone write down a few things they’re thankful for and share them. Focusing on what you do have rather than what you don’t reduces your stress level.(5)

Take care of yourself physically.

If you aren’t getting enough sleep or drinking enough water, you can easily find yourself more irritated. Being more irritated only increases your susceptibility to family stress.(5) While an irritating comment your aunt made might roll off your back when you’re feeling well, it might really bother you when you’re tired and out of sorts. Make sure throughout the holiday season and before family gatherings that you are taking care of yourself. For ICers, that can also includes things like resting for a day or so ahead of time to save up energy for a gathering, avoiding trigger foods and taking your medications as prescribed.

Ask for support.

Dealing with family stress is difficult. Finding the right support is important. Find a friend or other family member who will listen to you when you are struggling. Consider having that person “on-call” during family gatherings so you can reach out to them for support.(5)

And don’t forget to seek support within your own family. Well-intentioned relatives might be keen on doling out advice — like drink cranberry juice. Take advice with a grain of salt, knowing the person means well. Try your best to let your defensiveness go and shift the conversation elsewhere.(4)

Or other relatives might have lots of questions about your health or your life that you don’t feel comfortable answering. The family member may not be ill-intentioned in any way, but the impact on you can be difficult. Think ahead of time about how you’ll respond. Consider something along the lines of, “It would help me feel supported if you…” Then be ready with specific suggestions.(3) For example, if you have a relative pushing foods on you that you know will flare your bladder, you could say, “It would help me feel supported if you let me navigate my own diet today.”

References:

  1. Foston-English M. Surviving the Family Holiday. Stanford University BeWell News.
  2. Schrader J. Holiday Stress: Dealing with Family Drama and Dysfunction. Psychology Today. Nov. 19, 2014.
  3. Woods S. 7 Ways to Manage Family Stress During the Holidays. UT Southwestern Medical Center MedBlog. Dec. 9, 2021.
  4. Sayre N. The Ultimate Chronic Illness Holiday Survival Guide. The Mighty. Dec. 23, 2019.
  5. Families for Depression Awareness. 10 Helpful Ways Your Can Manage Family Stress During the Holidays. Dec. 9, 2019.
  6. Bernhard T. Surviving the Holidays When Your Chronically Ill. Psychology Today. Nov. 23, 2014.