Post-Traumatic Stress Disorder (PTSD) is a disability that typically occurs after exposure to a traumatic experience such as combat, assault, natural disaster, the threat of death to oneself or a loved one or a sudden, unexpected, loss of a loved one. The holidays can be a difficult time for people with mental health disabilities, including individuals with PTSD, even if the traumatic event didn’t occur during this season.

Holiday celebrations bring large, boisterous parties, sometimes include fireworks or other sudden, loud sounds, and talk about memories that remind us of people or places in our past. For people with PTSD, as well as many other mental health disabilities, these noisy get togethers can be difficult to deal with. For those of us who wish to support our family, friends and colleagues with PTSD, there are some things we can avoid doing in order to make the holiday season less stressful.

  1. Do not minimize their experiences

PTSD is a mental health disability and the symptoms that people with this disability experience are very real. It is not something that people can just “shrug off” or “get over.” Although in recent years, PTSD has received more attention and awareness, many people who have this disability struggle to go to friends and family members when they need help or support. This can be a part of the disability itself, as well as response to the stigma associated with the disability. Nobody wants to have PTSD and the symptoms that people experience are not something made up for attention.

Treating PTSD like it something that a person has control over, rather than being supportive, minimizes the person’s genuine feelings and creates an atmosphere where the person with PTSD knows they cannot approach you to talk about their feelings and experiences. For people with PTSD, communicating feelings and trusting others can often be very difficult; by treating their disability as something unimportant, you can create an atmosphere where it is impossible for them to trust or talk to you.

  1. Do not pity them

People with disabilities do not want to be pitied; this includes people with mental health disabilities like PTSD. Don’t assume that because someone has PTSD that they won’t want to attend a holiday party, participate in a gift exchange, or hear about your problems. Even if your intention is well-meant, it will make the person feel excluded. Instead, allow the person with PTSD to make their own decisions on which holiday events they wish to participate in.

Keep conversations to normal topics rather than making their disability a point for open discussion. People who have PTSD may not wish to talk about their experience, especially in environments that are already filled with factors that may cause stress or anxiety. Constantly bringing up their condition so that you can tell them how badly you feel that they are experiencing PTSD forces the person to have to continually relive the traumatic events that led to their disability and also may make them feel like you are judging them or pitying them. Instead let your friend or family member know that you are there if they want to talk and allow them to approach you when they are ready.

At work, do not require less of them than you normally would. Keeping busy and having meaningful things to do can help the person feel included and allows them the opportunity to contribute. For people with PTSD and depression, a struggle to feel self-worth is common, especially at the holidays. Having the ability to create positive impact can be encouraging, where as having responsibility removed can lead to additional feelings of inadequacy. 

  1. Do not be offended when they need space

For people with PTSD, some environments, sounds or smells may trigger fearful memories. While it is important to allow people the option to participate, it is equally important not to take it as a personal affront or insult if the person chooses not to. It is important as friends, family members and colleagues to listen when someone with PTSD says they are not ready for something. They may really want to go, but not yet feel ready to do so. Pushing the person to take a step they are not ready for may lead to feelings of additional stress in managing the symptoms of their disability. Many people with disabilities like PTSD are receiving treatment that include identifying triggers for their disability and learning when and how to best deal with those stressors. Allowing the person with a disability the opportunity to follow their mental health care plan without adding the stress of them having to worry that you will be angry with them or feel offended, will actually help to lessen the feelings of anxiety associated with these invitations.

If someone with PTSD is attending a holiday party and expresses the need to step away from a large group function, you can offer to step away with them for a few minutes. At most parties there are places away from the larger crowd where you can have a seat and a quieter conversation, or you can step outside for a few minutes to escape the noise and closed in spaces. Remember, it is the person with the disability’s choice whether or not to have you accompany them, and you should not be offended if they need some space alone.

If the person feels unable to attend a large holiday function, offer to get lunch or do something in a smaller group with the person at an alternate time. Whether its grabbing dinner at a quiet restaurant or meeting them at their place for a movie night, you are still getting to spend time with your loved one during the holiday season – and that is the most important part after all.

  1. Do not try to fix them

When someone you care about is hurting or experiencing things you don’t understand, it is natural to want to help them. The best way to do that is to be supportive and thoughtful in your interactions with them. Remember, it is not your fault that they have PTSD and they do not blame you or want you to feel responsible. You don’t need to be their super hero and fix things for them. It can be embarrassing and cause additional anxiety if someone asks them a question and you do not allow them to answer or make decisions for themselves. Allow them the space to work with their professional support team to find ways to manage their PTSD symptoms, rather than trying to take on this journey for them.

As referenced earlier, people with PTSD sometimes struggle to communicate how they feel or visibly show their emotions. As the holidays are an emotional time, often filled with laughter, happy tears and plenty of hugs, someone with PTSD may struggle to reflect the same level of joy as those around them. Someone who may have previously been the life of the party, may now be more sedate in their responses. Persistently asking if they are okay or enjoying themselves or calling out the differences in their behavior draws attention to these complex feelings and emotions and may make the person feel more stressed and anxious rather than helping with the situation. Allow the person to express themselves in the manner they are most comfortable with, rather than feeling responsible for their happiness.

Remember, the best thing to do when offering a person with a disability help is to ask them if they want it. Don’t be pushy or insistent. Allow them to let you know how you can best be supportive and be respectful if their answer is for you to do nothing.

  1. Do not pressure the person to partake

Whether it’s sweet treats, large meals or alcohol, the holidays are a time of abundance and over indulgence. For people with disabilities, including mental health disabilities like PTSD, diet can be an important factor for managing their disability. In some instances, people with disabilities will avoid functions with family and friends just to avoid social pressure to partake in food or drinks that adversely affect their health.

Alcohol and medication do not mix for many people with disabilities. For example, alcohol dilutes epilepsy medication and lessens its effectiveness in preventing seizures. If I were to have several drinks it would significantly increase the likelihood of having a seizure. For this reason, I rarely have a glass of wine or drink of any sort. This is also true for people with mental health disabilities. People with PTSD may be taking medications that are especially important for them during stressful times, such as the holidays, or they may just wish to avoid the feeling of losing control of themselves and their surroundings that alcohol can contribute to.

Studies have also shown that indulging in too much sugar can also negatively affect mental health. At the holidays, we are surrounded with wonderful sugary treats from Christmas cookies, homemade pies, candies to eggnog and holiday punches. In addition to all the sugary desserts we pile our plates high with many sugar-filled sides such as candied yams, sweet potato casseroles topped with marshmallows, cranberry sauce, and pasta dishes are a staple for holiday meals. It is hard for anyone to resist all the decadent options set before them. However, consuming an overabundance of sugars and fatty foods can impact the body’s chemical responses, lead to feelings of depression and anxiety, two things that people with PTSD are potentially already feeling during the holidays.

Whatever their reason, it is important to be supportive of anybody’s decision not to partake of alcohol or too much food during the holidays. Rather than encouraging them to make choices that are not in their best interest, offer healthier alternatives. Along with all the chips and soda, offer your guests bottled water and veggie trays with a Greek yogurt dip. Offering vegetable-based side dishes such as green beans cooked with garlic, grilled peppers or mushrooms, and roasted Brussel sprouts are all healthier alternatives to side dishes rich in butter, creams, and sugars.  Along with all the trays of sugar cookies, cheesecakes, and pecan pies, you can offer fresh fruit as a desert option. When you pop that champagne cork to ring in the new year, have some sparkling flavored water, cider or grape juice available for those who wish to participate in the toast without consuming alcohol. You will find that many diet conscious people will also appreciate the opportunity of healthy options. Regardless of what food you offer, at the very least be respectful of people’s decision not to partake.

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