MS and the Holidays: Practical Tips to Manage Energy and Expectations

Finding Joy in the Holiday Season

The holidays can be both a joyful and stressful time. We are often around people we love, but with those visits can come high expectations for how we see traditions and experiences needing to be completed during holidays. These expectations are often paired with intense feelings related to family and friends around the holidays. We feel nostalgia, overwhelm, the joy and then loss of loved ones leaving, frustration, and cheer, to name a few. 

With these perfectly normal feelings around the holidays, multiple sclerosis (MS) adds some additional challenges. MS relates to all kinds of symptoms that are both tough to endure and tough for others to understand. These symptoms can include fatigue, spasticity, nerve pain, and limited movement along with mental health symptoms such as depression, anxiety, and mood changes. The good news is with some planning, prioritizing, and support, the holidays can still be a time of joy.  

Prioritize with Joy in Mind

A great place to start is to prioritize what is important to you and brings you joy during the holidays. These may include activities like: 

• Making meals or food to enjoy with others or to give to others 

• Enjoying meals with loved ones  

• Shopping 

• Wrapping or preparing gifts 

• Going to community holiday events such as concerts, shows, or plays 

• Decorating your home or living space 

• Spending time with others (friends, family, etc.) 

A great way to know if an idea is a true priority that brings you joy, is to read the list above and see what your immediate gut reaction is. Do you smile when you read that item or do you frown, or do you not really care? Your gut reaction can help you decide what is a priority and brings joy, what needs to be put lower on the list, and what you may need to avoid. After doing this priority review, you will want to clearly communicate with your loved ones which activities are a priority for you and when you plan to devote energy to them. Talking with your loved ones before the activity comes up is best for preparation.  

Frequency and Duration

After you have a few top priorities, a good way to decide what kind of support you need to make those activities happen is to think about frequency and duration within that activity. Frequency is how often you repeat something in an activity and duration is how long the activity takes. You will want to consider frequency and duration for both the preparation for an activity, the activity itself, and its clean-up. For example, if hosting people for a meal is a top priority for you, you will want to consider the duration of how long the preparation will take, how long people will be over at your home, and how long clean-up will take. You will also consider frequency in those tasks such as chopping for meal preparation and doing dishes after everyone leaves. 

Supports

Along with frequency and duration, another good step is to consider your supports. Supports can be people, rest, tools, and pre-prepped items to make activities easier. If we consider again hosting people for the holidays, see the table below for possible supports for the preparation, the activity itself, and the cleanup. You can see how support can decrease frequency and duration so you can decrease fatigue and increase joy for being around people you care about.   

As you can see, many of these options can limit fatigue for sustained tasks, as well as limit long or repeated tasks. Some of these ideas may take some planning. Take the time sit down and plan how you would like the preparation, the activity itself, and the clean-up to go. If it’s difficult to prioritize or plan, this is a great opportunity to consult with an occupational therapist. Occupational therapists focus on the details of tasks and routines and how to break them down and make them more manageable.  

Tools and the Environment

Together with prioritizing, planning, and considering supports, there are also tools and environmental considerations to help you get some of your top holiday priorities done. While you may think of the environment as only the physical environment, there are other environmental considerations. These include the social environment, or who is around to support you, how time supports your activities, and sensory components of the environment, such as temperature, lighting, and sound. See the table below for some common holiday activities and some tools and environmental considerations for those activities. 

You Are Not Alone

The holidays can be intimidating but with some preparation and clear communication, they can also offer many moments of joy and peace. If you feel like any of the steps above seem too complicated or overwhelming, request a consultation with an occupational therapist. Occupational therapists focus on how people occupy their time, so we focus on routines and activities that are important to you and then help break them down into more manageable pieces.  

Don’t forget other valuable team members such as physical therapists and speech therapists. Physical therapists can assist with making sure you have the strength and movement capability to complete activities you care about. Speech therapists have additional strategies for managing the cognitive load of all of these activities. Additional mental healthcare professionals such as psychologists, clinical social workers, and licensed professional counselors may also help you manage what can feel like the weight of the holidays and help you feel well during this time. Just remember, some of these activities are complex and that’s okay. There are dedicated professionals here to help break down complexity and make sure important and joyful activities are a part of your daily life.