The holidays can be a joy-filled season, but they can be challenging for those impacted by mental illness. A NAMI study showed that 64% of people with mental illness report holidays make their conditions worse. “For many people the holiday season is not always the most wonderful time of the year,” said NAMI medical director Ken Duckworth. For individuals and families coping with mental health challenges, the holiday season can be a lonely or stressful time, filled with anxiety and/or depression.

If you’re living with a mental health condition, stress can also contribute to worsening symptoms. Examples: in schizophrenia, it can encourage hallucinations and delusions; in bipolar disorder, it can trigger episodes of both mania and depression.

Here are some suggestions for how you can reduce stress and maintain good mental health during the holiday season:

Accept your needs. Be kind to yourself! Put own mental and physical well-being first. Recognize what your triggers are. Is going to a holiday party too stressful for you? What situations make you feel physically and mentally agitated? Once you know this, you can avoid them when it’s reasonable to, and to cope when you can’t.
Write a gratitude list and offer thanks. As we end the year, it’s a good time reflect back on what you are grateful for, then thank those who have supported you. Even if you’ve had a challenging year, there is likely something or someone for whom you are grateful.
Manage your time and don’t try to do too much. Prioritizing your activities can help you use your time well. Making a day-to-day schedule helps ensure you don’t feel overwhelmed by everyday tasks and deadlines. It’s okay to say no to plans that don’t fit into your schedule or make you feel good.
Be realistic. The happy lives of the people on those holiday commercials are fictional. We all have struggles one time or another and it’s not realistic to expect otherwise. Sometimes, it’s simply not be possible to find the perfect gift or have a peaceful time with family.
Set boundaries. Family dynamics can be complex. Acknowledge them and accept that you can only control your role. If you need to, find ways to limit your exposure.
Practice relaxation. Deep breathing, meditation and progressive muscle relaxation are good ways to calm yourself. Taking a break to refocus can have benefits beyond the immediate moment.
Exercise daily. Schedule time to walk outside, bike or join a dance class. Whatever you do, make sure it’s fun. Daily exercise naturally produces stress-relieving hormones in your body and improves your overall physical health.
Set aside time for yourself. Schedule something that makes you feel good. It might be reading a book, going to the movies, getting a massage, listening to music you love, or taking your dog for a walk.
Eat well. With dinners, parties, and cookie trays at every turn, our eating habits are challenged during the holiday season. Try to maintain a healthy diet through it all. Eating unprocessed foods, like whole grains, vegetables, and fresh fruit is the foundation for a healthy body and mind. Eating well can also help stabilize your mood.
Get enough sleep. Symptoms of some mental health conditions, like mania in bipolar disorder, can be triggered by getting too little sleep.
Avoid alcohol and drugs. They don’t actually reduce stress: in fact, they often worsen it. If you’re struggling with substance abuse, educate yourself and get help. It’s okay to leave the party early or skip it in favor or quiet time with a friend or alone time to recharge.
Spending time in nature. Studies show that time in nature reduces stress. (More on the mental health benefits of nature.) Need to break away from family during a holiday gathering? Talk a walk in a local park.
Volunteer. The act of volunteering can provide a great source of comfort. By helping people who are not as fortunate, you can also feel less lonely or isolated and more connected to your community.
Find support. Whether it’s with friends, family, a counselor or a support group, airing out and talking can help. Consider attending a free support group.
Seek therapy. If the steps you’ve taken aren’t working, it may be time to share with your mental health professional. He or she can help you pinpoint specific events that trigger you and help you create an action plan to change them.