The holidays are meant to be a time of joy and celebration, but as we head into the holiday season, many of us are experiencing stress and anxiety — and Covid is magnifying those feelings. I reached out to Owen Muir, a child, adolescent, and adult psychiatrist and the cofounder of Brooklyn Minds, for ideas on how to manage family conflict, stay healthy, and make the holidays as enjoyable as possible.

John: What mental health strategies do you recommend for those who are stressed out about the holidays and not being able to go home? I’m not going home for Thanksgiving. We’re bucking tradition because we are being careful about Covid.

Owen: I’m Italian, so I do have some experience sitting around with large families during the holidays and it sometimes not going smoothly. I think Covid has changed a lot of the underlying assumptions we had about how things work. At a time when tradition usually runs the show, we’re asking ourselves, “Does this make sense anymore?”

I think the first thing to do is to recognize that tradition came from somewhere, right? We have these traditions for a reason, and the reason we have Thanksgiving is that people were starving, and someone came along and did them a solid, and we’ve been happy ever since. Similarly, Passover wasn’t because people were having an excellent time — it was because we decided the angel of death was going to pass over us. And so, remembering the historical underpinnings of most of our celebrations, which are generally not the most positive of times.

Usually, we get our traditions from overcoming adversity. This is that again. If you want something to give thanks for, think about the willingness of you and your immediate family to sacrifice the comforts of the holiday for the safety of everyone else.

As you explain to your children and yourself at the same time, this is hard because we are not going to see the rest of the family, and this is important because this is how we get to see the rest of the family in the future. This is what’s required to be safe.

J: It sounds like some of what you are talking about stems from being able to do a self-assessment — to be aware of ourselves, our concerns, and our feelings.

O: It’s a combination of checking in with yourself and understanding that you have a permission slip to do things differently, because the underlying assumptions that led to how we did things in the past are different.

J: Returning home, for those who do, often brings up conflict. How can people manage their mental health when they are home with their families?

O: A lot of conflicts are around things that are in our minds. We get in a fight with someone, and we’re getting in a fight with them in our head as much as we are getting in a fight with them in the world. In fact, what’s going on in both of our heads might be very different. This is a mental process, and if you’re depressed or have ADHD, it can be harder.

I think the first thing to recognize is that conflict is information. Not just about the fact that you disagree about something, but what’s going on inside you and the other person at the same time. In this case, it may be about how stressed we both are about Covid, how worried we both are about xyz, being unemployed, having to face uncertainty… Those things increase our levels of stress and distress.

J: Are there general guidelines for people if they are sitting in a room with family members and there’s an elephant in the room?

O: My guideline is to talk about the elephant in the room. Talk about it in a way that takes your own feelings into account. “I’m feeling X about living in a world that has gone crazy and I don’t know for sure…” This is the guideline: Don’t be so sure. If you can, replace the exclamation point at the end of your sentence and “What the hell is wrong with you?” with a question mark. “I wonder what is going on with you?” You have very different experiences and so do your family members, so the opposite of conflict I would say is feeling understood.

The word “but” should be excised from your Thanksgiving vocabulary. Slice it off the turkey. If you can get through the night without “but” or “just,” you’re going to do pretty well.

The holiday season is the Super Bowl of practicing this stuff. The nice thing is that you don’t have to get it right So, if you find yourself saying “but,” say “I just caught myself and I’m going to rewind. Let me know if this is any better…”  Instead of, “It’s great to see you, BUT Covid is a bummer,” say, “It’s great to see you AND isn’t Covid a bummer?”

J: Are there specific things that Brooklyn Minds does to help patients work on these types of things?

O: This is the work we do there every day. We are preparing to help people deal with the holidays all year long. We think about it like Santa’s elves, but for family conflict at the holidays. Every year we hope there are more question marks under the tree than exclamation points.

J: I know you spend a lot of time working with those who struggle with drugs and alcohol. Often during this time of the year it is a challenge to maintain sobriety, especially with Covid pushing people to isolate. Do you have recommendations for someone who is struggling with drug and alcohol abuse during the holidays?

O: The more it’s a secret, the harder it’s going to be. This might be a good time to reach out for help, especially if you are going to have a problem with drugs and alcohol. It’s going to make family members worry, as much as people don’t like to admit it, but you know what calms people down really quickly? “I just saw this great psychiatrist/psychologist/social worker who is really helping me think about how I can change this.” Then it becomes something your family doesn’t have to worry about on their own. They know that you’re trying to take care of yourself.

J: And how about for those who aren’t talking about it and family members are concerned that somebody is using or has relapsed. What are some signs that people should be looking out for?

O: You know who knows relapsing? Your mom, your brother, even your aunt. This is not going to be a surprise to them, so if you think you’re hiding it really well, these are the people that know you. It’s stressful to keep secrets. The more we hide things like this, the harder it is for anyone else in the family to come forward and admit that they are struggling and need help. I understand why people keep this a secret, and I also see how freeing it is for people when they don’t have to anymore. And so I encourage people to consider having those conversations, because right now, look, 11% of Americans thought about killing themselves last month.

This is a time when I hope it might be a little easier to talk about it. “How are you coping with this?” By the way, the options include not just self-care activities and yoga, right? “How’s wine club going for you? How’s your Netflix subscription?”

J: I feel that Covid has opened up discussions and people are talking more about mental health. If this vaccine comes in the next year, I’m optimistic that we can continue this discussion about mental health and address it in a more upfront and aggressive way and that companies and funding will follow suit.

O: I don’t know that we are going to have a choice. I think the scale of direct impact of the Covid-19 virus on the brain is significant. We don’t know how much, we don’t know in which ways, but this is essentially an autoimmune trigger for a variety of organ systems. It’s not just the lungs. So that alone is not good, but it’s also a great reason to talk about what’s going on. We’ve all had this shared experience of awfulness, so I hope nobody has to pretend on Facebook that they’re having a  perfect life right now. Instagram isn’t only pictures of us like “I’m having an amazing party,” and if that is the picture, it’s probably a problem. I hope that there will be more permission to talk about things in a way that’s more genuine.

J: Do you have any other advice for people around the holidays and managing their mental health?

O: If you have medications, talk to your doctor about whether they are safe to mix with drugs or alcohol. And most importantly, wear a mask when you are out and about. Follow the guidelines your local state and health board have for travel when it comes to Covid, because none of us are getting better from our depression if we are dead from Covid. And for all my colleagues who are working in ERs and ICUs, they need as much of a rest as humanly possible and that means us all doing our part to protect our health from Covid long enough to get that vaccine.

The Better Health Advisors team is grateful to Dr. Muir for sharing his insights, and we wish you and your family a safe, peaceful Thanksgiving.