Reading so many articles about holidays and depression but at the same time working almost exclusively with bipolar patients, I wondered too. Is Christmas good for your Bipolar disorder? What can I really tell you or to our patients about this?

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I have no data really from my own research. A pubmed search surprisingly enough brought up only one article/letter by Nick Cradock (a British Psychiatrist from Wales, UK conducting one of the largest genetic studies on Bipolar disorder) dated back in 1992. However, the letter refers to a patient with bipolar disorder and Haemophilia B (a genetic illness also known as Christmas disease, named after the first reported patient, Stephen Christmas)

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So even though we seem to have no data to tell you whether Christmas is good or not for your bipolar disorder, I will offer a few thoughts based on what we know from cognitive behavior therapy and bipolar research.

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It may all depend how you approach your forthcoming holiday season.

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If you have negative expectations about your forthcoming Christmas experience, then you are very much likely to confirm your negative expectations. Cognitive therapy works wonders by helping people to change their negative expectations of future events and negative appraisals of current events. If you did have negative experiences during previous Christmas holidays, and possibly also experienced depressive symptoms or episodes, then you are very much likely to have developed negative schemas about Christmas. Your negative schemas - if left alone - will affect how you will interpret your experiences during Christmas.

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From a behavioral point of view, if you start by predicting that you will have a horrible Christmas time, then you are likely to avoid your friends and family members. Or even avoid a little Christmas shopping spree because you don't have enough money to buy all the things you want or because you are afraid your most recent manic shopping spree. By avoiding pleasurable activities and social contact again you are destined to have a miserable Christmas experience. Behavior therapy has proven itself really effective for treating depression by ensuring that depressed people are once again slowly but gradually being exposed to pleasurable activities. Even if you are alone, you can always make the first step and get in touch with a local support bipolar group. I am sure they will be happy to have you along for Christmas.

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And then we have the change in your routines.

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As with any holiday season, during Christmas you are likely to experience a change in your usual routines. What we know from interpersonal and social rhythm therapy is that changes in your routine may destabilize your mood and lead to new bipolar episodes. Again, I do not think we have any hard data particularly about Christmas and bipolar episodes, but from the studies and the knowledge we have, if your Christmas holiday leads to major changes in your routines then you may end up having a negative Christmas experience.

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So all in all, I would say it all depends about how you will approach, and what you will do during your Christmas.

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Even if your previous Christmas experiences may not have been necessarily good ones, it is never too late to fall into the magic of Christmas. Become the Santa of your loved ones (and yourself), and enjoy your time off work and time back with your family. Forget the grudges, forgive past mistakes and quarrels, and move on with the positives in your life. Do so with care of course, and one step at a time. Look after your sleep and watch your alcohol intake.

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But engage with whatever positive comes your way, and make up your own Merry Christmas. This Christmas may be the start for a better and more balanced year or years to come.

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Merry Christmas and a Happy New Year to all from the BipolarLab team.

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