Not everyone has thoughts of sugarplums dancing in their heads this time of year.

For many, the holidays actually conjure up anxiety as they brace for the onslaught of relatives, office parties and school events. About eight out of ten adults occasionally suffer negative reactions to the holidays, ranging from the blues to severe depression. And for those with anxiety, the thought of mingling with strangers and making small talk can seem unbearable.

HOLIDAY HAVOC

It’s only six weeks from Thanksgiving to New Year’s and this excessive demand on time and wallets can cause stress. But rest assured, you can survive if you take back control of your experience. Karen Houseworth is a behavioral health therapist for Mercy Medical Group who teaches classes on surviving the holidays. “I give people guidelines of what they can do to have less anxiety and what I ask them to do first off is to keep their holiday expectations reasonable and realistic,” says Houseworth. “Set limits and determine what’s most important to you and your family.” Also, she encourages people to take care of themselves and not to let go of sleep, exercise or healthy living.

Houseworth understands that this may mean making changes to tradition – compromise by setting a time limit at work functions or letting your in-laws only stay for two nights instead of four. Also, consider alternatives to gift-giving if money has added to the stress. Try giving to a charity instead or whittle down the gift list to a select few.

EVERYDAY ANGST

For some, anxiety is a reality 365 days a year. Social anxiety disorder is defined as a fear in social situations that can lead to panic attacks. These people often believe they will embarrass themselves in public, resulting in them avoiding social situations. According to Maxine Barish-Wreden, M.D., co-director of Sutter Downtown Integrative Health Care, these anxieties usually go back to an incident in childhood or adolescence that then replays itself out physically when a situation triggers the emotion.

An estimated 19.2 million Americans have a social anxiety disorder. Physical signs of social anxiety disorder include panic attacks, intense anxiety, chest constrictions, difficulty breathing, sweating, shaking, pounding of the heart, diarrhea, upset stomach and abdominal pain. If diagnosed – by a physician or psychologist – most will first try cognitive behavioral therapy, and only then, if more help is needed, turn to medication.

“I think if you’re having symptoms, the first step is to make sure there is nothing physically wrong,” says Barish-Wreden. Then, try exercising a minimum of 30 minutes a day and look at your nutrition. “So once you rule out medical, lifestyle and nutrition, then you consider mind-body intervention, such as cognitive behavioral therapy,” she adds.

CREATIVE COPING

But how do those with anxiety power through the holidays? “It’s the freedom to say that everyone might be judging me, but I’m judging them more,” Barish-Wreden says. Then, learn to notice where you’re being judgmental and respond to it with compassion. “In a social situation, you don’t have to be comfortable, but instead it may help to be playful. Create some games,” she recommends. Try telling a friend about the game so you can be held accountable. For instance, challenge yourself to find out something interesting about 50 percent of the partygoers.

“It also helps that before you go to a party, to not just think it, but imagine it. Sit quietly for a period of time. Imagine people will be really lovely. We respond to images, so the more creativity, imagination and physical experience in a body, the more likely you are to have success.”