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Melissa Harris-Perry: It's just two days until the Thanksgiving holiday. Here's a little peek at what's happening in my head.

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Melissa Harris-Perry: Okay. All right. Lots to do. His parents are driving up. They get here at 7:00. Let me start just by getting these sheets in the washing machine.

[phone ringing]

Melissa Harris-Perry: Hello. Hey, kiddo. Oh, you're a vegan this year? No problem. We'll still have turkey, but how about quinoa squash too? Okay, great. Hey, look, before you go, did you get your booster shot yet?

[phone rings]

Melissa Harris-Perry: Did I send a Lyft to pick my niece up at the airport? Let me check. I better send her a text. Just a reminder that if the driver isn't wearing a mask, don't even get in that car. Back to the pie. Oh, dang, is this food processor not working? Okay, I'm just going to mash these sweet potatoes by hand. Washer done. Let me go get these sheets in the dryer. One more check on the Google Doc. I got to make sure I got all the ingredients. Wait, am I doing too much by having a Google Doc?

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Melissa Harris-Perry: No, I got to have it. How else can I be sure I haven't forgotten anything? Oh, yes. Let me get that butter out this oven. Wait a minute, one more quick text. "What's up, big bro? I know you haven't had the second vaccine dose. It's not the same, but don't worry. I'll send you a Zoom link so we can talk while I'm cooking."

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Melissa Harris-Perry: Yes, I know, it's a lot. To be clear, I love the holidays. I've got a supportive family and enough resources to get food on the table. Still, more than I'd like to admit, I'll notice my breathing is short, shallow. My cheek is sore from biting the inside and my shoulders are so high, they're practically touching my ear lobes. One part family stress plus one part pandemic panic can be a recipe for a seasonal sadness. You're feeling me, right? We ask you about how the holidays affect your mental health, especially in the second year of COVID.

Beth: Hi, my name is Beth from Glenside, Pennsylvania. This Thanksgiving is a really big anxiety inducer this year. Part of our extended family is unvaccinated and they're living like it's 2019, no masking, no limiting of where they're going. It's up to my nuclear family whether to create a big rift by not seeing them on Thanksgiving or to take the health risk to maintain good family relations.

Speaker 3: The holiday season makes me want to crawl under a rock and hide until January 2nd. My mental health declined sharply and never makes the full rebound come springtime. The pandemic has made everything worse.

Lori: Hi, this is Lori from Katonah. Mental health during the holidays is challenging for me, especially as an introvert. I find myself really craving quiet, solitude, especially after being around family and friends for long periods of time.

Melissa Harris-Perry: Thanks to all of you who shared how you're feeling during the holidays with us. I'm Melissa Harris-Perry. Today, we're starting with some health guidance on mental health this holiday season with Dr. Vaile Wright, senior director of healthcare innovation at the American Psychological Association. Welcome, Dr. Wright.

Dr. Vaile Wright: Thanks. It's a pleasure to be here.

Melissa Harris-Perry: What are the kinds of mental health challenges that tend to be exacerbated by the holidays?

Dr. Vaile Wright: Certainly one of them on common things would be stress. That everybody does tendency to feel a little bit of stress as the holidays approach, whether that's because you're wanting everything to be perfect or you know you're going to have to engage with family and that causes stress. Anytime stress is increased, then the chances of that being unmanaged could lead to things like depression, isolation, loneliness, anxiety. That's the kinds of things we get concerned about.

Melissa Harris-Perry: Talk to me a little bit about stress versus issues like depression. Clearly, they're linked, but I guess part of what I'm wondering is if you already have a diagnosed case of depression and you're treating it with maybe behavioral practices, medication, therapy, are there proactive ways to enter into the holiday season?

Dr. Vaile Wright: Absolutely. You want to make sure that you have your coping plan in place so that when you start to feel stressed, when you start to feel more sad or less connected, that you have ways to shore that backup. That might be engaging in some self-soothing activities. It could be reaching out to a friend, even when it's hard. It could be having that friend on standby who if they haven't heard from you in a couple of days knows to reach out to you instead because your depression may be getting worse. It's really entering into the holidays with a plan ahead of time so that when you start to struggle, you don't have to try to figure it out. It's already in place.

Melissa Harris-Perry: When you talk about entering in with a plan, clearly the pandemic has disrupted so many kinds of plans. There are probably more opportunities for gathering this year, but we are still very much in a situation where, I know at least in my family, we're still trying to take steps and measures to protect the most vulnerable among us. How does a second holiday season in the context of COVID-19, for whom might these be the most difficult days?

Dr. Vaile Wright: I think we are seeing a slightly different holiday season compared to last year, but there's still so much uncertainty, and clearly the pandemic has not gone away. I think for families, it's going to really depend on your own individual circumstances. If you have people in your family that you know are more vulnerable because of medical conditions, maybe you have children who still aren't able to get vaccinated, or we know there's still a lot of individuals who haven't been vaccinated from one reason or another. I think those are the groups that are most likely to be vulnerable this year to the stress and how to figure out how do you make decisions when there's still so much uncertainty?

Melissa Harris-Perry: Is there any way to have an actual happy Thanksgiving over Zoom?

Dr. Vaile Wright: I think that there is if you can approach it with the expectation that it's not going to be a real replacement for face-to-face individual time, but instead trying to make it more fun, more active. Not just sitting there having conversation about Thanksgiving or saying hi to each other, but actually maybe playing a game, doing something that's really more interactive and fun, time-limited I think is still better than nothing.

Melissa Harris-Perry: I'm wondering about substance abuse. I don't know that we always put this under the category of mental health, at least when we're talking about the seasonal stress. For many people, having alcohol on the table is part of the holiday season, but there are often those in our gatherings for whom alcohol is also a very real challenge. I'm wondering the ways to address and to be kind to and to assist and support those in our communities who may be gathering with us, but also might be struggling with substance abuse.

Dr. Vaile Wright: I think we really need to be entering these conversations with a lot of grace and empathy, and really trying to put ourselves in other people's shoes right now so that we can approach it in a collaborative way. If you have family members that are struggling, conversations need to be ahead of time about what makes people comfortable. If having alcohol on the table, for example, is triggering, then maybe have it someplace else, somewhere away where that individual won't have to confront it in their face. Again, I think it's about planning ahead. It's about having really honest conversations and then doing everything we can to support our loved ones.

Melissa Harris-Perry: Let's talk about young people and adolescent and children's concerns. We've seen such a rise in a variety of mental health diagnoses and concerns for young people, particularly as we've reentered this school year. Yet, we expect kids to always be happy and sometimes also to take a backseat. "Give up your bed for grandma who's coming to visit. Sit at the kids' table, not at the grownup table." I'm wondering if there are also particular ways that we can support adolescents and teens and other young people in our lives.

Dr. Vaile Wright: Teens and young adults and children need routine. Routine helps shore up their emotional wellbeing. It helps give them a plan. Things feel less uncertain. To the extent to which we can continue having those types of routines in place are really going to help kids out. Then we need to make sure we're talking to them. We need to be engaging them in conversations and modeling really strong behaviors for them.

We can be talking about the ways in which we have challenges, whether it's at work or maybe with a family member, and then how we might manage it. Then that helps kids understand that it's okay to not always feel great, but that there are also ways in which you can make yourself feel better if you really work at it.

Melissa Harris-Perry: I'm wondering, short of maybe something that is diagnosable, just if you have suggestions for how we think about setting the limit we need to set to protect ourselves from difficult or challenging family members while at the same time not having to spend the holidays alone and isolated.

Dr. Vaile Wright: I think it's really important for people to, at first, just give yourself permission to even have these boundaries. I think a lot of times, we have unrealistic expectations about our family. That somehow we're supposed to get along with family 100% of the time because we're blood-related. The reality is family are just a group of people like everybody else. Allowing yourself permission to set those boundaries and then enforcing them becomes really critical.

Then sometimes it's about having an escape plan too. If things start to get too stressful, if things start to get too overwhelming, can you remove yourself even briefly? Can you take a walk around the block? Can you say that you're not going to stay longer than a couple of hours? Again, setting those boundaries both the emotional ones, but also the physical ones are going to, I think, be the key to really having a successful holiday season.

Melissa Harris-Perry: I'm wondering, even for our own physiology, are there other signs we should look for like, "Oh-oh, I'm about to erupt in anger or I'm about to dissolve into tears over this cranberry sauce."? What are some of the ways that if we're not at our best, not the best rested, and most hydrated that we can just monitor our own holiday stress and maybe sadness?

Dr. Vaile Wright: I think for a lot of people stress and sadness and emotional distress is felt physically first. That can look like muscle tension, headaches, teeth grinding, or just that tension that people do in their shoulders. Even right now I think people probably listening could probably drop their shoulders away from their ears just to feel that sense of release.

Once you can start paying attention to those physical symptoms because that's your body really trying to wake you up and tell you, hey, something's not right. Then hopefully from there, you can identify, so what are some of the things I can do to help me feel better again? Do I need to take a walk? Do I need to call a friend? What can I do to regain some of that emotional wellbeing and stay grounded?

Melissa Harris-Perry: We've been talking a little bit about the stress of sitting down for dinner, but what about the stress of feeling like you can't put dinner on the table or you can't partake in the post-Thanksgiving holiday shopping that begins? Ways to maybe think about the self-talk we could be having with ourselves when our financial situations are difficult.

Dr. Vaile Wright: That's a real challenging one too. There are just some real realities for individuals that they're financially struggling maybe even before the pandemic, but certainly now with the pandemic given job losses and the rest. I think it's about trying to go back to remembering what we value, and what is it that we value during the holidays? Is it something commercial?

Is it having the newest, shiniest thing or is it connection? Is it connecting with family, connecting with our spirituality? Whatever those values are and then really focusing on that so that we're taking it away less from what I have and what I don't have in terms of tangible things, but what is it that I really value? How can I prioritize that in an important way that maybe hopefully doesn't cost anything?

Melissa Harris-Perry: Very last question. There's stress, there is anxiety, there's depression, but there can also be happiness and joy. Any thoughts for those who have every expectation of having a happy holiday season, but maybe want to still manage expectations so that even in our happiness, we don't feel disappointment?

Dr. Vaile Wright: I know we've been focusing a lot on the holiday stress, but really the holidays are a happy time of year for most people. It is about going in with the right expectation, and again, I think really focusing on what you value. Going in with the expectation that everything's going to be perfect is going to be very disappointing. Making sure you're going in recognizing that you might burn a meal here, you might say the wrong thing here. It's all going to be okay as long at the end of the day we're connecting, we're staying true to ourselves, staying true to our family, and remembering that this is the time of year to come together and to be grateful for what we do have.

Melissa Harris-Perry: Thanks so much, Dr. Vaile Wright, senior director of healthcare innovation at the American Psychological Association. We appreciate you stopping by and we hope you have a happy and joyous and healthy holiday season as well.

Dr. Vaile Wright: Thanks so much. You too.

[00:14:17] [END OF AUDIO]

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