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"I Can't Make It"

Cancelling plans is especially hard at holiday time. Get advice from experts on how to manage a chronic condition at the most wonderful time of the year.

girl sits on a couch by a Christmas tree on a video call

Even a normal day can be challenging for someone who’s living with a rare or serious disease. But the holidays add a little extra pressure. You might have to cancel or postpone plans because you’re not feeling well.

One strategy is to pace yourself.

“Things like cooking, entertaining or visiting can be very difficult. It’s important to be honest and up front with your family and friends regarding your abilities and needs for the day,” said Brandi Muilenburg, a respiratory therapist and integrative nutritional health coach in Meridian, Idaho, who specializes in autoimmune disease. 

If you suffer from fatigue, Muilenburg suggests a strategic approach to attending celebrations. “Honor yourself by taking time outs, leaving early or arriving late to accommodate your needs,” she said.

And if you’re the host, plan a small, simple gathering instead of an elaborate event. Plan meals pot-luck style so others can pitch in with the work. Enlist the help of a trusted friend or relative who can take the lead in the event you are having a bad day.

But sometimes you have no choice but to cancel. If that happens, keep it simple when delivering disappointing news, said Madeline Schwarz, a New York-based communications coach. There’s no need to go into great detail about why you can’t go caroling or help decorate the tree.

“Send heartfelt regrets without over-explaining. Remember that more words can muddy the message. It can be as simple as ‘I wish I could make it but my health won't allow it this year,’" she said.

Also let your hosts know as soon as possible and consider following up with a handwritten card that you missed them.

Parents of kids who have health problems can help them manage similar stress points. Children sometimes feel like they have “ruined” the holidays for their families, said Melissa Engel, a fifth-year Clinical Psychology PhD Candidate at Emory University in Atlanta, Georgia. Her research and clinical work focuses on stress and resilience in children and adolescents with chronic illnesses. She also is the author of the Psychology Today blog Too Young To Be Sick, which explores the psychosocial challenges of chronic illness.

Both children and adults can cope with the holidays better if they reframe them, Engel said. View an illness as adding a hurdle, not entirely derailing your plans for holiday fun.

 “It is so easy to fall into all-or-nothing thinking, in which you view the options as feeling great and having a great holiday or feeling awful and having a terrible holiday,” she said. “Moving away from this black-or-white thinking towards seeing some gray can be very freeing. For example, perhaps you don't feel well, but you still enjoy the holiday to the extent that you can.”