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December 16, 2025
3 min read
Key takeaways:
- Symptoms of bipolar disorder don’t vary with geography, but cultural context has definitive effects.
- Support and understanding for care partners is key to assist those with bipolar at the holidays.
With the expectations of friends and family to squeeze a high degree of activity and socialization into a short period of time during the holidays, individuals with bipolar disorder may find it difficult to maintain their daily routines.
Healio spoke to Roger Rivera, DNP, PMHNP, a family nurse practitioner and psychiatric–mental health nurse practitioner based in central Florida, to find out how those dealing with bipolar disorder can successfully navigate the holiday season, when feasting and socialization may be overwhelming.
Healio: How many are affected by bipolar disorder in the U.S., and is there a noticeable uptick in the need for treatment for these individuals around the holidays?
Rivera: Bipolar disorder affects an estimated 4% to 5% of adults in the U.S., and while that number doesn’t change during the holidays, the clinical demand absolutely does.
This season disrupts the very routines that keep mood stability anchored, namely sleep, structure, nutritional rhythm, over worry and predictable social pacing. People stay up later, travel across time zones, drink more, take on too many obligations and lose the daily rhythm that protects mood regulation.
It’s not the season itself. Rather, it’s the collision of overstimulation, disrupted sleep and reduced structure that shakes a condition that depends heavily on routine for stability.
Healio: What similarities or differences do you see or have you read about in how bipolar affects those in the southern U.S. around the holidays, compared with other parts of the country?
Rivera: The symptoms of bipolar disorder don’t change regionally. Bipolar disorder has no single “face,” and people across all walks of life and every community can be affected.
What does shift is the cultural context, especially in the South and within the vibrant Latino communities I serve. From the Caribbean to Central and South America, holiday traditions often translate into larger gatherings, longer nights, richer foods and an unspoken expectation to “show up for everyone.”
That level of collectivism is beautiful, but it can push individuals to overextend emotionally, socially and physically all factors that can destabilize bipolar illness. Compared with regions where holidays are quieter or more structured, southern celebrations tend to be more social, spontaneous and food driven. When routines give way to late nights, heavy meals and strong social pressure, individuals with bipolar disorder can feel that strain more quickly. Sleep, boundaries and pacing become essential protective factors in these environments.
Healio: How can those with bipolar best manage their symptoms, medication and things like proper nutrition at a time when large gatherings are planned and plenty of food is available?
Rivera: During the holidays, I tell my patients: reinforce the fundamentals.
Bipolar stability lives and dies on routine, so medication timing must remain non-negotiable.
Set alarms, carry doses with you, keep a small travel kit and plan ahead (e.g. always take at least a few days extra worth of medication). Protecting sleep is equally critical. Even 1 or 2 nights of shortened rest can shift mood reactivity. With food everywhere, moderation matters. Aim to limit excess sugar, caffeine and alcohol, all of which can trigger mood swings or sleep disruption.
Build predictable anchors into the day, such as a consistent wake time, a wind down ritual at night, hydration and balanced meals. The holidays don’t need to be avoided. They just require a bit more intentional structure so joy doesn’t become overstimulation.
Healio: How do clinicians approach these intertwined issues at this time of year, given cultural issues that may factor into a patient’s illness?
Rivera: Clinicians have to weave together the clinical, the cultural and the real world demands our patients face. I spend time mapping out upcoming events with patients, such as travel, gatherings and family obligations, to understand where pressure points sit. The more we understand, the better we can guide them.
Many cultures emphasize collectivism, service, hospitality and attending multiple gatherings, which is meaningful but can stretch someone living with bipolar disorder thin. A clinician’s role is to help patients identify what’s realistic, set healthy boundaries and maintain the anchors that keep mood stable. We also work on “buffer days,” intentional pauses to reset sleep and medication routines. The goal isn’t to restrict culture. It is to help people honor it without sacrificing their stability.
Healio: What can spouses, friends, family members or care partners do for someone dealing with bipolar around the holidays?
Rivera: Support systems are powerful protectors against mood instability, especially during the holidays.
I encourage families and partners to approach bipolar disorder with education, empathy and steady communication. Understanding the illness reduces judgment and helps loved ones respond to symptoms rather than react to them.
Checking in by asking simple questions can be supportive without feeling intrusive.
Protecting boundaries is key. Avoid over pressuring the person to attend every event, stay out late or drink socially if it jeopardizes their stability. Sometimes I invite families into sessions to align everyone on various warning signs and supportive strategies. At the end of the day, what helps most is a calm, respectful environment where the person feels understood, not overwhelmed.
For more information:
Roger Rivera, DNP, PMHNP, can be reached on Instagram: @Mentesuavepsychiatry.
Sources/Disclosures
Source:
Healio Interviews
Disclosures:
Rivera reports no relevant financial disclosures.
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