It’s that time of year again when everything is beautiful and everyone is happy. It’s a time for pretty parties and get-togethers with family and friends. It’s a time to be thankful for what you have. Most noticeable is that the holidays are for children. Lots of children. They seem to be everywhere.

For those who are experiencing problems with infertility or pregnancy loss, it can be a confusing and difficult time of the year. For many, the fact that another year has passed without a pregnancy or another child can be very disheartening. Time and sensation seem altered, like walking around in a bad movie. Even the simple act of shopping for gifts for others can be a trial.

There are a great many expectations about the holidays as well. Many families have enjoyable traditions and rituals that can be traced back for generations. It’s a time for good cheer and good will. We exchange gifts with loved ones. ‘Tis the season, put a smile on your face! Boy, that’s a tall order for someone who is worrying about their fertility.

I get a lot of questions this time of year from my patients who are struggling with infertility or pregnancy loss about the rules of engagement with family and friends. So often I hear that their presence is expected and even required at family gatherings. Not only is physical presence mandatory but emotional presence is required as well. It is at holiday time that my patients come to me in tears, not wanting to ruin a good time for others but tired and resentful about having to pretend to be happy. “We have been pretending to be okay for years,” they tell me, “and we are not.”

Sometimes acting like things are okay does work. It offers the opportunity to be a part of a treasured group. Since infertility can be very isolating, it can be helpful sometimes just to show up and be loved. But often, others who know you well can tell the difference between sincerity and acting. That can cause friction in some circumstances. People who are grieving just don’t make very good partygoers.

I’d like to make a suggestion. Just try this on and see how it feels to you. Maybe the holidays are a good time to practice being an adult. Let me explain. We are required all day to act like adults, whether we feel like it or not. At our jobs or our other roles, we make decisions, even difficult ones, and take responsibility for them. We take risks and deal with the consequences of our actions. We ask for help when we need to and we admit when we are too tired or too distressed to go any further. Adults make their own decisions about that they would like to do, or not, as the case may be. They choose who they would like to spend time with and under what conditions.

So why when it comes to setting good boundaries at holiday time do we forget all of our well-honed adult skills? It’s as if we pack our adult selves away, in exchange for acknowledgment or approval. We go along to get along. We worry more about hurting others’ feelings than about our needs or our own distress. Where does our ability to say “no” go? “No” is one of the first words a toddler learns. It helps to differentiate that child as a person who has wants and needs. Why does “no” get replaced with “Yes (g-r-r-r-r-r)” at holiday time?

What if you are truly out of sorts and out of steam and cannot even consider attending one more social event? What feelings does this raise for you? Are you afraid that you will have to pay a price for your absence? Unfortunately, in some circumstances, there will, in fact, be friction, guilt or some other manipulation that can make a person feel badly. Is that enough to make you want to do something that you don’t want to do? Could you suffer through it without feeling even worse? Will your family or friends love you less because you need to do something different this year? Answer truthfully. It is more realistic that someone will be disappointed and miss you, if you or your partner do not attend. Might you feel bitter or isolated, missing out on even more of your life?

Alternatively, might you get the warmth and caring that you need so badly just by showing up? Would it feel good to be with loved ones, enjoying relationships that sustain you in good times and in bad? Maybe it would be nice to put your worries aside, even if it’s only for a few moments. It might be the right idea for you to be with others, sharing hope and dreams and healing some of the hurts inflicted by infertility.

What I am suggesting is that you have choices about how you would like to engage in the holiday season. As with most things in life, it is important that you speak from your heart on these matters. It is very important that you talk openly and honestly with your partner about what you can and cannot do. Be prepared that you may each feel differently. That is a very normal experience in the fertility treatment world. You do not have to agree with one another but you must support your partner’s wishes. It is what we count on in close relationships, that someone will have our back. Maybe your spouse needs to explain to his family that you are just not up for things this year. Maybe both of you need to make a pact with one another that a quiet time away developing your own ritual is in order. The point is that you can decide what you need and when you need it.

Because this is what adults do. We do our best to do what is right. We try to live fair and just lives. It’s okay to put yourself first sometimes. Take a breather. Let this season be a time of growth and peace for you. You deserve it.