CEDAR RAPIDS, IOWA (December 12, 2025) — The holiday season is considered a joyous time of celebration and connection. Yet for some, it brings far more complex emotions. Nearly 57% of Americans say the holidays are stressful and 38% report feeling heightened anxiety, sadness, and even physical symptoms — and for those already managing behavioral health challenges, these feelings can intensify.
“For an individual struggling with depression, anxiety, substance use, or gambling, the pressures of the holiday season can feel overwhelming — even more so if they are also facing financial difficulties or housing insecurity,” said Jeremy Mask, District 7 Leader with the Behavioral Health Services team of the Iowa Primary Care Association (Iowa PCA).
Across the state, the Iowa PCA’s Behavioral Health Services team offers system navigation services, which connect Iowans who have behavioral health concerns to healthcare providers, community organizations, and educational resources. Between the implementation of the free statewide service in July and late November, the Iowa PCA’s team received 9,159 calls from Iowans seeking support for a wide range of behavioral health needs, including mental health concerns, addictive disorders and substance use. They expect those numbers to rise during the holidays.
“Every day, our team fields calls from family members and friends of struggling Iowans who want to know how they can help their loved ones,” said Kaitlyn King, District 7 Lead System Navigator with the Iowa PCA’s Behavioral Health Services team. District 7’s team of System Navigators in Eastern Iowa is one of seven behavioral health district teams in Iowa. Each team is staffed with behavioral health experts who live and serve in their respective area of the state.
“During the holiday season, we anticipate a rise in calls from family members and friends concerned about their loved ones. Our team empowers them by listening, answering their questions, researching options, and offering hope,” said King.
For people living with depression, anxiety, obsessive-compulsive disorder, schizophrenia, or addiction, the holidays may intensify everyday stress. Emotional factors — such as grief, family expectations, financial pressure, or loneliness — combined with environmental factors like colder weather and reduced sunlight can heighten existing symptoms.
During a season when many people have time off work, the holidays can become an extended period of isolation and loneliness. Those with OCD can experience increased compulsions — especially in social situations. Social pressure may also heighten symptoms like delusions of hallucinations for those with schizophrenia and for people with a mood disorder like depression or bipolar, the risk of relapse or a manic episode can increase.
Along with challenges to mental health, the holidays are difficult for those struggling with or in recovery from drug and alcohol addiction. Office parties, family gatherings and other social situations often include pressure to have a drink in celebration. Those focusing on sobriety may need additional support from friends or family.
If you know a loved one is struggling, consider reducing the amount of alcohol available at a function and giving grace to those who may need to stay home or leave early to avoid holiday relapse.
Combating any behavioral health challenge is daunting. Support from friends, family or the behavioral health system navigation experts at the Iowa PCA can be a game-changer. The team at Iowa PCA knows that an individual’s behavioral health needs are often complex. They answer questions of family members or friends to help them support a loved one, and they can research available services or reach out to providers for Iowans who are struggling this holiday season.
“Helping a loved one starts with showing up, listening, and offering compassion, and it can be as simple as reaching out for help. Our team can provide you with helpful language to use, like ‘I’ve noticed you seem overwhelmed lately, I care about you and want to check in,’” said Nicole Watters, Senior Lead Behavioral Health System Navigator, District 7.
Those experiencing heightened emotions during the holidays may feel embarrassed or defensive, or unsure of how to express what they are going through. Listening without judgment or interruption can help people speak openly about their experience.
Additionally, offering help with day-to-day tasks that may seem mundane takes away the smaller pressures.
Offer to assist with things like meal prepping, cleaning or transportation. In your effort to help, respect the boundaries of your loved one. Scaling back holiday traditions or time spent out of their home may be the way to make participation feel manageable.
In some cases, professional help may be beneficial. If they are open to it, gently encourage speaking with a doctor or therapist, or call Your Life Iowa — an entry point to the Iowa PCA’s behavioral health system navigation services – at 855-581-8111.
The holidays may be complicated, emotional, and strenuous, but with compassion and communication you can help your friends, family, and self-navigate the season a little easier.
If you or someone you know is struggling with depression, anxiety, substance use, or other behavioral health concerns, resources are available 24/7 at YourLifeIowa.org or by calling 855-581-8111 or texting 855-895-8398. Health-care providers and community-based organizations serving individuals with behavioral health needs can connect directly with the Iowa PCA’s system navigation services at 515-505-8988.
About Iowa Primary Care Association
The Iowa Primary Care Association (Iowa PCA) supports Iowa's community health centers (CHCs) and Iowa’s Behavioral Health Delivery System. With an ongoing commitment to expanding access to quality, affordable, and accessible primary and preventive health-care services, we work to support individuals and communities in reaching their full health potential.
