ASAP is Cincinnati’s premiere outpatient treatment center for teenagers and their families struggling with substance use.
White holiday lights look festive. How is your mental health?

Holiday Mental Health and Stress: Warning Signs and Solutions 

The holiday season brings unique mental health challenges for teens and young adults. While families celebrate, many teens experience increased anxiety, depression, and substance use risks during this high-pressure period.

At ASAP Cincinnati, we’ve treated many families navigating holiday-related mental health crises. Understanding how holiday stress affects teen and young adult mental health—and recognizing warning signs early—can protect your family and prevent escalation.

What Are the Triggers for Holiday Mental Health Struggles?

Academic Pressure Between Thanksgiving and Winter Break

The weeks before winter break intensify academic stress. Final exams, project deadlines, and semester grades create overwhelming pressure for teens and young adults who may be already managing anxiety or depression. Students with ADHD, learning differences, or emotional regulation challenges face particularly high risk during this period.

Family Conflict and Holiday Expectations

Holiday gatherings often expose underlying family tensions. Young people may bristle against expectations to show up at multiple events or behave in a particular way. Teens may navigate divorced parents’ competing desires, feel judged by extended family, or experience anxiety about family conflict. Young adults returning from college may struggle with independence issues or feel suffocated by childhood dynamics.

Social Media and Isolation During Holidays

Social media amplifies holiday-related depression and anxiety. Those who use social media regularly often fall into a trap of comparing their reality to curated online portrayals, triggering feelings of inadequacy and isolation. Anyone struggling with mental health may end up withdrawing further during a season emphasizing togetherness—deepening loneliness and depression.

Disrupted Routines Impact Mental Health Recovery

Structure protects mental health and substance use recovery. Holiday breaks disrupt sleep schedules, therapy appointments, support group attendance, and healthy coping mechanisms. Even fun events, like vacations, outings, and gatherings pose potential risks. Routine disruption creates significant vulnerability.

Holiday Stress and Substance Use: The Connection

Holiday stress directly increases adolescent and young adult substance use risk through multiple pathways:

Increased Access to Alcohol and Drugs

Holiday parties and family gatherings provide more opportunities for underage teens and young adults to access substances. Parents distracted by hosting or travel may provide less supervision, creating windows for experimentation or use. Some family members may be less aware of the risks and could even offer substances to those underage.

Emotional Coping Through Substances

Some people turn to alcohol, marijuana, or other drugs to manage uncomfortable holiday emotions—anxiety about family dynamics, sadness about losses, or pressure to appear happy while struggling internally. This is true for teens and young adults as well as the family members they may model their behavior after.

Normalized Alcohol Use at Gatherings

Holiday celebrations often normalize drinking. Young people observe adult alcohol use and may face peer pressure or perceive substance use as expected celebration behavior. Even when teens and young adults are not drinking at these events, the normalization of substance use can set future expectations.

Relapse Risk for People in Recovery

The holiday season presents critical relapse vulnerability for anyone in substance use treatment. Disrupted routines, emotional triggers, and increased access create dangerous conditions for those working toward recovery.

Mental Health Conditions Worsened by Holiday Stress

Depression During the Holidays

The pressure to feel joyful paradoxically worsens depression symptoms. Anyone with major depressive disorder may experience increased hopelessness, withdrawal, and suicidal ideation during the holiday season.

Anxiety and Holiday Triggers

People with generalized anxiety disorder, social anxiety, or panic disorder often experience heightened symptoms around holiday obligations, family expectations, and social gatherings.

Emotional Dysregulation

Adolescents and young adults are still developing emotional regulation skills. Science shows that these skills and other executive functioning skills are more fully developed as young people reach about age 26. Even for older adults, holiday stress can trigger intense emotional responses. Be on the look out for self-harm urges or behavioral outbursts that can disrupt family functioning.

Grief and Loss Amplified by Holidays

Holidays intensify grief for those experiencing loss through death, divorce, friendship changes, or life transitions. The season’s emphasis on family togetherness makes absence more painful.

Warning Signs To Engage In Mental Health Support

Early intervention significantly improves outcomes. Contact a mental health professional if someone you love shows these signs:

  • Social withdrawal: Isolating in their room, avoiding family activities – especially those they typically enjoy
  • Sleep and appetite changes: Sleeping excessively or experiencing insomnia, significant appetite changes
  • Increased irritability: Anger outbursts, emotional volatility, low frustration tolerance
  • Loss of interest: Abandoning previously enjoyed activities and hobbies
  • Secretive behavior: Unexplained absences, hiding phone activity, lying about whereabouts
  • Physical warning signs: Bloodshot eyes, appearance changes, unusual smells, unexplained injuries
  • Verbal red flags: Expressing hopelessness, talking about death, saying “I don’t want to be here”
  • Substance use indicators: Alcohol or drug use (more than incidental use for those under 21 is not typical), concerning comments about substances

Evidence-Based Strategies to Protect Mental Health During Holidays

Maintain Consistent Structure and Routine

Keep regular sleep schedules, meal times, and daily routines throughout holiday break. Prioritize commitments to therapy, treatment, and support groups. Consistency protects mental health and recovery. Create a plan with strategies and alternatives if you are not able to attend.

Create Safe Space for Honest Conversations

Let people know it’s OK not to feel festive. Create judgment-free opportunities for one-on-one connection. Ask open-ended questions like “How are you really feeling about the holidays?” and listen without immediately problem-solving. If you want to provide some suggestions, it’s a good idea to ask something like, “Would you like to brainstorm some solutions?”

Set Realistic Family Expectations

You don’t need to attend every gathering or create picture-perfect holidays. Prioritize your family’s mental health over external expectations. It’s all right to decline invitations or leave events early if someone is struggling. It can be enough to build a holiday season that is meaningful to your family.

Develop Trigger Management Plans

Identify potentially difficult situations—visiting relatives who drink heavily, attending events where your teen/young adult feels judged—and create plans together. Establish exit strategies, check-in signals, and coping mechanisms before challenging situations arise. Some families have a text signal or secret word to indicate that someone needs to leave quickly.

Continue Mental Health and Substance Use Treatment and Supports

Don’t pause mental health treatment or substance use recovery support during holidays. Attend scheduled therapy sessions, encourage support group participation, and maintain contact with your teen’s treatment team. These connections become more critical during high-stress periods. If you or your recovery team are away for part of the time, have a plan for emergency or crisis situations. Contacting 988 either by text or phone call can help when you can’t reach your regular provider. Some people in recovery create a habit of visiting a mutual support meeting in every place they vacation.

Model Healthy Stress Management

Demonstrate healthy coping strategies for your teen. Discuss your own feelings, practice visible self-care, and avoid using alcohol or other substances as your primary stress management tool. Teens and young adults learn emotional regulation by observing parents and other adult family members.

When to Seek Professional Mental Health Treatment

Don’t wait until January if your teen shows concerning signs. Seek immediate professional help for:

  • Significant behavior, mood, or functioning changes
  • Evidence of substance use or escalating use patterns
  • Self-harm behaviors or suicidal thoughts/statements
  • Inability to function in daily activities
  • Severe emotional dysregulation or behavioral outbursts
  • Expressing a need for help or an inability to cope

For crisis situations, call 988 (Suicide and Crisis Lifeline) or 911.

Mental Health and Substance Use Treatment Options

ASAP Cincinnati provides evidence-based outpatient treatment for adolescents and young adults struggling with mental health and substance use concerns:

Comprehensive Assessments

Two-hour assessments using evidence-based tools (SASSI-A2, GAD-7, PHQ-9) to determine appropriate treatment level and create individualized plans.

Intensive Outpatient Programs

IOPs typically meet 9 hours a week. Our programs are covered by most private insurance companies.

TRIP – IOP for teen substance use (ages 12-19), featuring family integration and evidence-based practices including dialectical behavior therapy (DBT) strategies and relapse prevention. Treatment includes individual pull-out sessions, drug screening and support group facilitation.

Clarity Intensive – DBT-based IOP for teens (12-19) with emotional dysregulation, anxiety, depression, and behavioral disorders. Includes family support, individual sessions, and phone coaching for skills activation.

PIVOT – Young adult substance use treatment (ages 18-28) with evening and weekend group sessions to accommodate work and school schedules and flexibly scheduled individual sessions. Family or other close support system groups help wrap young adults with support outside of group times.

Take Action This Holiday Season to Protect Mental Health

Struggles don’t pause for holidays. At ASAP Cincinnati, we schedule initial assessments quickly and work with most major insurance providers including Anthem and United Healthcare.

Early intervention produces measurable results. Our family-focused, evidence-based treatment helps 88% of clients achieve significant symptom reduction, and 95% of families report improved family life after treatment.

If your teen or young adult struggles this holiday season, contact ASAP Cincinnati at 513-792-1272. Our team provides hope and healing when families need it most.

Transforming tomorrow, starting today.

About ASAP Cincinnati: CARF-accredited outpatient treatment center specializing in mental health and substance use services for teens and young adults ages 12-28. With more than 15 years of experience serving Cincinnati families, we provide evidence-based, family-focused treatment producing measurable outcomes. Visit asapcincinnati.com or call 513-792-1272.