Extra stress and the holiday season sometimes go hand in hand. But as Iowans gather for festivities, you're being reminded to take seriously any warnings that your mental wellbeing may be under duress.

From added time with family to expanding your budget, the holidays bring on a host of demands that can boost your stress level.

Emily Berry, research and referral manager for the Iowa chapter of NAMI, the National Alliance on Mental Illness, said there are red flags that what you're experiencing might be more than the typical holiday stress "if you're feeling so anxious that maybe you're nauseated or getting a headache, you're really feeling down about things - so, you're being withdrawn from things you wouldn't normally be withdrawn from."

If you're breaking typical holiday patterns, such as your normal food and alcohol consumption at festivities or money spent on gifts, she said, these also could be signs your mental wellbeing needs greater focus. NAMI recommends calling the Iowa Concern line, Iowa Warm line or COVID recovery line and ask for a specialist to talk with. These resources may be especially helpful over the holidays, with appointments with therapists harder to come by.

Berry said stress often can build up during a holiday gathering. In those situations, she recommends finding someone in the room you feel you can talk things out with to reduce the tension.

"Go into another room, or step outside with someone you trust - a loved one, a parent, friend, partner - anyone like that you can just take that breath with them," she said, "and just talk about how you're feeling."

She noted that a number of Iowans still might be reeling from losing a loved one to COVID. When it comes to feelings of grief during the holidays, NAMI suggests trying to offset them with experiencing joy in the relatives that are present. Part of that can include recalling fond memories of holidays past.

Rates of suicide among young people have increased by about 36% in roughly the last two decades and the surge has caught the attention of federal policymakers.

The Biden administration has a new National Strategy for Suicide Prevention and a Federal Action Plan, highlighting the need for a coordinated approach to prevention and equity in treatment and research. It follows the Bipartisan Policy Center's launch of a youth mental health task force in January.

Val Demings, co-chair of the Youth Mental Health and Substance Use Task Force and a former member of Congress from Florida, said in Sioux Falls last week rural communities face unique mental health challenges.

"For example, having access to care, the affordability of care, removing the stigma," Demings outlined. "You may be in a substandard educational setting. You may also have substance abuse, addiction in the household. And so we have got to, as a nation, deal with the social ills that cause decay in certain communities in the first place."

A big focus of the task force is a link between suicide and increased use of technology and social media. The U.S. Surgeon General said young teens who spend more than three hours a day on social media are at double the risk of mental health struggles, including depression and anxiety.

Technology can also be used to help deliver health care services in rural places. In 2021, the Helmsley Charitable Trust launched a virtual crisis care program in South Dakota, equipping law enforcement with iPads, so they can connect people with mental health professionals by video.

Walter Panzirer, trustee of the trust, has seen positive results.

"We had a 75% reduction of transports to the mental health facilities," Panzirer pointed out. "They were able to get care at home, locally; 25% of the calls were for youth."

People living in rural places are almost twice as likely to twice as likely than those living in large cities, according to the Centers for Disease Control and Prevention. The agency said South Dakota had the fifth-highest suicide rate in the country in 2021 at over 200 deaths.

If you or someone you know is in crisis, contact the Suicide and Crisis Lifeline at 988.

New continuing education classes can help New York psychologists better work with disabled patients.

The courses center on understanding disabilities - providing universal access for patients with disabilities, ethics, and cultural competence.

Sharon McLennon-Wier, Ph.D. - executive director of the Center for Independence of the Disabled New York - said in developing the curriculum, there were certain takeaways people should have.

"The first step really is for people to understand that a disability is a disability, and there are going to be barriers to the environment with it," said McLennon-Wier. "And we need to work together to ensure that each and every person has access to treatment."

Other takeaways are ensuring clinicians are aware of their expectations, noting they're not trained to work with every single client.

It's taken two years to get these courses up and running, and McLennon-Wier said she is eager to see how these will shape up.

The first course begins on May 29 and anyone interested can register online at www.cidny.org/ce.

There's also a hope psychologists will learn about confronting their stigmas toward disabilities.

McLennon-Wier said she feels this begins by looking through the lens of ableism. She said people should consider how they implement universal access for disabled patients.

"Does your biases prevent you from utilizing the knowledge of treatment that you have?" said McLennon-Wier. "Does it work with what's needed by that person who has a disability because first is the treatment practice, but also you have to understand the implications of disabilities."

Other considerations should be given to issues like the segregation disability creates. She said she thinks certain determinants of health like race and gender also impact a person's mental health.

Future classes could deal with different psychological treatments with an infusion of multicultural disability competence.

The 2024 Arizona Alzheimer's Consortium Public Conference kicks off Saturday, where industry experts and researchers will share the latest scientific developments and ongoing advances to fight Alzheimer's disease and other forms of dementia.

David Coon, director of the Center for Innovation in Healthy and Resilient Aging at Arizona State University, will lead the conference.

Coon said experts continue to see growing numbers of people developing dementia in the Grand Canyon State, which also means increased demand for care from family and friends.

"The reality is we're still facing this," he said, "and we're facing it also with a growing number of people living alone with cognitive decline, and that is very important for us to recognize as well."

It's a growing public health crisis in Arizona, according to the Alzheimer's Association. An estimated 152,000 people 65 and older are living with Alzheimer's disease in the state.

Coon said increasing awareness about the disease is critical to not only diminish stigma but also plan for the future.

Saturday's event is free and will take place from 8 a.m. to 1 p.m. at the Memorial Union on ASU's Tempe campus. Coon said a panel of experts will share information about treatment options, but also the resources and support systems available across the state.

He added that it is critical for people not to wait until a crisis strikes, and that the sooner patients know their cognitive-health status, the better they can have a voice in their own preferences for care.

"How you get assistance, who's engaged, and I think that is really important for you to be, in part, in the driver's seat," he said, "and similarly, for somebody that's going to help you along that way to have those conservations."

Coon called Saturday's event a "family affair," and encouraged anyone impacted by dementia or Alzheimer's to bring family and friends to learn more. Topics will range from new drug treatments to reducing the risk of Alzheimer's with exercise, as well as resources for caregivers.