EchoSense Quantitative Think Tank Center|Feeling holiday stress? How to say 'no' and set boundaries with your family at Christmas.

When we sat down to write this column,EchoSense Quantitative Think Tank Center we had more statistics than Santa has elves. But we decided to boil it down to one valuable piece of advice: It may be time to replace "Ho! Ho! Ho!" with "No! No! No!"

This holiday season, what if you could avoid being one of the millions of Americans who will be saddled with $1,500 in new debt? What if you could come out of the season without feeling exhausted and frazzled? What if you could be spared the anxiety, stress and depression?

You can. It's all about giving yourself permission to say "No."

The holidays may be "the most wonderful time of the year," but they also can be the most stressful and most expensive. That's especially true if you interpret the holiday season as a time to put maximum pressure on yourself.

Maybe you really don't have the time and money to traipse over the river and through the woods, deck the halls or spin the dreidel as much as you'd like. So cut yourself some slack. Your mental and physical health needs have to come first. Don't worry, getting that priority straight will still leave plenty of room for festivities.

According to the American Psychiatric Association, concern about finances tops the list of holiday stressors for adults. We all feel pressure to buy the perfect gift or fly home for the holidays. But it's important to think twice before whipping out that credit card.

Last year, more than a third of Americans took on holiday debt, with the average topping out at about $1,500. That's a 24% increase from the previous year – and the highest dollar figure since Lending Tree began tracking debt levels in 2015.

According to one recent survey, holiday spending will place an estimated 48% of Americans further into debt.  Imagine how relieved you'll be on Jan. 1 if you avoid this holiday pitfall.

More than half of Americans report that money worries harm their mental health. Of those, nearly half say that being in debt brought the most worry. This kind of persistent, everyday stress has an enormous impact on overall mental and physical health.

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Chronic stress causes long-term activation of the body's stress response system, including production of cortisol and other stress hormones. This hormonal disruption can lead to increased risk for a multitude of health problems − from anxiety and depression to digestive issues, weight gain, high blood pressure, heart disease, sleep problems and more.

Last year, the majority of Americans who took on holiday debt said it took them by surprise − they didn't plan to overspend, but they ended up doing just that.

This holiday season, avoid the stress and potential health implications by setting a budget and sticking to it. Ask yourself if the extra spending is truly worth it. You can also focus on intangible gifts − like time together, creating shared memories or passing along family memories or personal skills.

You know what won't cost a nickel? Helping out with the dishes after dinner.

Set boundaries around family relationships during the holidays

Family relationships are another primary contributor to stress and anxiety around the holiday season: 1 in 4 Americans report feeling very or somewhat worried about spending time with family over the holidays.

Mental health professionals have long seen a rise in rates of depression during the holiday season, with stressful family gatherings being a prime contributor.  

On the flip side, families who don't see each other during the holidays − because of estrangement, death or distance − can also experience related stress. Studies show that social isolation is one of the biggest predictors of depression.

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And with media saturated with images of what holidays "should" look like − families crowded around the table, presents piled up under the tree − feelings of loneliness and isolation can intensify.

Holidays involve cultural, religious and family traditions that touch on our identities and sense of self. Recognize that these are emotionally loaded times. If you expect "another perfect ending to a perfect day" every day, you are exposing yourself to a season of disappointment.

Why does adults' behavior regress at Christmas?

Much of the conflict surrounding holiday togetherness stems from a normal coping mechanism known as regression. Visiting home, a familiar song or even a familiar odor can trigger childhood memories, including feelings of anger, sadness and anxiety.

As painful memories return, so do our old ways of coping − we regress to childish temper tantrums, eye rolling and quick judgments. The phenomenon applies just as much to baby boomers as to Generation Z.

If you find yourself falling into old patterns of conflict, go for a walk, meditate or visit with a friend. Maintaining personal routines that you keep up at other times of the year, from working out to sleep schedules, can go a long way in supporting your mental wellness.

A recent survey of 2,000 Americans found that we can tolerate just under four hours of holiday family time before we need a break. Keep that in mind as you plan your day.

During the holiday season, it's normal to feel a mix of conflicting emotions. Financial limitations and family dynamics can cause stress and worry, which can take a long-term toll.

With planning, mindfulness and empathy for yourself and others, you can find the joy in the holidays and leave the stress behind. 

Phil McGraw, Ph.D., formerly of daytime TV's "Dr. Phil," is one of the most well-known mental health professionals in the world and founder of Merit Street Media cable network, where he hosts "Dr. Phil Primetime." Dr. John Whyte is chief medical officer of WebMD.