Hot cocoa by a crackling fire, the sounds of family and friends' laughter heard throughout the house, your favorite holiday movies on the television – this is the idyllic holiday scene. But what's the reality?

Statistics show us that the holiday season, portrayed as the most wonderful time of year, can also be a time when a few uninvited guests come knocking – stress, anxiety and depression.

If this sounds familiar, then you are one of the millions of people who experience holiday-triggered anxiety.

One in five adult Americans already struggle with mental health disorders daily, and during the holiday season 64 percent of people with mental illness report that their conditions worsen, according to the National Alliance on Mental Illness.

Even people in warm-weather states like Florida, California and Texas can experience seasonal mental health issues around the holidays.

Why do so many people experience holiday-related anxiety? For starters, the emphasis on family time and togetherness can act as a constant and painful reminder that our lives may not look like joyful holiday cards – putting family conflict, loss, breakups and divorce under a microscope.

The stress and anxiety of being confronted with family events, combined with travel, darker and colder days, unusually packed schedules, and lack of sleep can trigger behavioral health issues. Also, when busy and/or traveling, it's common for people to de-prioritize their physical and mental health.

"A combined 58 million American adults are living with either major depression (16M) or an anxiety disorder (42M), but in my experience, 100 percent of people will experience a stressor, or a loved one will need support, during the holiday season," says Dr. Monika Roots, vice president of health services at Teladoc, the world's largest and most trusted provider of virtual care delivery services. "One of the reasons I'm an advocate of telehealth for mental health is that it allows people to access care upon feeling triggered, not waiting weeks to get an appointment. After your aunt asks you why you're single at the dinner table, for example, you can talk to someone immediately, making it easier to proactively manage stressors before they become major issues."

How else can you help yourself or a loved one maintain positive mental health during the holidays? Roots has provided the top five ways to mitigate holiday-triggered anxiety.

1. Set boundaries. If you are overwhelmed by family, friends or work commitments, take quality time for yourself. A long walk or designated time unplugged from work or social interactions will help clear your mind.

2. Ask for help. If you need to talk to someone, don't hesitate to get care. If you are away from your therapist or psychologist/psychiatrist, telehealth services are available by phone, web or mobile app.

3. Stick to a routine. If you are traveling, try to wake up, eat and go to bed at the same time as you normally would at home. Keeping an organized, regular schedule will help mitigate stress and anxiety.

4. Exercise. Maintaining physical health is key to maintaining mental health. Anything counts, even a walk around the mall while shopping!

5. Get some sleep: Try to log 7-9 hours a night. This will help improve mental focus and overall mood.