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It can change your appetite and your sleep patterns, even prevent you from seeing a doctor. In fact, financial stress could be affecting your health in ways you never imagined.

Financial pressure affects us all at some point, whether we’re worried about our investment portfolio or how we’ll pay this month’s rent. Stress is a risk factor for numerous chronic diseases and can prevent you from adequately caring for your health, so minimizing it should be a top priority.
Americans stressed about money across income levels

Although we’ve come a long way since the peak of the financial crisis in 2008, a lot of us are still struggling with mental peace when it comes to money.

In its 2014 Employee Financial Wellness Survey, PricewaterhouseCoopers found that about 48 percent of all employed adults felt stress because of their financial situation, compared to 52 percent  in 2013 and 61 percent in 2012. And that poll didn’t include the nearly 9 million Americans who are unemployed.

Such stress holds true across income levels. A 2014 survey from Financial Finesse Inc. found that just 11 percent of men and 7 percent of women earning less than $60,000 felt completely free of financial stress. But higher earners felt similar pressure, with 68 percent of men and women earning more than $100,000 admitting to “some financial stress” and 11 percent of men and 14 percent of women at this level reporting high financial stress levels.

Health as a cause and effect of financial stress

Stress isn’t only a psychological reaction to external stimuli but a physical reaction, too. When people struggle with financial stress in particular, they’re more likely to report health problems. For instance, a recent Gallup survey found that as student loan debt rises, financial and physical well-being decline.

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When you’re under stress, your body experiences immediate short-term effects, such as the release of cortisol, memory and concentration suppression, increased heart rate and blood pressure, faster breathing and a reduction in metabolism. In the long-term, stress is known to increase the risk of heart disease, stroke, digestive problems and sexual dysfunction. It can lead to unhealthy weight loss or gain, skin problems, sleep issues, increased pain and the exacerbation of chronic diseases like diabetes.

These effects make it easy to see how the relationship between health and stress can be cyclical. Any one of these health conditions or symptoms can both stem from stress and lead to more stress, including the financial kind.

READ MORE: How Does Your Medical Debt Measure Up?

Stress behind majority of doctor’s visits

According to a paper in The Journal of the American Osteopathic Association, between 75 percent and 90 percent of all visits to primary care doctors are for stress-related medical issues.

“Of the patients that I would attribute their medical problems to stress, the overwhelming majority have money at the root,” says Dr. Arta Bakshandeh, senior medical officer with Alignment Healthcare in Los Angeles. “Most commonly, these patients complain of headaches, elevated blood pressure, ulcers, depression and moderate to severe anxiety.”

And these patients are the fortunate ones. Many people who lack insurance or can’t afford out-of-pocket health care costs delay or avoid going to the doctor altogether.

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Stress management is key

You might be able to cut spending or find a part-time job to help pay the bills, but with even high earners under significant financial stress, it isn’t clear whether these approaches will simply help your bottom line or truly benefit your health.

Bakshandeh recommends several stress management techniques to keep the effects of financial stress at bay. For those experiencing severe psychological distress, he often recommends a counselor to help patients deal with stress on an ongoing basis.

“I also recommend that patients exercise three to four times a week for at least 30 minutes,” he says. “Exercise releases brain chemicals called endorphins, which makes us feel good and lowers blood pressure and symptoms of depression.”

READ MORE: Does Your Insurance Cover Mental Health Treatment

Research indicates people avoid healthy behaviors when under significant financial stress. But it’s these very behaviors that could mitigate the effects of the pressure. Deep breathing, meditation and a healthy diet can all contribute to successful stress management.

Finally, Bakshandeh recommends patients do what they may find most difficult: laugh.

“Laughing lowers cortisol, your body’s stress hormone, and boosts endorphins, which help your mood,” Bakshandeh says. “Find something that makes you laugh hard and often.”

The weight of financial stress can be considerable, with long-term health effects. Lifting such a heavy burden requires not just sound money management, but also successful stress management.