Debt: Everybody’s got it, so how bad can it really be for you? It’s true, we are a nation in the red—student-loan debt has doubled since 2007, credit-card debt is on the rise, and more than a third of Americans haven’t paid their bills in so long they’ve got collection agencies after them. Even Hilary Clinton said she and Bill were “dead broke” when they left the White House in 2001.
But regardless of who you are—or why you owe money—science suggests that being in debt could be affecting your physical and mental health. Here are just some of the reasons to get back in the black.
|It can raise your blood pressure|
A 2013 study from Northwestern University found that adults ages 24 to 32 who had high debt-to-assets ratios (meaning that if they sold all of their belongings they still wouldn’t have enough to pay back what they owed) also tended to report poorer health in general. They also had significantly higher blood pressure, a risk factor for heart disease and stroke.
“We were a bit surprised to see these effects in people so young and otherwise healthy,” says study author Elizabeth Sweet, Ph.D., now an assistant professor of anthropology at the University of Massachusetts Boston, “but it just goes to show you how salient debt is as a health issue in today’s society.”
|It could lead to anxiety|
You probably didn’t need a study to tell you this, but Sweet’s research also found that those in greater debt reported perceived stress levels 11.7% higher than average. (And yes, she believes that the higher stress level is linked to higher blood pressure.)
“We’re seeing that debt really does have serious impacts on psychological health,” says Sweet. “It causes a feeling of being underwater and not being able to get out, and that can really drag on for a long time and do a lot of damage.”
|It’s been linked to depression|
It’s not just young people who feel the strain of debt, either. Older adults can fall victim to financial troubles and it can affect their mental health. In a 2014 Rutgers University study, adults age 51 and older were more likely to report depressive symptoms when they owed a high amount of unsecured debt (like credit card balances and medical bills) and didn’t feel in control of their financial circumstances.
|It may lower your immunity|
Though there haven’t been any large-scale studies done specifically on debt and immunity, Sweet says it isn’t hard to draw an association between the two. “We know that chronic stress can suppress the immune system and we know that debt is a huge source of chronic stress.” Money worries may keep you awake at night, she adds, which can also impair your body’s ability to fight off infection.
|It can impact your doctor visits|
People who have high levels of credit card or medical debt are less likely to visit a doctor or dentist for regular checkups or even when they’re sick, according to a 2013 study from the University of Michigan. (Home, car, or student loans, on the other hand, did not seem to have an effect on medical care.)
“These people can’t afford to accumulate more bills, especially if they don’t have good insurance,” says Sweet. “It’s another really important mechanism we need to consider—that debt doesn’t just affect your health but it can then keep you from getting the treatment you need, as well.”
|It can be a pain in the neck — literally|
Got chronic aches and pains? If an Associated Press/AOL Health poll is any indication, your credit card statements may have something to do with your physical symptoms. The 2008 survey found that 44% of people with high levels of “debt stress” had frequent migraines or other headaches, compared with just 15% of those with lower levels. They were also more likely to have muscle tension, back pain, ulcers or digestive tract problems, and suffer heart attacks.
|It could ruin your relationship|
Debt doesn’t have to drive a couple apart, but if it’s something you and your significant other argue about frequently, it’s not a good sign. In a 2012 study published in Family Relations, newlywed couples who disagreed about financial issues at least once a week were more likely to divorce within five years than were those who argued about other issues, such as chores, in-laws, time spent together, and sex.
Both failed marriages and just plain unhappy ones have been linked to their share of health problems including depression, high blood pressure and cholesterol, elevated blood sugar, and obesity—and they seem to hit women more than men. (The silver lining? For some couples, money problems actually seem to strengthen their bond, according to a 2011 survey.)
This article originally appeared on Health.com.