Stress doesn’t trail far behind credit card bills, tight budgets, student loans, or retirement plans. Money is not the root of all evil, but it does manifest in most people as stress accompanied by a grocery list of health problems. The American Psychological Association (APA) published a study Wednesday outlining the dangers of stress and how young Americans are paying for it with health.

As it turns out, the most stressed out people in the United States fall between the ages of 18 and 35. When the APA surveyed 3,068 adults throughout the country, they found this group has an average stress level of 5.5 on a scale from 1 to 10. It’s the group with the highest unemployment rate — 15 percent of young adults — compared with the 5.6 percent national average.

"It's very hard to be a millennial in this generation," APA Vice President Dr. Norman Anderson said in a statement. "In the past, when you reached the age of 18 or 20, your prospects for gaining a foothold in the American economy and establishing yourself as an adult were much easier. Despite the good news that overall stress levels are down, it appears that the idea of living with stress higher than what we believe to be healthy and dealing with it in ineffective ways continues to be embedded in our culture.”

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Stress has Americans so worried, one in five said they have either considered skipping or have skipped going to the doctor because they were worried about money. The APA also found the high level of stress Americans deal with affect almost a third of conflicts in relationships, and another third said money is holding them back from a healthy lifestyle. It’s true quinoa costs more than white rice, but there are other financial barriers to consider, including time and energy.

Chronic stress interferes with a person’s ability to live a normal life on a physical, mental, and emotional level. High demands from job strains can cause a misinterpretation of stress. Humans' primal instincts tell us to run from the tiger or fight for the last crumb of food, and stress hormones give us the gas to get it done. Adrenaline rushes increase heart rate, elevate blood pressure, and boost energy supplies, but a lesser known hormone known as cortisol is the primary cause of chronic problems, according to the Mayo Clinic. It increases sugar flow into the bloodstream, slows down the immune, digestive, reproductive, and metabolic system’s normal regulation in order to turn up the fight-or-flight hormones.

When the body is under stress constantly under stress, the body can’t function properly with the imbalance of hormones and other systems. Chronic stress often causes anxiety, depression, digestive problems, heart disease, sleep problems, weight gain, and memory impairment.

The APA recommends health stress levels stay around 3.7 on the scale, but according to the survey 22 percent of respondents said they’re not doing anything to manage their stress. In order to lower levels, stress sufferers need to first identify what exactly is causing them stress, according to the APA. Is it money? Or could it be something else like their health, in which case they’re stuck in a vicious cycle of worrying about their health and as a result become unhealthier. Next, build strong relationships to have a network of support systems to help tackle problems, then learn to rest your mind, and get help if you’re overwhelmed.

Asking for help is hard, especially for young Americans who are stepping out into the world as adults for the first time. Stress worsened significantly for 43 percent of the participants who had no emotional support. Get help before the green paper tears you apart from inside out.

Source: Anderson NB, Belar CD, Breckler SJ, Nordal KC, Ballard DW, and Bufka LF. Stress In America: Paying With Our Health. American Psychological Association. 2015.