The Debt-Stress Connection

Gas and food prices are sky-high, the stock market is down, and the housing market is in the doldrums. But can worrying about the health of your bank account really make you sick?

From the WebMD Archives

Graphic designer Joshua Lurie-Terrell of Sacramento, Calif., described himself as an easy-going person. That is, he did until the market started tanking and he and his wife lost half of their retirement savings.

"I never let stress run my life before. But ever since money got tight, I've found that I'm a prisoner to it," he says. He worries that if he fills up the gas tank, he won't be able to afford the movies on the weekend, or if he keeps paying for health insurance, he won't be able to get his wife the birthday present she wants. With a baby on the way, he has seriously considered taking a second job on the night shift.

But then this past spring, the 37-year-old suffered a heart attack, even though he had no warning signs or risks. His doctors point to stress as a major contributing factor.

"I feel like I'm a completely different person than I was," he tells WebMD. "I would attribute more than 90% to worrying about my finances. I've tried to do everything that Suze Orman says to do, but we still have problems."

Lurie-Terrell is certainly not alone. Money is a leading source of stress for Americans, according to a 2007 survey by the American Psychological Association. In the survey, 73% of the respondents cited money as a significant source of stress in their lives. Today, more than three out of every four American families are in debt, according to the Federal Reserve's Survey of Consumer Finances.

An AP-AOL study reveals that debt-related stress is 14% higher in 2008 than in 2004. Those who report high levels of debt stress suffer from a range of stress-related illnesses including ulcers, migraines, back pain, anxiety, depression, and heart attacks.

With fuel and food prices on the rise and the economic crunch targeting more Americans, this is a critical time to examine these serious health concerns and stress management.

The debt-stress connection: Fighting the saber-tooth tiger

There's a general reaction to stress that's been a part of our genetic makeup from the time we were cavemen, says Jay Winner, MD. Winner is author of Take the Stress Out of Your Life. Back then, when a saber-tooth tiger appeared, your heart would race, your pupils would dilate, and your body would release stress hormones like adrenaline and cortisol. That way, you'd be able to fight the saber-tooth tiger -- or run.


Our "fight-or-flight" system evolved as a way to physically deal with a physical danger.The problem is now that same response gets activated by everyday encounters. For example, getting stuck in a traffic jam or arguing with your spouse can bring it on.

"One of the bigger things that activates it is when people see trouble in their finances," Winner tells WebMD. "If people don't know how to deal with this higher adrenaline level, then the levels of stress can build and build. This can cause real physical and physiologic changes in the body that can account for people feeling poorly."

The stress may be correlated with physical symptoms like heartburn, headaches, and abdominal pains. "If you have a knot in your stomach all the time, or if you're feeling anxious and worried a lot of the time, that would be an area of concern," he says. "These are signs that stress is starting to take a toll and you should give it more attention than the average person."

Former financial reporter and author of Zero Debt: The Ultimate Guide to Financial Freedom Lynette Khalfani-Cox knows firsthand the havoc debt can wreak on your life. "I was living above my means," she says. "It's a tremendous burden. The true cost of debt and financial problems isn't just the interest rate you're paying to Mastercard or Visa. The true cost is the toll that it's taking on your life and your relationships."

By making a series of important changes, Khalfani-Cox was able to pay off $100,000 in credit-card debt in three years and now coaches others struggling with the same issues.

Is debt making you tired?

"I am a big ball of stress," admits Chris, a 30-something blogger who writes about dealing with $75,000 in credit card debt and a possible foreclosure at "Our mountain of debt is constantly on my mind," he says, "but I don't feel as stressed about it since I started blogging." Before, he would often stay up until 3 a.m. worrying about how he would take care of his wife and two young kids.


The stressors do invade the bedroom. Frustrated designer Lurie-Terrell lies staring at the ceiling for hours or wakes up in the middle of the night worrying about his savings. "It's a vicious cycle," he says. "If you're aware that you're stressed out, that makes you even more stressed out because you don't have any control over it."

There's so much information on how bad the economy is that it heightens people's anxiety, says WebMD sleep expert Michael Breus, PhD. And that anxiety prevents people from being able to fall asleep.

"You may be working really hard throughout the day and by the time you get into bed, it's the first chance you've had to think about the day," he says. "And your brain starts going and going. People basically amp themselves up because they're so worried about paying the mortgage and bills. While they may be physically tired and sleep deprived, the constant worry actually prevents them from being able to sleep."

Once you start worrying about something that is emotionally charged, it causes autonomic arousal, which can affect everything from muscle tension to anxiety. Studies have shown that it takes longer to heal when you're sleep deprived, Breus says. Your reaction time, thinking, and creativity are slowed, so everything can be affected by sleep deprivation.

"We're going to see a slight increase until we see better economic news coming down the pipe," Breus says. "People who were worriers before are certainly going to continue to worry. And then we'll have a new group who are going to have situational-related insomnia. We saw the same thing happen after 9/11 where lots of people were having nightmares about terrorist attacks. Obviously, that's a far graver situation than something like finances."

Calming your money worries: Take action and seize control of your future

Debt or money is such a pervasive and difficult kind of stress because it's so interconnected with other areas of our lives, says Kelly McGonigal, PhD. McGonigal is a psychologist and researcher at Stanford University. "Basically, it invades your home, your work, what you're able to provide for your family, and your fantasies for the future. There are studies that show it's not how much money you owe that predicts depression and health problems. It's how much you worry about it."


Seek social support, advises McGonigal, because you're not the only person going through this. Talk to people you care about to take away the sense of stigma and shame. "When people are in debt or worried about losing their home or job, often they will try to hide it for a long time," McGonigal says. "A huge thing with money is the stigma. In this culture, that's a huge part of identity -- what we own, where we live, what we do."

There's a huge difference between active coping and comfort coping, says McGonigal. "Don't fall into the trap of feeling better immediately instead of doing something that's a little bit uncomfortable now. Sit down, get the information, and make a plan. And be an active coper. That way, you'll feel you're in control of the situation -- and a sense of control shuts down the whole stress process."

Here's advice from the experts on how to actively cope with your situation:

  • Put things into perspective by asking yourself: What's the worst that would happen? Yes, you may have to move or shelve your credit cards for the time being. "You may have to make a significant lifestyle change," says Winner. "But it's not life-threatening. Sometimes we act like there is a saber-tooth tiger with his jaws right around our heads."
  • Keep a worry journal. Take a piece of paper and draw a line down the middle, recommends Breus. On the left side, write down all the things you're worried about. On the right side, write down one solution. The solution could be, think about this tomorrow at 11 o'clock or make a phone call tomorrow that could lead to a new opportunity. Do it for 10 minutes and when you fold the paper in half, close it in your mind.
  • Take the necessary steps for smart financial planning. Opt out of new credit cards by calling 888-5OPTOUT. Organize your financial records, pull your annual credit report, and make a plan with an advisor or your partner to transform your financial life. "The number one benefit to having zero debt is your financial piece of mind," says Khalfani-Cox. "It diminishes the stress, worry, and anxiety. You will have the freedom to do other things in your life."
WebMD Feature Reviewed by Matthew Hoffman, MD on August 12, 2008



Joshua Lurie-Terrell, graphic designer, Sacramento, California.

Stress in America Report, American Psychological Association, Oct. 24, 2007.

Federal Reserve's 2004 Survey of Consumer Finances.

AP-AOL Health Poll, April 4, 2008.

Jay Winner, MD, Santa Barbara, California; author Take the Stress Out of Your Life.

Lynette Khalfani-Cox, author, Zero Debt: The Ultimate Guide to Financial Freedom.

Chris, blogger,

Michael Breus, PhD, WebMD's sleep expert.

Kelly McGonigal, PhD, psychologist, Stanford University.

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