Stress is not just a state of mind. It can manifest itself in many physical ways as well. After all, it is stress that propels the body into the ‘fight or flight’ response. Stress can trigger migraine headaches and cause ulcers, increase heart rate, and elevate blood pressure. If the body is left in a heightened state of stress, the immune system can become weak leaving the person susceptible to infection and serious illness. In a 2007 online study conducted by the American Psychological Association, nearly 1,900 adults were surveyed regarding their stress levels and triggers. Results from the study show that nearly a third of U.S. participants reported that they have experienced extreme stress, and almost half state that their stress levels have only continued to get worse over the past five years. The study revealed that the reasons for stress are many. The top five reported sources of stress were work (74 percent), money (73 percent), workload (66 percent), children (64 percent), and family responsibilities (60 percent). Health issues, housing costs, and close relationships were not far behind. An overwhelming majority of adults surveyed reported that they had experienced both physical and mental manifestations of stress in the past month. Physical symptoms of stress included exhaustion, dizziness, headache, stomach pains, muscle aches, an increase or decrease in appetite, teeth grinding, and an increase or decrease in sex drive. Psychological issues also surfaced such as crankiness, anxiety, lethargy, anger, frustration, and sadness. The study showed that people prone to stress had problems sleeping, and many turned to food, nicotine, or alcohol for comfort. In fact, as many as 67 percent of those surveyed who smoke reported that stress caused them to smoke more. Could it be that stress is a common denominator when it comes to health problems associated with obesity, smoking, and alcoholism? Stress is known to cause many problems. Those under a continued state of high stress are more susceptible to heart problems. Hostile individuals appear to be at greatest risk. Also, because stress has been linked to hypertension, it is also raises the risk of stroke, heart failure, kidney failure, and heart attack. Stress can also make you physically ill and can increase the time required to bounce back from illness. Stress is responsible for causing problems ranging from muscle stiffness to acne. It may also hinder a woman from conceiving. In addition, reports show that repeated exposure to stress may contribute to the onset of diabetes, especially in those who were prone to or had a family history of the disease. Chronic stress is definitely not healthy. The American Psychological Association has some pointers when it comes to proper stress management. It says the key is to know how stress affects you and to pinpoint those situations that generate stress as well as the physical and mental manifestations that may go along with it. It recommends replacing poor habits with healthy means of stress management such as exercise, confiding in those you trust, meditation, rest, and proper diet. And finally, if you still feel overwhelmed by stress and aren’t sure how to cope, seek the help of a professional; you are not alone.