If you’ve ever been in debt, you know how stressful it can be.

In fact, a survey of over 2,000 people found 23 percent of respondents “were experiencing symptoms commonly associated with post-traumatic stress disorder (PTSD) related to their finances.” And, according to the same survey, one-third of millennials have experienced PTSD symptoms owing to financial stress.

The symptoms people felt in connection to financial stressors included denial, avoidance, hypervigilance and nightmares, which is where the connection to PTSD comes in.

Here’s more on the link between debt and stress, plus some tips on possible actions to take to break this damaging cycle.

More on the Psychological Effects of Debt

The American Psychological Association conducted another poll of nearly 3,100 adults — and found nearly 72 percent of Americans reported feeling stressed about money at least some of the time over the previous month. Nearly one-fourth of respondents classified their stress as “extreme.”

Stress is certainly unpleasant, but the effects can actually run deeper than just negative feelings. The same survey found about one-fifth of Americans have either considered skipping or have skipped seeking healthcare because of financial concerns.

Money-related stress has also been shown to impact relationships; nearly one-third of respondents with partners answered that money is a major source of conflict for them.

Now that we’ve established the potential for debt to fuel negative feelings and even take a toll on health and relationships, let’s get into some possible actions you can take to alleviate these ill effects over time.

Recognizing some of the early warning signs is very important.

Proactive Steps for Working Down Your Debts

There’s no easy answer when it comes to exactly what to do about money-related stress, although it is important to consider seeing a mental health professional if possible.

Credit Counseling: The first piece of advice most financial experts offer is to rework your budget. But this can be an overwhelming task to tackle on your own. Making a free appointment with a credit counselor at a reputable, not-for-profit agency is an excellent move; these professionals have the training to help you create a budget, understand your options and come up with a plan.

Meeting with a credit counselor, you may learn you’re eligible for a debt management program (DMP). If you do your research and decide to enroll in a DMP, you can expect to make a monthly payment to the agency instead of payments to your individual creditors. Meanwhile, your credit counselor will try to work out arrangements with your creditors in which you’re able to repay what you owe for less in interest and fees as long as you abide by the terms of your DMP — which usually specify three to five years for repayment, but may vary.

Debt Settlement: Another potential route for eliminating more serious debt is enrolling in a debt settlement program like the one offered by Freedom Debt Relief. This option is especially important to consider if you’re considering bankruptcy — a drastic action that can linger on your credit report for up to 10 years and may require you to liquidate some of your assets.

Debt settlement hinges on negotiating with creditors. Here’s the basic overview: After speaking with a certified consultant and doing your research, you’ll start making monthly payments into a special account. Once you’ve saved up a certain chunk of change, negotiators will reach out to your creditors and try to get them to accept a lesser settlement — think a percentage of the original balance. Creditors, who fear getting nothing, will often agree. The repayment funds will come out of your designated account. The process repeats until there’s been an attempt to settle all your various unsecured debts.

Debt Consolidation: A third option also worth exploring further is consolidation, or the act of bundling multiple debts into one payment. One common route is taking out a personal loan, paying off various high-interest balances with it, then focusing on repaying the loan at a fixed rate over the next few years. The potential benefit here is a reduction in interest — plus an all-around simpler process for repayment. After all, the more debts you’re juggling, the easier it is to miss a payment.

The link between debt and stress is incredibly real, but there are actions you can take to start chipping away at your debts and regaining control of your financial future.