Imagine that a health epidemic affected the vast majority of U.S. women, with about 65% suffering from its symptoms daily and 40% of those experiencing them multiple times a day. Imagine that it could mess with your appetite and sleep, pockmark your relationships, add pounds around your middle, and make you prone to illness. Imagine that researchers believed it was a reason more and more young women were having early heart attacks.

Well, this epidemic is real. It’s called stress, and it’s present at sky-high rates. That’s according to a recent survey Prevention conducted with the nonprofit HealthyWomen and healthcare communications agency GCI Health as part of our #BeHealthiHer movement. Stress is the brain’s code-red response to perceived danger: It gets your blood pounding, lowers activation of systems it finds nonessential during an emergency (like digestion and the immune response), and floods the body with adrenaline and cortisol. “It’s basically a whole bunch of stimulants, so you can react quickly and fight or run away,” says Elizabeth Piccione, M.D., a specialist in women’s cardiology at the University of Pittsburgh Medical Center’s Heart and Vascular Institute. This hyper-focus is great in a crisis. But it wasn’t designed to work nonstop. In fact, that takes a real toll on your body, contributing to obesity, insomnia, heart disease, and more.

Making things worse, says Beth Battaglino, a registered nurse and CEO of HealthyWomen, is that many of us think that extra strain is just, you know, life. “We’ve normalized it,” she says. “These things don’t surprise us, because we’re all feeling it. We’re not thinking of stress as a health issue. But it is, and a serious one.”

Luckily, along with ringing the alarm bell, the new survey also offers a few clues as to what we can do to fend off stress’s worst effects.

The Irony of Women’s Stress
According to our survey, the distress call is coming from inside the house. Of nearly a dozen choices, “family” and “household clutter or projects” were consistently the top two stressors across most demographic groups. (Women who worked were one exception—they rued “job demands” slightly more.) This is a double whammy, because time at home and with family is when we’re supposed to be relaxing and recharging.

One particular victim of this dynamic: our evenings. Normally, evening would be a time when, among other circadian changes, your body would be dialing back your cortisol levels to get you to unwind before bed. But in modern life, that’s when women around the country are coming home, scrambling to put together dinner, looking around at a ragged living room, and thinking, I can’t deal. Human brains simply have to work harder to process jumble than order. And this tends to breed relationship discontent, because research says that (as you might have long suspected) men just don’t have the same physical reaction to clutter—which might help explain why 54% of us don’t feel our partners are as stressed as we are. A 2010 study from UCLA found that women who described their homes with words like “mess” and “chaotic” didn’t see their cortisol levels drop at the end of the day the way most men did—they started out stressed and stayed that way.

A 2010 study from UCLA found that women who described their homes with words like “mess” and “chaotic” didn’t see their cortisol levels drop at the end of the day the way most men did.

What you can do:
Work it out. “My female colleagues and I always tease that we wish we had a prescription pad that just said yoga,” says Dr. Piccione. “When your body gives you a lot of stress hormones, what it wants is for you to use those to move. So if you exercise, you will be giving your body what it wants. Yoga is particularly good because it includes meditation, focusing on the here and now rather than sitting at your desk just thinking about your problems.”

Clear the clutter—at least mentally. Let’s face it: An Insta-worthy home might just not be in the cards for your family. And that’s OK! What you need to do is get your mind off it. Chantal Hofstee, a psychologist and the author of Mindfulness On the Run, suggests that you practice seeing your clutter factually and in the moment, reserving judgment (e.g., ”We need to load the dishwasher”) so you can formulate an attack plan later with a clear head rather than instantly attacking your family. Joanna  Thornhill, author of My Bedroom Is an Office, narrows it even further, suggesting that if you have time to clear only one space, you make it your bedroom: “Of all the spaces in the house, it really needs to be your oasis,” she says. “You don’t want your eye casting around as you’re trying to get to sleep—or just waking up—so you think, I need to do that pile of laundry in the corner.”

Ask your family for help. These days, kids are doing less around the house than they used to: A 2014 survey of more than 1,000 adults found that though 82% of parents said they’d grown up doing chores, just 28% regularly assigned tasks to their own kids. This is madness, especially since research says chores are good for kids, making them feel more capable and proud of themselves. So delegate away! Just be sure to give your sons as much to do as your daughters: A Pew Research Center paper found that girls spent twice as much time on cleaning and cooking than boys did, and that’s a recipe for a new generation of cortisol overload.

Grab the clicker guiltlessly. Our survey respondents said that watching TV was one of the top ways they chose to deal with stress. And you know, that’s not a bad thing! “The traditional message was, ‘TV is a guilty pleasure; TV is always bad,’” says Robin L. Nabi, Ph.D., a professor of communications at UC Santa Barbara. “But it’s actually more complicated than that.” Recent research says the boob tube can work as a “mood management” tool, interrupting the cycle that keeps you, say, turning that argument with your partner over and over in your head. There are some caveats, though: Keep it moderate—bingeing four hours of Game of Thrones is not a great idea, as that will probably mess with your sleep. And since the whole point is to relax, beating yourself up about following The Bachelor not only is pointless but will actively get in your way.

Make that coffee date. During your most stressful times, you may find yourself telling friends you’re just too busy to get together, but actually you’re too stressed not to. Friends are a female superpower: A woman with a bestie, research says, can keep her mood elevated in situations that would send someone more solitary to divorce court. So pencil your BFF in.

Understanding Stress vs. Anxiety
You’re driving during morning rush hour when suddenly you feel your heart start to pound and your palms start to sweat. You’re hyperventilating, and you feel so nauseated or faint that you pull over. This isn’t stress—it’s a panic attack, a symptom of anxiety.

Unlike stress, which is based on an external stimulus (even if that’s just a lip-purse from your boss) and will dissipate once you, say, get a new job, anxiety is internal, a persistent feeling of dread in reaction to situations that actually aren’t threatening. And while stress can be managed in the short term via lifestyle changes like getting enough exercise and sleep, anxiety can easily become anxiety disorder, the most common mental health condition in the U.S., and should be treated.

In our survey, 34% of women said they’d been diagnosed with anxiety disorder—which is in line with other national estimates. But 53% copped to sometimes feeling this sort of persistent worry in everyday situations. That’s something you should get checked out, as stress can be a trigger for anxiety disorder. What you definitely shouldn’t do? Ignore it. “It’s amazing how many women say, ‘It’s just a panic attack,’” says Dr. Piccione. “A panic attack is not normal! It’s not an everyday thing.”

We Need to Talk More About Stress
“One thing experts agree on is that just talking to somebody about your stress is among the best stress reducers,” says Wendy Lund, CEO of healthcare communications agency GCI Health, one of our survey partners.

Most of the survey respondents seemed to instinctively understand that, reaching out to friends or, more often, family members to blow off steam. But a worrying percentage—about 15% of the older women, for example—said they never did. When these tight-lipped ladies were asked why they didn’t share their stress, most said they didn’t want to be a burden or didn’t think anyone would care.

The numbers were grimmer when it came to talking to the family doctor, who should absolutely hear if you’re feeling stressed out. Less than half of respondents who were stressed brought it up to their docs—and the younger they were, the less likely they were to have done so. Some mentioned not having a health care provider (or insurance), not wanting to use up their precious 10 to 15 minutes, and not feeling heard (She blew it off, one respondent wrote). But a shockingly large subset—nearly a quarter—said they didn’t know why they weren’t tackling it.

What you can do:
Rethink your hesitation. Let’s be clear: You deserve to take care of yourself, period. But if, as Lund puts it, “you’re always number seven on a to-do list of six,” then Wright, of the APA, has a trick for you: “Think, If a friend were telling me this, what would I tell that person? It probably wouldn’t be ‘Don’t burden me with this,’ right? You’d say, ‘I’m here to be your friend.’ ”

Share—but don’t ruminate. While talking about what’s eating you is definitely good, talking about it over and over again isn’t. Scientists say that can actually solidify thought patterns in your brain so you’ll be more likely to wallow in the future. So give yourself permission to dig deep, but then resist stewing further over the facts—let your friend help you let it go.

Learn the magic phrase.
“I don’t believe in a division between body and mind, but you have to speak doctors’ language,” says Dr. Piccione. “So make a list of your symptoms before you go in, and then say, ‘I need better strategies to deal with my stress. It is affecting me physically.’ The doctor may just need to hear that one word.” Wright agrees: “You have to know your ask,” she says. “Do you need an exercise plan? Nutrition? Strategies? The doctor may have a different answer, but that will focus him or her on action.”

Where We Go From Here
It’s important to remember that stress isn’t always the enemy. After all, the same wide-awake, hyperaware feeling that tortures you when you’re trying to count sheep is an absolute boon when you’re, say, powering through a presentation or whipping together Thanksgiving dinner for 30. “Your stress response evolved to help you,” says Dr. Piccione. “It’s how you deal with it that matters.”

The work of Stanford University psychologist Kelly McGonigal, Ph.D., puts a finer point on it: Accepting stress as something you can handle makes you less likely to try to flee from it in an unhealthy way like drinking or overeating and actually mitigates some of its damaging effects. She suggests trying to consciously think of stress as something good: If you can feel your heart beating, for example, think, My body is trying to give me energy for this meeting! Remember: As you deal with daily pressures and larger worries, you have more control than your stress might make you think. Some circumstances you can change; in other cases, you can change your reaction. Understand which choice to make each time you’re stressed, and you’ll clear a path for yourself to a calmer, healthier life.

This article originally appeared in the December 2019 issue of Prevention.