If you’re wondering what conditions and symptoms stress can make worse, the answer is simple: all of them. Stress can be experienced in every part in the body. “Basically, our nervous system flows to every tissue in the body,” says Philip Barr, MD, an integrative medicine physician at Duke Integrative Medicine in Durham, North Carolina. “If the stress side of our nervous system is overactive, it literally affects every tissue in our body. Any kind of disorder that is already going on in that organ system can be made worse by stress.” That makes the list of illnesses that can be aggravated by stress as long as the entire list of diagnoses — thousands of pages of medical conditions, says Dr. Barr. The more common afflictions can be ever present, while others may be dependent on the time of year, says Barr. “For example, gastrointestinal conditions are equally diagnosed all year round. In the winter, we see more respiratory illnesses, because stress will impair your immune system.” Anything that a virus can affect, stress can make worse, including colds, sinus conditions, bronchitis, and even ear infections, he explains. Many people don’t realize that it’s very common for something like an ear infection to be related to stress, he says. RELATED: The United States of Stress: You’ll Never Think About Stress the Same Way Again

How Our Thoughts, Perceptions, and Body Are Connected

The fields of psychoneuroimmunology and psychoneuroendocrinology explore how the body’s response to stress affects our health. “Psycho” refers to how we perceive the events and the environment around us, Barr says. “You take that information and you funnel it into your brain where that information is processed; that’s the ‘neuro’ part. Is what you are perceiving friendly or threatening?” Once the information is processed, signals are funneled throughout our body and trigger a cascade of responses, including the release of various hormones from the endocrine glands. And while hormones released in response to acute stress keep us in balance, chronically high hormone levels, caused by chronic stress, throw us out of balance. Many of the most common conditions are associated with greater amounts of stress, including headaches, gastrointestinal symptoms, heart-related symptoms, skin breakouts, and psychological issues such as anxiety and depression. Here we explore how those symptoms can be related to stress, as well as when you should seek medical attention.

Headaches

According to Barr, stress is a common cause of tension headaches, especially when our neck muscles are tenser. “We all tend to hold stress differently according to our own makeup,” says Barr. “The people who hold stress in their shoulders and their neck can be more susceptible to headaches,” he says. When muscle tension comes up the back of the neck into the scalp, stress is almost always the culprit. Stress can also trigger migraine, particularly if the stress leads to changes in diet, sleep habits, or caffeine intake. Should you see a doctor when you have a headache? If you feel like you might lose consciousness or your thinking is impaired, then yes, you should seek help immediately. It’s also a good idea to see a doctor if your headaches are debilitating, frequent, or getting worse. Even if your head pain is caused or triggered by stress, your doctor may be able to help you control it so it doesn’t become an additional cause of stress in your life. There’s probably no reason to see a doctor for mild headaches that go away on their own, but exploring stress-reduction methods to decrease the frequency of your headaches may be time well spent.

Gastrointestinal Symptoms

Stress can cause symptoms in any part of the gastrointestinal system, from canker sores in the mouth, to stomach aches, indigestion, nausea, constipation, diarrhea, and more. According to Barr, “When we are triggered by stress and release adrenaline, the body shunts more blood flow to our muscles so that we can be ready to run or confront an aggressor, and when we shunt more blood to our muscles, our gut gets less blood flow,” which may contribute to symptoms. In addition, the brain and the gut are closely connected via the nervous system, so that thoughts and emotions can be felt in the gut, and stress-reduction techniques can sometimes reduce gastrointestinal symptoms. In people with a gut condition such as inflammatory bowel disease, irritable bowel syndrome, or gastroesophageal reflux disease, stress can worsen symptoms or cause a relapse. When to seek help? When symptoms such as abdominal cramping, pain, bleeding, diarrhea, constipation, and weight loss persist, it’s a good idea to see a doctor to diagnose what’s going on.

Stress can set off heart-related symptoms, but it can be difficult to know whether a racing heart is a panic attack, atrial fibrillation, or something else. According to Barr, when your heart rate is affected, it’s important to seek medical help to find out the cause. Barr notes that a fast-acting relaxing medication is often prescribed to people with panic attacks, but other forms of stress management could help, including forms of meditation. “Once people start doing mindful meditation, it can be both a treatment at the time of their stress, but it can also help manage stress in their life to avoid a future event,” says Barr. RELATED: Heart Palpitations: Is It Afib or a Panic Attack?

Skin Breakouts

“If you ask a seasoned dermatologist about what they see in their practice, they’ll tell you that more than half the dermatitis diagnoses they make are related to stress in the person’s life,” says Barr. “The skin is our largest organ. One of the things that happens when you are stressed and release adrenaline is you actually shunt blood away from the skin. If you’ve ever noticed when you shake hands with someone who’s really stressed, their hand can feel cold and clammy. It’s a function of the skin not getting enough blood flow,” he says. You need your blood flow to constantly send the cells through the tissue to help clear up and detoxify the skin, says Barr. “We’re constantly in touch with things in our environment that our body needs to clear,” he says, adding that this is just one way stress can make a skin condition worse. Changes in hormone levels and diet, which can be influenced by stress, can also affect the skin. Most stress-related skin conditions aren’t medical emergencies, but they can be uncomfortable and distressing to live with — and they may not go away on their own, even when your stress level declines. What’s more, skin breakouts are difficult to self-diagnose, so what you think may be a stress-related breakout may not be. If you have a rash, breakout, or any other kind of skin lesion that’s bothering you or isn’t clearing up on its own in a few days, see a doctor for advice on treating it.

Psychological Issues

Stress can be hard to separate from anxiety and depression. All these conditions can lead someone to feel overwhelmed and worn down. According to Mental Health America, it’s common to be unsure what kind of help you need, so it’s important to consult a mental health professional in those cases. There may actually be a physiological explanation for why stress can affect our moods. Chronic stress has been shown to make inflammation in the body worse. New research, such as a study published in January 2016 in Nature Reviews Immunology, suggests that increased inflammation may be associated with depression. Don’t feel you can’t seek professional help because you’re “only” dealing with stress. Stress can have detrimental effects on your mind and your body. Why live with it if you don’t have to?

Don’t Dismiss Stress as ‘All in Your Head’

There is no hard and fast rule for when to seek medical help for a stress-related symptom, according to Barr. Don’t assume that because a condition is stress-related that it is “all in your head” or not serious. “The fact is that stress can cause life-threatening conditions,” says Barr. “For example, cardiac rhythm disturbances can be caused by stress.” There are times when you need to seek medical attention right away, according to Barr. “This would include any kind of symptoms that feel life threatening,” says Barr.  If your breathing is impaired, your heart rate is affected, or if your level of consciousness is impaired — that is, if you’re not thinking clearly or it feels like you’re going to lose consciousness — those symptoms need immediate medical attention, he says. Once you get past the critical organs of brain, heart, and lungs, you’re at a place where you can take a less acute approach, says Barr. You can still schedule an appointment to see a doctor or go to an urgent care center to treat the symptoms, but you may want to also seek help from a mental healthcare professional, an integrative medicine specialist, or even a life coach to resolve the underlying cause of the stress and not just the symptoms that it may be exacerbating.