According to the recently released annual poll from the American Psychiatric Association (APA), two concerns tied for first place of what we are most anxious about: Keeping our families safe and finances, which 66% of Americans reported they were somewhat or very anxious about. These topped health, politics, and relationships with friends and co-workers. “The poll results reinforce the fact that basic needs, such as personal safety or finances, have a large impact on a person’s mental well-being,” said APA president Altha Stewart, M.D., in a statement. “We urge anyone who is struggling with anxiety, regardless of the reason, to seek treatment.” There are many systemic, societal issues that lead to widespread financial anxiety. These cannot be ignored in the conversation. To start, student loan debt collectively reaches $1.5 trillion, which will likely explain that when you silo out Americans aged 18 to 34 in the APA poll, financial anxiety increases to 70%. And income inequality in the U.S. is as drastic as it’s been since the great depression, according to a paper on global wealth inequality. And wage stagnation is a very real thing and has been for decades. These might explain why the number of people reporting financial anxiety went from 56% in 2017 to 66% today. And for many of us, the anxiety is deeply personal too. How we approach money stems from how we were raised around money, what our current situation is, any relationship’s influence, and a plethora of other individualized hangups we might have. Whether you realize it or not, you probably have some sort of emotional tie to money that’s causing you anxiety. “Unfortunately, neither financial literacy nor emotional literacy are taught, so when these feelings come up, we don’t know how to deal with it,” says Bari Tessler, a financial therapist. “And after you’ve used money to provide your basic needs—food, clothing, shelter—money issues are no longer just about money. It is always about other deeper stuff.” None of this is aided by the fact that money is still very much taboo. In the not-so-distant past, money, politics, and religion were not polite conversation. And as the internet and social media ushered in the Age of Overshare, money is the sole thing we keep out of bounds. All you need to do is pull up Twitter to see endless posts and stories about politics, religion—and even sex. But money? You’d still be hard-pressed to find something, anything. “The thing is money is a normal part of life that we just like to pretend isn’t so we don’t have to talk about it very often,” says financial coach Lynne Somerman. And—unfortunately, but not surprisingly—this has significant outcomes on our health. We know that anxiety wreaks havoc on our bodies, affecting everything from cardiovascular health to gastrointestinal. And according to recent research from the APA, loneliness presents more of a public health hazard than obesity. Of course, loneliness doesn’t solely stem from financial isolation, but it can contribute to it, especially if you are struggling and don’t feel you have anyone you can reach out to. So starting a healthy, productive, goal-oriented conversation around money shouldn’t just be a fiscal priority; it should be a mental health one too.