There is no doubt that stress is a part of everyday life, but too much can have detrimental impacts on people’s physical and mental health.

I wanted to delve more into depth about the health impacts of stress during National Stress Awareness Month. What does stress do to the body? When does it become a problem, and what are some ways to cope with it? And what can people do with stressors such as a hard job or caregiving responsibilities that can’t just go away?

To help us answer these questions, I had a conversation with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously served as Baltimore’s health commissioner.

CNN: What does stress do to a person’s body?

Dr. Leana Wen: When people experience a perceived threat, a variety of hormones are released that make the heart beat faster and increase blood pressure and blood sugar. These hormones also divert energy away from other parts of the body, such as the immune system and digestive system. These are evolutionary adaptations that once helped people to respond to situations such as predators chasing after them. Such “fight or flight” responses are normal and may be helpful in modern-day life. For instance, they could help an athlete with a faster performance or a student with staying up to study for an exam.

The problem arises when the body’s stress response is continuous. A perpetual state of “fight or flight” could lead to many chronic problems. Individuals could experience anxiety and depression, and other mental health ailments. They could also have headaches, muscle tension, abdominal pain, sleep disturbances, decreased immunity to infections, and problems with memory and concentration. Chronic stress has also been linked to increased likelihoods of high blood pressure, diabetes, heart attack and stroke.

CNN: Everyone experiences stress, so when does it become a problem?

Wen: It’s natural for people to experience stress to discrete stressful events (those that have a clear onset such as the birth of a child, starting of a new job, a divorce or the death of a loved one) that happen in their lives. The problem is when stress becomes a chronic state of being.

Warning signs to look out for include signs or symptoms of mental health concerns or physical manifestations of stress—for instance, if someone starts having new heart palpitations, abdominal pain or headaches. In addition, some people may attempt to cope with stress by using alcohol or drugs. A change in substance use could be a red flag to look for underlying stressors.

People should also ask themselves if stress is negatively affecting their function at home, at work and with their friends. Someone who finds themselves unusually irritable and is lashing out at loved ones and colleagues may also be doing so because of excessive stress.

CNN: Why should we be aware of excessive stress and try to reduce it as a health priority?

Wen: We can think of stress as something in our lives that is modifiable, just like high blood pressure or high blood sugar. The stressor itself may not be able to be changed, just as we cannot change our genetic predisposition to hypertension or diabetes. However, our reaction to it is within our control. And it’s our reaction to the stressor that determines our health outcomes. If stress has detrimental effects on our health, just as high blood pressure and diabetes do, then we can and should look for ways to reduce these effects.

CNN: What are some ways we can cope with stress?

Wen: First, it’s important to clarify that there are good and bad ways to cope with stress. Some people may turn to these not-so-good ways because it may help them feel better in the short-term, but there are real risks. I mentioned drinking alcohol and using drugs—obviously, these are not healthy coping strategies. Neither are binge-eating or smoking.

I think it’s really important to be self-aware. Be honest with yourself: When you have faced stressful situations in the past, have you turned to these unhealthy ways to cope? If so, be on the lookout and work to prevent these behaviors during stressful times.

Also, try to anticipate when there will be stressful situations. Is there a big deadline at work coming up? A family gathering that is likely to elicit negative emotions? A difficult conversation with a loved one? Knowing that a stressful event may occur can help you anticipate your reaction and plan accordingly.

I advise, too, that people make a list of stress relief techniques that have worked for them in the past. And try new techniques. Deep breathing exercises are something everyone can try and help both in the moment of the stressful encounter and after, for example, as is mindfulness meditation.

I’m also a big fan of exercise. There is excellent scientific evidence that exercise is very effective at managing stress. Exercise reduces stress hormones and increases endorphins, which are “feel-good” neurotransmitters that can relax the body and improve mood.

CNN: What is your advice for people who have stressors in their lives—such as a hard job or caregiving responsibilities—that can’t easily go away?

Wen: This is really hard, because of course it would be ideal to address the stressors themselves. But many people have stressful situations that they can’t change.

It helps to be up front about that and acknowledge that changing the situation is not in your control. What is in your control, though, is your reaction to the situation.

Here is where self-awareness and self-care are so important. Learn to recognize when you are feeling especially stressed. Perhaps you feel tension in your neck and back muscles, or you have abdominal cramps or jitters. These are the times to practice deep breathing, meditation and other exercises that help you in the short-term.

For both short- and long-term benefit, it’s essential to make time for self-care. By that, I mean activities that you enjoy and that can take your mind off the stressful life situations. These could include taking a walk with a good friend, working in the garden, playing with your pets, reading a good book or otherwise participating in activities you enjoy. Think of the time you are putting aside for yourself as a kind of therapy; stress can make you unhealthy, so this is your way of giving yourself “treatment” to offset that stress.

Along those lines, knowing that stress is one factor that can impact your well-being, work to maximize the other aspects that contribute to overall health. Try to get adequate, restful sleep. Aim to eat healthy, whole foods and reduce your consumption of ultra-processed products. Make sure other chronic medical conditions, such as high blood pressure, are being treated. And do not wait to seek help from your mental health or primary care provider if the stress you are experiencing is leading to continuing mental health or physical distress.