These are real symptoms—the fact that they may be caused by or exacerbated by stress does not mean that they’re all in your head. There are a wide range of physical symptoms that can be triggered by stress, but these are some of the most common ones you might experience:

1. You feel wiped all the time.

As part of the stress response, your brain produces the hormone cortisol and releases it into your bloodstream. If you’re  stressed on a regular basis , this can wear your body down and make you feel tired all the time because you’re often in a hopped-up state of cortisol.

2. You have bad cramps.

It’s easy to write off cramps as being related to your cycle in some way, but they can actually be due to stress.  Stress increases the production of cortisol and fellow stress hormone epinephrine in your system and, when released, these hormones can mess with your gastrointestinal system, causing cramps.

3. You’re having chest pains.

That “kicked in the chest” feeling you might get when you hear bad news is actually a neurotransmitter reaction. When you feel anxious or stressed, neurotransmitters are activated through your sympathetic nervous system, which can create a feeling of tightness in your chest, even though the heart is working just fine.

Chest pain is also linked to heartburn, which can be worsened by stress, according to the Mayo Clinic. Of course, if you’re experiencing chest pains, you should see a doctor ASAP since they could also be a sign of a heart attack.

4. You’re shedding more hair than normal.

Sure, it’s normal to lose some strands daily, but if you notice you’re suddenly losing a fair amount of hair, it could be due to stress. When cortisol levels in your body increase, your body is shifted into an inflammatory state which decreases nutrition to hair follicles and shuttles it to other areas of your body.  Your dermatologist should be able to recommend some options to treat your hair loss, including special shampoos and nutritional supplements.

5. You have rash-like spots on your skin.

Psoriasis is an autoimmune disease that causes red, scaly, itchy patches to form on a person’s skin, and it’s pretty common—about 7.5 million Americans have psoriasis, which develops when a person’s immune system sends faulty signals that tell skin cells to grow too quickly, according to the American Academy of Dermatology. Eczema, a condition that causes a red skin rash, is even more common—it impacts 31.6 million Americans, according to the National Eczema Association.

6. You’re going No. 3 a lot.

Some people tend to have bad diarrhea in response to stress, and it’s not a coincidence. Your intestinal tract is filled with the same neurotransmitters that are in the brain and they fire in response to what is happening with your mind. People who suffer from gastrointestinal conditions like irritable bowel syndrome also tend to have more symptoms when they’re stressed.

7. Your skin keeps breaking out.

This  goes back to the inflammatory state that stress creates in your body—this can also cause breakouts or make acne issues worse.

For more information on how stress effects your body, watch the video below: