sad, depression, loneliness
When you're sad or stressed, do you have someone you can reach out to in confidence for help? A new survey suggests millions of Americans may be forced to bottle up their emotions and secrets when it comes to having someone to confide in.

The survey, commissioned by the counseling service BetterHelp, found that a quarter of the 2,000 adults questioned didn't have someone to privately turn to for their their private struggles or thoughts. Seven in ten participants admitted that when sharing their feelings with a co-worker, friend, or romantic partner, they tend hold back their true feelings. And a staggering 90% of participants say they downplay their emotions so they don't burden or worry a loved one.

The study segmented the participants by age. On the whole, participants between the ages of 18 and 30 are much more withdrawn than participants over 50 years old when discussing potentially anxiety-inducing topics like finances, job stress, parents and family, or other friends, with a partner.

Continuously holding back many emotions at once causes stress and anxiety to manifest in physical ways. The survey indicated that the top five physical symptoms of holding back emotions are difficulty sleeping, difficulty focusing, irritability, and poor eating habits.

Three in ten participants say they're more likely to cry when stressed, and there is a pattern to where and when these crying attacks occur. Slightly more than half (53%) admit they've cried in their car, 40% have broken down at a family event, and 34% cried at their job from the stress and lack of emotional release. Another 29% say they've shed tears just walking down the street, and 16% have done so at the grocery store.

"A lot of people think that therapy is all about wading through deep-rooted trauma. While it certainly can be, there is a lot of benefit to consulting with a counselor on a regular basis about daily stressors," says BetterHelp's founder and CEO Alon Matas in a statement. "It takes a lot of courage for people to reach out and get help. Often people find that traditional therapy can be prohibitively expensive, difficult to access, and hard to schedule."

An overwhelming majority of the participants - three in four - said they are hesitant about going to therapy because of the stigma surrounding seeking professional help for mental and emotional problems. As for what prevents individuals from trying therapy, 32% say they don't have the time, 26% don't feel their problems are serious enough, another 26% are just too embarrassed, and 23% don't want anyone to know about their problems.

About a quarter (24%) say they just don't know how to go about finding a therapist.

Half of the respondents also feel the costs are too high. The average fee for an hour-long session with a good therapist was about $189 without insurance.

Still, 54% of those surveyed say they do wish they'd tried therapy at some point in their lives. Of the experiences they regret not getting help for: the passing of a loved one (50%), feeling depressed (50%), financial struggles (42%), a breakup (35%) and a traumatic experience (35%).

"Regular counseling can be a gamechanger for a lot of people in improving and maintaining their mental health," says Matas. "Having someone in your corner who is there to help you with life's challenges can make a world of difference."

The survey was conducted on behalf of BetterHelp by market research firm OnePoll.