Debt is bad for mental health. Relief from Biden’s student loan forgiveness could take time.

A federal plan to cancel thousands of dollars in student loan debt will lighten the financial load for millions of Americans, but the mental and emotional effects of living in debt for years will be harder to erase.

The plan, announced Wednesday by President Joe Biden, would eliminate $10,000 of federal student debt for borrowers earning $125,000 a year or less, and erase $20,000 in debt for Pell Grant recipients, among other provisions. The White House estimates that the plan could provide relief to up to 43 million borrowers, with roughly 20 million seeing their full remaining balance erased.

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But debt could have a long-lasting toll on people’s physical and mental health that may take much longer to resolve. The effects vary, from stress and anxiety to anger, depression, and feelings of hopelessness.

“It makes people feel insecure,” said Courtney Boen, an assistant professor of sociology at the University of Pennsylvania. “It makes them worry about the future. … That is not good for health.”

Regardless of how wealthy people are, debt contributes to higher stress levels and worse health, said Boen, who has studied how debt affects health and well-being.

Assets, like owning a home or having a savings account, make people feel protected and stable, but “debt does the exact opposite.”

“The stress of debt is pretty ubiquitous,” she said.

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Boen’s research further found that debt could contribute to racial disparities in health, as Black and Hispanic Americans carry more of it.

The weight of debt can be “tremendous,” said Allen Miller, the cognitive behavioral therapy program director at the Beck Institute for Cognitive Behavior Therapy.

In addition to anxiety and stress — common reactions when money is tight — debt can also lead to anger, he said, especially if the borrowers feel that they have been cheated or that the bargain was misrepresented.

“Borrowing money to go to school is a really, really big investment,” Miller said. “You expect that there is going to be some value associated and some payoff for doing that.”

People often take on large amounts of student debt at a young age without much guidance about the long-term commitment, says DaVonti’ DeAngelo Haynes, an assistant professor of instruction in the Temple University School of Social Work.

“There is not much financial literacy that we’re giving these young folks as they take out these loans,” he said.

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Biden acknowledged in his remarks that some people took on debt with a goal — a chance at social mobility and a higher-paying job — that was no longer guaranteed. The burden of student loan debt, he said, is “so heavy that even if you graduated you may not have access to the middle-class life that a college degree once provided.”

In a CNBC-Momentive poll from January, 62% of respondents — all adults with federal student loans — said their debt hurt their mental health. Borrowers who earned less reported higher rates of poor mental well-being. Just over half said taking on the debt wasn’t worth it, citing having to delay life milestones (such as buying a house or saving for retirement) to make loan repayments.

Miller, of the Beck Institute, says debt can lead to being too anxious to plan ahead or too depressed to take certain actions that will improve a situation.

That’s where therapy and mental health counseling can help, he said.

“Does the fact that somebody goes for counseling change the fact that they’re in trouble for not paying their debts? No, it doesn’t change that. But it can put them in a position so that they can feel better and have a better quality of life,” Miller said.

Mental health counseling can be especially important for anyone who begins feeling a sense of hopelessness, Miller said. In those most extreme cases, when people feel trapped by debt without seeing a way out, some can resort to self-harm. “People may begin to think about suicide at that point,” he said. Mental health professionals can help people learn ways to cope with those negative thoughts.

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The news of debt relief is a cause for celebration for many borrowers — but some will still have large sums of debt. The average federal student loan debt in Pennsylvania is $36,103, according to Fortune. Black students are more likely to have student loans and to have borrowed larger amounts.

For some borrowers, especially borrowers of color who come from lower-income households, student debt looms over every decision, said Haynes of Temple. Some students skipped opportunities in college because they had to work and send money back home to support their families, he said. Others saw peers buy homes while they made repayments or might have been unable to complete their degree because the financial burden was too great.

Nearly a third of borrowers with debt do not have a degree, according to data released by the White House on Wednesday.

Biden’s student debt relief won’t reverse the experience of living with debt or the mental health effects overnight. But Haynes said that without debt, borrowers can focus on wellness, which will “ultimately lead to the improvement of their mental well-being.”