American are worried about paying the bills, reduced work hours and salary cuts and not being able to find a job. But their biggest worry right now is the mental strain of the pandemic, according to a survey by the Harris Poll on behalf of the University of Phoenix.

The survey, which included 1,055 adults, found more than 40% of Americans say their top concern is experiencing increased anxiety. One-third said they worry about not being able to pay their bills, 26% fear reduced salary/work hours and 22% are concerned about losing their job or not being able to get a new job.

Sixty-eight percent said they feel like everything is out of their control right now and 56% indicated that they are balancing more issues now than ever before during this pandemic.

Dean Aslinia, the counseling department chair at University of Phoenix, said people can make behavioral changes while they are experiencing anxiety during these times. “Instead of texting or emailing, make a phone call or use video chat to build a more meaningful connection. Build activity in your day by trying something new or setting a goal for yourself to start a new project,” he said.

He said it is OK to seek professional help if negative feelings persist. He noted many mental health practitioners are offering virtual counseling sessions, so there is someone to talk to without leaving the house.

While Americans reported feelings of being overwhelmed and anxious, 65% expressed feelings of gratitude and hope, indicating they are thankful for their health, family and friends. They are also looking toward the future when social distancing guidelines are lifted.

Even so, many are worried about the long- term mental health repercussions of being quarantined. And 84% say that if the social distancing continues longer than they expect, it will have an impact on their mental health.

Many people said they are engaging in activities to maintain connections and improve their mental health. The survey found that 60% check in with a loved one, 35% have increased exercising, 30% have limited news consumption and 29% have performed acts of kindness for others.

Notwithstanding the anxiety, more than a third of respondents are optimistic that the country will emerge from this pandemic stronger than ever and 30% are making plans for a post-pandemic future.