Secrets are a fact of life. Everyone has them. But some secrets can carry a hidden price that affects both your psychological and physical health.

The power that a secret can hold over you is highly individual. To learn more, High Energy for Life spoke with Gail Saltz, MD, a psychiatrist in private practice and clinical associate professor of psychiatry at Weill-Cornell School of Medicine, both in New York City, and author of Anatomy of a Secret Life (Morgan Road).

Why do people keep secrets? Beginning at about age four or five, we all want to have some information about ourselves that our parents don’t know. This is an important step in becoming an independent human being, because it helps create a boundary between the child and the world.

In adulthood, secrets continue to serve this function. Keeping some thoughts and actions private helps you maintain the feeling that you’re a unique individual. Adults also may keep secrets to avoid potentially critical judgments by others and/or negative consequences. The potential danger occurs, however, when we feel that some secrets cannot be revealed to anyone. That can lead to a “secret life.”

What is a secret life? When the number or importance of secrets you keep starts to significantly affect your relationship with those around you, the balance of power shifts. You no longer control the secret. It controls you.

You may feel that it would be forbidden to admit to having lustful thoughts about a neighbor even though you may not be acting on them. Someone else may not feel as threatened by making such a disclosure. Or you may have told everyone that you gave up smoking 10 years ago but don’t admit to anyone that you still have a cigarette once in a while. Another person may go ahead and admit to the occasional smoke. A secret life develops when the shame and guilt and the fear of consequences (real or imagined) create in you a desperate need to keep such things from becoming known.

Let’s say you never went to college but lied about it on your résumé. You would probably lose your job if this were disclosed to your employer — and your friends and loved ones might very well think less of you for fabricating such information. Or you are cheating on your taxes. You could get into trouble with the IRS, and the people who are important to you might think less of you.

Your life then begins to revolve around various maneuvers to maintain the facade — or, at best, the secret may remain in the back of your mind, requiring constant vigilance.

Can secrets really be bad for your health? Yes. Even if a secret isn’t carried to the extreme of creating a secret life, keeping secrets provokes inner conflict. Should you conceal or reveal — and if you do reveal your secret, to whom? This conflict inevitably leads to anxiety and endless worry.

Living in this state can produce sustained stress that may contribute to various health issues, including digestive problems, headaches, back pain and high blood pressure. If you’re prone to depression, chronic stress makes you all the more vulnerable.

Do some secrets affect our health more than others? Certain things we try to hide from others are literally unhealthy. For example, there’s shame associated with drug and alcohol abuse, eating disorders and smoking — all of which pose health risks in their own right, including heart disease and cancer. This type of secrecy also produces anxiety that fans the flames of the unhealthy behavior.

How do secrets affect a person’s relationships? Keeping secrets cuts you off from others. You’re not the person your friends and loved ones think you are, and you know it. And when some secrets get out — infidelity, in particular — it often means the end of a marriage and all the stress and isolation that entails.

Since the health benefits of being in a long-term, happy marriage are well established, this gives even more reason to avoid having an affair. Perhaps the most dangerous secrets, however, are those we hide from ourselves.

How do people keep secrets from themselves? Most of us are aware of what we’re doing, but often unaware of why we’re doing it — this is the secret behind the secret. For example, a man who has one affair after another can make sure that no one knows about his activities. But what he doesn’t know about are his own needs and conflicts that are driving him to act in a way that may ultimately destroy his marriage.

What you “refuse to know” can also hurt your physical health in insidious ways. For example, a woman who finds a breast lump and keeps “forgetting” to make an appointment with the doctor is hiding from herself the paralyzing fear that it could be the sign of something serious.

A man with high blood pressure who doesn’t make necessary diet and lifestyle changes hasn’t faced the reality that he has a significantly higher risk for cardiovascular disease — a real illness that may shorten his life.

People who hide symptoms or illness from friends and family — supposedly to spare them worry — actually may be motivated by this kind of self-deception.

With addictive behavior, denial also can be at work. If you tell yourself that It’s just that I really enjoy drinking/smoking/gambling… I can stop if I want to, you may be refusing to acknowledge that a destructive habit has taken on a life of its own. The less we know about our need to hide such secrets from ourselves and others, the less able we are to come out of hiding.

How can you tell if you’re threatening your health by keeping secrets from yourself and/or others? Emotional distress without apparent explanation suggests that you’re keeping things from yourself and/or others. Feeling increasingly anxious, depressed or sad might tip you off that there’s something you’re too ashamed of or upset about to admit.

Angry outbursts over insignificant things, exhaustion for no reason and/or physical ailments (such as those described earlier) with no medical explanation suggest that you could be suffering from stress related to keeping secrets.

What can you do about it? Self-exploration is the antidote to secrecy. This involves letting yourself become aware of the feelings and memories that surround your troubling behavior and understanding events and relationships in your past that may be controlling how you act now. A well-trained therapist can help with this process.