Debt can be devastating. A Google search for “how to get out of debt” has over 28 million results, and there are hundreds of nonprofit credit-counseling agencies devoted to helping people manage their debt in order to improve their lives, and save their financial ones. (Though, as the Federal Trade Commission warns, you should always make sure that the agency is trustworthy and doesn’t have hidden fees.)

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When you hear the word “debt,” especially if you’re a millennial who went to college in the United States, you probably almost immediately think “student loans.” Maybe you think “credit cards.” But not everyone owes because of the astronomical costs of higher education or the allure of “pay just a little right now.”

Read on for five causes of debt that are often overlooked.

Medical Costs

One of the many outrageous aspects of American life is the cost of health care. Even if you have insurance, you may still be stuck with a medical bill that leaves you deep in debt—like thousands and thousands of dollars in debt—because health care in the U.S. is about double the price of that in any other developed country.

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A 2014 report from financial advice company Nerdwallet found that medical bankruptcy was the leading cause of personal bankruptcy in the United States and that Americans paid three times more for medical debt than they did for bank and credit-card debt combined—which is just insane, right?

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The Atlantic illustrates what this might look like in the opening paragraph of a piece they ran in 2014 about why Americans are “drowning” in medical debt. “After his recent herniated-disk surgery, Peter Drier was ready for the $56,000 hospital charge, the $4,300 anesthesiologist bill, and the $133,000 fee for orthopedist. All were either in-network under his insurance or had been previously negotiated,” says staff writer Olga Khazan. “But as Elisabeth Rosenthal recently explained in her great New York Times piece, he wasn’t quite prepared for a $117,000 bill from an ‘assistant surgeon’—an out-of-network doctor that the hospital tacked on at the last minute.”

Disability

When people go into debt because of medical expenses, it may be from a sudden diagnosis or accident—but those living with any type of disability, mental or physical, often face a slow accumulation of costs that becomes more and more difficult to bear.

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As UK-based freelance writer Diane Shipley explains in The Billfoldher own diagnosis with depression and the neurological condition ME/CFS left her in need, and indebted to, as she says, the British government, the student loans company, her credit card company, and her parents.

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Disability rights activists campaigned against welfare cuts that the British government began pushing through in 2010.

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“Between December 2011 and February 2014, according to the government’s own figures, 2,380 disabled people died after they were found ‘fit for work’ by a government contractor and had their only source of income taken away. They died of heart attacks, suicide, and starvation,” writes Shipley. “I know what it’s like to sit across from a doctor, stomach lurching as you try to convince them you’re genuinely ill; your quality of life dependent on them believing you. I know what it’s like to come out of that room and feel worthless, having spent an hour explaining everything you can’t do, all the ways your life didn’t turn out how you planned.”

Overspending

The concept of spending too much money is simple, but the motivation for doing it? Not so much. According to DePaul University’s Financial Fitness program, the three most common reasons that people overspend are consumerism, poor planning, and compulsive spending.

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The power of advertising is real, and its messaging tells you that you’ll be happier (or healthier or sexier or more successful) if you just have That One Thing (spoiler alert: That One Thing is never enough). If consumers aren’t conscious of this messaging, they’ll be more likely to fall for the marketing, and more likely to overspend.

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Poor planning and compulsive spending may go hand in hand. When your schedule gets hectic, tracking and thinking about how to minimize spending may be the last thing on your mind; another result of a hectic schedule is stress, and stress lowers willpower.

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Stress is often what triggers spending binges. Hava Buchanan, telling of her mother’s compulsive spending for The Billfold, writes, “When I was 13, she was diagnosed with breast cancer. She dealt with it the only way she could—by spending. As her cancer got worse, the bills piled up. It would continue this way for the next 13 years, until her death.”

Inflation

Investopedia defines inflation as “the rate at which the general level of prices for goods and services is rising and, consequently, the purchasing power of currency is falling.” In other words, it’s the phenomenon of stuff—like food, housing, utilities, gum, whatever—becoming more expensive over time.

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Unfortunately, that doesn’t mean you’ll continue to make more money. “Many people do not realize how much the cost of living goes up each year,” writes Grayson Bell for Debt Roundup. But, “most people will not receive an annual raise to offset their increases. If they are not able to cut back on spending, this will lead to more debt. If you are leaving your money in a regular savings account, then your savings will be stripped because of inflation.”

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Bell recommends finding a savings accounts that offers a good return, such as American Express personal savings.

Identity Theft

According to a 2014 Forbes article, identity theft is one of the fastest-growing crimes in the United States. As if it isn’t bad enough dealing with the trouble that comes along with having your name, social security number, and/or credit card hijacked by a complete stranger and used to buy a tanning membership and an all-inclusive cruise package, the pain doesn’t always end when you call the right people and cancel all your cards.

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Although the cost, on average, to make this problem go away is $500 per person, this isn’t always the case. The money woes go on and on and on for the unluckiest victims until they’re in financial ruin.

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Sometimes outstanding debts—like that from a student loan—can be complicated by identity theft. One victim, writing in to certified financial planner and NerdWallet’s personal finance columnist Liz Weston, tells the story of going back to school in 2002 to get a teaching credential, taking out loans, and setting up a repayment plan after graduation that automatically deducted payments from her checking account.

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“Several years ago, the IRS started garnishing my bank account stating that there was a lien but I never received any other type of indication what was going on. After contacting the IRS, we found that someone took out a fraudulent student loan using my former married name,” she writes. “I also got my credit reports, which showed the loan. I was able to get the signed loan documents from the U.S. Department of Education but now the department does not respond to my certified letters or phone calls.”

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After filing a police report and notifying the credit reporting agencies, she says she’s “at a loss at what to do”—and nearly $10,000 in the hole.