Mixed messages still prevail regarding bullying. While it is addressed as a problem that shouldn’t be tolerated, some people still think that bullying is a part of growing up. But downplaying bullying can have lasting consequences.

The Centers for Disease Control and Prevention says that one out of five children are bullied. The Cyberbullying Research Center offers that 5.4 million American students skip school at some point in the year due to bullying. What’s more, bullying doesn’t end when classes let out. Digital harassment is a growing problem that brings bullying into a person’s life, day or night.

Victims of bullying may experience short and long-term consequences. Here is a look at some of the experiences and behaviors that may be result from bullying.

1. A UCLA study of 2,300 students in 11 middle schools in Los Angeles found that high levels of bullying were associated with lower grades across the three years of middle school. Students who were bullied the most performed significantly worse in school than their peers who were not bullied.

2. Children who are bullied tend to have increased feelings of sadness and loneliness that can manifest as future diagnoses of depression and anxiety, according to the U.S. Department of Health and Human Services. These issues can persist into adulthood.

3. Victims may experience psychosomatic symptoms like headaches or muscle aches or other physical problems. Visits to the doctor may turn up no physical causes of these issues.

4. Remedy Health Media advises that bullying can result in changes in appetite and sleeping patterns. Students also may experience low self-esteem.

5. A longitudinal study led by scientists in Norway looked at the long-term psychological effects of being bullied as an adolescent. The results pointed to adverse mental health outcomes in adulthood, with victims showing a high level of depressive symptoms. Both bullies and victims were also at an increased risk of psychiatric hospitalization due to these mental health disorders.

6. Bullying also can affect bystanders. Students who witness their peers or friends being bullied may be more likely to use tobacco, alcohol or other drugs. Such students also may be at an increased risk of developing mental health problems, says StopBullying.gov.

The effects of bullying can be profound, which is why all bullying should be taken seriously.

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