Understanding Toxic Stress

Understanding Toxic Stress

Imagine that science discovered a toxic substance that increased the risk of cancer, diabetes, and heart, lung, and liver disease for millions. Imagine that this substance also increased a person’s risk for smoking, suicide, drug abuse, teen pregnancy, sexually transmitted disease, depression, and domestic violence. And imagine that at the same time, this substance significantly reduced a person’s chances of succeeding in school, performing well at a job, or sustaining healthy relationships. 

This sounds like some of the things we’ve worked in public health to eliminate – pollution, lead paint, second-hand smoke, mercury – so we would certainly work to contain or eliminate this substance as well, right? 

There is such a thing, and it’s not a substance.  It is something known as “toxic stress.”

For nearly 15 years, researchers have known that frequent or continued stress affecting young children – those who don’t have enough or positive support from adults to buffer the stress – increases the lifelong likelihood of myriad physical health, mental health, and other dysfunctions that shorten life and effect society.

In the late 1990s, a landmark study was conducted to examine the long-term effects of toxic stress – what the researchers called “adverse childhood experiences” or ACEs – including family dysfunction, substance abuse, poverty, domestic violence, abuse, and neglect.  The control group was comprised of 17,000 adults, mainly white, well-educated, middle-class people. What they found was a powerful connection between the level of stresses a person had faced as a youth and myriad social, physical, and emotional health problems.  The more “ACEs,” the higher and greater the damage.

And please note that “toxic stress” is very different than:

  • Positive stress, such as the first day of school or a childhood vaccine – which mildly and briefly increases the heart rate, and
  • Tolerable stress, like the loss of a loved one or personal injury – when the body’s alert systems are more active, but the stress is temporary, and the child can adapt

Toxic stress occurs when a child experiences frequent, strong, and/or continuous stress, such as emotional or physical abuse, mental illness in a parent or caregiver, poverty – and has no adult support to cope or buffer.  Not only does the child experience high and sustained levels of stress hormones – cortisol, adrenaline – which can damage the brain and lead to difficultly learning, memory, or responding to stress, but this significantly changes the architecture of the brain – including reduced brain size, damage to the hippocampus (part of the brain involved in emotion, memory, the senses, and organizing), and fewer neurologic connections.  It also affects development of vital organs and organ systems, and it damages hormonal systems, causing poor development, weakened immune systems and cognitive and behavioral problems.

Researcher have also proven that maternal stress during pregnancy and poor maternal care during infancy alter the genes involved in brain development. For mothers who have experienced or are experiencing toxic stress themselves, there is no model for understanding their children’s behavior, so their response likely exacerbates the problem.

What do the effects of this “trauma” look like? For youth, it’s typically one or more of the following symptoms:

  • physical complaints – stomachache, headache
  • constant worry about danger, or about the safety of loved ones
  • signs of depression – withdrawal, lack of enjoyment in favorite activities
  • difficulty paying attention, concentrating, or learning
  • outbursts of anger – toward others or toward themselves
  • refusal to follow rules
  • use of violence to get their way
  • bullying or aggression toward others
  • rebellion
  • risky behaviors – driving dangerously, dangerous “tricks”
  • seeking revenge
  • lashing out
  • abrupt changes in relationships and/or friends
  • belief in stereotypes – males are aggressors, females are victims

What can be done?

First: work to understand -

  • a child/person is responding to trauma – in a “hyper-alarmed” state – true PTSD
  • the brain is in “survival” state – feeling unsafe, threatened, loss of control – and can be triggered by many things (smells, noises, eye contact)
  • a child or adult is overwhelmed
  • a child may feel unsafe or abandoned
  • a child may act out – shouting, tantrums, throwing or hitting objects

As I noted in our history with Chrysalis After-School during the board meeting, we have anecdotally studied girls involved in Chrysalis After-School programs and have found that many girls are dealing with the effects of this stye of stress in their lives. We regularly work with program facilitators to help them deal with toxic stress by delivering recommended practices including:

  • treating every girl respectfully
  • providing encouragement instead of criticism
  • delivering structure, routine, and consistency
  • helping girls feel they are “in control”
  • assuring them that adults will take care of and protect them
  • being that positive adult in girls’ lives that always helps them feel safe, confident, and competent

 We also work to help our program facilitators know  how to help girls with “emotional regulation” by:

  • helping girls feel safe and stable
  • not downplaying a girl’s feelings
  • not making promises you cannot honor
  • remaining calm – staying out of their “chaos”
  • checking in periodically, asking “are you doing okay?” and showing attention and care
  • helping find positive ways to “replace” fear or anger – giving girls a project, talking things through

 We are a part of a larger system, but through education and understanding we can make a difference.