Toxic Stress in Children and Teens

Stress can be a normal and sometimes healthy or even helpful part of life. When a child or adolescent experiences a stressful moment, event, or situation, the body responds in a certain way such as freezing or activating the fight-or-flight response.  These reactions are triggered by normal hormonal reactions within the body.  “Toxic Stress” refers to the physical response and changes that occur within a child’s body due to extreme or prolonged activation of these stress response systems.  This is especially seen in cases where the child is without sufficient buffers from stress or the lack of a caring and supportive individual to help them lower stress levels and hormones as they begin to feel safe again.  Toxic stress can occur from numerous inciting stressors but is especially common in children and adolescents with a history of Adverse Childhood Experiences (ACES).  Some examples of ACEs include child abuse or neglect of any kind, parental mental illness or substance abuse, witness to domestic violence, incarceration of family members, parental separation or divorce or the death of a parent or sibling.  

The body’s response and changes from Toxic stress can lead to numerous physical, cognitive, and behavioral health symptoms or disorders including: 

• Increased or frequent flares of medical conditions (such as asthma attacks or allergies) 
• Obesity 
• Frequent stomachache, headache, nausea, vomiting, constipation 
• Irregular or delayed 1st menstruation 
• Poor dental health 
• Depression, self-harm, eating disorders, substance use, suicidal thoughts, or suicide attempts  
• Difficulty sleeping 
• Difficulty with concentration or ADHD 

It is also associated with increased social problems or difficulties such as:  

• Poor peer relationships, lack of trust, low self-esteem 
• Unhealthy romantic relationships 
• Frequently missing school
• Early sexual activity
• Avoidance, being withdrawn, anger 

What can I do? 

Fortunately, there are effective ways to both prevent and treat toxic stress in children and teens.  If your child shows signs of stress or has a history of stressful experiences or ACEs talk to them about how they are feeling and responding to the stressors. 

• Offer comfort, support, and guidance on ways to reduce or handle stress. 
• When possible, act as a buffer to reduce or eliminate stress.  It also may help to ask the child what kind of support they would like in these situations. 
• Create positive experiences.  These can be small acts that create a connection between yourself and the child.  Playing, reading a book, enjoying nature and other healthy activities such as hiking, or bike riding are some examples of where healthy positive connections can be made.  
• If the effects of toxic stress have already started in your child, treatment should be driven by your pediatrician in conjunction with a behavioral health specialist.  The parent or guardian will still play a vital role in treatment. 
• Treatment is typically a combination of trauma specific behavioral therapy and focusing on supportive relationships, physical activity, quality sleep, mindfulness practices, and experiencing nature.  

Resources: 

Stress and Health: What Parents Need to Know 

Childhood Adversity: Buffering Stress & Building Resilience 

How Safe, Stable Relationships Can Prevent Toxic Stress in Children