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Toxic stress: Information for patients and families (The Primary School)



Information for patients and families

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Content Reviewers:

Rishi Desai, MD, MPH

Everyday we encounter stressful situations, like our first day of school, meeting new people, or going through a job interview.

In these situations, the body responds by activating our sympathetic nervous system.

That’s the system that diverts blood away from organs like the intestines or the bladder, so that we can increase blood flow and energy to organs like the brain, heart, and muscles, which help us respond or cope.

This is sometimes called the fight-or-flight response because it’s the same system that kept our ancestors safe in dangerous situations.

Short bursts of stress are helpful, especially if the stress is addressed in a positive way, which often means with the help of a supportive social environment with parents, friends, or teachers that care.

In fact, even a hug from a loved one can release hormones that can ease the stress and make it more tolerable - in that situation it’s called tolerable stress.

But if there’s a stressful situation like the loss of a parent, and there isn’t a strong support structure to help cope with the stress, then the stress can persist and it can have negative effects like insecurity, anger, and fatigue.

And when the stress system gets activated repeatedly, like when a child experiences physical abuse or chronic neglect, and if there’s no supportive social environment, then the stress can be overwhelming and have a lasting, biological impact.

Basically, the brain and body adapt to chronic exposure to threat, by developing a heightened alarm state, and the body feels threatened all the time, even after the threat is removed.

This type of stress isn’t tolerable and when it becomes chronic, it’s called toxic stress.

And events that trigger toxic stress in children are called adverse childhood experiences.


Toxic stress occurs when an individual, especially a child, experiences long-term stressful events such as physical or emotional abuse, neglect, poverty, or violence, all in the absence of a protective environment.

Toxic stress can have dramatic effects on the body and brain development and lead to psychological, behavioral, and learning problems. In the long-term, toxic stress has been linked to health problems like heart disease and cancer, as well as depression.

Symptoms of toxic stress include difficulty sleeping, anxiety, fearfulness, and irritability. However, complications of toxic stress can be prevented with the support of a supportive environment with caring adults such as parents, caretakers, and teachers.