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The subtle poison

A version of this commentary appeared in the Huffington Post, Winnipeg Free Press and the Waterloo Region Record

For most parents today, stress is a constant companion. Everyone’s heard of the dangers of high blood pressure, of chronic workaholics having heart attacks at forty, of harried professionals pouring themselves an extra glass of wine (or three) with dinner. Pausing at our desks or kitchen tables for an all-too-brief moment, many of us long for the carefree days of childhood, when our lives seemed simple and our worries small and far away.

However, childhood is not quite the stress-free paradise that our rose-tinted memories might suggest. Children — even infants — can suffer from chronic, toxic stress. It’s stress of a very different sort than that of meetings and mortgage payments, but its long-term effects can be no less serious.

Last year, the American Academy of Pediatrics launched an urgent call to action informing healthcare practitioners of the dangers of toxic stress to children, and Harvard University established the Centre on the Developing Child to study its effects. Cleary, toxic stress is serious stuff.

But what is it, exactly?

Even before they can stand on their own, children have already mastered a balancing act of sorts. It’s a balance not of posture, but of hormones and chemicals meticulously regulated to keep us in a state of internal harmony called “homeostasis.”

Homeostasis is where our bodies function best. Everything from heart rate to digestion to internal temperature runs smoothly. In the face of stress, our body shifts gears. Stress hormones flood our bloodstream, initiating a red alert status commonly called Fight or Flight. Our hearts pound, our digestive and immune systems hibernate, and homeostasis takes a back seat to survival.

Once the source of anxiety passes, our bodies downshift to homeostasis and things get back to normal. This “gear change” was a vital survival strategy for our distant ancestors, when a burst of adrenaline could mean the difference between being quick and being dinner.

However, in a modern society, stress doesn’t come in short bursts. It comes in constant, rolling waves that our bodies aren’t built to handle. As a result, our stress response systems sometimes get overloaded, and our bodies stop returning to homeostasis. Our gears stop shifting quite so smoothly. They may even jam up altogether. The result: toxic stress.

This is bad enough in adults. In children, it can be a disaster.

Children’s young bodies and minds, still adjusting to the business of achieving homeostasis, can become dangerously and permanently misaligned by toxic stress. Researchers have linked toxic stress in childhood to an increased risk of depression, addiction, teen pregnancy, alcoholism, liver disease and heart problems, among other ailments.

However, the last thing we all need is one more thing to stress about. So here’s the good news: children can actually handle quite a lot of stress. From everyday frustrations – pinching their fingers in a cupboard, getting a booster shot or dropping an ice cream cone on the floor — to more serious, traumatic events — a broken leg, the death of a grandparent or a divorce — children can bounce back, as long as they have one important thing: a nurturing, supportive caregiver.

The really toxic part of “toxic stress” isn’t the stress at all. It’s stress without a supportive caregiver present to mitigate it.

Stress regulation is a complicated process involving many different parts of the brain, and young children aren’t able to manage it all on their own. They need an adult caregiver to help them calibrate the way they respond to stress. It doesn’t take much: regular hugs, smiles and gentle encouragement do the trick. When parents are abusive or negligent or simply not around enough, their children miss out on this critical step.

Children growing up in low income households may be subject to disproportionate amounts of toxic stress that their parents may be largely unable to control: inadequate nutrition, inappropriate housing conditions, an inability to afford prescription drugs, dental care or other health services can make toxic stress a real and present danger. Policies that support early childhood education, income assistance and affordable housing can provide the touchstone struggling children — and their parents — need to thrive.

We must make sure that no child in Canada grows up in an environment of toxic stress. We need to work together to provide families with the support they need to support their children in turn.

Nicole Letourneau is an expert advisor with EvidenceNetwork.ca and professor in the Faculties of Nursing and Medicine. She also holds the Norlien/Alberta Children’s Hospital Foundation Chair in Parent-Infant Mental Health at the University of Calgary. Justin Joschko is a freelance writer currently residing in Ottawa. Their co-authored book, Scientific Parenting, is due for release in August.

April 2013

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