How Much Do You Know About Toxic Stress?

How Much Do You Know About Toxic Stress?

What is Stress?

People normally experience stress. Usually they tolerate it, have the coping skills to endure it, and adapt. Usually, no damage results from normal, short-term stress when people have support and coping skills, and some stress can be a good thing. According to researchers and the University of California, Berkeley, the body’s stress response sometimes pushes us to be more alert, perform our best physically and mentally, and adapt (Kirby et al., 2013). It is important to emphasize that it is not events that are toxic, but the body’s stress response that can become toxic.

How Does the Body Respond to Stress?

According to the Center on the Developing Child at Harvard University, the body responds to stress in one of three ways:

  • Positive stress response – this is described as “a normal and essential part of healthy development, characterized by brief increases in heart rate and mild elevations in hormone levels. Some situations that might trigger a positive stress response are the first day with a new caregiver or receiving an injected immunization.”
  • Tolerable stress response – this response “activates the body’s alert systems to a greater degree as a result of more severe, longer-lasting difficulties, such as the loss of a loved one, a natural disaster, or a frightening injury. If the activation is time-limited and buffered by relationships with adults who help the child adapt, the brain and other organs recover from what might otherwise be damaging effects.”
  • Toxic stress response – this response “can occur when a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support. This can actually disrupt the architecture of the brain and other organ systems. When it does, those who experience it are at increased risk of stress-related illness and cognitive impairment even as adults, and sometimes result in lifelong problems such as developmental impairments and health problems such as cardiovascular disease, diabetes, substance use disorder, and depression” (Franke, 2014; Harvard University, 2020).

Stress can become negative and unhealthy and when the body’s stress response systems are activated too frequently, in negative ways, and when adequate support is not available it can become toxic. Some effects of Toxic Stress that have been identified in the literature are:

  • Abnormal stress response, where the duration of adversity and lack of a supportive caregiver has resulted in disruption of the neuro-endocrine-immune response and extended cortisol activation. This results in an inflammatory state of the body.
  • A prolonged inflammatory state, which can result in lifelong:
    • Maladaptive coping and poor stress management skills (Shonkoff et al., 2012)
    • Mental illness (Danese et al., 2009)
    • Poor health behaviors (Garner, 2013)
    • Physical illness (Kelly-Irving et al., 2013)
    • Substance Use Disorder (Benjet et al., 2013)

For an in-depth article about Adverse Childhood Experiences (ACEs) read our blog post Adverse Childhood Experiences: A Public Health Crisis That is Treatable and Preventable.

Can Toxic Stress Be Prevented or Treated?

Some of the most current research on Toxic Stress is being done by the JPB Research Network on Toxic Stress at Harvard University. New and emerging uses of biological information are thought to be useful in assessing how adverse experience and preventive measures for them can help to prevent impact on the development of young children (Harvard University, 2019). Under development is a battery of tests that use biologic, behavioral, and social and behavioral context, metrics to identify stress effects, resilience, family assets and stressors, and key behavioral indicators in children from age 2 months and older. When developed, this battery of tests will enable implementation of preventive measures before obvious physical or behavioral problems develop. This paradigm will also allow for studying and evaluating impacts of interventions on learning, behavior, social-emotional development, and other health indicators. More information on this cutting edge research is available on the JPB Research Network on Toxic Stress website. A variety of articles and multi-media presentations are also available on the site that describe how Toxic Stress can disrupt brain development, the behavioral and social determinants of Toxic Stress, and science-based best practices for preventing or reducing the damage that can be done by Toxic Stress (Center on the Developing Child at Harvard University, 2016).

Preventive interventions should include “preventive measures that promote positive environmental influences and interactions with supportive caretakers preventive measures that promote positive environmental influences and interactions with supportive caretakers” (Franke, 2014). Other strategies include teaching positive parenting skills, support for families, resilience building, and stress management techniques. Interventions that assist caregivers in providing a stable, supportive, and positive environment are also effective, as are eliminating caretaker stressors and improving their ability to maintain a safe and stable nurturing relationship.

Professional Development on Toxic Stress

If you would like to know more about Toxic Stress, a professional development opportunity is being offered by CASAT Learning on April 15, 2022 (PST). This Toxic Stress & High Risk Behaviors Webinar is being presented by Mayra Pacheco, Program Coordinator for the Nevada Institute for Children’s Research and Policy. The workshop description follows:

“ Living in stressful environments can negatively affect an individual’s emotional, social, and physical development. Through this training, attendees will be provided with an overview of how stress can affect brain development and will learn how these changes in the brain may lead to the adoption of high-risk behaviors. The training further discusses substance misuse as a common coping strategy and participants will learn key action items to promote a public health approach and improve interactions with individuals engaging in high-risk behaviors.


  • Participants will learn how to recognize when an individual might be experiencing toxic stress.
  • Participants will learn how stress can actually change and affect brain development and lead to the adoption of high risk behaviors.
  • Participants will learn how to support individuals engaging in high risk behaviors by taking a public health approach.

Continuing Education Units: 2 CEUs”

For additional reading related to Toxic Stress and ACEs, check out our related blog posts. Relevant links and materials can be found on the Resources & Downloads page.

Nevada Resources

Prevent Child Abuse Nevada – “The Mission of PCA NV is to ensure that Nevada’s children thrive in safe, stable, and nurturing environments and relationships. Through providing education, advocacy, and awareness, PCA NV aims to inspire communities to prevent all forms of child maltreatment.” The website has a huge variety of resources and links for Parents, Educators, and others interested in advocating or getting involved to positively influence children and families in Nevada.

Do you have information or resources to share about Toxic Stress? Please share below in the comments.


Benjet, C., Borges, G., Medina-Mora, M. E., & Méndez, E. (2013). Chronic childhood adversity and stages of substance use involvement in adolescents. Drug and alcohol dependence131(1-2), 85-91.

Danese, A., Moffitt, T. E., Harrington, H., Milne, B. J., Polanczyk, G., Pariante, C. M., … & Caspi, A. (2009). Adverse childhood experiences and adult risk factors for age-related disease: depression, inflammation, and clustering of metabolic risk markers. Archives of pediatrics & adolescent medicine163(12), 1135-1143.

Franke H. A. (2014). Toxic Stress: Effects, Prevention and Treatment. Children (Basel, Switzerland)1(3), 390–402.

Garner, A. S. (2013). Home visiting and the biology of toxic stress: opportunities to address early childhood adversity. Pediatrics132(Supplement 2), S65-S73.

Kelly-Irving, M., Mabile, L., Grosclaude, P., Lang, T., & Delpierre, C. (2013). The embodiment of adverse childhood experiences and cancer development: potential biological mechanisms and pathways across the life course. International journal of public health58(1), 3-11.

Kirby, E. D., Muroy, S. E., Sun, W. G., Covarrubias, D., Leong, M. J., Barchas, L. A., & Kaufer, D. (2013). Acute stress enhances adult rat hippocampal neurogenesis and activation of newborn neurons via secreted astrocytic FGF2. Elife, 2, e00362-e00362.

Center on the Developing Child at Harvard University (2016). From Best Practices to Breakthrough Impacts: A Science-Based Approach to Building a More Promising Future for Young Children and Families. Retrieved from

Center on the Developing Child. Harvard University. Toxic stress. (2020, August 17). Retrieved April 08, 2021, from,hardship%E2%80%94without%20adequate%20adult%20support.

The JPB Research network on Toxic stress. Harvard University. (2019, June 19). Retrieved April. 08, 2021, from

Shonkoff, J. P., Garner, A. S., Siegel, B. S., Dobbins, M. I., Earls, M. F., McGuinn, L., … & Committee on Early Childhood, Adoption, and Dependent Care. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics129(1), e232-e246.

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