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  • What Is Toxic Stress?What Is Toxic Stress?
  • Common SymptomsCommon Symptoms
  • Signs to Watch ForSigns to Watch For
  • Possible CausesPossible Causes
  • Physical & Mental ImpactsPhysical & Mental Impacts
  • Can It Be Prevented?Can It Be Prevented?
  • Treatment OptionsTreatment Options
  • Coping With Toxic StressCoping With Toxic Stress
  • In My ExperienceIn My Experience
  • InfographicsInfographics
  • Additional ResourcesAdditional Resources

Toxic Stress: Definition, Causes, & Treatment

Headshot of Hailey Shafir, LCMHCS, LPCS, LCAS, CCS

Author: Hailey Shafir, LCMHCS, LPCS, LCAS, CCS

Headshot of Hailey Shafir, LCMHCS, LPCS, LCAS, CCS

Hailey Shafir LCMHCS, LPCS, LCAS, CCS

Hailey specializes in adults, children, and families with addiction and mental health disorders.

See My Bio Editorial Policy
Maloa Affuembey, MD

Medical Reviewer: Maloa Affuembey, MD Licensed medical reviewer

Published: September 14, 2023
  • What Is Toxic Stress?What Is Toxic Stress?
  • Common SymptomsCommon Symptoms
  • Signs to Watch ForSigns to Watch For
  • Possible CausesPossible Causes
  • Physical & Mental ImpactsPhysical & Mental Impacts
  • Can It Be Prevented?Can It Be Prevented?
  • Treatment OptionsTreatment Options
  • Coping With Toxic StressCoping With Toxic Stress
  • In My ExperienceIn My Experience
  • InfographicsInfographics
  • Additional ResourcesAdditional Resources

Toxic stress is frequent, chronic stress that has harmful and potentially lasting effects on physical and mental health. While stress is a normal and temporary response to threats, toxic stress can impact every aspect of life. Symptoms often include physical pain, increased anxiety, and impaired functioning. Therapy and lifestyle changes can help individuals cope with and prevent the long-term effects of chronic stress.

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What Is Toxic Stress?

Toxic stress occurs when the fight or flight response is activated too often or too long by perceived threats, problems, or demands. While this response happens naturally, toxic stress can cause persistent and severe consequences. Chronic stress heightens cortisol levels, often contributing to chronic illness, infections, injuries, mental illnesses, and addictive disorders.1,2,3

Toxic Stress Symptoms

Toxic stress affects everyone differently. Some individuals may display more symptoms than others, but the effects can be equally distressing and uncomfortable. Toxic stress in adults may manifest as impulsivity, decreased interest in activities, and increased anxiety. Childhood toxic stress can cause abnormal development and permanent structural changes in the brain closely linked to cognitive impairment, severe mental illness and addiction, and a range of chronic health issues.

Symptoms of toxic stress may include:4,5

  • Muscle pain
  • Headaches
  • Gastrointestinal upset (such as stress-induced constipation)
  • Increased heart rate, blood pressure, or respiration
  • Sleep disturbances or nightmares
  • Changes in appetite, eating, and weight
  • Trouble regulating emotions
  • Increased anxiety and irritability
  • Depression or mood swings
  • Impulsive, risky, or destructive behavior patterns
  • Increased use of substances or alcohol
  • Difficulty focusing, concentrating, or remembering things
  • Inability to feel present or engaged in activities
  • Impaired functioning in one or more areas of life
  • Social withdrawal or isolation
  • Racing thoughts or negative thoughts about self and future

Signs of Toxic Stress

Similar to symptoms, the signs of chronic and toxic stress manifest differently depending on the individual and situation. Toxic stress in children and teens is particularly harmful because it impacts normal development, possibly producing long-lasting effects on physical and mental health.1,2

Children may exhibit decreased academic performance, defiance, and aggression. Toxic stress in adults may manifest in their work, family, and relationship obligations. They may struggle to fulfill responsibilities and lose interest in once-enjoyed activities.

Signs of toxic stress may include:1,2,6

  • Dropping grades or poor work performance
  • Increased behavioral outbursts and tantrums in children
  • Reduced interest in social and recreational activities
  • Aggressive behaviors or fighting in older kids/teens
  • Increased defiance or rebellion
  • Fidgeting, restlessness, or trouble sitting still
  • Increased separation anxiety in younger children
  • Bedwetting or toileting accidents in younger children
  • Cutting or other forms of self-injury

Causes of Toxic Stress

Various stressors can lead to toxic stress. Ongoing stressors, trauma, or prolonged exposure to adversity can accumulate over time and result in the physical and mental impacts associated with chronic stress.

Possible triggers and causes of toxic stress include:1,4,5,7

  • Job loss or change in employment status
  • Bankruptcy or an unexpected change in financial status
  • Chronic or terminal illness
  • The death of a parent, spouse, or other loved one
  • An accident that leads to a serious injury
  • Divorce or separation from a significant other
  • Physical, emotional, or sexual abuse
  • Being the victim of a crime
  • Traumatic events
  • Racial or cultural prejudice and oppression
  • Toxic work environments
  • Family conflict and discord
  • Lack of safe, adequate housing
  • High exposure to crime
  • Being bullied or harassed
  • Having a physical or developmental disability

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Physical & Mental Health Effects of Toxic Stress

Toxic or chronic stress can have severe effects on physical and mental health. Stress activates the sympathetic nervous system, initiating a chemical chain reaction that increases heart rate, blood pressure, and respiration.

Normal and tolerable stress typically temporarily changes how a person thinks, feels, and behaves without lasting effects. However, a toxic stress response occurs too often, resulting in heightened cortisol levels and long-term effects.

Possible effects of toxic stress include:2,3,7

  • Weakened immune system & more frequent infections
  • Higher rates of chronic illnesses
  • Higher rates of mental illnesses
  • Poor coping and emotion regulation skills
  • Increased vulnerability to substance addictions
  • Impairments in memory, learning, and thinking

How Can Toxic Stress Impact Brain Development?

Adversity, trauma, and chronic stress in childhood can be detrimental to all aspects of a child’s health and development. Toxic stress affects the brains of children, sometimes leading to permanent structural changes and emotional, behavioral, and cognitive health issues.1,3,6,7

Exposure to toxic stress in children may lead to long-term impacts, such as:

  • Being in an abusive relationship
  • Substance misuse
  • Suicide attempts
  • Developing heart disease or liver disease
  • Chronic illnesses like asthma or auto-immune disorders
  • Cognitive impairments affecting learning and memory
  • Poorer executive functioning (i.e., planning, decision-making, etc.)
  • Destructive habits like gambling or promiscuity

Can Toxic Stress Be Prevented?

Certain internal and external factors make a person more likely to experience chronic stress. While individuals cannot always control their environment or physical and mental health problems, they can take preventative action to protect against the long-term impacts of toxic stress.

Risk and protective factors of toxic stress include:1,2,7

Risk FactorsProtective Factors
Emotional and physical neglect as a childLess severe/direct impact or exposure

Physical, sexual or emotional traumaEffective coping skills
Separation or loss of a relationshipFinancial stability
Unemployment or underemploymentStrong problem-solving skills
Unhealthy lifestyle choicesAbility to understand/accept emotions
Existing physical or mental health conditionHigh levels of social support and connection
Socially or economically disadvantagesStrong belief system that helps a person cope
Few social supportsHigh self-efficacy (confidence in abilities)
Pessimism, self-blame, poor coping skillsHigher levels of hope and optimism
Living in a high crime neighborhoodHigher education and IQ
Poor or limited access to healthcareConsistent nurturing from an adult (as a kid)
Single parent householdInvolvement in social/leisure activities

Treatment of Toxic Stress

Toxic stress is a treatable condition, but treatment is highly individualized and depends on the causes and manifestations of the stress. Some people experiencing toxic stress need physical and mental health treatment to control their symptoms.

Therapy for Toxic Stress

Therapy can be helpful for people experiencing signs of toxic stress. Individuals can choose from weekly group, family, or individual therapy sessions with a licensed provider to help them address possible causes of their stress. They can learn to better understand and manage their symptoms with healthy coping mechanisms and problem-solving skills.

Those interested in therapy can begin searching online or by calling their insurance company to ask for in-network providers. Online therapist directories are an excellent tool for finding the right therapist.

Physical Health Treatment

Primary care or specialist physicians can provide health care when toxic stress causes physical symptoms or worsening health conditions. Treatment may include prescribed medications, recommended lifestyle changes, or diagnostic procedures. A person may seek guidance for insomnia, weight loss or gain, migraines, or constipation.

Support Groups

Support groups are available in most communities and online. These options can help people struggling with toxic stress receive support from others experiencing similar issues. Members provide both emotional support and practical advice.

How to Cope With Toxic Stress

Managing stress should be a priority for everyone. Some stress can be healthy and motivating, but lasting, severe, and toxic stress is not. Practicing healthy coping skills, maintaining a balanced life, and setting goals can help you combat and prevent the effects of chronic stress.

Below are five tips for coping with toxic stress: 1,2,5

1. Focus on Things in Your Control

Many different triggers and demands, some of which are beyond your control, can foster toxic stress. Focusing on the causes you cannot change will leave you feeling overwhelmed. Instead, address whatever factors are within your control, such as your responses to situations, outlook, or pleasurable activities. Take action to improve your situation by investing time and energy into positive actions.

2. Maintain a Healthy & Balanced Lifestyle

People struggling with toxic stress more commonly fall into unhealthy habits like smoking, drinking, or overeating. These unhealthy habits may provide temporary relief but can lead to long-term issues that worsen stress. Make your health a priority and do what you can to ensure you eat well, sleep enough, exercise regularly, and avoid drugs and alcohol.

3. Strengthen & Maintain Your Relationships

One of the greatest protective factors against toxic stress is support from people who care about you. Some tend to push loved ones away or isolate when stressed. However, social withdrawal only worsens the harmful effects of toxic stress. Make an intentional effort to reach out, respond, and attend to those you love.

4. Practice Relaxation Techniques

Numerous practices promote relaxation, and making these a part of your routine helps you reduce and manage stress. Many benefit from mindfulness, guided meditation, yoga, progressive muscle relaxation, or visualization exercises. Whatever route you take, stress management techniques are key to maintaining well-being and health.

5. Set Goals & Plan for Your Future

Many experiencing toxic stress believe their situation will never improve, only increasing overwhelm and hopelessness. Goals and plans for the future provide you with direction, purpose, meaning, and optimism. These feelings are crucial when dealing with toxic and chronic stress.

In My Experience

Headshot of Hailey Shafir, LCMHCS, LPCS, LCAS, CCS Hailey Shafir, LCMHCS, LPCS, LCAS, CCS
“Toxic stress can be difficult to cope with, but help is available for those ready to address their issues. Consider speaking with a mental health professional to uncover the causes behind your stress and start on your healing journey.”

Toxic Stress Infographics

What Is Toxic Stress? Impacts of Toxic Stress Toxic Stress Treatment Coping With Toxic Stress

Additional Resources

To help our readers take the next step in their mental health journey, ChoosingTherapy.com has partnered with leaders in mental health and wellness. ChoosingTherapy.com is compensated for marketing by the companies included below.

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For Further Reading

  • Best Stress Management Books
  • How to Deal With Feeling Overwhelmed: 25 Ways to Cope
  • Eustress vs Distress: Positive & Negative Types of Stress
  • Therapy for Stress: How It Works, Examples & Effectiveness
  • Diabetes and Anxiety: Connection, Symptoms, & Treatment

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Sources Update History

ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Branco, M. S. S., & Linhares, M. B. M. (2018). The toxic stress and its impact on development in the Shonkoff’s Ecobiodevelopmental Theorical approach. Estudos de Psicologia, 35(1), 89–98. https://doi.org/10.1590/1982-02752018000100009

  • Franke H. A. (2014). Toxic Stress: Effects, Prevention and Treatment. Children (Basel, Switzerland), 1(3), 390–402. https://doi.org/10.3390/children1030390

  • Shern, D. L., Blanch, A. K., Steverman, S. M. (2016). Toxic stress, behavioral health, and the next major era in public health. Am J Orthopsychiatry, 86(2), 109-123.

  • NAMI. (2017). What you should know about toxic stress. Retrieved from https://www.nami.org/Blogs/NAMI-Blog/August-2017/What-You-Should-Know-About-Toxic-Stress

  • The American Institute of Stress. (2022). Stress research. Retrieved from https://www.stress.org/stress-research.

  • Dowd, M. D. (2017). Early Adversity, Toxic Stress, and Resilience: Pediatrics for Today. Pediatr Ann., 46(7), 246-249.

  • Gutman, L. M. (2008). Risk and resilience. University of London, UK: Elsevier Inc, 23-33.

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We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

September 14, 2023
Author: No Change
Reviewer: No Change
Primary Changes: Edited for readability and clarity. Reviewed and added relevant resources.
October 15, 2020
Author: Hailey Shafir, LCMHCS, LPCS, LCAS, CCS
Reviewer: Maloa Affuembey, MD
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