Toxic Stress: 6 Signs & Positive Ways to Cope

What exactly is toxic stress, and why does it matter?

Stress seems to be an inevitable feature of our urgent, fast-paced, and technology-saturated lives. We may be familiar with stress as a reaction that prepares us for a short, intense flight-or-fight response to a perceived threat.

In moderation, stress can serve as a motivator, enhancing our performance and resilience.

However, toxic stress, which we can understand as chronic exposure to severe stress, has detrimental effects on both our physical and mental health.

This article explores the concept of toxic stress; identifies its key signs, symptoms, and impact on both children and adults; and provides a selection of evidence-based coping mechanisms.

Before you continue, we thought you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free. These science-based exercises will equip you and your clients with tools to better manage stress and find a healthier balance in your life.

What Is Toxic Stress? A Definition

Stress is a multifaceted concept that encompasses our physiological and psychological responses to perceived threats or demands, referred to as stressors.

Midway through the 20th century, Hans Selye (1956) popularized the term “stress.” Selye famously defined stress as the nonspecific response of the body to any demand for change. This definition emphasizes the fact that a wide range of stimuli can cause stress.

Physiologically, stress involves the activation of the hypothalamic–pituitary–adrenal axis and the subsequent release of glucocorticoids, such as cortisol, as well as the activation of the sympathetic nervous system, resulting in the release of catecholamines like adrenaline and noradrenaline (McEwen, 2007).

These biochemical events prepare the body to cope with acute challenges through the fight-or-flight response, which includes increased heart rate, elevated blood pressure, and enhanced energy availability. These events are an adaptive response that channels our energy and attention into the parts of our bodies that are needed to respond effectively to a threat, such as running, fighting, and being cognitively alert.

Psychologically, stress can be understood through the lens of cognitive appraisal theory, as proposed by Lazarus and Folkman (1984).

According to this theory, stress arises when we perceive a situation as exceeding our coping resources and endangering our wellbeing. In other words, stress arises when we feel that there is an imbalance between our resources and external demands.

This subjective evaluation involves two key processes:

• Primary appraisal, where the significance of the stressor is assessed
• Secondary appraisal, where our ability to manage or respond to the stressor is evaluated

There are various types of stress based on duration and intensity. Acute stress refers to short-term stress that typically arises from specific events or situations, while chronic stress denotes long-term stress that persists over an extended period due to ongoing pressures or adversities (Lupien et al., 2009).

Additionally, stress can be categorized as eustress, which is positive and motivating, or distress, which is negative and harmful (Selye, 1974). The impacts of those different kinds of stress are wide ranging, influencing both mental and physical health, and are contingent upon individual differences in perception, coping strategies, and the availability of social support (Cohen et al., 2007).

Toxic stress is a form of chronic, long-term stress. It refers to the extreme, prolonged activation of the body’s stress response system in the absence of supportive relationships or protective factors (Shonkoff et al., 2012).

Toxic stress can lead to significant health problems and developmental disruptions. It can also be the result of adverse experiences such as abuse, neglect, exposure to violence, or chronic neglect (Shonkoff & Garner, 2012).

Various researchers have established a connection between chronic stress and adverse childhood experiences (Anda et al., 2006; Evans & Kim, 2013; Felitti et al., 1998; Repetti et al., 2002; Shonkoff & Garner, 2012). Toxic stress is also correlated with poverty (Kuo, 2001; Santiago et al., 2011).

6 Signs & Symptoms of Toxic Stress

Recognizing the core signs and symptoms of toxic stress is crucial for timely and effective intervention.

While the manifestations of toxic stress can vary considerably, some common indicators include:

1. Persistent anxiety:
   A chronic state of heightened alertness and worry that is disproportionate to actual threats (McEwen, 2007)
2. Sleep disturbances:
   Difficulty falling asleep, staying asleep, or experiencing restless sleep, often due to hyperarousal (Meerlo et al., 2008)
3. Cognitive impairment:
   Problems with memory, attention, and executive function stemming from stress-induced changes in brain structure and function (Lupien et al., 2009)
4. Physical health issues:
   Increased risk of cardiovascular diseases, metabolic syndrome, and immune dysfunction, linked to prolonged stress hormone exposure (Sapolsky, 2004)
5. Emotional dysregulation:
   Heightened sensitivity to emotional stimuli, frequent mood swings, and difficulty managing negative emotions (Davidson et al., 2000)
6. Behavioral changes:
   Increased irritability, aggression, or withdrawal from social interactions, which can impact personal and professional relationships (Felitti et al., 1998)

If your clients experience some of these symptoms in combination, it might be advisable to check whether they may be struggling with toxic stress.

Toxic Stress in Children & Its Effect on Development

Children are particularly vulnerable to the effects of toxic stress, which can interfere with their brain, emotional development, and overall wellbeing.

During critical periods of growth, exposure to severe, chronic stress can impair the formation of neural circuits in regions critical for learning, memory, and emotional regulation (Center on the Developing Child, 2010). This disruption can result in long-term cognitive deficits, emotional instability, and an increased risk of mental health disorders such as depression and anxiety (Anda et al., 2006).

Moreover, toxic stress can alter the functioning of the hypothalamic–pituitary–adrenal axis, leading to sustained elevations in cortisol levels. These neuroendocrine changes can adversely affect multiple organ systems, predisposing children to chronic health conditions later in life (Shonkoff & Garner, 2012).

This video provides more information:

How Toxic Stress Affects Adults: 3 Examples in Practice

In adults, toxic stress can manifest in various forms, influencing both physical and mental functioning. Chronic exposure to stressors without adequate healthy coping mechanisms or support can lead to significant health challenges.

1. Toxic workplace stress

Persistent workplace stress due to high job demands, lack of control, and inadequate support can contribute to burnout, reduced job performance, and health issues such as hypertension (Ganster & Rosen, 2013).

Maria had always been a dedicated employee at her firm. She prided herself on her attention to detail and her ability to manage multiple projects simultaneously. However, over the past year, the company took on several high-profile clients, and the pressure to deliver outstanding results increased dramatically.

Initially, Maria felt excited about the new challenges. She believed the extra work would be a stepping stone to a promotion she had long been hoping for. But as the weeks turned into months, the constant deadlines, endless meetings, and the expectation to be available 24/7 started to take a toll on her.

Maria found herself working late into the night, often bringing work home and checking emails during what little personal time she had. She stopped going to her weekly yoga classes and rarely saw her friends. Worries about unfinished tasks and upcoming presentations caused her sleep to become erratic.

The physical effects of chronic stress began to manifest. Maria started experiencing frequent headaches, back pain, and a persistent feeling of exhaustion. She also noticed she was getting sick more often, with colds and minor infections that seemed to linger longer than usual. Despite her best efforts to maintain a healthy diet, she started gaining weight, a consequence of stress-induced eating and a lack of exercise.

Emotionally, Maria was on edge. She found herself snapping at colleagues over minor issues and felt increasingly irritable and overwhelmed. Her usual enthusiasm for her work dwindled, and tasks that once excited her now felt like insurmountable burdens. She began to doubt her abilities and felt a constant sense of impending failure.

2. Toxic relationship stress

Ongoing conflicts or an unsupportive relationship can exacerbate stress responses, leading to mental health issues like anxiety and depression (Kiecolt-Glaser & Newton, 2001).

Dave and Emily had been together for five years, but the past year brought mounting pressures from work and family, straining their relationship. Emily grew distant, and their frequent arguments left Dave feeling frustrated and helpless. Dave noticed Emily seemed often preoccupied and less communicative.

He tried to brush it off, attributing it to her demanding job. But as the months went by, the distance between them grew. They argued more frequently, often about trivial matters that would escalate into full-blown conflicts. Dave felt increasingly unable to bridge the growing chasm between them.

The relationship stress took a toll on Dave’s mental health, making it hard for him to concentrate at work. He lost his appetite, experienced insomnia, and became anxious. Physically, he suffered from tension headaches, muscle pain, and constant exhaustion. Isolating himself from friends, Dave felt increasingly lonely.

3. Toxic financial stress

Chronic financial difficulties can induce a constant state of worry and insecurity, affecting both physical health, such as increased blood pressure, and mental health, for example, depression (Santiago et al., 2011).

Chloe had always been careful with her finances, but a series of unexpected events turned her stable life upside down. First, she lost her job due to company downsizing. Then her car broke down, requiring an expensive repair. With mounting bills and no steady income, Chloe found herself sinking into financial stress.

At first, Chloe tried to remain optimistic, believing she would find a new job quickly. But as weeks turned into months, her savings dwindled, and the pressure intensified. The constant worry about money started to affect her mentally. She found it difficult to focus during job interviews; her mind was clouded with anxiety about unpaid bills and looming debt.

Chloe’s sleep patterns became erratic. She would lie awake at night, staring at the ceiling, calculating how long she could stretch her remaining funds. The lack of sleep left her exhausted during the day, and she began relying on coffee to stay alert. Her mood fluctuated wildly; she was irritable and short tempered with friends and family, often lashing out over minor issues.

Physically, the stress manifested in various ways. Chloe started experiencing frequent headaches and digestive problems. Her once-healthy diet deteriorated as she turned to cheap, processed foods to save money. The poor nutrition took a toll on her energy levels and overall health.

These three examples show how stress in different life domains may affect us adversely and how toxic stress impacts on our bodies and minds.

6 Risk & Protective Factors

Understanding the factors that can exacerbate or mitigate the effects of toxic stress is essential for developing effective interventions. Below is a list of three common risk factors and three protective factors.

Risk factors

Adverse childhood experiences

Early exposure to abuse, neglect, or household dysfunction can predispose individuals to toxic stress (Anda et al., 2006; 2013; Felitti et al., 1998; Repetti et al., 2002; Shonkoff & Garner, 2012).

Socioeconomic disadvantages

Low socioeconomic status is associated with higher exposure to stressors such as financial instability and lack of access to resources (Evans & Kim, 2013; Kuo, 2001; Santiago et al., 2011).

Lack of social support

The absence of a supportive social network can exacerbate the effects of stress, increasing vulnerability to its harmful impacts (Cohen, 2004).

Protective factors

Supportive relationships

Strong, positive relationships can buffer the effects of stress and promote resilience (Repetti et al., 2002).

Healthy coping mechanisms

Engagement in activities such as physical exercise, mindfulness, and hobbies can help manage stress effectively (Salmon, 2001).

Access to mental health services

Timely access to psychological support and counseling can mitigate the effects of toxic stress (Kazdin & Blase, 2011).

Some other risk factors are related to burnout and our working habits. Regularly working long hours, poor work–life boundaries, and an inability to switch off from our work even in our free time have all been shown to increase our risk of experiencing chronic stress and exhaustion (Schaffner, 2024).

5 Child-Friendly Stress Management Activities

Stress management activities for children matter because they play a crucial role in promoting healthy development. They contribute to enhancing our children’s emotional regulation, academic performance, social skills, resilience, and overall wellbeing.

1. Mindfulness exercises
   Teaching children simple mindfulness practices, such as deep breathing or guided imagery, can help them manage stress by promoting relaxation and present-moment awareness (Schonert-Reichl & Roeser, 2016).
2. Physical activity
   Encouraging regular physical activity, such as sports or play, can reduce stress levels and improve overall wellbeing (Strong et al., 2005).
3. Creative expression
   Activities like drawing, painting, or playing musical instruments can provide children with a healthy outlet for their emotions (Malchiodi, 2013).
4. Storytelling and reading
   Sharing stories and reading together can foster emotional connection and help children process their experiences.
5. Nature walks
   Spending time in nature has been shown to reduce stress and enhance mood, making it an effective stress management activity for children (Kuo, 2001).

Incorporating stress management activities into a child’s routine, such as mindfulness exercises, physical activity, creative arts, and relaxation techniques, can have lasting positive effects on their development and quality of life.

For more suggestions on self-care and relaxation skills for kids, you may enjoy this video:

5 Worksheets for Coping With Toxic Stress

PositivePsychology.com offers a variety of worksheets designed to help individuals cope with toxic stress. These worksheets provide structured activities and strategies to manage stress effectively.

1. Coping: Stressors and Resources

Finding the sources of stress and then finding matching coping resources is made easier with this Coping – Stressors and Resources worksheet. It helps clients identify their key stressors and associate them with the relevant coping resources.

2. Identifying your stress resources

Clients can learn to rely on a personal network of support by using this worksheet: Identifying Your Stress Resources. It helps clients understand the resources they can mobilize and draw upon in times of severe stress.

3. The ABC Worksheet

The ABC Worksheet is based on cognitive behavioral therapy. It helps clients understand the relationship between their thoughts, emotions, and behaviors to make positive changes (Beck, 2011).

4. One-Hour Stress Plan

The One-Hour Stress Plan provides a structured, analytical 60-minute action plan for dealing with sudden, serious demands. It allows clients to establish a hierarchically ordered list of tasks, allowing them to establish which ones require urgent attention (D’Zurilla & Goldfried, 1971).

5. Gratitude journaling

Finally, there is a lot of research on the beneficial effects of gratitude. Simply writing down three things we are grateful for each day has been shown to increase positive emotions (Emmons & McCullough, 2003).

Useful Resources From PositivePsychology.com

As stress is so prevalent in modern society, we have a wide range of articles addressing various aspects of stress management.

You may enjoy reading these additional articles:

• How to Cope With Stress: 10+ Strategies and Mechanisms
• 26 Best Stress-Relief Techniques According to Psychology

If you’re looking for more science-based ways to help others manage stress without spending hours on research and session prep, check out this collection of 17 validated stress-management tools for practitioners. Use them to help others identify signs of burnout and create more balance in their lives.

A Take-Home Message

Toxic, long-term stress can have far-reaching consequences for the mental and physical health of both adults and children.

Understanding its causes, symptoms, and effects is crucial for early intervention and effective management.

By fostering healthy habits and supportive relationships, and regularly practicing generative coping mechanisms, we can mitigate the harmful impacts of toxic stress. This allows us to enhance our resilience and wellbeing and lead more fulfilling lives.

We hope you enjoyed reading this article. Don’t forget to download our three Stress & Burnout Prevention Exercises (PDF) for free.