Tender Young Brains
What kind of childhood stress should parents actually be stressing about?
Back when my daughter was a toddler and didn’t want to go to bed, my husband and I, desperate for a decent night’s sleep, decided to try the last resort of many exhausted parents: the “cry-it-out” method. Each evening we put her to bed, kissed her goodnight, and huddled in the next room as she cried (and we did tiptoe in occasionally for a quick hug). Eventually, utterly exhausted, she’d drop off to sleep.
If you read a December Psychology Today blog post with the alarming title “Dangers of Crying It Out,” you might think the stress my husband and I inflicted on our daughter led to changes in the structure of her brain and put her at risk for developing diseases like diabetes and heart disease as an adult. The idea that something so seemingly innocuous could create ever-lasting damage is enough to make any parent want to wail all night.
But the Psychology Today post, and the many terrified responses it generated (take the horrifying-sounding “Cry It Out: The Method That Kills Baby Brain Cells”), missed something very important: Not all early childhood stress is created equal. Earlier this month, the journal Pediatrics published a wide-ranging and sensible policy statement on the lifelong effects of early childhood (that is, infancy through about kindergarten) adversity and toxic stress.
When parents stress about the wrong kinds of stress, it distracts us from a real and grave public health issue. But it’s easy to get tangled and confused by media reports about stress hurting preschoolers. Here, then, is a brief guide to the three types of childhood stress responses.
In a positive stress response, the stress hormones (like cortisol, adrenaline, and epinephrine) are revved up briefly—curdling stomachs, dampening palms, speeding up heartbeats, quickening breaths, setting the brain to high alert—and then return to their normal state. Picture a little kid freaking out when a nurse approaches with a needle or hiding under a table on the first day of nursery school. It may break your heart as a parent to witness your child’s tears, but it isn’t going to create long-lasting damage. A positive stress response is mild to moderate and—importantly—includes the presence of a supportive adult who can help the child manage the stress.
A tolerable stress response is triggered by rougher experiences: the death of family member, a serious illness, a natural disaster, a bad divorce. As with positive stress responses, as long as a caring and responsible adult is involved, the risk that the cascade of stress hormones will trigger potentially long-term consequences for health and learning plummets.
Now kick that tolerable stress response up a couple of giant notches. Remove the supportive adult from the picture, jimmy the off switch for the outpouring of stress hormones, and now we’re talking a toxic stress response. Young children who are abused, grow up with parents who are substance abusers, and have no responsible and caring adult in the picture—these are the ones who are at highest risk of suffering the damaging effects of prolonged and frequent toxic stress.
Anna Reisman is a physician in Connecticut. You can follow her on Twitter: @annareisman.