F. David Schneider, M.D. Answers Questions On: Toxic Stress

Toxic stress refers to the stress that comes from very difficult experiences. For instance, being a victim of intimate partner violence, child abuse, sexual abuse, being raped, being in war, being held captive or kidnapped, or living through a natural disaster or other severely traumatic experience. Toxic stress can lead to post-traumatic stress disorder (PTSD).

Physical effects can be significant and disabling. Toxic stress can lead to heart disease, cancer, neurologic problems, chronic headaches, and chronic pain.

People who experience toxic stress, especially as young children, have a much greater likelihood of engaging in risk-taking behavior. This includes doing things like smoking or drinking heavily at an early age, using drugs, having multiple sexual partners, and getting pregnant at a young age. These are things that can get in the way of having a successful life, as well as lead to chronic illness in adulthood.

We see many behavioral health issues related to toxic stress. It can cause significant mental distress or emotional illness – things such as depression, anxiety, PTSD, and eating disorders. We don't know that it can lead to schizophrenia, but we do know that it can make it worse.

Yes, it’s beginning to. For a long time it was seen more as a social problem than a health problem, but that’s changing. As a physician, if you don't understand trauma and speak to people in a trauma-informed manner, you can easily re-traumatize someone who's a victim of trauma and worsen the condition. Or you can inadvertently make a patient feel that you don't care. This involves carefully choosing words that are sensitive to how the patient might perceive them. We need to work on how we work with people who have been victims of toxic stress, to help them cope and enable them to have a better life.