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  • Writer's pictureRebecca Bryan

"I was traumatized by that long line!" Understanding stress.

I remember when I first came across the science generated by the Adverse Childhood Experiences (ACE) Study. It was 2013, I was just getting my feet under me as director of the UrbanPromise Wellness Center, and I was trying to share the profound shift in understanding I was experiencing by everything I was reading and watching. One of the challenges very quickly became: how do I succinctly, yet safely, get the point across that child suffering is incredibly common and has insane effects on health and behavior? And how could I get people to realize that the annoying stress that they experienced in daily life was in no way comparable to the toxic stress I was trying to describe? This graphic (available in many forms; this one is from helped to put things in perspective.

We all need positive stress; we learn from it. As a matter of fact, having regular doses of challenge, including failures, that we recover from in a healthy way strengthens us - it makes us more resilient. In the U.S., we are witnessing the effect of over-parenting in college freshmen who don't know how to problem-solve for themselves - my take on this phenomenon is that these kids were protected from experiencing necessary, positive stress.

And then there's tolerable stress: a bad car accident, a deeply broken heart, the diagnosis of cancer and resulting treatment...fill in the blank. We all experience this at some point in our lives, right? But what makes it tolerable has a lot to do with social determinants of health, like having loving, supportive connections, good health insurance, living somewhere safe to be able to exercise, access to healthy food, and having transportation to needed services.

Toxic stress is a whole other ball game. It is stress that tends to be chronic, often triggering - or keeping on - the body's survival response, and overwhelming coping mechanisms. In medical terms, this is chronic activation of the HPA axis. In every day language it's living in fight, flight or freeze. Nadine Burke Harris, trauma expert who gave this TED Talk, talks about meeting a bear in the woods, and how it's perfectly appropriate for your eyes to dilate, your heart to beat hard, and your muscles to tense to prepare to fight or run from that bear. But what happens when that bear follows you home every night? That's toxic stress. And that is the stress measured by the ACE study. And that too many American children live with day in, day out, getting under their skin, altering brain development, immune and hormone systems, and influencing genetic expression.

Dr. Anda, one of the original researchers, likes to say, "What is predictable is preventable." It is predictable that if a child grows up with toxic stress, it will negatively affect her health, behavior and social consequence. We all have the responsibility to raise awareness of this, and work towards prevention. Amen? May it be well with your soul.

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