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Toxic Stress in Kids: What Parents Should Know

June 23, 2026

For children, learning to handle everyday stress is an important part of maturing.

“As children grow, they need to encounter and navigate challenges in order to learn important life skills,” says Columbia pediatrician Evelyn Berger-Jenkins, MD. “For example, when learning to walk, they gain balance and strength as they fall and get back up. The same is true for their social and emotional development.”

But when stress becomes intense or prolonged, or happens without enough support, it can take a toll on a child’s development.

With a focus on behavioral health and wellness, Dr. Berger-Jenkins helps young people build the tools they need to manage emotions and navigate challenges. “Learning how to regulate emotions and behaviors is essential to mental, physical, and social health,” she says.

Dr. Berger-Jenkins breaks down what toxic stress is, how it affects kids, and what families can do to support their child’s development.

What is toxic stress?

Not all stress is bad. In fact, says Dr. Berger-Jenkins, some stress is necessary for healthy development. When an infant separates from a parent for the first time, they may feel distress, but they also learn to adapt and build relationships with others.

These manageable stressors, especially when paired with nurturing and scaffolding from supportive caregivers, help children build an understanding of the world around them and the resilience to respond to, and overcome, inevitable challenges.

Toxic stress is different. It occurs when a child experiences severe, prolonged, or repeated stress, such as ongoing hardship, instability, or adversity, without enough guidance and support from trusted adults. Without that support, stress can overwhelm a child’s development. The physiologic impact of stress hormones on the child’s developing brain and body can also cause lifelong health challenges. Even in nurturing, stable homes, children can experience toxic stress.

What are the signs of toxic stress in kids?

The effects of toxic stress do not always look the way people expect, says Dr. Berger-Jenkins. It may show up as behaviors that are mistaken for other conditions.

Children experiencing toxic stress may:

Be constantly on edge or expecting something bad to happen, or have trouble concentrating. These signs are similar to anxiety or post-traumatic stress
Lose interest in activities, have low energy, and/or act withdrawn. These signs are similar to depression.
Display impulsivity, restlessness, and/or inability to sit still. These behaviors are associated with hyperactivity.
Have speech delays, difficulty focusing, and/or challenges with reading or math that lead to struggles in school.
Toxic stress can also affect basic daily routines. Changes in sleep, appetite, or energy levels are often early warning signs.

How does toxic stress affect a child’s body and brain?

Toxic stress can change how a child’s brain functions. It activates the brain’s “alarm system,” particularly the amygdala, which is responsible for detecting threats. When this system is overactive, children may become hypervigilant—constantly on the lookout for danger.

Due to this overactivity, the parts of the brain responsible for thinking, learning, and self-regulation may become less active or less functional. This can make it harder for children to focus, control impulses, and process information effectively.

The effects of toxic stress go beyond behavior and brain function. When the body is under constant stress, it releases high levels of stress hormones like cortisol. Over time, this can lead to inflammation and affect multiple systems in the body, including the cardiovascular and immune systems. Research has shown that exposure to toxic stress during childhood is associated with a greater risk of many diseases in adulthood, including heart disease, diabetes, and even cancer. These effects can be long-lasting and may not appear until later in life. In some cases, the impact of toxic stress can even extend across generations.

Ways to alleviate stress

“Stress is a normal and necessary part of life, especially for growing children,” says Dr. Berger-Jenkins. It’s not possible or beneficial to eliminate stress entirely, but there are ways to reduce its effects and prevent it from becoming toxic.

Here are some steps you can take:

Notice signs of stress: Children often express stress through behavior. Changes in sleep, mood, and interactions with others can be early clues that something is overwhelming them.
Understand the root cause: Instead of wondering “What’s wrong with my child?” ask: “What might they be feeling or reacting to?” This shift in perspective can lead to more effective support.
Prioritize connection and routine: Simple routines, like maintaining regular sleep schedules, eating meals together, and providing daily hugs, can provide stability, helping children feel secure. Stress becomes harmful when children feel alone in their experience.
Take care of the caregivers (yourself) too: Even small moments of joy, rest, and simple breathing can help grown-ups and caregivers relax—and that feeling of calm can be passed on to a child.
Ask for help: If a child is struggling with learning, anxiety, or attention, additional supports may be helpful. Pediatricians, teachers, and counselors can be part of your team. Reach out and ask what assessments and/or services are available.

The good news is that with the right support and understanding, children can recover from stress, adapt, and thrive.

Evelyn Berger-Jenkins, MD, is an assistant professor of pediatrics at Columbia.