What are trauma and toxic stress?
We all experience stress. At every age, our daily lives are full of situations that frustrate or worry us. Most of the time, we have the support and skills we need to handle life’s challenges. But sometimes, the stress we experience is so intense—or goes on for so long—that it overwhelms our ability to cope.
Trauma is the impact felt from high levels of toxic stress. This can be emotional or physical. We may feel toxic stress when we face strong, frequent, or prolonged challenges. These can include abuse, neglect, violence, or substance use in the home. These experiences can trigger our body's stress response. This response floods our body with "fight or flight" chemicals.
The toxic stress caused by childhood trauma can be harmful. It may damage or delay the healthy development of a child’s body and brain. This can leave them vulnerable to chronic health problems, risky behaviors, and mental illness as adults.
Recognize the signs
Learn to recognize the different types of stress and signs of trauma. It can help you identify when you, a friend, or a loved one may need help.
Types of stress
- Positive stress: While every child experiences stress differently, a little stress is a normal part of healthy child development. The first day of child care, meeting new people, or getting an immunization at the pediatrician’s office can cause positive stress.
- Tolerable stress: Tolerable stress turns the body’s alert system up higher and for longer. As long as these experiences are short-term and made easier with support from caring adults, most children recover from difficulties like natural disasters and pandemics, the loss of a family member, or a serious illness.
- Toxic stress: When the stress children feel is strong, frequent, or prolonged, it can disrupt healthy brain development and impact the way they think, feel, and grow well into adulthood. Without a caring environment, attention from caring adults, or other protective factors to soften the effects of toxic stress, children who’ve experienced trauma have higher risks for physical, mental, and behavioral health problems throughout their lives.
Symptoms of trauma and toxic stress
- Changes in thinking: Confusion, disorientation, heightened or lowered alertness, poor concentration, difficulty identifying familiar objects or people, memory problems, and/or nightmares.
- Changes in emotions and behavior: Anxiety, guilt, denial, grief, fear, irritability or Intense anger, emotional outbursts, depression, withdrawal, panic, feeling hopeless or overwhelmed, difficulty sleeping, changes in sexual behavior, excessive alcohol consumption, and/or temporary loss or increase of appetite.
- Changes in physical health: Fatigue, nausea or vomiting, dizziness, profuse sweating, thirst, headaches, visual difficulties, clenching your jaw, and/or aches and pains. Seek immediate medical care if you experience chest pain or difficulty breathing.
Types of trauma
What is trauma? It's the response to a terrible event. This can be a single event or a series of events—or both. Because trauma can be experienced in many ways, many types exist. Understanding the different types of traumas can lead to better recovery and support.
Acute trauma results from a single stressful or dangerous event. Because of such an event, our body gets stuck in threat response.
Examples of acute trauma include:
- Physical or sexual assault or abuse.
- Sudden death of a loved one.
- Being diagnosed with a life-threatening illness.
- Natural disasters.
- Terrorist attacks.
Collective trauma results from a shared emotional reaction to a terrible event. These events affect large groups of people. Collective trauma has the potential to change the way we live.
Examples of collective trauma include:
- Terrorist attacks
- Mass shootings
- Natural disasters
Complex trauma is the result of many stressful events. These events are often a result of negative experiences with someone we know.
Examples of complex trauma include:
- Sexual abuse.
- Physical and emotional abuse.
- Neglect or abandonment.
- Torture or sex trafficking.
Historical trauma is experienced by groups who face or once faced oppression. The emotional and physical trauma builds up over time. It can go on for generations.
Examples of historical trauma include:
- Forced migration.
- Violent colonization.
Racial trauma is the result of ongoing exposure to racial stressors. These can be mental or physical stressors.
Examples of racial trauma:
- Hate crimes.
- Media depictions of ethnic groups.
When a person experiences trauma, they often seek safety and support. But what happens when that "safe place" causes more trauma and makes things worse? The result is often sanctuary trauma.
Sanctuary trauma is often experienced In:
- Foster care.
- Health care systems.
- Domestic abuse shelters.
- Homeless shelters.
Vicarious trauma is the result of indirect trauma. Seeing bad images. Hearing graphic stories. Being exposed to challenging experiences. Even though you aren't a direct witness to the trauma, it can affect you.
People more vulnerable to vicarious trauma include:
- EMS workers.
- Police officers.
- Spiritual leaders.
Understanding the effects of trauma and toxic stress on first responders
Helping others during a crisis is stressful. And that stress can build up and express itself in many ways. That's why it's important to know the symptoms of secondary trauma and burnout. These conditions can affect anyone on the front lines.
- The feeling that other’s traumatic experiences are your own
- Excessive fear or worry that something bad may happen
- Feeling hyper aware or “on guard” at all times
- Recurring thoughts about traumatic incidents
- Elevated breathing, heartbeat, and blood pressure
- Changes in your normal sleep or eating patterns
Hear from first responders
Watch a firefighter, a nurse, and two police officers explain why it is okay to ask help.
"When you're in distress, you gotta reach out and get help. You can't do it alone."
"If you don't deal with your feelings, listen to your feelings, and address the feelings, they're going to come back."
"We don't have to be all tough guys."
"Whatever it is that's bothering you, please talk to somebody."
Resources for first responders
You are not alone. Tools, information, and support are available for first responders living with trauma and toxic stress.
For those living with trauma and toxic stress, nothing is more important than learning how to strengthen your ability to manage stress, recover from trauma, and ask for and accept help. Start by exploring the resources below:
Overcoming trauma and toxic stress takes a supportive network of friends, family, and colleagues. Learn how you can offer the first responders in your life the understanding and support they need.
Trauma and toxic stress prevention and treatment is an important tool for protecting every first responder’s physical wellness, mental health, and effectiveness on the job. Invest in education and training opportunities that can help you maintain continuity in your community services.
- Building Resilience to Prevent PTSD, Decrease Suicides, and Increase Happiness
- The Resilience Alliance: Promoting Resilience and Reducing Secondary Trauma Among Child Welfare Staff (PDF)
- Secondary Trauma and Child Welfare Staff: Guidance for Supervisors and Administrators (PDF)
- The Vicarious Trauma Toolkit
Emergency medical services professionals, firefighters, and law enforcement officers are invited to watch the video below. It provides information on how to recognize the symptoms and risks associated with toxic stress and tools for self-care to improve mental and physical health.
Resource: Toolkit for first responders (PDF)
After you watch the video, complete a short evaluation survey to earn a digital certificate of completion.