Making Sense of Stress in Children
Making Sense of Stress in Children
The human brain consists of distinct parts, each fulfilling a unique role in perceiving and responding to the world. The lower part of the brain, often referred to as the reptilian brain, is the primitive region responsible for survival responses, such as the fight-or-flight response. This area is reactive and triggers automatically in response to a threat. The almond-shaped structure known as the amygdala, located deep within the brain, functions as the centre of all emotions, concentrating on survival and self-preservation.
Above it lies the thinking brain, which is responsible for reasoning, problem-solving, and language. When this higher brain is active, we can evaluate situations, consider options, and respond thoughtfully and effectively. However, in moments of stress, the brain’s “lid” can flip, shutting down the thinking brain and allowing the reactive lower brain to take control. In this state, communication and logical thinking are often compromised.
Chemical Responses to Stress
The body is constantly exposed to chemicals that affect how we feel and respond to them. In response to immediate threats, the pituitary gland in the brain signals the release of stress hormones, such as adrenaline and noradrenaline, from the adrenal glands located above the kidneys. This prepares the body to fight or flee. Another vital chemical, cortisol, is released in response to long-term stress.
Endorphins may also be released in stressful situations, helping to dull pain and allowing a person to push through intense moments. This may explain why some children, particularly those with neurodevelopmental conditions, may engage in behaviours like head banging without seeming to feel pain.
Healthy stress
“Wherever there is change, and wherever there is uncertainty, there is opportunity”- Mark Cuban.
Some level of stress is beneficial—it encourages growth and learning. For instance, learning a new skill activates stress pathways as the brain forms new connections. With practice, the task becomes easier, and stress levels decrease. Exposure to stress leads to the release of cortisol in the amygdala. Optimal cortisol levels play a crucial role in forming new connections within neural networks, known as synapses. It’s not about avoiding stress, but rather optimising the level of stress that aids in learning.
Response and reactions to environmental stimuli
All sensory input from the environment is filtered through the brain and compared to stored templates from past experiences. If something feels familiar and safe, the brain allows for calm processing. However, if an experience is unfamiliar, the brain may interpret it as a threat, even when there is no actual danger. This response might be more intense if the person already has a relatable adversity linked to the stimulus.
For instance, a child entering a new school might feel anxious, looking for signs of safety or sources of comfort. Previous experiences significantly shape this adjustment. A child who has faced challenging transitions may be more wary, particularly in unfamiliar or culturally diverse settings.
Fight or Flight
The human brain has evolved over many years. In earlier times, when humans were hunters and gatherers, they needed to be alert to wild animals that posed a threat to their lives. Our bodies are designed to handle short bursts of stress.
As humans have evolved, the world is no longer as dangerous as it once was. However, our brains have not developed as rapidly as our environment. Consequently, responding to seemingly minor threats, such as a new school setting, navigating relationships or public speaking, triggers the same stress response as encountering a sabre-toothed tiger.
When the brain detects danger, the fight-or-flight response triggers, shutting down the thinking brain in favour of swift action. Blood is redirected from the brain and other vital organs to the muscles, resulting in the physical reactions associated with this response. However, this rerouting of blood flow can also lead to brain fog, which hinders clear thinking and impairs rational decision-making. The effects on the body from this redistribution of blood and the release of various chemicals may include rapid breathing, a racing heart, and a sensation of butterflies in the stomach. Aditi Nerurkar, in her TED talk, refers to the feeling in the chest as a stampede of wild horses.
The stress response is particularly heightened if childhood experiences reinforce fear and insecurity in a child. Children already under stress may react impulsively, exhibiting aggression or avoidance, as they operate from this survival brain rather than from thoughtful awareness. For instance, a child who frequently engages in fights may not do so with the thinking brain engaged—they may be caught in a reactive mode. Likewise, school refusal or avoidance may serve as a form of flight—an unconscious effort to escape perceived danger. Understanding this allows us to shift our question from “What is wrong with this child?” to “What might be underlying these reactions and responses?”
I explain to my patients that some clinical manifestations serve as canaries in a coal mine. Canaries were used in coal mines to detect dangerously high levels of carbon monoxide. The canary continues to sing if the air quality is good. However, as soon as it becomes polluted and reaches hazardous levels, it stops singing, becomes lethargic, or dies. Specific behavioural abnormalities, such as impulsivity or aggressiveness, can indicate stress and act as canaries in a coal mine. If not explored carefully, this may lead to misidentification and harm.
I also use this metaphor for my well-being. I usually sing when I’m completely relaxed, whether I’m at work or at home. When I stop singing, I realise that I’m not relaxed internally, and there may be something I need to do to unwind. It’s useful to develop your own internal canaries in life to build self-awareness.
Chronic Stress
In many animals, the body returns to a state of relaxation once a threat has passed. However, this reset may not occur easily in humans, particularly in children who experience repeated or unrelenting stress. Instead, the body may become stuck in a heightened state of alertness, leading to chronic stress, which can start to feel “normal.” Over time, children living in chronic stress may struggle to relax and may even seek out high-stress environments without realising it, simply because that is what their body has come to expect. Some authors argue that stress can be in a way addictive. The amygdala is always humming in the background.
Chronic stress can have a profound impact on overall health. It may manifest as persistent irritability, difficulties with emotional regulation, heightened responses to minor issues, impaired memory, lack of concentration, abdominal pain, irritable bowel syndrome, anxiety, insomnia, fatigue, chronic headaches, and other nonspecific symptoms.
In clinical practice, stress frequently acts as the underlying factor in many cases of chronic abdominal pain, headaches, and nonspecific symptoms. Children with ADHD are at risk of cognitive fatigue due to the level of focus they must invest in learning new tasks, which heightens their vulnerability to mental fatigue. This is further exacerbated by chronic stress. Nonetheless, paediatricians exercise due diligence to rule out any pathological conditions before arriving at this conclusion.
Stress, Memory, and Associations
Children who have experienced trauma often form strong emotional associations with specific objects, sounds, or environments. For instance, children raised in contexts where physical punishment was prevalent may find that an object like a bamboo stick brings back distressing memories. Conversely, a child from a nurturing environment might associate bamboo with creating playthings.
Personal and cultural experiences shape these associations, and although they may appear irrational to others, they are entirely genuine for the child experiencing them.
Stress and Dissociation
When stress is ongoing and overwhelming, some children may not fight or flee; instead, they might dissociate. This adaptive coping mechanism involves turning inward—becoming quiet, numb, or disconnected from their environment.
Dissociation may appear as a child who seems spaced out, unresponsive, or unusually calm in distressing situations. In some cases, paediatricians are referred to children with these spaced-out episodes, which are misinterpreted as seizures.
While it may provide temporary protection, chronic dissociation can impact learning, relationships, and emotional development. Supporting such children requires patience, predictability, and safe spaces.
“The paradox of volcanoes was that they were symbols of destruction, but also of life. Once the lava cools, it solidifies and then breaks down over time to become soil-rich, fertile soil.” – Matt Haig, The Midnight Library.
Conclusion
By understanding how stress affects the brain and body, we can support children more compassionately and effectively, helping them develop into emotionally resilient and confident individuals.
Disclaimer: The content in this blog is intended for general information only and does not substitute for professional medical advice.
Suggested resources
“The Boy Who Was Raised as a Dog” by Dr. Bruce Perry.
How to make stress your friend. TED Talk by Kelly McGonigal
https://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend
https://youtu.be/RcGyVTAoXEU?si=ldhMWFJSwsMxPz0U