How stress affects our kids brains too.

Stress in the workplace and home has been blamed for much of the prevalence of stress related illness such as heart disease, cancer and mental illness including anxiety and depression. What hasn’t been known is how much stress affects our children and the impact this has on their own physical and mental well being.

The headline in last Saturday’s edition of the West Australian was “Secret Stress Of Our Kids” This was based on the published results of a survey of nearly 959 WA children aged between 5 and 18 years. The Commissioner of Health Michelle Scott reported that it appears from the research that children on the whole are doing pretty well but there were a couple of clear and consistent areas of concern. She went on to say that the quality of family life was shown to have the greatest impact on children’s wellbeing, so it was not surprising that issues such as family conflict and alcohol abuse were sources of trauma to them.

The survey results showed:

• 35% reported as having too much stress in their lives • 60% had been bullied and 44% had bullied someone else. • 40% said they did not feel safe on public transport in the daytime (79% at night) • 19% did not feel safe at home. • 42% felt scared in public places • 38% said they did not have anyone to talk to and preferred to keep their problems to themselves.

This week I listened to a lecture given by Dr. Anke Van Eekelen at the Telethon Child Health Institute. Dr Anke has been involved with developmental neuroscience research focussing on brain development, adolescent brain function and neuroendocrine regulation of stress and adaptation. Her talk focussed on how our children’s brains mature and how stress in childhood by affecting their brain maturation in late adolescence can affect their ability to cope with life’s stresses as adults. Our brain's stress circuitry (the HPA) is completed by early adulthood and will stay stable then through out the rest of our lives. Our level of resiliency to deal with life’s stressors depends on how our brain is wired at that time.

Her team have been trying to identify some of the main factors that influence adolescent brain maturation. Their focus has been to evaluate the role of genetic factors, combined with childhood and adolescent experiences. The data has been collected from around 2900 women and their children who enrolled in the Raine Study, a longitudinal pregnancy cohort that began in 1989.The teenagers are now aged between 16 and 18 years. Data from a second longitudinal study, the Peel Child Health now in its second year is also being included. Her findings are due to be published in the near future.

When we are under prolonged stress our levels of circulating cortisol in our body is increased and this is known to have a damaging effect on our brain. Stress reduces the brains plasticity, or in other words its ability to produce new brain cells, or to maintain or produce new connections between brain cells.

In the developing brain the flight or fight mechanism, is not fully developed until late adolescence. In some instances this is not complete until the age of 25! This therefore provides a final phase of opportunity to influence the final development stage of the brain, which also happens to coincide with the cognitive maturation of the forebrain, the part of our brain concerned with higher-level thinking.

However for teenagers, this time also coincides with puberty, big surges of hormones and and an increased vulnerability to stress.

In her preliminary findings Dr Anke revealed that teenagers levels of stress hormones are influenced by the life stressors their mothers had experienced pregnancy. The type and timing of the stress was shown to be the most important. Maternal stress experiences in early pregnancy whether it is relationships (separation/divorce, marital problems or death of a family member) or financial (job loss, financial problems) were the most significant. In the 17-year-old group those whose mothers had had more stress during pregnancy, had higher resting levels of stress hormones on blood and salivary testing. In the 18-year-old group tests of blood and salivary hormone levels were taken during and after stressful events. The form of the stress used is known as the Trier Social Stress using the challenge of public speaking and also doing mental maths. The results from this group are currently still being evaluated. What has been found though, is that there is a gender difference in stress hormone levels. The boys had a higher level of the brain stress hormone ACTH, but lower blood cortisol (which is produced by the adrenal glands), whereas the girls had lower ACTH levels but an increased adrenal response with a higher cortisol level. This suggested gender difference in response to stress has also been shown in a study in adults.

Here a study at the University of Pennsylvania in 2008, used fMRI scans to look at the gender differences of stress on adult brains. The results showed that different areas of the brain were engaged in the stress response depending if it was a woman or a man. Men tended to show an increase in blood flow to the prefrontal cortex, which is responsible for the flight or fight response. Women showed increased blood flow to the limbic areas, which is associated with a more nurturing response and also showed longer lasting changes in blood flow and brain activity. These results imply that gender needs to be taken into consideration when dealing with stress related disorders such as PTSD (Post Traumatic Stress Disorder) along with other genetic and environmental factors. Dr Anke’s team have been able to obtain neuro imaging by fMRI of sixty 17 year old boys. These scans show that those boys with lower levels of stress hormone activity required less brain activity to complete mental tasks than those with higher levels. This is thought to represent a difference in the maturity of their brains. The less mature requiring greater brain intervention and energy to achieve the same task.

A new study from Brown University published in Neuropsychopharmacology has revealed that healthy adults who suffered abuse or neglect in early childhood will continue to carry higher levels of inflammatory markers such as interleukin-6, which may be linked to a higher risk of anxiety and depression. This was a small pilot study so a larger study is required to see whether this biological abnormality, which appears to be stress induced could be used as a way in the future to either prevent depression in those identified as being at higher risk, or treatment.

Whether we are children or adults, there are a number of strategies we can put in place to help ourselves to cope with life’s stresses and be more resilient:

• We can recognise what we can change and what we can’t. If we are dealing with something we have no control over, we can simply let it go. • Don’t seek perfection. Perfectionism can be out of sync with reality. It’s not about not trying to do something well, it’s about determining what is a reasonable outcome for a particular task, rather than trying to be the best in everything. This includes not expecting others to be perfect as well. • Be aware of when we have simply taken on too much. It’s important to recognise when we need to press the “pause” button so we can re-evaluate what is essential, what isn’t and to delegate or dismiss as appropriate. • Getting enough sleep to allow our brain to rest, recuperate and review all that it has previously learnt and experienced. • We need to exercise every single day. This has been shown to reduce stress levels and improve our resiliency. Children especially need to be physically active preferably for a minimum of one hour a day. • Follow a brain healthy diet. Avoid the junk food and include plenty of fresh vegetables, fruit and nuts along with lean protein, fish and eggs. • Ensure every day has some down time. Make the time to switch off and relax, enjoy going to a movie, soaking in a hot bath or just spending time with friends.

Reference: Linda L Carpenter, Cyrena E Gawuga, Audrey R Tyrka, Janet K Lee, George M Anderson, Lawrence H Price. Association between Plasma IL-6 Response to Acute Stress and Early-Life Adversity in Healthy Adults. Neuropsychopharmacology, 2010; DOI: 10.1038/npp.2010.159