Tara L. Powell is a professor of social work at the University of Illinois Urbana-Champaign who researches the impact of disasters on youths, health care workers and first responders, and assesses interventions for strengthening their coping skills. Powell spoke with News Bureau research editor Sharita Forrest about U.S. Surgeon General Dr. Vivek H. Murthy’s recent advisory warning of a looming mental health crisis among youths in the U.S. caused by the coronavirus pandemic.

The surgeon general’s mental health advisory indicates that pandemic-related disruptions may lead to the development of toxic stress in young people. What is toxic stress?

Toxic stress is when a child experiences sustained adversity without the presence of protective relationships. Such adversity may include abuse, neglect, poverty, the death of a close friend or family member, parental divorce or community violence.

Toxic stress impacts a child’s physical and mental health due to prolonged activation of the stress response cycle—the “fight or flight” system that tells us when there is a perceived threat. The stress response cycle releases hormones causing symptoms such as an increased heart rate, shallow breathing and the release of cortisol.

Over the short-term, this cycle can be useful and trigger us to swiftly react to a threat. Toxic stress, however, results in the continuous activation of this cycle without the opportunity to recover or return to normal.

What are the long-term effects of toxic stress on children and adults?

Children who experience toxic stress are at risk for a host of challenges such as learning disabilities and emotional or behavioral dysregulation. In adulthood, they are at increased risk for physical ailments such as cardiovascular disease and mental health difficulties including depression, anxiety and substance use disorder.

Many young people have experienced the loss of loved ones, family adversity, economic hardship and social isolation during the pandemic. Prolonged pandemic-related stressors can overwhelm a young person’s coping capacity, leading to continuous activation of the stress response cycle.

Protective factors such as safe and supportive relationships with family and peers, however, can buffer the impact of these stressors and help a child overcome these pandemic-related challenges.

With experts forecasting a difficult winter ahead due to the omicron variant, what safeguards might employers put in place to promote resilience in workers and help those who need additional support?

With the omicron variant projected to overwhelm the already fatigued health care system, it is likely that we will continue to see rates of burnout escalate. Additionally, the ongoing pandemic has led to emotional exhaustion among the general public, making it crucial for employers to support workers in all industries.

Burnout is related to an array of factors such as the transition from in-person to remote work, increased caregiving responsibilities at home, and ongoing pandemic-related threat, loss and uncertainty. There are several steps employers can take to increase individual and workplace resilience as the pandemic continues to cause disruptions, including:

• Encouraging work-life balance. Remote work has created challenges separating work and personal life. Employees have noted that during the pandemic, employer expectations have risen and nontraditional work hours have become the norm. Practices that promote a work/life balance include reviewing workloads, encouraging breaks and urging workers to take time off when needed.
• Establish community. Social and professional support is critical to workplace wellness and resilience. Employers should establish and/or promote activities for workers to connect and receive support from each other.
• Create clear expectations. Lack of clear expectations is a sizable contributor to worker burnout. Collaboratively setting clear, realistic and measurable goals and providing meaningful feedback are a few steps to increasing worker well-being and motivation.
• Provide support and empathy. Most individuals have experienced both personal and professional hardships over the course of the pandemic. Having a supervisor and colleagues who provide empathy can help a person persevere through challenging times. Some ways to provide empathy include checking in, practicing active listening and showing interest in the needs of employees.

What are signs or symptoms that might indicate someone is becoming overwhelmed or experiencing trauma and may need professional help?

You may not always know when someone is experiencing distress, but there are a few indicators that an individual could benefit from professional support. Subtle signs of distress or trauma can include:

• Withdrawal from friends or colleagues.
• Heightened frustration or loss of patience.
• Emotional outbursts such as crying or yelling.
• Increased substance use.
• Not feeling understood.
• Physical changes such as rapid weight loss or gain.

More noticeable signs include:

• Suicidal statements or thoughts.
• Anger, rage or aggression toward others.
• Extreme anxiety or panic.
• Bizarre, paranoid or irrational thinking.

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