Address toxic stress in young adults

Inward flight—or "numbing out" through addictive substances—is common among young adults when trauma exists in the home, said Claudia Black, PhD, author and addictions expert. Not only must the underlying issues of the young person be addressed, but the family must also be an active client in treatment for recovery work to be effective.

“Young adults will derive their greatest strength or greatest sabotage from their families,” Black said at the Institute for Clinical Excellence in Tempe, Ariz. this week. “Many will turn to self-medicating as a way to escape pain, and if we don’t treat the underlying issues causing it, prognosis is poor.”

It all comes down to the nervous system and stress. Periods of increasing and decreasing arousal are experienced on a daily basis, Black explained, and everyone has a window of tolerance where fluctuations can be experienced while still having the capacity to self-regulate. But during times of stress, fluctuations can dysregulate.

While there are both positive and tolerable stressors, Black says stress can become toxic when coinciding with traumatic conditions or when there’s strong, prolonged activation of the body’s stress management system without buffering protection.

“Toxic stress can fundamentally change the trajectory of a young adult's life,” she added.

A young person can become stuck as a result of chronic, long-lasting dysregulation from toxic shame, which is sometimes characterized as "failure to launch." The more severely someone is dysregulated, the greater risk for feeling discomfort in their own skin.

However, according to Black, mindfulness reduces psychological distress, lessens emotional reactivity and increases immune functioning. She also advised implementing in treatment grounding and emotional regulation practices, gender-specific programming to reduce trauma-based gender stereotypes while encouraging same-gender bonding, and trauma therapies including yoga, meditation and expressive arts.

It’s also critical to regularly re-evaluate medications previously prescribed to young adults, as they could no longer be appropriate and be might be enabling the young person's substance use.