Family stress: An evidence based guide

When one family member is stressed, it can disrupt the entire family. How is stress transmitted, what are the effects of family stress, and what can we do to cope?

child's stuffed toy and cars left abandoned on worn wooden floor, next to a broken picture frame
  • The baby won’t stop crying.
  • Your toddler suddenly dashes out into a busy street.
  • Your teenager has a frightening emotional episode, or engages in self-harm.
  • Your family needs you, but you’ll endanger your job (and paycheck) if you don’t go to work.

The triggers are different, but the effects are the same. Your body is flooded with stress hormones—adrenaline and the glucocorticoids. Your pulse quickens. You breathe faster. You are alert and high-strung. Your blood pressure shoots up. Your blood sugar rises, and the blood flow is redirected from non-essential systems (like digestion and repair) to the muscles required for strength and speed.

This is the stress response, your survival kit for coping with threats. It’s a helpful in a crisis, but it comes at a cost. Shifting to emergency mode means investing less in other important functions, and stress reactivity is intrinsically taxing.

What if the stress is prolonged? If your brain interprets your daily life as a continuous struggle in a threatening world? When stress is chronic, it can cause adverse changes throughout the body and brain. And this “toxic stress” doesn’t just affect us as individuals. It can also have an impact on our social relationships. So it makes sense to talk about “family stress.”

What is family stress?

Stress researchers think of the family as a system. Family members have a joint understanding of how the family is supposed to function, and they each play their roles.  They have certain routines and expectations, and when everything is going smoothly, those routines work. The system functions the way everybody expects it will (Boss 2014).

But what if something happens that puts pressure on the system? It might be a stressor applied to a single family member, like the stress experienced by a parent with a grueling job. Or maybe a child is getting bullied at school. Alternatively, it might be an environmental stressor that everyone experiences together, such as a natural disaster, or the loss of housing.

Regardless, the important point is that stress doesn’t stay compartmentalized. One person experiences stress, and it changes her behavior. If her usual routines and familiar resources aren’t equal to the challenge, she may feel overwhelmed, triggering physiological and psychological symptoms of distress. And her symptoms end up affecting other people, so that they, too, feel distressed. Family relationships may suffer, routines may break down, people may feel confused about how to adapt. Individual family members may find that they aren’t getting the social and emotional support they need.

In the Encyclopedia of Behavioral Medicine(2013), Ashley  Randall and Guy Bodenmann have summed it up this way:

“Family stress can be defined as any stressor that concerns one or more members of the family (or the whole system) at a defined time, which impacts the emotional connection between family members, their mood, well-being, as well as the maintenance of the family relationship.”

What are the major causes of family stress?

Sometimes stressors originate from outside the family (Randall and Bodenmann 2013; Nelson et al 2009). I’ve mentioned examples of this already: Stress in the workplace, or at school. A natural disaster. Other outside stressors include job loss, racial discrimination, and financial hardships. Family stress might also be triggered by living in a neighborhood blighted by poverty, crime, violence, noise, or pollution.

Stressors can originate from within the family, too (Nelson et al 2009; Fujiwara et al 2011), and they may include troubles like

  • postnatal anxiety or depression;
  • frustration caused by excessive infant crying;
  • marital dissatisfaction, fighting, or stress related to a divorce;
  • interpersonal conflict or tension (like fighting among siblings);
  • death or imprisonment of a family member;
  • illness, disability, or mental health problems in a family member; and
  • perceptions of household chaos (which includes feelings of commotion, being rushed, running late all the time, having trouble staying on top of things, not being able to “hear yourself think”); and
  • sleep problems.

The last item on this list is worth emphasizing, because people sometimes underestimate the stress caused by chronic sleep loss. In addition to making us tired and cranky, sleep loss interferes with our natural patterns of stress hormone production. Ordinarily, glucocorticoid stress hormones peak in the morning and decline throughout the day. But when we don’t get enough sleep, glucocorticoid levels tend to remain high, disrupting our circadian rhythms, causing further sleep problems, and increasing risk of stress-related disease (Hirotsu et al 2015; Oster et al 2017). Sleep loss also has a way of intensifying our psychological experience of stress, something I’ve written about in another Parenting Science article.

Finally, it’s clear that parenting itself can be stressful. Parents may feel overwhelmed or inadequate — unable to meet the demands of caregiving, because they lack the time, money, emotional resources, or social support needed to keep their family thriving (Deater-Deckard 1998; Holly et al 2019). The stress can be especially intense if parents have children with developmental disabilities, behavioral problems, or a serious medical condition. (For more information, see my article, “Parenting stress: What causes it, and how does it change us?”)

How does stress get transmitted within the family?

It’s a good question to ask, because sometimes people assume they can stop the spread of stress merely by keeping their personal problems to themselves.

This makes a certain amount of sense. Stress can definitely make us anxious or short-tempered, and it’s easy to see how the chain of events  could unfold: I get stressed out, so I yell at you, or throw a tantrum, or otherwise behave in ways that makes you feel threatened. In response, you become anxious or short-tempered, triggering the next person, and so it goes. It’s stressful when family members are snapping at each other, or acting out in ways that seem hostile or frightening. Eliminating that kind of behavior is a good thing.

But that’s not the only way that stress spreads through a family.

For instance, suppose you respond to a personal stressor by turning inward. You don’t yell at people. You don’t direct negative behavior at them. But you’re still feeling overwhelmed inside — anxious, angry, or possibly depressed. So you feel more disconnected, and you show less warmth and sensitivity to your family members. You’re less in tune with what other people are feeling and thinking.

What is the result? You might have succeeded in keeping your inner distress bottled up, but your behavior is still altered in ways that contribute to family stress. Family members rely on each other for support. When that’s missing — when you aren’t as emotionally accessible, responsive, or sensitive — it can weaken the family. In fact, it can deprive children of crucial developmental input, which is one reason why researchers count living with a depressed family member as an “adverse childhood experience” — an experience that puts kids at higher risk for stress-related diseases and problems (see below).

So we can spread stress in at least two ways — by directing negative behavior at others, and by failing to provide others with sensitive, responsive support. But there is yet another, rather fascinating way that  family stress gets transmitted:  You can “catch” stress by merely observing another person under pressure.

You don’t need to interact with the other person directly. It’s enough to see that something is upsetting them. In effect, the stressed person is giving off “stress cues” — via tone of voice, facial expressions, body movements, and maybe even odors or pheromones. These cues tell your brain that there is a threat in the environment, and your autonomic nervous system responds (Calvi et al 2020; Dimitroff et al 2017).

How early in life are we susceptible to this kind of “stress contagion”? You might think that babies are too immature to notice stress in others. But, as I explain elsewhere, experiments show that babies can sense when their mothers are stressed. And there’s evidence that frequent conflicts between parents have an impact on babies’ brains.

So it’s a mistake to assume that individual family members can keep their stresses entirely to themselves. When one person is stressed, it affects others.

What are the consequences of family stress?

First, it’s good to remember: Not every experience with family stress results in a crisis. If family members perceive that they have what it takes to cope — if they can get the support they need, and come up with effective coping strategies — then the family may get through it unharmed.

Such outcomes are more common when family members maintain emotional closeness, communicate clearly, engage in constructive problem-solving, and hold reasonable beliefs about cooperating and accommodating each other  (Sheidow et al 2014). Indeed, as I’ve written elsewhere, studies suggest that warm, sensitive social support provides us with a protective buffer against the worst effects of toxic stress.

But of course families aren’t always optimally adapted to handle stress, and, even the best-adapted families can encounter situations that are extreme or overwhelming. When that’s the case, individual family members may suffer a variety of negative effects, as mentioned earlier.

Chronic, toxic stress subjects the body to greater wear and tear, putting individuals risk for cardiovascular and metabolic problems. It can impair the immune system, disregulate the stress response system, accelerate aging in the body’s cells, and alter the functioning of DNA, switching certain genes “on” or “off.” And these physiological changes are often accompanied by psychological symptoms, including anxiety, depression, impulsiveness, aggression, and poor emotional regulation.

Children may be especially vulnerable, because their brains are still developing.  For details, see my articles, “How toxic stress affects child development” and “Adverse childhood experiences (“ACEs”): What are they, and how much harm do they cause?”

So there are many ways in which stress can impact the health and well-being of each family member. Yet that isn’t all. Family stress can also cause harm to the family system itself, altering the way we interact, and damaging our personal relationships.

For example, consider the research on kids with autism or a developmental disorder. Raising these children can be particularly stressful (Barroso et al 2018), and the stress doesn’t just affect the well-being of individual parents. It can also give rise to conflict between parents. Co-parents may disagree about tactics — how to respond to the child’s challenging behavior — and this may spark angry arguments and emotional estrangement (Chan and Leung 2020).

Similar parenting stress “spillover” can occur in other situations, too. Parenting a child with a serious medical illness. Coping with a baby who cries excessively. Dealing with chronic sleep troubles. Raising a child who engages in aggressive or anti-social behavior. When parenting stress increases, marital tensions tend to increase as well (Coles et al 2022; Botha et al 2019; Goldberg and Carlson 2014).

Does family stress also impact the relationship between a parent and child? Yes indeed. Studies indicate that stressed-out parents are less likely to engage in positive parenting practices — strategies that help children cope with their negative emotions and impulses. Distressed parents are also at greater risk of being emotionally distant, sad, hostile, overreactive or otherwise out-of-touch with their children’s needs.

It’s one reason why highly-stressed parents (like those experiencing economic adversity) are more likely to have kids with externalizing behavior problems, problems like aggressiveness, disruptiveness, and anti-social behavior. When you’re stressed out, you are more likely to adopt negative parenting responses, leading to more conflict and trouble (e.g., Taraban et al 2019; Sullivan et al 2022).

So what can we do about family stress?

We need to be aware of the stressors that families face, and take toxic stress seriously. The good news?

Research indicates that parents and their supporters can do a great deal to protect their families from long-term damage.

As I’ve written elsewhere, studies indicate that sensitive, responsive parenting buffers children from the physiological effects of toxic stress. Secure, loving attachment relationships — and positive parenting strategies — can go a long way. But parents need help, too.  As I argue in an article about hunter-gatherers, human parents weren’t designed to do it all, to be the sole providers and caregivers of our children. We need the support of others, and the time and space for self-care. For more information, see these evidence based tips for coping with parenting stress, as well as the Parenting Science articles I mention below.

Prenatal and postnatal stress

Some mothers-to-be are exposed to toxic stress during pregnancy, which puts their babies at higher risk for poor developmental outcomes (Caparros-Gonzalez et al 2022; Wu et al 2022). Other mothers experience traumatic childbirth. And — after an infant is born — many parents struggle with postpartum distress. Read more about it in my articles about childbirth trauma,  postpartum stress, and symptoms of postpartum depression. In addition, check out this article where I review the evidence that treating postpartum depression benefits babies.

Understanding stress in babies and children

As noted earlier, there is evidence that babies can sense stress in their mothers, and detect angry verbal conflicts between bickering parents. But babies experience stress in other ways too. Daily hassles — and the way we respond to them — can make some babies especially reactive. Does this mean they are doomed? No. Research suggests that even highly reactive, irritable babies can turn into very well-adjusted children — if they receive sensitive, responsive care (Belsky et al 2015). For evidence based tips, see my article, “Stress in babies: How to keep babies calm, happy, and emotionally healthy.”

What sorts of stuff stresses children as they get older?

Kids may experience stress in daycare and at school (Nystad et al 2022). They may feel stressed by the birth of a sibling, or a move to a new home. Kids are affected by bullying, peer rejection, and conflicts with their teachers. They may develop nighttime fears and chronic bedtime problems. And even modest restrictions in sleep may trigger problems with anxiety, rapid mood swings, anger, and poor self-regulation (Davidson et al 2021; Baum et al 2014). You can read more about these stressors in the following Parenting Science articles:

What specific strategies can adults use to help children grow up with strong stress-coping skills?

Talk with your pediatrician or therapist, and check out these evidence-based articles:


References: Family stress

Barroso NE, Mendez L, Graziano PA, Bagner DM. 2018. Parenting Stress through the Lens of Different Clinical Groups: a Systematic Review & Meta-Analysis. J Abnorm Child Psychol. 2018 Apr;46(3):449-461

Belsky J, Newman DA, Widaman KF, Rodkin P, Pluess M, Fraley RC, Berry D, Helm JL, Roisman GI. 2015. Differential susceptibility to effects of maternal sensitivity? A study of candidate plasticity genes. Dev Psychopathol. 27(3):725-46.

Berger RH, Miller AL, Seifer R, Cares SR, LeBourgeois MK. 2012. Acute sleep restriction effects on emotion responses in 30- to 36-month-old children. J Sleep Res. 21(3):235-46.

Boss P. 2014. Family Stress. In: Michalos A.C. (eds) Encyclopedia of Quality of Life and Well-Being Research. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0753-5_1008

Botha E, Joronen K, and Kaunonen M. 2019. The consequences of having an excessively crying infant in the family: an integrative literature review. Scand J Caring Sci. 2019 Dec;33(4):779-790.

Calvi E, Quassolo U, Massaia M, Scandurra A, D’Aniello B, D’Amelio P. 2020. The scent of emotions: A systematic review of human intra- and interspecific chemical communication of emotions. Brain Behav. 2020 May;10(5):e01585.

Caparros-Gonzalez RA, Lynn F, Alderdice F, Peralta-Ramirez MI. 2022. Cortisol levels versus self-report stress measures during pregnancy as predictors of adverse infant outcomes: a systematic review. Stress. 25(1):189-212.

Coles L, Thorpe K, Smith S, Hewitt B, Ruppanner L, Bayliss O, O’Flaherty M, Staton S. 2022. Children’s sleep and fathers’ health and wellbeing: A systematic review. Sleep Med Rev. 61:101570.

Cousino MK, Hazen RA.2013. Parenting stress among caregivers of children with chronic illness: a systematic review.  J Pediatr Psychol. 38(8):809-28.

Dimitroff SJ, Kardan O, Necka EA, Decety J, Berman MG, Norman GJ. 2017. Physiological dynamics of stress contagion. Sci Rep. 2017 Jul 21;7(1):6168.

Fredriksen E, von Soest T, Smith L, Moe V. 2019. Parenting Stress Plays a Mediating Role in the Prediction of Early Child Development from Both Parents’ Perinatal Depressive Symptoms. J Abnorm Child Psychol. 2019 Jan;47(1):149-164.

Fujiwara T, Barr RG, Brant R, Barr M. Infant distress at five weeks of age and caregiver frustration. J Pediatr. 2011 Sep;159(3):425-430.e1-2. doi: 10.1016/j.jpeds.2011.02.010. Epub 2011 Mar 22. PMID: 21429518.

Goldberg JS and Carlson MJ. 2014. Parents’ Relationship Quality and Children’s Behavior in Stable Married and Cohabiting Families. J Marriage Fam. 2014 Aug 1;76(4):762-777.

Graham AM, Fisher PA, and Pfiefer JH. 2013. What sleeping babies hear: A functional MRI study of interparental conflict and infants’ emotion processing. Psychological Science. 24(5):782-9.

Gregory A and Weinstein RS. 2004. Connection and Regulation at Home and in School: Predicting Growth in Achievement for Adolescents. Journal of Adolescent Research 19(4): 405-427.

Hill K, Boesch C, Goodall J, Pusey AE, Williams J, Wrangham RW. 2001. Mortality rates among wild chimpanzees. Journal of Human Evolution 40: 437-450.

Hirotsu C, Tufik S, Andersen ML. 2015. Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Sci. 2015 Nov;8(3):143-52

Lee J. 2013. Maternal stress, well-being, and impaired sleep in mothers of children with developmental disabilities: a literature review. Res Dev Disabil. 34(11):4255-73.

Luby J, Belden A, Botteron K, Marrus N, Harms MP, Babb C, Nishino T, Barch D. 2013. The effects of poverty on childhood brain development: the mediating effect of caregiving and stressful life events. JAMA Pediatr. 167(12):1135-42.

Marlowe, F. 2005. Hunter-gatherers in human evolution. Evolutionary Anthropology 14: 54-67.

Masefield SC, Prady SL, Sheldon TA, Small N, Jarvis S, Pickett KE. 2020. The Caregiver Health Effects of Caring for Young Children with Developmental Disabilities: A Meta-analysis. Matern Child Health J. 24(5):561-574.

Monaghan P, Heidinger BJ, D’Alba L, Evans NP, Spencer KA. 2012. For better or worse: reduced adult lifespan following early-life stress is transmitted to breeding partners. Proc Biol Sci. 279(1729):709-14.

Nelson JA, O’Brien M, Blankson AN, Calkins SD, Keane SP. 2009. Family stress and parental responses to children’s negative emotions: tests of the spillover, crossover, and compensatory hypotheses. J Fam Psychol. 23(5):671-9.

Nystad K, Drugli MB, Lydersen S, Lekhal R, Buøen ES. 2022. Change in toddlers’ cortisol activity during a year in childcare. Associations with childcare quality, child temperament, well-being and maternal education. Stress. 2022 Jan;25(1):156-165.

Oster H, Challet E, Ott V, Arvat E, de Kloet ER, Dijk DJ, Lightman S, Vgontzas A, Van Cauter E. 2017. The Functional and Clinical Significance of the 24-Hour Rhythm of Circulating Glucocorticoids. Endocr Rev. 2017 Feb 1;38(1):3-45.

Poggi-Davis E and Sandman CA. 2006. Prenatal exposure to stress and stress hormones influences child development. Infants and Young Children 19(3): 246-259.

Randall AK and Bodenmann G. 2013. Family Stress. In: Gellman M.D., Turner J.R. (eds) Encyclopedia of Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1005-9_17

Sapolsky RM. 2004. Why zebras don’t get ulcers. Third edition. New York: Henry Holt and company.

Sheidow AJ, Henry DB, Tolan PH, Strachan MK. 2014. The Role of Stress Exposure and Family Functioning in Internalizing Outcomes of Urban Families. J Child Fam Stud. 2014 Nov;23(8):1351-1365.

Song JH, Miller AL, Leung CYY, Lumeng JC, Rosenblum KL. 2018. Positive Parenting Moderates the Association between Temperament and Self-Regulation in Low-Income Toddlers. J Child Fam Stud. 2018 Jul;27(7):2354-2364.

Spiegel K, Leproult R, Van Cauter E. 2003. [Impact of sleep debt on physiological rhythms] Rev Neurol (Paris) 159(11 Suppl): 6S11-20.

Sullivan ADW, Forehand R, Vreeland A, Compas BE. 2022. Does Parenting Explain the Link Between Cumulative SES Risk and Child Problems in the Context of Parental Depression?  Child Psychiatry Hum Dev. 2022 Apr;53(2):330-341.

Taraban L, Shaw DS, Leve LD, Natsuaki MN, Ganiban JM, Reiss D, Neiderhiser JM. 2019. Parental Depression, Overreactive Parenting, and Early Childhood Externalizing Problems: Moderation by Social Support. Child Dev. 2019 Jul;90(4):e468-e485.

VanReeth O, Weibel L, Spiegel K, Leproult R, Dugovic C, and Maccari S. 2000. Interactions between stress and sleep: From basic research to clinical situations. Sleep Medicine Reviews 4: 201-220.

Wu Y, Espinosa KM, Barnett SD, Kapse A, Quistorff JL, Lopez C, Andescavage N, Pradhan S, Lu YC, Kapse K, Henderson D, Vezina G, Wessel D, du Plessis AJ, Limperopoulos C. 2022. Association of Elevated Maternal Psychological Distress, Altered Fetal Brain, and Offspring Cognitive and Social-Emotional Outcomes at 18 Months. JAMA Netw Open. 2022 Apr 1;5(4):e229244.

Yoo SS, Hu PT, Gujar N, Jolesz FA, and Walker MP. 2007. A deficit in the ability to form new human memories without sleep. Nat Neurosci. 10(3):385-92.

Small portions of this text are derived from previous versions of this article, written by the same author between 2008 and 2014. Current content last modified 5/2022.