Back in February I wrote a post about the effects of cortisol on the behavior of children (part one). A research study by Concordia University linked stress in children to increased levels of cortisol, simultaneous to behavior we would consider negative. They also found that over time, childrens levels of cortisol decreased to below normal levels although the behavior problems continued. The findings show that over time their reactions became blunted to the things a 'typical' child would experience as stressful. For example, a typical child might worry about a test or a difficult homework assignment but the child who experienced long term stress will not.
The study results are fascinating to me because my daughter had already experienced this effect by the time she was two and a half years old. Her little body had already burned out its ability to produce cortisol to an extent that was life threatening. The physiological damage did reverse, and after she had been with us for a year we were able to take her off all the medications and throw out her medic- alert bracelet. (Actually, I hucked it into a corner behind the TV where it probably still is).
So, what to do. If you know your child has a history of trauma, and he/she does a lot of acting out, there is a good chance their cortisol levels are imbalanced. Trauma is many things, and what an adult might consider to be an ordinary event may significantly effect a child. Consider that if your child is adopted, you will not know everything that occurred prior to their coming to you, and that the very act of bringing the child into your home could have been traumatic for your child. Also consider if you know your child has experienced trauma but does not act out. Genea was extremely withdrawn when her cortisol production burned out. Her stress at the time was carried inside.
As the parent, you will need to ask your child's doctor to test for cortisol levels. It is not something that is typically done and would usually only be done if there are signs of an adrenal disease. You want the test done because your child has the signs of a stress related disorder. It can be tested from saliva, blood or urine. Follow up testing might include suppressing the adrenal system and introducing synthetic cortisol to assess the effects. Presumably then the physician would have recommendations, or send your child on to an endocrinologist.
There is a good chance you will have to push, and push hard, to get the testing done and then to convince them that the cause is emotional stress due to a past trauma. My daughter saw several pediatric endocrinologists and not once was emotional stress even hinted at as a cause. Despite the obvious traumas that I explained over and over. The research showing a connection is new and there is not much of it. Not one physician, not one adoption professional, not one psychologist suggested there could be an emotional connection. Because I was living it, I could see it and link it all together. Her constant extreme emotional distress was driving her cortisol levels. We had medication to regulate her cortisol levels but that did nothing to change her emotional state. Her rage and grief were impenetrable and I could see, it was visible, that the slightest provocation early on each day sent her careening into fight- or- flight mode that she could not recover from. I realized we had to approach the emotional aspect with a psychiatrist and psychiatric medications. I had to do a lot of convincing. I dragged in books and research studies that I printed off. It was intimidating to be bringing information to the people who spent their lives studying and treating this but it worked.
There are a few other ways to "feed" cortisol. Omega 3-6 -9 is the most commonly recommended and I will have a post coming soon that describes our startling experience with that. One expert strongly recommends flax oil, another strongly recommends fish oil. Both are available as supplements just about anywhere that sells vitamins and such. They are also of course produced naturally from eating certain food. Lists of good sources are here.
I do not know what amount of food a person needs to eat to attain good levels, and the recommendations are generally in terms of what a person with heart disease might need. As per the Wikipedia entry on Cortisol, there are ways to reduce cortisol levels without ingesting pills. Music therapy, massage, laughing and even crying can help the levels self correct. Additionally, vitamin C and black tea can help.
It seems the best way to address stress related cortisol problems is to reduce stress. Obvious, right? It is an issue if your child is like mine, where the loop of stress hiking up her cortisol led to an exaggerated stress response which further elevated her cortisol, which caused her body to stop producing the cortisol it needed and became life threatening. It can take a long time to break the cycle and balance out mood and behavior. We are still working on it. Diligently, daily. You may have to step far out of your comfort zone to find out if this is an issue affecting your child. Always remember, you are the parent and you know your child the best. You are the expert.