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Born Anxious: The Lifelong Impact of Early Life Adversity and How to Break the Cycle

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Why are we the way we are? Why do some of us find it impossible to calm a hair-trigger temper or to shake chronic anxiety? The debate has always been divided between nature and nurture, but as psychology professor Daniel Keating demonstrates in The Stress Gene, new science points to a third factor that allows us to inherit both the nature and the nurture of previous generations - with significant consequences.

The Stress Gene introduces a new word into our lexicon: "methylated." It's short for "epigenetic methylation," and it offers insight into behaviors we have all observed but never understood - from the boss who goes ballistic at the slightest error to the sibling who is sure that everything you say is a hidden insult; from the infant who can't be calmed to the husband who can't fall asleep at night. In each case, because of an exposure to environmental adversity in utero or during the first year of life, a key stress system has been welded into the "on" position by the methylation process. The effect: lifelong, unrelenting stress and its side effects - from an inability to learn to an early death.

An extreme stress response enabled our ancestors to survive in harsh climes, but in today's Western world, harsh environments tend to be low-income, high-crime areas. In an age of rising social inequality, the fate of ever-larger segments of the population may be debilitating stress - unless we take action to break the cycle.

256 pages, Hardcover

First published July 12, 2016

90 people are currently reading
1884 people want to read

About the author

Daniel P. Keating

11 books7 followers

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Displaying 1 - 30 of 40 reviews
Profile Image for Lorilin.
761 reviews232 followers
April 7, 2017
In Born Anxious, author Daniel Keating makes a simple but intriguing assertion. After years of scientific research, he has come to the conclusion that if a person experiences serious enough early life adversity (in the womb or during the first year of life), then that person is at major risk for developing Stress Dysregulation (SDR), i.e., a genetic modification that prevents the body from shutting down the stress response. In other words, too much stress early in life will physically modify this specific “stress” gene so that it can’t turn itself off. Keating says, “The decision by the epigenome to lock that stress gene is made in response to one question asked while a child is still in the womb or in the first year of life: what kind of world will this child be entering–one that is kind and supportive or one that is harsh and unforgiving?” If the body decides the child will be born or raised in a hostile environment, the end result is that she will have an almost constant oversupply of cortisol in the body, all in anticipation of life’s “worst case scenarios.”

Pretty intense stuff, eek. So at what level of stress does the body permanently alter its ability to turn off that stress response? The short answer is, we don’t know. Obviously children born into war zones or born to mothers who have experienced significant trauma during pregnancy are at risk. But (and this is where the book gets a little dicey, in my opinion…) what about in first-world countries, where we’ve seen a significant rise in stress dysregulation? Well, Keating claims that rising inequality is what is mostly to blame for our growing stress. And not just in people who are poor. He sees this as affecting everyone, regardless of class or income level. Poorer people may worry about simply getting by, but richer people worry about losing their status. This “constant underlying fear that things could go wrong pretty quickly” produces the same increased risk for stress dysregulation in pregnant women and young children across income levels.

Truth be told, I’m not sure I’m 100% on board with Keating’s assertion that inequality, both real and anticipated, is completely responsible for our rising stress levels and, specifically, SDR. However, his thoughts and observations about how stress impacts us as babies, children, teenagers, and adults (he has a chapter for each developmental stage) is fascinating. And I absolutely agree with his conclusion that we can combat our current stress epidemic by investing in human development: early education, public education, stress reduction training (especially for kids), universal healthcare, quality prenatal care, paid maternity leave, job security post-maternity leave, paid parental leave, and comprehensive sex education. As Keating has found in his research, “Countries that tell their citizens they will be taken care of when the chips are down have happier citizens.”

Ultimately, there is a lot to love in this book. I learned so much, not only about stress and how it so powerfully affects the body, but also about what we can do–what I can do–to help myself and others cope. I don’t necessarily agree with all of Keating’s arguments, but I still think this is a fascinating book and well worth the read.

ARC provided through Amazon Vine.

See more of my book reviews at www.BugBugBooks.com!
Profile Image for Shannon.
650 reviews42 followers
June 9, 2017
Why are we the way we are? Why do some of us find it impossible to calm a hair-trigger temper or to shake chronic anxiety? The debate has always been divided between nature and nurture, but as psychology professor Daniel Keating demonstrates in The Stress Gene, new science points to a third factor that allows us to inherit both the nature and the nurture of previous generations - with significant consequences.

Both my husband and myself suffer from anxiety disorders, so I frequently read books on the topic. And as we start trying to have children this year, this book sounded very interesting to me. The author, after years of research, came to the conclusion that if an individual experiences stress early in life, whether that is in the womb or in the first few years of life, this individual is at risk for developing SDR or Stress Dysregulation. This is defined at a genetic modification that prevents the body from shutting down the stress response.

The book does include quite a bit of information and there are chapters focusing on baby's first year, the effect of peers and school, adolescence and managing family, work, and relationships. Although I found the whole book to be extremely interesting, I was particularly intrigued by the chapter on Baby's First Year, as I have been reading a great deal of pregnancy and parenting books recently. In this chapter, the author talks about how infants can literally be "born anxious' either because excess stress experienced by the expectant mother causes stress the stress gene too be locking into the "on" position or because they inherited this version on the gene. However, the author goes on to explain how this stress system can be altered by what infants experience during the first year. Positive things such as the parenting being super nurturing, can help if the stress system is already switched to on. Which goes along with most of the attachment parenting book I have read.

Overall, I found that this book was really interesting and I could write a very long review about how the author talked about other important things such as early education, public schools, home life, etc. that also impact a child's stress. I gave me some great insight on how to alter some things in my life during pregnancy and things to do in area of parenting. Thank you to the publisher for sending my an advanced reading copy of this book.
Profile Image for Claudia Putnam.
Author 6 books144 followers
April 1, 2018
Very important read. A bit depressing if you happen to be one of the BA. There's hope for future generations, if a society wants to organize itself in its own best interests (haha, for the USA), but not much for you.

So, it turns out that CONCEPTION TO AGE ONE is the most developmentally significant time in a child's development, and if you don't get it right during that window, the kid's fucked. More or less. Simplifying--there are "dandelion" kids who do all right, even thrive, in almost any environment, and "orchid" kids who are going to struggle no matter what you do (but if you stay on top of things and keep tweaking, well, look how lovely orchids are, and while dandelions are unfairly maligned and have much to contribute, who would want a world full of only dandelions?). And the idea that you can't fix a kid after age one in the anxiety department comes from follow up studies of children post-adoption from Romanian orphanages and similar scenarios. IE, the worst cases. So I'm not sure that your average nervous mother is always going to screw up her kid forever.

However, nervous mothers stand a good chance of wiring their kids for a rough time, and yes, moms, this is yet another way of blaming you, and yes, making you EVEN MORE NERVOUS while you're pregnant. The way it works is that we have these stress genes. These turn on and off in relation to our environment. Saber tooth tiger about to pounce? ON! Tiger ran off? OFF. Famine? ON ON ON ON. War? ON ON ON ON. What turns them on and off? Another gene, which is regulated by chemicals that control gene expression. This is that thing you've been hearing about: epigenetics. If you've been under stress for too long, the gene that turns the stress gene off gets myelinated. That is, the off gene is off. Forever. And the stress gene is ON ON ON ON.

So, put a kid in a soup of stress during gestation and infancy, and its stress gene will be ON ON ON ON.

War, famine, poverty, social inequality (coming back to this), orphaning, etc, are all likely to tilt the lever the wrong way. But so is domestic violence, single parenting, dual-income families, working at high-stress jobs while pregnant, a lost job during those crucial early years--that is, many things that can cross country and class lines.

Worse, epigenetics, like genetics, can be inherited. So, if your great-grandparents were in a war, or a famine, or were driven out of their homes and came to America as one of the tired, the poor, etc, or handcarted across the country, or lost half their children to scarlet fever, it's possible that one of those women was pregnant during that terrible time with a grandparent of yours, that person was born with the myelinated gene, and now you have it too.

What can be done? All the usual stress mitigation strategies--mindfulness, meditation, eating right, exercise, neurofeedback. Awareness, management. But these are palliative approaches. The gene stays in its position. In young children it's likely to manifest in ways that look like what we call ADHD, or in more extreme cases child bipolar (I'm guessing here--one of the flaws in the book is that there is no discussion of the overlap with child-onset bipolar which I believe is now being called something like overaroused threat disorder... PTSD in reverse, where children are born with a nervous system that stresses them out from the beginning, which sounds just like what Keating is talking about) or oppositional defiant disorder, except these are in a REALLY young kid. But you'll see learning issues, inability to concentrate, explosive tempers, extreme clinginess, or its opposite.

Keating doesn't think it can really be helped, though engaged teachers and parents who understand what's going on and immediately work to correct the stressful situation in the home can help. Also, he says, there are periods, such as ~age 13 and again in the early 20s when the brain again becomes more plastic, when there might be some hope for rewiring.

The best approach is to try to look at the environmental drivers for this situation in the first place, though. Countries with less social inequality have fewer children who are innately anxious. And fewer of the associated social costs. Prior to the Reagan period in America, that is, prior to the enormous wealth transfer that began in the 80s, we too had more social equality and despite our inheritances from our parents' and grandparents' and great-grandparents' traumatic pasts, we had less generalized anxiety as well. This have grown worse since then. I'll leave it to you to sort through his supporting detail.

Keating makes a distinction between income inequality and social inequality that's worth mentioning. Two people can work at the same job, earning roughly the same amount and still have vastly different security levels. Don't you look on Facebook and wonder how a friend who should have around the same salary as you manages all those trips to Europe, or that enormous house, with a stay-at-home wife on top of it all? Well, you know the answer, when you think about it. His or her parents bought the house, or at least paid the down payment. The parents buy a new car every couple of years and give your friend the "old" one. The parents take them to Europe, expenses paid. They've funded the college account, at least partially. Every time an aunt or uncle dies, they get $5 or $10K to pay down credit cards or take a trip. And then, of course, there will be an inheritance when the parents die.

If you don't have that, your salary, even if you have a 401k and rainy day fund and a good escrow account for roof repair and snow tires and reasonable travel, etc, just doesn't amount to the same thing. It only takes one major medical emergency to wipe out that escrow, and then maybe a lay-off to clear out the rainy day fund. You'll never be able to save it back up, you know. Then the roof goes. You're into your 401k, now. So the level of anxiety, maybe low-level at first, for you is totally different than the level of anxiety for your friend, even if he or she has the same salary and even has some mortgage and credit card debt. Some of these people even CLAIM they're stressed out by these things, but in the backs of their minds, they know they have a safety net.

They work hard, just as hard as you do, but if you fall, you'll fall all the way to the ground and they won't.

That's social inequality vs. income inequality. Other countries, like Norway etc, work to reduce social inequality by creating more of a safety net across the board. Unemployment is not as stigmatized. Childcare is provided. In most European countries, upward class mobility is much more fluid than it is in the US precisely because of childcare. Retraining is provided to those who lose their jobs. Consequently, there is less anxiety over both survival and status.

And consequently, lifespans are longer, health is better, children learn better, crime is lower, etc. The social investment is repaid, Keating shows.

Of the other countries in this category, Canada does better than the US, but is closest to us, ie, the worst of the others--it has the most social inequality.

Check his data out for yourself.











Profile Image for Tracey.
1,181 reviews15 followers
July 1, 2017
What I learned fromthis book is the "biological mechanics" of how anxiety can be inherited. The emerging fields of epigenetics and social epigenetics have revealed that our ability to control anxiety may be limited because the switch that turns off the production of cortisol can be permanently switched on due to environmental factors in utero OR from generations ago. This is where the cycle of social inequality becomes critical, as it impacts generations of people who live under the harshest conditions. The ultimate conclusion that Keating draws is that..."Making evidenced-based decisions using this information is the only reliable way forward, even in our somewhat fact-challenged, postmodern world. A strong argument of this book is that monitoring health and development from the prenatal period onward especially, in terms of the social inequality of those outcomes, should be a central feature of evidence-based social policy decisions." Unfortunately this book was written prior to the election November 2016, and so a lot of the recommendations at the end of the book are fairly depressing in light of what's happening with health care and other social issues in the United States. This book is well-written and has a lot of interesting information in it that is research-based, but it's not dry so that someone who doesn't enjoy reading about scientific research wouldn't enjoy the recommendations or the insights. I think every teacher and every parent should read this book to help them understand why it's so important that kids who suffer from SDR feel supported and understood.
Profile Image for Sammy M.
6 reviews2 followers
June 7, 2022
I found the entire book extremely interesting. The first half of the book peaked my interest since it talked more about our genetics and what affects us as babies and children. When it goes into adulthood and on the second half, it gets a little more dense and hard to keep up with but still very interesting.
76 reviews
September 2, 2020
Utterly unhelpful for actual survivors, which makes me think that this guy has had a lot of experience with numbers and statistics but has very little experience trying to empathize with and heal traumatized populations. Many passages in this book are actively insulting and pathologizing to survivors.

The final chapters (AKA the "How to Break the Cycle" part) also provide very few resources/treatments for people who are chronically dysregulated but instead suggest that an overhaul of capitalism is the only solution. Which I suppose is fine for policymakers, scientists and doctors. But as a reader actually hoping for real advice, that's just not enough. I felt that this book was honestly pretty lazy, poorly edited, and more harmful than it is helpful. It also falls into the same trap many of these books do, which is providing solutions for child populations but essentially giving up adult populations (the ones reading the book!) as a lost cause.
Profile Image for Debdanz.
861 reviews
August 26, 2017
I might have given this book 5 stars except that it left me more hopeless than when I started it. Well-written nonfiction, thought provoking, great for a book club. The science is simplified enough for the general public (and not dumbed down so much as to be too annoying for the general science reader, I hope). But, like The New Jim Crow Laws, this author identifies huge social problems, and even offers fixes, but I look around at our world and wonder whether we have the collective desire to save ourselves from the mess we have created.
Profile Image for Jenny.
66 reviews
November 12, 2019
The first time I learned about epigenetics, it sounded like nonsense. I could pass down my stressed out genes? But Keating’s research is compelling and I’ve realized I have more to learn. I was hoping for more practical help, but I was grateful for all the book recommendations for practical help he gives at the end of each chapter. It also got surprisingly political, but he brought up points that I had never considered. In all, the book was a learning experience and I would definitely read more.
Profile Image for Michele.
445 reviews
May 19, 2017
Per this book, it seems that severe stress experienced early in life (even pre natal) can result in epigenetic changes to a person that makes them hyper sensitive to stress throughout life, and exhibit hair-trigger fight or flight responses to events that seem minor to the everyone else. The high Cortisol levels stress brings on will cause many lifelong adverse health effects.

Not sure I am on board with inequality being at the base of a lot of this.
Profile Image for Jodi.
185 reviews
July 29, 2017
Geared more toward parents that are concerned about the emotional development of kids who have been exposed to prolonged or severe stress. Ultimately the answer as an adult if you have this stress disorder is just mindfulness and physical activity so no new or different results really. Ultimately I didn't see much assistance in treatment as a result of treating this as a physical change in the body versus nurture resulting in learned behaviors.
Profile Image for Chloe Russo.
102 reviews1 follower
March 24, 2024
Such a great, comprehensive look at stress and the biological functions and societal pressures/structures behind stress. I enjoyed learning about how stress can occur at all ages (from womb to old age) and how it affects all ages, along with its detrimental effects to society as a whole. I wish the book was a bit longer and included more on differences between “low-resilient” and “high-resilient” countries’ policies and societal viewpoints, but all in all a worthy read!
Profile Image for Carlos Mestas.
44 reviews
May 28, 2019
Great book, great insights into the nurture nature debate. Allows those “born anxious” to mitigate stressors and facilitate coping with anxiety in our everyday environment. Recommend to those who want to learn more about their anxiety, those interested in the topic, specially from a biological lens and those simply looking to expand knowledge toolbox
96 reviews4 followers
August 2, 2021
Bland, tells a blog post amount of information in a very long-winded book. Not what I thought it would be at all - all about the research and the policy change the author recommends with zero self help. The changes recommended by the author are spot on and the topic of methylation and epigenetics needs to be discussed more, but this book was just not for me.
Profile Image for India Nelson-Alexander.
8 reviews
February 7, 2022
I loved this book! I especially appreciated that they take the view of stress as being a societal issue, and provided actionable steps that can be taken to mitigate the stress epidemic using scientific evidence.
I hope that we can move in the right direction and help current and future generations succeed.
Profile Image for Sara.
3,254 reviews46 followers
May 23, 2017
A bit dry and research heavy, but an interesting view on why some people have their stress reaction set to high all the time based on conception to age 1 stress. The book is divided into life time periods and what can be done to help their lives go smoother.
Profile Image for Jami M..
585 reviews24 followers
May 28, 2017
This book does a good job of describing the current study of epigenetics in a concise, textbook fashion. I learned a lot about stress and its effect on the human body. If you have any questions regarding anxiety and the notion of nature v. nurture, there are some interesting ideas to be found here. This book is particularly relevant with regard to children and anxiety.
Profile Image for Jennifer.
905 reviews22 followers
December 23, 2017
We forget our bodies are made of chemicals and electricity and water - we are products of whatever process those ingredients sustained. From personal experience I can say there is a lot in this book that makes sense and answers some of the mysteries of my confusing childhood.
1 review
April 23, 2020
Routine child rearing and not very good at that.

Has very little to do with a born anxious child or a stressed pregnancy. Waste of money. Unfortunate because it’s a subject worth pursuing.
Profile Image for Shyann Huiyan.
1 review
July 9, 2021
The factors of anxious is very well explained and the story brings us back to the source of the SDR. Super nurturing from the close one helps, but not everyone gets this. Was expecting more from this as well…
Profile Image for Bruno.
5 reviews
July 30, 2018
Some incredible insights. Sometimes, a bit biased though.
Profile Image for Maree Silver.
462 reviews10 followers
January 28, 2024
Quite fascinating looking at the impact of inutero and early life stress on people and how it can then become passed on genetically. Generational trauma anyone??
Profile Image for Rolena Maria.
24 reviews2 followers
January 16, 2021
"《Stresul mă omoară 》- probabil că ai rostit si tu aceste cuvinte la un moment dat în viață. Dar pentru cei care suferă în mod cronic de niveluri ridicate de stres,aceste cuvinte li se potrivesc, din păcate, zi de zi. Studii recente ne arată că stresul este un ucigaș tăcut, care ne afectează și biologic,atât pe noi, cât și familiile noastre și pe cei din jur. Mai mult, ne vizitează într-un moment deosebit de vulnerabil- din mediul intrauterin până în primul an al vieții- cu implicații care au ecou pentru tot restul vieții."

"De exemplu, unii copii sunt literalmente《născuți anxioși》fie pentru că excesul de stres cu care se confruntă mama în timpul sarcinii provoacă metilarea stresului la nivelul stresului- adică gena stresului este blocată în poziția de 'pornire'- sau pentru că bebelușul a moștenit versiunea metilată a genei. Dar modul în care funcționează sistemul lor de gestionare a stresului poate fi influențat în mod radical de ceea ce trăiesc în timpul primului an de viață. Îngrijirile intense, empatice și pline de răbdare pot ajuta copiii să treacă peste dereglarea nivelului de stres, chiar dacă a fost moștenită, protejându-i împotriva efectelor adversitații timpurii. Dar și scenariul opus este la fel de adevărat: stresul ridicat sau adversitatea pot duce la metilarea stresului la copiii care nu s-au născut cu el."

"În mod obișnuit, sistemul nostru de reacție la stres se amplifică sau se reduce proporțional cu amenințările cu care ne confruntăm. Dacă există un leu care urmează să ne atace sau un om cu un pistol care vine în direcția noastră, acest sistem eliberează cortizolul care ne pune în alertă. Când pericolul trece, cortizolul este oprit. Se dovedise, însă, că atunci când puii de șoareci din laboratorul lui Michael se confruntau cu un nivel de stres ridicat din cauza lipsei de îngrijire maternă, exista ceva care împiedica oprirea cortizolului.
Acest proces este cunoscut ca schimbare epigenetică: funcția unei gene este modificată- fie pornită, fie oprită- de un anumit factor extern. În acest caz, factorul extern a fost stresul suprem dintr-o copilărie lipsită de confort, care a provocat o schimbare epigenetică numită 'metilarea stresului'. Metilarea presupune că o grupare de metil s-a atașat comutatorului de pornire și oprire existent în fiecare genă. În cazul particular al metilării stresului, gena a cărei sarcină este de a spune axului hipotalamo-hipofizo-corticosuprarenal să stea locului- să oprească producția de cortizol- este redusă la tăcere. Nivelurile ridicate de stres experimentate în fragedă pruncie pot metila gena care controlează sistemul de gestionare a stresului. Când se întâmplă acest lucru, trăim de parcă am fi mereu față în față cu acel leu pregătit de atac sau cu atacatorul care ne pune pistolul la tâmplă."

"Un copil neglijat de unul dintre părinți- sau care simte că îngrijitorii lui nu se preocupă de el- are toate șansele să se lupte cu anxietate, depresie și tulburări de dispoziție."

"Când sistemul de stres este prea des solicitat, stimularea pe termen scurt cauzată de activarea cortizolului se acumulează, generând cantități mai mari din din acest hormon decât este necesar. Deoarece excesul de cortizol este toxic pentru majoritatea organelor, există o serie de consecințe negative asupra sănătății. Studiile au arătat în mod repetat o asociere clară între excesul de cortizol și sindroamele metabolice,cum ar fi obezitatea și diabetul, precum și tulburările de somn și bolile cardiovasculare."
Profile Image for STEPHEN PLETKO!!.
258 reviews6 followers
January 10, 2022
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An empowering guide to combating the stress epidemic!

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“If an expectant mother is experiencing high levels of stress—for whatever reason over a period of time—her elevated stress levels may, through a mechanism we are just coming to understand, result in her child being ‘born anxious’.”

The above quote (in italics) comes from the prologue of this well-researched and well-written book by Daniel Keating, Ph.D. He is professor of psychology at the University of Michigan. Keating focuses on developmental differences (cognitive, social, & emotional) and in physical and mental health.

The book begins by explaining the biological mechanism hinted at in the above extract. Without going into the technical details (which this book articulates quite well), we’re told that “stress can get under the skin” so as to last a lifetime.

Then the author goes through the individual stages—from baby (baby’s first year is critical) to toddler, to adolescent to adult—explaining the current science on stress for each stage, as well as the best ways to integrate and respond to it in a variety of circumstances.

In the last chapters, this struggle with stress is viewed from a societal standpoint with a focus on changing social policy (with respect to inequality) so that it embraces this new stress scientific paradigm which has the potential of mitigating lifelong stress.

The author provides very useful resources for new parents of distressed infants, resources for helping toddlers during the school years, resources for troubled teens, and resources for the stress dysregulated (SDR) adult.

This book draws on the collaboration and suggestions of many researchers and clinicians across many different disciplines from epigenetics to epidemiology, from developmental & clinical psychology to psychiatry, and from politics & economics to neuroscience.

Finally, this book has an excellent appendix (not labelled as such) entitled “Research Background: A Primer.” Before reading the main narrative of this book, I would recommend first reading this appendix’s section titles since they summarize the entire book nicely.

In conclusion, this is a truly empowering guide to combating the stress epidemic!!

(2017; author’s note; prologue [xi-xiv]; introduction; 7 chapters; epilogue; main narrative 195 pages; appendix; bibliography; acknowledgements; index)

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