As if we didn’t have enough to worry about regarding our kids being bullied at school or online, now there is evidence that being bullied during childhood can lead to an increased risk of chronic disease in adulthood. A new study published in Harvard Review of Psychiatry conducted by researchers at the Mayo Clinic suggests that adults who were bullied as children have an increased risk for heart disease and diabetes.

The researchers reviewed existing literature and data regarding bullying, impacts of stress, and physical and psychological symptoms from these experiences. For years, researchers have known that bullied children and adolescents have a significantly higher risk for both psychological and physical symptoms than their non-bullied peers. Commonly reported physical health problems associated with bullying include poor appetite, sleep disturbances, headaches, abdominal pain, breathing problems, and fatigue. These symptoms linking bullying and victimization have been observed in children as young as four years old.

The more that experts study the negative health effects of chronic stress, the more likely they will be able to draw conclusions about the specific actions or experiences that cause them. The scientists leading this study looked to recent advances in understanding the negative health effects of chronic stress to explore the long-term health implications of childhood bullying. They consider bullying to be a form of chronic social stress and wanted to evaluate if it has significant health consequences.

Studies of other types of chronic stress show that continued physical or mental stress can put a strain on the body. This process, called allostatic load, reflects the cumulative impact of biological responses from lingering stress. When we are exposed to brief periods of stress, our body can cope and recover pretty quickly. But when we experience chronic stress, the recovery process can take much longer. Then our body suffers, potentially leading to changes in inflammatory, hormonal, and metabolic responses. Over time, these changes can contribute to the development of diseases – including depression, diabetes, and heart disease – as well as the creation or worsening of psychiatric disorders.

Stresses that we experience when we are young, like bullying, can also affect the way these physiological systems respond to future stressors. This may happen because of epigenetic changes – alterations in gene function related to environmental exposures – that alter the stress response itself. Chronic stress may also weaken a child’s ability to develop psychological skills that help them build resilience, which is the ability to adapt to adversity, trauma, tragedy, threats, or stress. When children are resilient, they are braver, more curious, more adaptable, and more able to obtain happiness and success. Resilience cushions us from mental health conditions like anxiety and depression and helps us cope with new stresses in the future. Without resilience, stress can have a snowballing effect on our lives.

The study’s authors believe that the scientific literature suggests that chronic bullying could have significant physiological and mental health consequences and that changes in the physiological stress response, including chronically elevated levels of inflammation, could play an important role. However, they are unable to draw a definite cause-and-effect relationship between bullying and the increased health risks. They are calling for additional research to make their findings more conclusive.

The most important takeaway from this study is that the current data shows how bullying as a form of chronic social stress may have significant health consequences if not addressed early on. Pediatricians and mental health professionals should ask questions about bullying when evaluating their patients. This is the first step towards being able to intervene appropriately to prevent traumatic exposure and, therefore, increased risk for health problems down the road.

Additionally, it is imperative that we pay close attention to our children and look for signs of them being bullied. Take precautions like using electronic device monitoring systems, teaching them tools to deal with bullying, and building a strong, open relationship with them so they feel comfortable talking to you about anything.