The toxicity has become all too real after 20 months, driven by not just disarray but death as well. As of this past June, more than 140,000 children lost a close caregiver—such as a parent—to COVID, according to research published in the journal Pediatrics. Since 2019 there has been a rise in suicide attempts among people younger than age 18, researchers at the Centers for Disease Control and Prevention found when they examined mental-health-related emergency room visits during the past three years. And astudy of pediatric insurance claims filed between January and November 2020, conducted by the nonprofit FAIR Health, found a sharp increase in mental-health-related problems, especially generalized anxiety disorder, major depressive disorder and intentional self-harm. These and other distressing trends recently led the American Academy of Pediatrics and two other health organizations to declare that children’s mental health is currently a national emergency.

Burke Harris says those patterns arise from what pediatric health specialists term adverse childhood experiences (ACEs). These events include 10 types of specific traumas that range from direct abuse and neglect to overall household dysfunction. The adverse experiences activate the brain’s fight-or-flight system—a normal response to an immediate physical danger such as a bear rushing at you. But “what happens when the bear comes every night?” Burke Harris asks. Because adverse events put children in prolonged and repeated danger, it extends their stress response and creates damage.