“It Hurts:” Physical Results of Bullying

By: Dr. Christine Eady Mann

“I’m not as strong as you, when you punch me it hurts.”–Isaac, 11 year old bullying victim

Bullying is distressingly common among school-aged children, and is most common during the middle school years. Research has shown that bullying occurs to between 25 and 33 percent of children, and 30% of children admit to bullying others. Parents and educators are often unaware that bullying is happening. While bullying has always occurred, the negative effects of bullying on children and adults has only been considered and addressed in the last few decades. Bullying traditionally was treated as a common rite of passage of childhood unless overt physical harm occurred.

Most people know about the psychological affects of bullying on children, such as mood disorders, depression, and anxiety. Victims may also experience increased feelings of sadness and loneliness. Sleeping and eating patterns may be affected. Bullying in children often presents as physical symptoms such as headaches and digestive problems.

Less commonly discussed are the harmful effects of bullying on physical health. While there is a wealth of research on the emotional effects of bullying on children and teenagers, fewer studies have been done on the health effects of bullying. The limited studies that are available show that the stress on victims of bullying affects the body just as any other form of stress does. Research using twins has shown differences in the stress responses between the bullied and non-bullied twin. Recent research shows that these negative effects may last into adulthood.

The effects of bullying work through the human cortisol system. Cortisol is a naturally occurring steroid hormone produced by the adrenal glands. It is one of the main substances that the body makes to regulate blood sugar and fat stores during non-stress times. Spikes of cortisol occur during episodes of stress and when blood glucose drops. This system is essential for maintaining a steady supply of energy for the body.

When humans are facing a dangerous or acutely stressful situation, cortisol is part of the cascade of chemicals released to help manage the body’s response. This is commonly called the fight-or-flight response. A burst of cortisol during an acute stress event raises the blood sugar, providing a ready supply of quick energy for the brain and muscles to use to help escape the situation. Cortisol also suppresses body systems that are not immediately needed, such as the immune, digestive, and reproductive systems. The cortisol response is necessary during times when humans need to get away from danger rapidly, and it has deep roots in our evolutionary history and development.

Chronic bullying causes chronic stress in all age groups, leading to chronic activation and dysfunction of the cortisol system. Dysfunction of the cortisol system is know to have negative biochemical effects in all ages. High levels of cortisol leads to changes in metabolism that can cause abdominal obesity, which, in turn, increase the risk of diabetes and heart disease. Chronically elevated cortisol causes digestive problems and weakens the immune system, leading to higher susceptibility to viral and other infections and delayed healing. Reproductive health can also be negatively affected, leading to decreased fertility. It is unknown what amount of bullying leads to these long-term issues, and what co-factors may have an impact. It is likely that the effects on children are distributed unevenly, and can be mitigated with support through schools and families. But we need more answers before we can find solutions.

It is critical that we continue to develop methods to identify bullying and to do research into the physical as well as mental effects of bullying. Researchers, educators, physicians, and families all have a role to play in protecting vulnerable children. School districts and government bodies should support continued research and enact policies that prevent bullying when possible, and provide help for victims when needed.


Dr. Christine Eady Mann is a practicing physician from Cedar Park, Texas and a Congressional candidate for Texas’ 31st District. Besides having run her own medical practice in two Texas towns she is also a wife and mother of 3. Service is a family affair for the Mann’s as her husband works with incarcerated juveniles. Dr. Christine sat on the board of directors for the Williamson County American Heart Association and is a volunteer to help at risk children. Find her on Twitter @DrMann4Congress