How your childhood can predict your health
** This blog comes with a trigger warning. I discuss trauma and the detrimental effects it can have on your lifetime health **
In my private practice the number one thing that I treat is trauma; usually childhood trauma. Obviously, my view is a little skewed because this is something that I specialize in, but to me, it is upsettingly common. To clarify, when I say childhood trauma I’m not referring to failing an exam, or not winning a footy game, albeit those events can be extremely distressing. I’m talking about more serious trauma - abuse, neglect or the experience of growing up with a parent who struggled with a mental health disorder or substance abuse. A childhood spent experiencing single or multiple life changing, confusing, frightening and extremely distressing events. Events that change that child, during their most crucial developmental years, at a physiological level. This is what I encounter with sad regularity in my practice. This is childhood trauma.
What I started really noticing is that a lot of these people, as adults, had other major health concerns. And when I was fortunate enough to see a child who was experiencing these things (when I say fortunate, it’s because of my hope for early intervention!) the most common reason for referral was ADHD. Disturbingly, a lot of these kids didn’t seem to me to meet the criteria for this diagnosis and the subsequent labelling and medication of the child. Instead, they were traumatized. They had no idea how to regulate because their environment wasn’t safe. The trauma was affecting their developing brain.
The research
In the mid-90s the Centre for Disease Control and Prevention and Kaiser Permanente discovered something that explained 70% of the leading causes of death in the US. In high doses this exposure affects brain development, hormones, the immune system and it can even have an impact on the way DNA is read and transcribed. If experienced in very high doses, it TRIPLES the lifetime risk of heart disease and lung cancer- not to mention knocking up to 20 years off life expectancy!
And guess what that ‘something’ is? It’s childhood trauma.
What does this research mean?
This is a study everyone needs to know about. These amazing researchers asked 17, 500 adults about their history of exposure to what they called, “adverse childhood experiences”. These ‘adverse childhood event’s or ACEs included physical, emotional or sexual abuse, physical or emotional neglect, parental mental illness, parental substance dependence, incarceration of a parent, domestic violence in the childhood home and separation or divorce.
From this groundbreaking study an ACE score was developed. For every yes, the research subject would get a point on their ACE score. Essentially, the tougher someone’s childhood was, the higher their score and the higher their risk for health problems later in life.
Now don’t get me wrong, this score isn’t a crystal ball. It doesn’t take into account genes, diet, excessive smoking or drinking, resilience or the balance of positive experiences. However, what these researchers found is that 67% of the population has at least one ACE score and 12.6% had four or more!
A score of four or more predicts the relative risk of chronic obstructive pulmonary disease or hepatitis to be 2.5 times that of someone with an ACE score of zero. For depression, it was 4.5 times. And for suicidality it was an extremely worrying 12 times higher.
For someone with an ACE score of 7 or higher, the health outcomes are pretty bleak. They have triple the lifetime risk of lung cancer and 3.5 times the risk of ischemic heart disease, which is the number one killer of Australians.
How the brain changes
Some of you might be thinking that these individual’s poor health outcomes have more to do with their subsequent, adult lifestyle choices. It would seem to make sense that people who have had a rough childhood are more likely to make poor health choices later in life, leading to these alarming statistics. This, however, is proven not to be the case.
Exposure to adverse childhood events changes how the brain and body develops. They affect areas like the nucleus accumbens, the part of the brain for pleasure and reward. This part of the brain is implicated in substance dependence. ACEs can inhibit the prefrontal cortex, which is necessary for impulse control and executive function . On MRI scans researchers found measurable differences in the amygdala, the brain’s fear response centre.
So, in essence, there are real, neurological reasons why individuals who are exposed to high doses of adversity are more likely to engage in high-risk behaviours. And, unfortunately, even if someone with a high ACE score doesn’t engage in high risk behaviours they’re still more likely to develop heart disease or cancer. This is down to the stress response system (hypothalamic-pituitary-adrenal axis) that controls our fight-or-flight response.
Nadine Burke Harris explains how this works beautifully.
“Imagine you’re walking in the forest and you see a bear. Immediately, your hypothalamus sends a signal to your pituitary, which sends a signal to your adrenal gland that says, “release stress hormones! Adrenaline! Cortisol! And so, your heart starts to pound. Your pupils dilate, your airways open up, and you are ready to either fight that bear or run from the bear. And that is wonderful if you’re in a forest and there’s a bear. But the problem is what happens when the bear comes home every night, and this system is activated over and over and over again, and it goes from being adaptive, or lifesaving, to maladaptive, or health-damaging.”
We know that children are especially sensitive to this activation because their brains and bodies are still developing. In fact, particularly in those formative years, this type of adversity changes the structure and function of the brain. The brain goes from being in learning and development mode to existing in survival mode. And you can only imagine the effects this then has on other developing areas of the body, like the immune and hormonal systems.
What can we do?
If the experience of childhood trauma applies to you or someone you know, I would highly recommend trauma-informed therapy. EMDR (Eye Movement Desensitation Reprocessing) is the gold standard trauma treatment and it can have a healing effect on the brain. Other therapies, like mindfulness, yoga, meditation and trauma based cognitive-behavioural therapy can be helpful too!
And in terms of children who are experiencing this, early intervention is the key. We need to spot these kids earlier on. Some have nightmares or recurring thoughts of a stressful event, or they may re-enact the trauma through play. The child might seem distracted or withdrawn (this is where the misdiagnosis of ADHD is so common). Kids dealing with adverse experiences may be more impulsive. They may act out with anger or other strong emotions.
The most important thing to know is that research shows that just one caring, safe, relationship early in life can give a child a much better chance of growing up resilient and healthy. If you take away one thing from this blog, I’d like that to be it and to know that intervention could improve even one child’s outcomes for the future.
