How Childhood Trauma Affects the Brain and Body - The ACES Study

Childhood trauma can have a direct, lasting  impact on physical health, mental health, and the ability to function in society. But  we didn't have any idea how much impact it had until the late 1990s, when a curious doctor  made a groundbreaking discovery. Dr Felitti led an obesity clinic at Kaiser Permanente.

In the  late 1980s he observed a strange phenomenon where many patients who successfully lost weight quickly  regained it. Some even dropped out of the program, even though they were successful. So he was  curious about this pattern.

So Dr Felitti started interviewing patients to understand why they  regained the weight. And during these interviews he uncovered that a significant number of these  patients had a history of childhood trauma and abuse. So he started to wonder if obesity might be  a coping mechanism for dealing with the unresolved trauma.

So DrFelitti collaborated with the CDC  to ask over 17,000 adults about their exposure to various types of childhood trauma. And these  are called adverse childhood experiences, or ACEs for short. The original ACEs study  identified 10 categories of these experiences, which can be grouped into three broad categories:  abuse, which includes physical and emotional and sexual abuse; neglect, which is physical and  emotional neglect; and household dysfunction, which includes domestic violence, substance abuse,  untreated mental illness, parental separation or divorce, or parental incarceration. 

Now, the original study didn't explore other forms of adversity, like environmental  violence, like war or gang violence or crime; or relocation, like moving, asylum-seeking,  or divorce; grief and loss; racism; prejudice; or poverty. But even just with their limited  study they had two findings that changed our understanding of childhood trauma forever. First,  they found that a huge number of people have experienced at least one ACE - 64% of people. 

And then they found that 17. 7% of children - so that's one in six children - experience at  least four ACEs - even more specifically, 28% of women and 16% of men reported being sexually  abused during their childhoods. And this study was done with a mostly middle-class white folk, but  the rates are actually probably higher with other demographics.

So that was the first finding, that  childhood trauma is way too pervasive. And then the second big finding, DrFelitti found that this  trauma is directly correlated with a wide range of negative health outcomes in adulthood, including  chronic disease, mental health issues, substance abuse, and early death. Okay.

So let's let's dive  into this a little bit. Let's explore the impact of childhood trauma on physical health. So ACEs  increase your chance of autoimmune conditions, heart disease, diabetes, or obesity.

With six  ACEs you are twice as likely to have cancer and 15% more likely to have a chronic disease,  like heart, lung, or liver disease. ACEs fuel behavioral problems like substance abuse, smoking,  risky sexual behavior, and criminal activity. With four or more ACEs you are 17 times more likely to  struggle in school and seven times more likely to be an alcoholic.

And then, of course childhood  trauma massively impacts mental health. People who didn't experience ACEs as a child have around  a 12% chance of experiencing depression compared to a 35% chance for men and a 66% chance for women  who did experience ACEs in their childhood. With an ACE score of six there's a 5,000% increase in  suicide attempts, in the likelihood of a suicide attempt.

And adverse childhood experiences  increase your chances of PTSD, anxiety, and most other mental health concerns. And ACEs  are directly related to at least one-third of mental health conditions in adulthood. So by by  helping children grow up in safer homes we could reduce the rate of depression by 44%.

This  is just so impactful. The ACEs study was one of the first to demonstrate how childhood trauma  could have a lasting impact on physical and mental health. And childhood trauma can impact basically  every aspect of your life.

The ACEs study showed that it can impact our ability to form healthy  relationships or perform at work. Now, I do think that almost everyone experiences something  in their childhood that they could consider traumatic. And the study found that two-thirds of  people experienced at least one of these events on the ACEs list.

But when we have supportive  adults in our lives, most of us have the capacity to process through a traumatic experience.  Sadly, though, at least one-third of the kids with an ACE had at least four ACEs, which means  that they were living with recurring trauma that permeated multiple aspects of their life, and this  trauma was often coming from the people who were supposed to be supporting them. The ACEs study  found that the more ACEs a person experiences, the higher risk for these negative impacts  in their adult years.

So in addition to the individual suffering caused by childhood trauma,  it's also really expensive for our society. The Journal of American Medical Association recently  published a new study that found that ACEs cost our nation a staggering $14 trillion annually  because of the related health conditions but also the cost of law enforcement and substance abuse  treatment and and incarceration, all the lost productivity that people have due to disabilities  from depression and other mental health concerns. Now, like childhood trauma is having a massive  impact on our society and on our individual and personal health, but this isn't all bad news. 

Understanding ACEs has led to the development of trauma-informed care. So this helps teachers and  doctors and therapists recognize and respond to the effects of trauma in both children and adults.  So that's one of the good things that came from this study.

So let's just explore for a second  why trauma can be so harmful to physical health, and then we'll explore what we can do about it.  So how does trauma increase the risk of disease? Chronic exposure to stress in childhood can lead  to long-lasting changes in how the body and the brain react to stress, which can contribute  to various health problems later in life.

The body's stress response system, also known as the  hypothalamic pituitary adrenal axis, the HPA axis, is responsible for managing how the body reacts  to stress. When faced with a stressful situation, the HPA axis triggers the release of stress  hormones like cortisol and adrenaline. These hormones prepare the body for a fight-or-flight  response, which increases your heart rate, your blood pressure, your blood sugar levels,  and a bunch of other physiological changes.

Now, adversity isn't inherently bad. When a child faces  adversity and has caring adults to support them and access to resources to recover and restore  their sense of safety, they can develop a healthy response to stress, where their parasympathetic  response, the calming response in the nervous system, kicks on. And adversity with support can  make them more resilient, confident, and capable.

But when a child is isolated or threatened by  their own caregivers or exposed to repeated stressors, they never get a chance to restore that  sense of safety. So this creates chronic stress, which can interfere with the body's natural  ability to regulate. The HPA axis can become dysregulated and can get stuck in one of  two states: hyperarousal, which is where the stress response becomes overactive, which  leads to consistently high levels of cortisol and other stress hormones.

And this chronic stress  response can damage body systems over time, including cardiovascular, immune, and digestive  systems. And then this second way the nervous system can respond is sometimes it gets stuck in  hypoarousal. So the HPA axis becomes underactive, leading to an insufficient release of cortisol. 

This is essentially getting stuck in the freeze state, or the shutdown state. And this can make it  difficult for the body to respond appropriately to stress. So this might leave an individual feeling  overwhelmed or unable to cope with challenges.

It it really, it looks like depression. Now, ACEs  can also cause structural and functional changes in key brain areas involving stress regulation. So  this includes the amygdala, which plays a crucial role in processing fear and emotional responses. 

Um it can become hyperactive due to ACEs. And this makes people more sensitive to perceived  threats, and it leads to these heightened anxiety and fear responses. The prefrontal  cortex is responsible for executive function, like decision-making and impulse control, and  this can become less effective in regulating emotional responses after trauma.

So people  who've experienced trauma have a harder time making rational decisions and managing stress  and and dealing with the pressures of life. Changes to the hippocampus can impair memory  and cognitive function, and they can also reduce our ability to properly assess and respond to  stressful situations. Okay.

So long story short: childhood trauma, it's really harmful to our  mental health, our physical health, our brain, and our stress response in our nervous  system. But can it be treated afterwards? Yes.

As we learn how trauma impacts mental and  physical health, better treatments for trauma have been developed. So schools, workplaces, and  doctors are implementing trauma-informed care, and individuals can get support through various  types of therapy, education, and experiences. I have a whole playlist on on these treatments,  so you could check that out.

I'll link that in the description. But I really do believe  that we humans have a massive potential for post-traumatic growth, and we have the ability to  heal and to learn to regulate our nervous systems and to improve our brain and body's ability to  regulate stress. It's just that most people have never been taught how to do so.

So if you want  to learn more, there is a ton of resources out there. I'm I'm making a document to put as many  of the good ones as I can find in one place. And of course you can take my free Grounding Skills  course to learn the basics of how to regulate your nervous system.

And again, I'll make sure and  link those down below. Now, another interesting thing is if you're interested in whether adverse  childhood experiences might be affecting you now, you can take an ACEs quiz over at NPR. And I'll  link that in the description as well.

Okay. So, yes, trauma can be treated. But even more  importantly, can it be prevented?

And I would say yes, absolutely. We don't just want to have  an ambulance at the bottom of the cliff picking up the kids who fell off the cliff; we want to  build a fence at the top of the cliff preventing children from getting getting hurt in the first  place. I really do believe that we can prevent ACEs.

And a large study by the CDC has explored  how. And I'm going to share some lists. But what it really comes down to is building up community  support for families, strengthening marriages, and supporting parents.

It involves helping people  learn the skills to function better at work and school and build financial security. And this can  be as simple as helping families connect to free uh parenting resources or volunteering in your  local school and you're reading to kids or being a Big Brother Big Sister. It it makes a difference  if you connect with your neighbors or you support community programs.

Or even just working on your  own healing process can help break the chain of generational trauma. When children have a handful  of supportive people in their lives, that can make all of the difference, and adversity can become a  resilience factor instead of leading to PTSD. Now, I am feeling really fired up about this right  now.

I seriously believe that we, that you people watching my videos can take active steps  to stop passing down generational trauma, whether that's just by taking small steps to improve your  own mental health or strengthening your family or reaching out and supporting your community. So  comment below, what is a one small step you're going to take this week to help prevent childhood  trauma? Thank you for watching, and take care.