Have you ever wondered why people who were exposed to extreme stress early in life tend to suffer from physical ailments more than the general population? The ACEs study, a large-scale research endeavor, showed that those who were subjected to childhood trauma were, as expected, significantly more likely to develop mental health symptoms, such as depression and substance misuse. But they also demonstrated significantly poorer health outcomes, with increased risk for chronic illness – such as heart disease, diabetes, and cancer – as well as overall mortality.
How does this happen? It turns out that childhood trauma, in the form of abuse, neglect, or prolonged stress, alters key processes in the body involving pain, inflammation, and immune functioning. Experiencing ongoing trauma attunes us to danger and can cause chronic hyperarousal, a tendency to more easily get into – and stay in – fight or flight. This level of activation, though, is only meant to be temporary, not permanent or even quasi-permanent. With trauma, the body’s stress response can get stuck in the “on” position, even exceeding arousal to the point of nervous system collapse, known more commonly as the freeze state. This state is commonly associated with immobility, dissociation, and depression.
At the cellular level, significant stress over time can lead to free radical buildup, cellular dysfunction, and cell aging and death. Chronic stress also tends to increase pro-inflammatory molecules in the body. These molecules – such as cytokines – damage tissues, increase pain sensitivity, and can even trigger autoimmune attacks.
Experiencing ongoing trauma can also lead to the experience of sustained muscle tension. It makes sense; when we’re stressed, we tense up. Chronic tension can ultimately impact experiences such as headaches, back pain, and joint discomfort. Additionally, chronic stress impacts what is known as the hypothalamic-pituitary-adrenal (HPA) axis, the system that orchestrates the body’s stress response. This impacts circulating levels of cortisol, which along with adrenaline and noradrenaline, can lead to more well-known impacts – such as cardiovascular issues and digestive issues – and increased pain sensitivity. The traumatized brain also tends to amplify pain signals, making any experience of discomfort feel more intense.
Autoimmune issues are more common in those who have experienced significant stress, with stress impacting immune functioning. A trauma survivor’s immune system can become hyperactive, attacking even healthy tissue, or it can wear out, leading to a higher risk for infection and/or compromised healing. This dysfunction, coupled with inflammation, is implicated in the development of a number of autoimmune conditions, including rheumatoid arthritis, multiple sclerosis, lupus, and Hashimoto’s disease.
While many aren’t born with these conditions, experiencing early trauma can result in epigenetic (altered gene expression) changes, such as methylation, that then predispose them to immune dysregulation. Another mechanism responsible for changes in genetic expression is telomere shortening. Telomeres are protective caps on the ends of chromosomes, similar to an aglet at the end of your shoelaces. With chronic stress, telomeres are shortened, a shift associated with increased heart disease, autoimmune disease, anxiety, depression, and early death.
It is incredibly unfortunate that those who were subjected to childhood trauma suffer both while this trauma is occurring and in its aftermath of associated physical and mental health symptoms. The physical concerns outlined above are typically faced alongside a backdrop of anxiety, depression, and PTSD. In parallel with the overactive fight-flight-freeze response, trauma survivors also struggle with insufficient development of the part of the nervous system associated with safety, ease, connection, and rest. And, while the stress-related midbrain is repeatedly activated with ongoing trauma, the development of the prefrontal cortex can be stunted, resulting in difficulties with learning, emotion regulation, and behavior.
So, traumatic responses are a result of what happened and what didn’t. Thankfully, some of these effects can be mitigated by childhood resilience factors. The Resilience Questionnaire  details various factors that can buffer us against the impact of early trauma, such as having at least one safe and supportive person growing up, having a community of caring adults, having a family member invested in your schooling, or living in a home with structure and rules.
Even if you didn’t experience any of these resilience factors, suffering indefinitely isn’t a fait accompli. Just as trauma can change the brain, so can healing. A number of approaches can be called upon to help childhood trauma survivors recover from the impact of stress on the mind and body. Some of these interventions include:
- Trauma therapy: cognitive and/or somatic interventions
- Mind-body practices: mindfulness, physical activity (if possible, practices such as yoga or walking), breathing techniques, biofeedback
- Medical treatment: immune therapies, pain management, psychiatric medications, hormonal support
- Body-based treatments: physical therapy, massage, acupuncture
In fact, treatment often works best when approached from multiple angles. And it’s crucial to find sufficient time for rest, rejuvenation, and other forms of self-care. While this isn’t always possible, it can have a large impact on regulating the nervous system; trauma survivors likely require more time to rest and recover than their non-traumatized counterparts. Self-compassion is important here too. The childhood trauma survivor isn’t to blame for their trauma nor the physical and emotional sequelae of their experiences. This is an important point to continue to emphasize. The invitation to shift from “What’s wrong with you?” to “What happened to you?” isn’t just a pithy sound bite but a reality based on significant science. Finding providers who are trauma-informed and can provide safe, affirming care can facilitate recovery over time.