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December 30, 2015

Adversity & Illness – Thoughts for Your New Years Resolutions

LO_RES_Untitled1Summarized from ‘Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal’ (Atria), by Donna Jackson Nakazawa & Dr. Ursula Stehle

New findings in neuroscience, psychology and immunology tell us that the adversity we face during childhood has farther-reaching consequences than we might ever have imagined. When children or teens face adversity and especially unpredictable stressors, they are left with deeper, longer‑lasting scars. When the young brain is thrust into stressful situations over and over again without warning, and stress hormones are repeatedly ramped up, small chemical markers, known as methyl groups, adhere to specific genes that regulate the activity of stress‑hormone receptors in the brain. These epigenetic changes hamper the body’s ability to turn off the stress response. In ideal circumstances, a child learns to respond to stress, and recover from it, learning resilience. But kids who’ve faced chronic, unpredictable stress undergo biological changes that cause their inflammatory stress response to stay activated.

Joan Kaufman, director of the Child and Adolescent Research and Education (CARE) program at the Yale School of Medicine, recently analyzed DNA in the saliva of happy, healthy children, and of children who had been taken from abusive or neglectful parents. The children who’d experienced chronic childhood stress showed epigenetic changes in almost 3,000 sites on their DNA, and on all 23 chromosomes – altering how appropriately they would be able to respond to and rebound from future stressors.

Kids who’ve had early adversity have a drip of fight-or-flight hormones turned on every day – it’s as if there is no off switch

Likewise, Seth Pollak, professor of psychology and director of the Child Emotion Research Laboratory at the University of Wisconsin at Madison, uncovered startling genetic changes in children with a history of adversity and trauma. Pollak identified damage to a gene responsible for calming the stress response. This particular gene wasn’t working properly; the kids’ bodies weren’t able to reign in their heightened stress response. ‘A crucial set of brakes are off,’ says Pollak.

Experiencing stress in childhood changes your set point of wellbeing for decades to come. In people with a history of chronic childhood stress, the endocrine and immune systems are churning out a damaging and inflammatory cocktail of stress neurochemicals in response to even small stressors – an unexpected bill, a disagreement with their spouse, a car that swerves in front of them on the highway, a creak on the staircase – for the rest of their lives. They might find themselves overreacting to, and less able to recover from, the inevitable stressors of life. They’re always responding. And all the while, they’re unwittingly marinating in inflammatory chemicals, which sets the stage for full-throttle disease down the road, in the form of autoimmune disease, heart disease, cancer, fibromyalgia, chronic fatigue, fibroid tumors, irritable bowel syndrome, ulcers, migraines and asthma.

Researchers Anda and Felitti surveyed these 17,000 individuals on about 10 types of adversity, or adverse childhood experiences (ACEs), probing into patients’ childhood and adolescent histories. Questions included: ‘Was a biological parent ever lost to you through divorce, abandonment or other reason?’; ‘Did a parent or other adult in the household often swear at you, insult you, put you down or humiliate you?’; and ‘Was a household member depressed or mentally ill?’ Other questions looked at types of family dysfunction that included growing up with a parent who was an alcoholic or addicted to other substances; being physically or emotionally neglected; being sexually or physically abused; witnessing domestic violence; having a family member who was sent to prison; feeling that there was no one to provide protection; and feeling that one’s family didn’t look out for each other. For each category to which a patient responded ‘yes’, one point would be added to her ACE score, so an ACE score of 2 would indicate that she had suffered two adverse childhood experiences.

To be clear, the patients Felitti and Anda surveyed were not troubled or disadvantaged; the average patient was 57, and three-quarters had attended college. These were ‘successful’ men and women, mostly white, middle-class, with stable jobs and health benefits. Felitti and Anda expected their number of ‘yes’ answers to be fairly low.

The correlation between having a difficult childhood and facing illness as an adult offered a whole new lens through which we could view human health and disease

When the results came in, Felitti and Anda were shocked: 64 % of participants answered ‘yes’ to having encountered at least one category of early adversity, and 87 per cent of those patients also had additional adverse childhood experiences; 40 per cent had suffered two or more ACEs; 12.5 per cent had an ACE score greater than or equal to 4.

Felitti and Anda wanted to find out whether there was a correlation between the number of adverse childhood experiences an individual had faced, and the number and severity of illnesses and disorders she developed as an adult. Felitti, stated, ‘Our findings exceeded anything we had conceived. The correlation between having a difficult childhood and facing illness as an adult offered a whole new lens through which we could view human health and disease.’… here ‘was the missing piece as to what was causing so much of our unspoken suffering as human beings’.

Felitti and Anda went a step further: they were able to directly link their ACE scores to illness. The higher the ACE score, the higher the number of doctor’s appointments in the past year, and the more unexplained physical symptoms  reported.

  • People with an ACE score of 4 were twice as likely to be diagnosed with cancer than people who hadn’t faced any form of childhood adversity.
  • For each point an individual had, her chance of being hospitalized with an autoimmune disease in adulthood rose 20 per cent.
  • Someone with an ACE score of 4 was 460 per cent more likely to face depression than someone with a score of 0.
  • An ACE score of 6 or higher shortened an individual’s lifespan by almost 20 years.
  • People healthy lifestyle habits (didn’t drink or smoke, weren’t overweight or diabetic, and didn’t have high cholesterol) with ACE scores greater than or equal to 7 still had a 360 per cent higher risk of heart disease than those with ACE scores of 0.

Time does not heal all wounds.  One does not just get over something. Time conceals. And human beings convert traumatic emotional experiences in childhood into organic disease later in life.  -Felitti

Often, these illnesses can be chronic and lifelong. Autoimmune disease. Heart disease. Chronic bowel disorders. Migraines. Persistent depression. Even today, doctors puzzle over these very conditions: why are they so prevalent;

Scientists at Duke University in North Carolina, the University of California, San Francisco, and Brown University in Rhode Island have shown that childhood adversity damages us on a cellular level in ways that prematurely age our cells and affect our longevity. Adults who faced early life stress show greater erosion in what are known as telomeres – protective caps that sit on the ends of DNA strands to keep the DNA healthy and intact. As telomeres erode, we’re more likely to develop disease, and we age faster; as our telomeres age and expire, our cells expire and so, eventually, do we.

Researchers have also seen a correlation between specific types of adverse childhood experiences and a range of diseases. For instance,

  • children whose parents die, or who face emotional or physical abuse, or experience childhood neglect, or witness marital discord between their parents are more likely to develop cardiovascular disease, lung disease, diabetes, headaches, multiple sclerosis and lupus as adults.
  • Facing difficult circumstances in childhood increases six-fold your chances of having myalgic encephalomyelitis (chronic fatigue syndrome) as an adult.
  • Kids who lose a parent have triple the risk of depression in their lifetimes. Children whose parents divorce are twice as likely to suffer a stroke later down the line.

Something that happened to you when you were five or 15 can land you in the hospital 30 years later

To date, more than 1,500 studies founded on Felitti and Anda’s hallmark ACE research show that both physical and emotional suffering are rooted in the complex workings of the immune system, the body’s master operating control center – and what happens to the brain during childhood. The unifying principle of this new theory is: your emotional biography becomes your physical biology, and together, they write much of the script for how you will live your life.

Just as physical wounds and bruises heal,

we can recover function in under connected areas of the brain

Now we have scientific evidence that the brain is genetically modified by childhood experience With hundreds of studies showing that childhood adversity hurts our mental and physical health, putting us at greater risk for learning disorders, cardiovascular disease, autoimmune disease, depression, obesity, suicide, substance abuse, failed relationships, violence, poor parenting and early death, we just can’t afford to make such distinctions.

Science tells us that biology does not have to be destiny. ACEs can last a lifetime, but they don’t have to. Just as physical wounds and bruises heal, just as we can regain our muscle tone, we can support recovery of the brain. If anything, that’s the most important take-away from ACE research: the brain and body are never static; they are always in the process of becoming and changing.

Even if we have been set on high-reactive mode for decades, we can still dial it down. We can respond to life’s inevitable stressors more appropriately and shift away from an overactive and inflammatory response. We can become neurobiologically resilient. We have the capacity, within ourselves, to create better health.

Today, scientists recognize a range of promising approaches to help create new neurons (known as neurogenesis), make new synaptic connections between those neurons (known as synaptogenesis), promote new patterns of thoughts and reactions, bring under connected areas of the brain back online – and reset our stress response so that we decrease the inflammation that makes us ill.

Many mind-body therapies not only help you to calm your thoughts and increase your emotional and physical wellbeing, but research suggests that they have the potential to reverse, on a biological level, the harmful impact of childhood adversity.

Recent studies indicate that individuals who practice mindfulness meditation and mindfulness-based stress reduction (MBSR) show an increase in gray matter in parts of the brain associated with managing stress, and experience shifts in genes that regulate their stress response and their levels of inflammatory hormones.

Meditation, mindfulness, neurofeedback, cognitive therapy, yoga therapy, TRE – tension release exercises, CES – cranial-electro therapy stimulation, and other somatic therapies show promising new avenues to healing.  If only healthcare practitioners would begin to treat the whole patient – past, present and future, without making distinctions between physical and mental health – and encourage patients to explore all the treatment options available to them. The more we learn about the toxic impact of early stress, the better equipped we are to counter its effects, and help to uncover new strategies and modalities to come back to who it is we really are and meant to be.

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