One of the most common questions people ask after learning about the Adverse Childhood Experiences study is, “how can childhood events have such profound, diverse effects, decades later?”
The answers to that question are complex but start with the way harm is done directly to body systems by chronic stress and the changes the toxic stress does to the brain and most basic emotional processing.
Our bodies develop to respond to stress in ways that favor short-term survival over long-term survival. This response makes sense; if you can’t survive a situation that poses an immediate, life-threatening emergency, long-term survival is irrelevant.
The ten traumas identified in the Adverse Childhood Experiences Study [see panel] are so profound that they cause children to have ongoing fear for their lives and safety. That causes a stress response that is helpful in the short term but not in the long term.
These chronic stress responses can change how a child’s circulatory system, nervous system, respiratory system, endocrine system, and immune system develop. Even when people with high ACE scores don’t engage in other high-risk activities, their risks of dying prematurely from diseases like cancer, heart disease, diabetes, and COPD are higher.
However, many people with high ACE scores will also engage in high-risk activities, thus further increasing adverse health outcomes.
Chronic stress in childhood is likely to cause a child’s brain to develop to be ready for more chronic stress. Children are more likely to view the world as a terrifying place. Depending on the child’s trauma, they may develop Post Traumatic Stress Disorder (PTSD), Attention Deficit Hyperactivity Disorder (ADHD), or have difficulty forming a healthy, secure attachment.
These things will cause further stress for the child; PTSD means the child will experience debilitating bouts of anxiety and panic. Impaired attachment means the child will have trouble learning to calm themselves and regulate their emotional ups and downs. When a traumatized child starts school, their brain is still in survival mode. That means their learning and social skills are likely to develop slower than they would otherwise, and this makes school less enjoyable and rewarding for them.
All of this translates into children with brains that are strongly predisposed to behavioral or chemical addictions, as they are ways that the child can make their brain more normal. Behavioral addictions include risk-taking and eating. Chemical addictions can consist of smoking or vaping nicotine, marijuana, alcohol, or harder drugs. These coping mechanisms can have adverse health outcomes. The consequences from addiction, impaired school performance, involvement in the criminal justice system can set young people on a different life trajectory than they would be on otherwise.
Children who have suffered ACEs are less likely to succeed in school. More likely to suffer from addiction. And more likely to be in an unhealthy relationship. All this making it less likely they will pursue an advanced degree or hold down a steady job. Financial hardship is one of the metrics identified in the original ACE research.
If someone struggles with employment, the primary source of health insurance for most people, the odds of them consistently receiving medical care are lower.
And here we see how the harm caused by ACEs comes full circle; changes in emotional health affect psychosocial and economic health, which, in turn, affect physical health. There are countless ways these different spheres can affect each other. But the good thing about circles is you can break them at any point.
Our brains can change and respond to positive experiences, even in adulthood. There are specific therapies that are particularly helpful in healing from childhood trauma. But treatment will be of limited use if you’re in an abusive relationship, don’t have a stable income, housing, or access to food and medical care. You can also fix all of these things. Therapy and lifestyle improvements will help reduce the stress in your life, and that, alone, will help with physical ailments related to ACEs.