This is blog four of the series to educate you about stress and to help you increase your ability to cope with stress. Please refer to previous blogs for background information and to review the behaviors that reduce the response of the brain to chronic and acute stress.
The focus of this blog is to make you aware of the effects of high levels of stress early in life on the structure and function of the brain, on an individual's susceptibility to mental and physical disease, and also on longevity. Understanding that early life abuse harms both mental and physical health across one's lifespan is the first step to developing and implementing programs to reduce the extent of stress early in life that now exists.
There are many types of abuse that children may experience. They are not all equal in the severity of their effects on the brain, health, and behavior of children. Yet, each can have an impact. A primary source for learning more about early life abuse and health is the Adverse Childhood Experiences Study (ACE) which studied the extent and effect of abuse on 17,000 middle class individuals. This has previously been discussed on HuffPost.
Here are some of the difficult circumstances that a young person could face that could have a lasting impact:
•Physical abuse
•Verbal abuse
•Sexual abuse
•Neglect -- either physical or emotional
•Witnessing domestic violence
•Disappearance of a parent through divorce, death, or incarceration
I am going to cite a few examples of the effect that abuse of children has on altering mental and physical health. I want you to be aware that the effects may be lifelong and can have a significant effect on longevity. When I speak to University of Pittsburgh medical students and community groups I spend considerable time emphasizing the fact that being abused early in life can alter mental and physical health throughout one's life. All I can do here is ask you to realize the significance of this. I will be glad to send you a comprehensive list of scientific publications for your review. Send your request to me at: rabinbs@upmc.edu
The following are examples of the effect of early life abuse on health:
•The structure and function of the brain is altered resulting in a decreased ability to learn and behavioral difficulties.
•The risk of developing cancer, heart disease, high blood pressure or asthma is increased.
•The risk of hyperactivity disorder, posttraumatic stress disorder, or bipolar disorder are increased.
•The duration of life is shortened (and the quality of life during that time is affected). People with six or more ACEs die nearly 20 years earlier on average than those without any ACEs.
•The risk of developing autoimmune disease is increased.
•The risk of developing diseases such as irritable bowel syndrome, fibromyalgia, or multiple sclerosis is increased.
•The length of telomeres, the caps, on the end of our chromosomes, is shortened by early life abuse and is associated with an increased risk of mental and physical disease during aging.
Scientific research has identified the mechanism associated with the increased susceptibility to mental and physical health alterations in children who have been abused. It involves alteration of the hypothalamic-pituitary-adrenal axis (HPA) axis, which is the area of the brain that controls the release of cortisol from the adrenal gland. Too much cortisol, not enough cortisol, or lack of effectiveness of cortisol can result in the health alterations we are discussing.
For example, too much cortisol can damage the brain cells in an area of the brain called the hippocampus. When this occurs the person feels depressed
Fortunately, the hippocampus grows new brain cells, and if the concentration of cortisol is decreased by using the behaviors and techniques described in this series of blogs, the brain cells regrow and the depression will go away. The individuals who are most susceptible to depression are those who were abused early in life.
Depression can also occur when there is an inadequate amount of cortisol or cortisol does not function properly. Again, this alteration of cortisol occurs more frequently in individuals who were abused early in life.
As an example, do you notice that when you have an upper respiratory infection, that you have the "blues," e.g., you feel depressed. The reason this occurs is because when your immune system is reacting to the flu virus several chemicals (called cytokines) are released into the blood by the immune system. When this occurs, the cytokines travel to the brain and cause you to feel tired and depressed. Fortunately, if everything is going well the adrenal gland starts to release cortisol which stops the production of the cytokines and you feel fine. However, if for some reason there is an inadequate cortisol response, the production of the cytokines continues and depression stays constant. It is those individuals who have been abused where this is most likely to occur.
It is important to note that not every person with depression or atherosclerotic heart disease or high blood pressure, was abused as a child. However, approximately two-thirds of middle-class adults had experienced at least one adverse childhood experience.
What can be done to prevent childhood abuse? The Center for Disease Control recommends:
- Parenting training programs
- Intimate patent violence prevention
- Social support for parents
- Parent support programs for teens and teen pregnancy-prevention programs
- More attention to mental illness and substance treatment
- Preschool enrichment
- Sufficient income support for lower-income families
I realize the topic is a very sensitive one. However, over the past 12 years with all my stress coping programs which have reached many people of diverse backgrounds I have come to appreciate how widespread and serious this issue is. Unless we implement programs to reduce the frequency of childhood abuse, our succeeding generations will be even less healthy than they are now:
I suggest we must become more vocal about the issues of abuse and hope that those who have been abused will tell others how it has impacted their lives. We can learn from such examples as the experience and programs developed by Linor Abargil in response to her being raped. We must develop and implement more programs to help not only those who are being abused, but the persons doing the abusing.
The next blog of the series (blog five) will teach techniques to decrease the response of the brain to chronic stress.
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Need help? In the U.S., call 1-800-799-SAFE (7233) for the National Domestic Violence Hotline.
Need help? In the U.S., call 1-800-656-HOPE for the National Sexual Assault Hotline.