Category Archives: Life-threatening Childhood Diseases

7 Ways Childhood Adversity Can Change Your Brain (Donna Jackson Nakazawa)

According to science journalist and author, Donna Jackson Nakazawa, early emotional trauma changes who we are, but we can do something about it. This article, reprinted here with the author’s permission, first appeared in a Psychology Today blog of August 7, 2015.
(Donna wrote this as Part I; Part II offers science-based methods for reversing the changes related to ACEs. Part II can be accessed through a link at the bottom of this article.)

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7 Ways Childhood Adversity Can Change Your Brain, Donna Jackson NakazawaIf you’ve ever wondered why you’ve been struggling a little too hard for a little too long with chronic emotional and physical health conditions that just won’t abate, feeling as if you’ve been swimming against some invisible current that never ceases, a new field of scientific research may offer hope, answers, and healing insights.

In 1995, physicians Vincent Felitti and Robert Anda launched a large-scale epidemiological study that probed the child and adolescent histories of 17,000 subjects, comparing their childhood experiences to their later adult health records. The results were shocking: Nearly two-thirds of individuals had encountered one or more Adverse Childhood Experiences (ACEs)—a term Felitti and Anda coined to encompass the chronic, unpredictable, and stress-inducing events that some children face. These included growing up with a depressed or alcoholic parent; losing a parent to divorce or other causes; or enduring chronic humiliation, emotional neglect, or sexual or physical abuse. These forms of emotional trauma went beyond the typical, everyday challenges of growing up. (For stories of those who faced childhood adversity, see these videos on Laura and John, two patients featured in my newest book, Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal.)

The number of Adverse Childhood Experiences an individual had had predicted the amount of medical care she’d require as an adult with surprising accuracy:

• Individuals who had faced 4 or more categories of ACEs were twice as likely to be diagnosed with cancer as individuals who hadn’t experienced childhood adversity.
• For each ACE Score a woman had, her risk of being hospitalized with an autoimmune disease rose by 20 percent.
• Someone with an ACE Score of 4 was 460 percent more likely to suffer from depression than someone with an ACE Score of 0.
• An ACE Score greater than or equal to 6 shortened an individual’s lifespan by almost 20 years.

Childhood Disrupted, Donna Jackson NakazawaThe ACE Study tells us that experiencing chronic, unpredictable toxic stress in childhood predisposes us to a constellation of chronic conditions in adulthood. But why? Today, in labs across the country, neuroscientists are peering into the once inscrutable brain-body connection, and breaking down, on a biochemical level, exactly how the stress we face when we’re young catches up with us when we’re adults, altering our bodies, our cells, and even our DNA. What they’ve found may surprise you.

Some of these scientific findings can be a little overwhelming to contemplate. They compel us to take a new look at how emotional and physical pain are intertwined. (For more on why I wrote about how ACEs can change the way we see illness and how we do medicine, see this video.)

[In Part I of this article, we’ll talk about the science of early adversity and how it changes us. In Part II, we’ll talk about all the science-based ways in which we can reverse these changes, and get back to who it is we hope to be, so stay tuned for the good news.]

1. Epigenetic Shifts

When we’re thrust over and over again into stress-inducing situations during childhood or adolescence, our physiological stress response shifts into overdrive, and we lose the ability to respond appropriately and effectively to future stressors—10, 20, even 30 years later. This happens due to a process known as gene methylation, in which small chemical markers, or methyl groups, adhere to the genes involved in regulating the stress response, and prevent these genes from doing their jobs. As the function of these genes is altered, the stress response becomes re-set on “high” for life, promoting inflammation and disease.
This can make us more likely to over-react to the everyday stressors we meet in our adult life—an unexpected bill, a disagreement with a spouse, or a car that swerves in front of us on the highway, creating more inflammation. This, in turn, predisposes us to a host of chronic conditions, including autoimmune disease, heart disease, cancer, and depression.

Indeed, Yale researchers recently found that children who’d faced chronic, toxic stress showed changes “across the entire genome,” in genes that not only oversee the stress response, but also in genes implicated in a wide array of adult diseases. This new research on early emotional trauma, epigenetic changes, and adult physical disease breaks down longstanding delineations between what the medical community has long seen as “physical” disease versus what is “mental” or “emotional.”

2. Size and Shape of the Brain

Scientists have found that when the developing brain is chronically stressed, it releases a hormone that actually shrinks the size of the hippocampus, an area of the brain responsible of processing emotion and memory and managing stress. Recent magnetic resonance imaging (MRI) studies suggest that the higher an individual’s ACE Score, the less gray matter he or she has in other key areas of the brain, including the prefrontal cortex, an area related to decision-making and self-regulatory skills, and the amygdala, or fear-processing center. Kids whose brains have been changed by their Adverse Childhood Experiences are more likely to become adults who find themselves over-reacting to even minor stressors.

3. Neural Pruning

Children have an overabundance of neurons and synaptic connections; their brains are hard at work, trying to make sense of the world around them. Until recently, scientists believed that the pruning of excess neurons and connections was achieved solely in a “use-it-or-lose-it” manner, but a surprising new player in brain development has appeared on the scene: non-neuronal brain cells—known as microglia, which make up one-tenth of all the cells in the brain, and are actually part of the immune system—participate in the pruning process. These cells prune synapses like a gardener prunes a hedge. They also engulf and digest entire cells and cellular debris, thereby playing an essential housekeeping role.

But when a child faces unpredictable, chronic stress of Adverse Childhood Experiences, microglial cells “can get really worked up and crank out neurochemicals that lead to neuroinflammation,” says Margaret McCarthy, PhD, whose research team at the University of Maryland Medical Center studies the developing brain. “This below-the-radar state of chronic neuroinflammation can lead to changes that reset the tone of the brain for life.”

That means that kids who come into adolescence with a history of adversity and lack the presence of a consistent, loving adult to help them through it may become more likely to develop mood disorders or have poor executive functioning and decision-making skills.

4. Telomeres

Early trauma can make children seem “older,” emotionally speaking, than their peers. Now, scientists at Duke University; the University of California, San Francisco; and Brown University have discovered that Adverse Childhood Experiences may prematurely age children on a cellular level as well. Adults who’d faced early trauma show greater erosion in what are known as telomeres—the protective caps that sit on the ends of DNA strands, like the caps on shoelaces, to keep the genome healthy and intact. As our telomeres erode, we’re more likely to develop disease, and our cells age faster.

5. Default Mode Network

Inside each of our brains, a network of neurocircuitry, known as the “default mode network,” quietly hums along, like a car idling in a driveway. It unites areas of the brain associated with memory and thought integration, and it’s always on stand-by, ready to help us to figure out what we need to do next. “The dense connectivity in these areas of the brain help us to determine what’s relevant or not relevant, so that we can be ready for whatever our environment is going to ask of us,” explains Ruth Lanius, neuroscientist, professor of psychiatry, and director of the Post-Traumatic Stress Disorder (PTSD) Research Unit at the University of Ontario.

But when children face early adversity and are routinely thrust into a state of fight-or-flight, the default mode network starts to go offline; it’s no longer helping them to figure out what’s relevant, or what they need to do next. According to Lanius, kids who’ve faced early trauma have less connectivity in the default mode network—even decades after the trauma occurred. Their brains don’t seem to enter that healthy idling position—and so they may have trouble reacting appropriately to the world around them.

6. Brain-Body Pathway

Until recently, it’s been scientifically accepted that the brain is “immune-privileged,” or cut off from the body’s immune system. But that turns out not to be the case, according to a groundbreaking study conducted by researchers at the University of Virginia School of Medicine. Researchers found that an elusive pathway travels between the brain and the immune system via lymphatic vessels. The lymphatic system, which is part of the circulatory system, carries lymph—a liquid that helps to eliminate toxins, and moves immune cells from one part of the body to another. Now we know that the immune system pathway includes the brain.

The results of this study have profound implications for ACE research. For a child who’s experienced adversity, the relationship between mental and physical suffering is strong: the inflammatory chemicals that flood a child’s body when she’s chronically stressed aren’t confined to the body alone; they’re shuttled from head to toe.

7. Brain Connectivity

Ryan Herringa, neuropsychiatrist and assistant professor of child and adolescent psychiatry at the University of Wisconsin, found that children and teens who’d experienced chronic childhood adversity showed weaker neural connections between the prefrontal cortex and the hippocampus. Girls also displayed weaker connections between the prefrontal cortex and the amygdala. The prefrontal-cortex-amygdala relationship plays an essential role in determining how emotionally reactive we’re likely to be to the things that happen to us in our day-to-day life, and how likely we are to perceive these events as stressful or dangerous.

According to Herringa:

If you are a girl who has had Adverse Childhood Experiences and these brain connections are weaker, you might expect that in just about any stressful situation you encounter as life goes on, you may experience a greater level of fear and anxiety.

Girls with these weakened neural connections, Herringa found, stood at a higher risk for developing anxiety and depression by the time they reached late adolescence. This may, in part, explain why females are nearly twice as likely as males to suffer from later mood disorders.

This science can be overwhelming, especially to those of us who are parents. So, what can you do if you or a child you love has been affected by early adversity? The good news is that, just as our scientific understanding of how adversity affects the developing brain is growing, so is our scientific insight into how we can offer the children we love resilient parenting, and how we can all take small steps to heal body and brain. Just as physical wounds and bruises heal, just as we can regain our muscle tone, we can recover function in under-connected areas of the brain. The brain and body are never static; they are always in the process of becoming and changing. ###

For Part II, “8 Ways People Recover From Post Childhood Adversity Syndrome,” CLICK HERE.

 

Donna Jackson Nakazawa is an award-winning science journalist interested in exploring the intersection between neuroscience, immunology, and the deepest inner workings of the human heart. In addition to this book, Childhood Disrupted, she has authored The Autoimmune Epidemic and The Last Best Cure. For more information on Donna and her work, visit her website.

 

 

Childhood Trauma: Helping Youngsters Recover (Guest: Christy Monson)

BTRadioInt-300x75-300x75This excellent interview with Christy Monson was featured under a slightly different title on April 6, 2014. Unaddressed, the effects of childhood trauma can be substantial. Christy has some great insight on the issues affecting the traumatized child, and how we can help these youngsters recover more quickly and more effectively. -JDS

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Christy Monson, childhood trauma, the traumatized childHow does one explain and process tragedy, trauma and loss to a child? Although youngsters have the ability to handle these circumstances as well as most adults, how we help and support them certainly matters.

In this program, Christy Monson, will share her insights and interventions for recognizing the behaviors and reactions of the tragedy-affected youngster and how we can help the grieving, traumatized and hurting child heal with our love and support. As Christy will explain, our role in helping this child stabilize and recover is a very important one.

Love, Hugs and Hope, When Scary Things Happen, Christy MonsonAn experienced Licensed Marriage and Family Therapist, Christy built a very successful counseling practice in Nevada and later in Utah. She is the author of Love, Hugs and Hope: When Scary Things Happen. This book for children is the focus of this program.

Christy has authored other books, also, including the soon-to-be released, The Family Council Guidebook: How to Solve Problems and Strengthen Relationships.

www.ChristyMonson.com

TO LISTEN, use the player below or left-click the link. To access the file right-click and “Save Target as …” to save to your audio device), CLICK HERE FOR LINK

Turn September Gold: Fight Childhood Cancer (Steve Havertz)

BTSpotlightWhen I saw Emmalee exhale for the last time I was forever changed. I never dreamed my life would have so many twists and seemly impossible roadblocks. I firmly held the belief my children would bury me, not the other way around. Emmalee was only nine years old when she fell victim to the second leading cause of death among children. [Emmalee’s FaceBook page]

Steve&EmmaleeCancer Statistics
Accidents are the number one killer of children and cancer is the number one disease that kills children or second overall killer of children. One in five who are diagnosed will die from the disease. According to an article in TIME [link], 80% of children who survive cancer treatment will end up with a life threatening, disabling or serious health condition by the age of 45. Also, this article cited a study of 1,700 children, which showed that 98% of those children who survived cancer treatments ended up with chronic life long problems such as new cancers, heart disease or abnormal lung functions.

Is Chemotherapy the Answer?
Emmalee had two rounds of in-patient hospitalization chemotherapy. As a result of chemotherapy, she had to have her intestines removed out of her body to search for a hole caused by chemotherapy. A few cancers like Leukemia boast an 80% survival rate, but if the treatments cause a multitude of long-term, life altering issues, or other diseases and problems, then I dare say this is an archaic way of treating this horrific disease. For a nation that has made amazing technological advances and we still use chemotherapy as our best solution fighting cancer, I question our resolve.

Ribbons and Awareness
We all know that the pink ribbon represents breast cancer awareness, but how many know the gold ribbon represents awareness for all pediatric cancers? In October, which is breast cancer awareness month, we see the NFL players wearing pink socks, pink shoes and pink hand warmers… Breast cancer advocates have done wonderful job marketing for money and clout.

Appropriateness of Campaigns
I find it a little strange that high schools and even elementary schools are promoting breast cancer awareness, when their own classmates are suffering from cancer. Recently, I posted a photo on Emmalee’s FaceBook page [link] and one of the comments from a young man was “In America we like boobs, not kids.” I don’t believe this represents the majority mindset by any means, but it does speak to the over-sexualized society we live in. Is it appropriate for students to be advocating for breast cancer when there are plenty of youth-focused foundations?

DragonflywingsbookA Change is Coming
This year there is finally a change occurring. Major League Baseball is going gold for pediatric cancers [link].  This is great news for us advocates who have worked so hard to have pediatric cancers recognized.

Don’t ask How and Why
When we asked the doctors the taboo question of why and how Emmalee got this cancer, ultimately they had no answers. The first day she was diagnosed we were asked by at lease three different doctors if we had been to a third world country where Hepatitis B runs rampant. We had not, nor was she a drinker of alcohol, this being another cause of her type of rare cancer.

What Causes Childhood Cancer?
This is the case in most pediatric cancers: few answers to troubled questions. There is no rational explanation as to why or how each child ends up with this heinous disease. With some adult cancers there is at least an explanation, i.e. genetics, lifestyle or personal choices, but no casual root has been established for pediatric cancers.

Six Children Die Everyday
Any time we see a child die or killed on the news, our hearts skip a beat in sorrow. Every day, however, in homes and hospital beds across the country, six children die of cancer, according to www.cancer.gov.

In the last few days of Emmalee’s life we knew her time was up. She hated the hospital and we didn’t want her to die there, so we took a big risk and had an ambulance take her home to die. The doctors thought the ride would kill her, so we rode with her just in case. But Emm was strong and wanted to be in her favorite place at home to pass. When we arrived home, I gently picked her up from the gurney and carried her to the couch in our front room. Her breathing slowed and within 20 minutes she peacefully slipped away.

Plain and simple, we need to stop this disease. ###

Steve Havertz has been a Licensed Clinical Social Worker for 22 years. He is the author of many articles and two books, including Dragonfly Wings for Emmalee [link about the book].