Is childhood stress really connected to chronic disease? There is definitely a distinct connection between the mind and the body. Ongoing research continues to validate this fact. Some of the most interesting research about this topic, in my opinion, revolves around the connection between childhood trauma and the inflammatory response, specifically the autoimmune response.
But Before We Go Any Further, What is Autoimmune Disease?
An autoimmune disease is one of up to 80 different inflammatory disorders that affect approximately 50 million people in the United States. When a person has an autoimmune disease, the body begins to produce antibodies that attack and damage its own tissue instead of fighting disease as they were intended. This happens in response to a trigger. Oftentimes, the trigger is unknown, but research has identified common triggers as certain bacterial and viral infections, certain medication, certain chemical or environmental toxins, and, as studies are showing more and more, a stressful childhood.
Some of the most common autoimmune diseases are:
- rheumatoid arthritis,
- lupus,
- diabetes type 1,
- Celiac’s disease,
- multiple sclerosis,
- Crohn’s disease,
- ulcerative colitis,
- Hashimoto’s thyroiditis,
- Grave’s disease,
- Guillian-Barre,
- myasthenia gravis,
- ALS,
- scleroderma,
- Sjögren’s,
- and psoriasis.
Symptoms vary with each autoimmune disease, but some common symptoms include fatigue; joint or muscle pain; muscle soreness, numbness, or weakness; changes in weight; changes in bowel movements; abdominal pain; and skin rashes.
The ACE-Autoimmune Connection
A study was conducted in the late 90s on 15,357 adults. Participants were asked whether or not they had endured any adverse childhood experiences (ACEs). Based on the participants’ responses, they were given an ACE score and researchers used this score to gauge childhood stress.
What researchers found was that people with 2 or more ACEs were at 70-100% increased risk for hospitalizations with autoimmune-type diseases decades into adulthood. In fact, people who were treated poorly as children showed high levels of systemic inflammation as adults, up to 20 years later. People with stressful childhoods were more likely to have high levels of inflammation as adults, regardless of whether they experienced a large or small amount of stress during adulthood.
[Click here to complete my ACE assessment and find out your ACE score]
The Science Behind it All
What’s interesting is that there are individuals who experienced high levels of childhood stress yet were never diagnosed with a single autoimmune disease. This is because ACEs aren’t the entire story. We currently believe that when a person experiences stress as a child, the psychological experiences like abuse and neglect are programmed into the immune system. The macrophages (a type of white blood cell) develop a pro-inflammatory tendency (e.g. they display an exaggerated inflammatory response within the body). This still isn’t the entire story.
The makeup of the microbiome (bacteria and other flora in the gastrointestinal tract) and epigenetics (certain genes being expressed more or less based on interactions with the environment) also play crucial roles in whether or not a person develops autoimmune disease after ACEs. The “environment” that influences gene expression in epigenetics includes hormones (which is why many autoimmune diseases are more prevalent in females than males), smoking history, diet, environmental toxin exposure, and social interactions.
Stressful Events in Adulthood and Autoimmune Disease
The effects of stress on autoimmune disease diagnosis are not limited to childhood. Up to 80% of adults in one study reported an abnormally high level of emotional and psychological stress immediately prior to diagnosis with an autoimmune disease. In these cases, abnormal levels of stress hormones lead to dysregulation of the immune system which then leads to autoimmune destruction of body tissues. Being diagnosed with an autoimmune condition also puts stress on the mind and body leading to an ongoing cycle of worsening autoimmunity.
Why Does this All Matter?
Long-term health effects of individuals who have experienced ACEs are not limited to autoimmune disorders. People who have experienced ACEs are also at greater risk for substance abuse, mental illness, suicide attempts, and other health outcomes, such as heart attacks. This shows that humans are not compartmentalized. Our physical health, our mental/psychological health, our spiritual health, and our social health are all interconnected; each affects the others. As we seek health and wellness, the practitioners we choose should ideally understand this and the therapies and treatments that we undergo should uncover and address the underlying causes and contributing factors while taking the whole person into consideration. Because they have different risk factors compared to their peers, people with a history of ACEs need to be treated (medically speaking) differently, and this just may be the missing link in your healing. Unfortunately, the adverse childhood experiences and mental health aspects are usually neglected when it comes to treating autoimmune disease.
In my opinion as a doctor who chose to focus my training and clinical practice on mental health and the chronic diseases that are affected by and that in turn affect it, the best approach to addressing autoimmune diseases in individuals with ACEs is a comprehensive, integrative, functional medicine approach that addresses the whole person. Here are some of the factors that the ideal approach would include:
- addressing individual genetics,
- optimizing your diet,
- identifying and treating underlying infections,
- addressing gut health by optimizing digestion and the microbiome,
- modulating the immune system,
- decreasing environmental exposure to substances known to disrupt the immune system,
- and balancing hormones.
The ideal approach would also address the mental health aspects of autoimmunity:
- educating and empowering yourself to manage stress;
- learning coping mechanisms;
- addressing anxiety, depression, trauma, other mental health concerns specific to you;
- connecting with others with a similar history in a group setting to learn and grow from experts and professionals in the field, and from the experiences of others;
- and more.
[Click here to complete my ACE assessment and find out your ACE score]
If you’re ready to finally address your autoimmunity and the factors that contributed to it, click here to learn more about working with Dr. Louis, the author of this post.
Not surprised I have cutaneous lupus. Anxiety as a child. Developed after mental abuse, emotional neglect and not being fed adequately.
Hello, my score was a 6. Not surprised that I have R.A., Lupus, Addison’ s Disease, etc. My Rheumatologist retired and now I need to find another one here in Michigan. How do you find a specialist that understands the relationship between trauma and autoimmune disorders? I really think I need a new way to treat my body besides all of the pills. I have no quality of life right now, I’m 58 and I know I’m missing out on my life and its really not fair.
I am not surprised that my ACE scorce was 7 however, I was surprised to find out that my autoimmunity could be connected to my childhood. It makes so much sense though. I have hypothyroidism that started as graves disease as a child. I have type 1 autoimmune diabetes. I have raynauds. I have IBS. I know for sure that those diagnoses are autoimmune. I also have polycystic ovarian syndrome, endometriosis, rosacea, eczema, migraines, gastroparesis and have had to have my gallbladder removed. I don’t know if those diagnoses are autoimmune in nature or not.
My score was 7-no surprise after being raised in a physically and emotionally abusive home, multiple relative placements, and foster care. I have been diagnosed/misdiagnosed with several different autoimmune disorders, however the most recent is Mixed Connective Tissue and Raynaud’s. Interesting to see how the Sed Rate can change–possibly related to diet changes?
Hi Jenni!
Thanks for sharing your experiences. I’m sorry to hear about your misdiagnoses and I hope you are able to get the care you need with your current medical team. Inflammatory markers can absolutely change with alterations in lifestyle factors such as diet and exercise. Learning how your body reacts to different foods is so beneficial because it enables us to choose the ones that produce the best results as far as our health is concerned.
All the best,
Dr. Janelle Louis ND
Second comment After reading. I believe that my diseases were activated about age 35 my brother who sexually abused me from age 7to17 was arrested for abusing his daughter all my memories came back my parents knew about the abuse I told them when I was young. But the told the attorney how close we were. I decided to tell the truth and defend my niece let them know about his abuses sexual physical mental threatening because of that my folks disowned me I was told I was no longer a member of that family that was over35years ago I have not heard from them since. Shortly after that my physical and mental health crashed. Psych care out patient
Wow they are still messing up my life. I have SS RA Raynauds depression with anxiety DDD osteoarthritis sometimes I feel so tired of all of it. The guilt of not being a full functioning adult of not having good parenting skills is so depressing I’ve had suicide thoughts always
Hi Nancy,
In my experience, understanding how our past affects our health has been beneficial because it helps us to be easier on ourselves. Realizing that your past contributed significantly to your present situation helps to dissipate that feeling of guilt for many people. I hope you can think of it in this way. If you are having suicidal thoughts, please speak with a professional in order to get some assistance or call the suicide prevention hotline at 1-800-273-8255. I’m certain that, with your experiences, you have a lot to contribute to the world especially along the lines of educating people about the effects of ACEs and that the world would be a better place for you being here.
I am so sorry to read about your experiences. It definitely sounds like you have been through a lot and I’m deeply regretful about your family’s reaction.
I have another website that is focused on helping women who have experienced ACEs. It’s temporarily down for maintenance as I’m having it redone, but if you go there and enter your email address, I’ll notify you when it is back up. I have several courses/programs designed to help individuals who have experienced ACEs and I believe you would benefit from them. The website is https://www.mhaspot.com
Finally, I hope you will take what I stated in this message to heart and seriously consider doing what you can to educate people about the effects of ACEs and to decrease their frequency. Your story is a powerful example of their effects and I believe that if you can arrive at a better place physically and emotionally, then you will be a very bright light to help others to follow in your footsteps who right now cannot see their way.
All my best,
Dr. Janelle Louis ND
Deep down I’ve always known there was a correlation between my childhood and my autoimmune disease. Growing up I was raised by several different maids who came and went and this gave me trust issues, i ended up despising affection and hated being hugged which lasted until my early teens, I had an alcoholic half brother who’s much older than me and would get violent, my father worked abroad so I didn’t see him much, and my controlling mother was busy with her social life so I didn’t see her a lot either, being painfully shy I was the easy target for bullies, and moved schools/countries frequently due to my mothers indecisiveness, I never felt grounded, wanted or safe. I always felt really isolated and bottled how I felt due to not feeling like I could trust anyone enough to tell.
There was always a huge absence of encouragement which lead me to become a perfectionist and my own worst enemy. I thought I dealt with it fine enough until an additional emotional trauma at the age of 18 which is when I was diagnosed with an autoimmune disease shortly after that event.
I’ve since struggled with eating disorders and suicidal ideation, It all makes sense, unfortunately. I’m still dealing with a lot of unresolved issues, an identity crisis and low self esteem. But I’ve gained a deeper understanding of it all and I appreciate this article for recognising auto immune diseases as more than just another disease on a pharmaceutical conveyabelt, because for the longest time I believed that doctors didn’t understand what I was going through beyond that of a textbook, but this gracefully puts it all into perspective, thank you.
Hello Alana,
Thank you so much for sharing some of your experiences. I’m sorry to hear about everything you’ve endured over the years, but I’m also glad to learn that it’s all coming together for you. I hope you are able to access the care you need and deserve where you are and I wish you all the best along your healing journey!
Why is there not one question about death of a parent????
Hello Anamaria,
The reason the quiz does not mention the death of a parent is that that question was not on the original list that the researchers used when they studies adverse childhood events. This does not in any way mean that individuals who experience the death of a parent do not experience the negative effects that have been associated with enduring adverse experiences in childhood. I hope this answers your questions and I hope you find the answers you are looking for. I wish you all the best on your healing journey.
Hello Dr. Louis,
Thank you for the wonderful article portraying the correlation between childhood stress and risk of autoimmune disorders. I had a traumatic childhood (childhood bullying, emotional neglect, gender non-conformity and sexual abuse). I was diagnosed with a rare condition called ‘polymyositis’ at the age of 15. Though I was treated well and completely recovered now, I am wondering whether polymyositis was triggered by the emotional stress that I encountered. Your valuable response to my question is highly appreciated.
Since the article says that “People who have experienced ACEs are also at greater risk for substance abuse, mental illness, suicide attempts, and other health outcomes, such as heart attacks”, would you recommend any preventive measures for people with ACE scores of greater than 2? I have an ACE score of 5.
Thanks in advance,
Shyam
Hello Shyam,
Thanks for your comment. I’m glad to read that the article was beneficial to you. In response to your question, it is entirely possibly that your polymyositis diagnosis may have been related to the adverse childhood experiences you endured.
Regarding your second question, there are many different interventions that a person could make to limit their risk and I regularly make individualized recommendations in my practice; however, I’m not in the habit of making individualized recommendations for people who are not my patients. This is for both your and my protection as I do not know anything about your health history outside of what you’ve shared and some of my recommendations may be contraindicated in your individual case.
If you are the type of person who likes to read research, there is some research that I’d like to share with you as I believe it is relevant to your question. This research is regarding the changes that occur in the gut microbiome and the hypothalamus-pituitary-adrenal axis in early life in response to stressors and the effects that modulating the microbiome by means of high-quality probiotics and other modifiers can have in normalizing these two crucial areas. You can read a review on the subject here: https://www.ncbi.nlm.nih.gov/pubmed/23384445
Thanks again for reaching out and I hope you find the answers you are looking for!
I am so pleased to have discovered this site/ info. I scored an 8 on the test. I have 7 diagnosed Autoimmune diseases and a few other things I picked up along the way. As a woman of 46, it is scary to realize that my childhood, which was terrible but I thought I had “coped” with over the years, actually affected me physically as well. Thanks to this new information, I can now go and see my Specialist Rheumatologist and approach the subject of healing PROPERLY. Not just taking handfulls of pills every day to effectively deal with the symptoms but the root causes and the actual problems. Very sad that more Medical Professionals don’t realize the link and fill us with serious drugs which could cause more harm than good. THANK YOU 😉
Adel, not a problem. Thank you very much for your feedback! I’m sorry to hear about your childhood, but I am also very grateful to have had the opportunity to share this information with you so that you and your medical team can address the underlying causes of your medical diagnoses and you can be on your way to renewed health. I wish you all the best along your healing journey!
Hi there, I find it a bit disappointing that most of the literature that I have come across, doesn’t touch on children that live in rich parent’s homes, were the children are left in the hands of strangers that seem to rotate constantly, because of the unhappy environment.
This home help, in many cases, also abuse the children, because they perceive that the parents are too self-involved to notice. When as a child you complain about “the help,” it is very inconvenient to the parents.
There’s nowhere to go. On the contrary, most people assume you have a dream life, when all you think about is how to end the pain. Suicidal thoughts on a daily basis, from age 5 onwards, is not very healthy….. (I am being sarcastic)….. but nobody talks about this.
Hello, MC. I would assume that researchers believe the situation you’ve described is covered under the general topics of abuse and neglect (ironic to think of it that way, but emotional neglect is just as damaging as physical neglect). I agree with you that this situation is a completely different dynamic compared with physical neglect and should be given its own category. It is definitely worthy of further research via large-scale studies.
I am passionate about treating autoimmune conditions due to a variety of different causes, but I also have a special place in my heart for treating autoimmune concerns, other physical problems, and mental/emotional concerns that arise as a result of emotionally damaging social and familial environments, especially since this area is so under-addressed in medicine today. I hope these considerations will become more mainstream in the years to come. Thanks for your response and I hope you find the answers that you are looking for!
This test didn’t even touch on the death of a parent, loss of home, critically ill sibling, multiple moves, or other Traumatic childhood events.
Iris, thanks for your comment. You are absolutely correct! We chose to construct the quiz based on the adverse childhood experiences that were actually studied in the research I referenced so that people would know whether or not, based on this research, they had a score of 2 or greater and were therefore at increased risk for an autoimmune disease. Like you said, though, there are lots of other traumatic things that can take place in childhood and have adverse effects on health, even into adulthood. Just because those events you mentioned aren’t as heavily researched does not nullify their effects on our health! Thanks again for your input!