This series of blog posts presents the science linking chronic illness and trauma. It introduces research that made me think differently about disease from what I learned as a doctor. It may that help you think differently too, as well as understand why events that trigger the onset of disease are rarely the first or only experiences of environmental stress, and why none of this is in your head.

In these posts, I describe the process by which I discovered a vast body of research and scientists around the world who are recognizing that life events shape our nervous systems, immune systems, gene function and much more to affect risk for disease.

In this series I intersperse stories about my personal journey and gradual improvement from a debilitating illness to give you ideas on what adversity can look like and how seemingly ordinary events can influence health.

And give you examples of what you can do about it.

I never heard of any of this research in medical school and most medical training has yet to catch up.

But you don’t have to wait – the science is here now.

We finally have the research capacity and technology to answer the age-old question about whether it’s nature or nurture.

The answer is that it’s nature dancing with nurture and that both interact and influence one another throughout our lives ⁽¹⁾Shonkoff, J. P., et al. (2012). “The lifelong effects of early childhood adversity and toxic stress.” Pediatrics 129(1): e232-246.

Welcome to my discovery series.

I’ve shared a version of this and the following post on Health Rising, a blog about chronic fatigue, also known as ME/CFS or “myalgic encephalitis/ chronic fatigue syndrome,” which is the chronic illness I have. My guest post on Cort Johnson’s blog appears with the title “What if ME/CFS is an Intelligent Process Gone Awry?”

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Intro to the Series

The science is changing the face of medicine and how we understand chronic diseases of all kinds – including, very possibly, your own.

I never thought I’d experienced anything beyond the normal everyday stressors we brush off as ordinary until I delved into the research.

Even then, I blew off some of the findings at first because I didn’t think they applied to me. This is likely how you’ll feel too at first.

Until I really started to get an understanding of what environmental stressors are, and what adversity and “trauma” really mean, I didn’t get it.

My current view is that chronic illness:

• evolves through adaptations in our brains and nervous systems – and how they learn to perceive threat
• involves a process that begins long before onset or diagnosis
• results from a similar process in diseases as different as type 1 diabetes and heart disease, asthma, Parkinson’s, and ME/CFS
• arises after exposure to multiple environmental stressors or “hits”
• follows a different pathway for each person – even in the same disease
• may be caused by different mechanisms – even in the same disease

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Get this and the next 4 posts of the series in PDF or Kindle (approximately 60 pages in PDF). These posts present research on the role of adverse babyhood experiences (ABEs), how they shape risk for disease, and why it’s not in your head. The downloads form will appear momentarily.

I. A Large Body of Evidence

Trauma and adversity fit into a unifying theory of disease that is emerging across many disciplines.

The findings presented in this chronic illness and trauma series comes from a large body of scientific studies. These include:

• medicine
• epigenetics
• cellular biology
• neurophysiology
• neuroscience
• brain plasticity
• embryology
• brain development
• child development
• the science of attachment and adverse child relationship experiences (ACREs)
• multigenerational trauma and its effects
• epidemiology
• traumatic stress and more
• as well as research from many different chronic illnesses

We’re learning that life experiences interact with our genes to affect long-term health (learn more about epigenetics in my introductory post).

Our experiences in the womb, at birth and in childhood also guide the formation of nerve pathways and the ability of our nervous systems to help us settle and rest, calm ourselves down, recover from fear, pain or grief, and experience a sense of safety and connection.

Early experiences also influence whether our bodies will function with extra care and caution because they are primed for survival and are highly sensitive to stress.

These are risk factors for chronic illnesses of all kinds.

And it’s not psychological.

II. The Cell Danger Response

The latest research finds that different types of environmental stressors have something in common: they trigger a cell danger response ⁽²⁾Naviaux, R. K. (2014). “Metabolic features of the cell danger response.” Mitochondrion 16: 7-17.

This cell danger response (CDR) happens in our mitochondria. In health our mitochondria go into a fight, flight or freeze mode when facing a threat, and return to a sense of safety when the danger is vanquished or goes away. In safety, mitochondria focus on energy production.

In chronic illness, the threat response gets turned on and remains stuck in a survival response.

A body that gets stuck in a prolonged cell danger response develops symptoms. These symptoms represent all kinds of normal processes of fight, flight and freeze that are prolonged and unable to resolve or relax.

This is what eventually leads to diseases of all kinds, including illnesses listed in this post (see Dr. Robert Naviaux article and list of 100 diseases in table 1) ⁽³⁾Naviaux, R. (2018 (epub ahead of print. “Metabolic features and regulation of the healing cycle—A new model for chronic disease pathogenesis and treatment.” Mitochondrian)).

Learn more about the 5 types of environmental stressors that increase risk of a prolonged CDR – and consequently for all kinds of chronic diseases – and why it’s not psychological in this post.

III. Diseases Affected by Stress & Trauma In Pregnancy, Birth and Infancy

Risk for chronic disease can be initiated by exposures to adversity in the womb, during labor or birth, or in the first few years of life. I refer to these events as adverse babyhood experiences (ABEs).

Early adversity could include being born premature, needing incubator care, having surgery such as circumcision or another procedure in the first year or two of life, and more.

Some events are over threats. Some are “missing experiences” such as premature birth involving a loss of time in the womb that is especially designed to optimize growing organ systems such as lungs, eyes, the brain and other organ systems.

Early adversity can initiate a cell danger response, and alter the nervous system and other developing organs. It’s not psychological – it’s because our experiences and exposures interact with our developing brains and organs.

Below is a list of some of diseases increased in people who experienced trauma (or whose mothers’ experienced emotional and physical stressors) during pregnancy, birth and infancy.

This list comes from multigenerational research called the Fetal Origins of Adult Disease (FOAD) and is found at the National Institutes of Health. Other diseases on the list come from studies of these individual diseases.

Stress & Trauma in Pregnancy Increase Risk for:

• Alzheimer’s disease
• Asthma
• Autoimmune disease (see the next post of this series)
  • diabetes, type 1
  • inflammatory bowel disease
  • lupus
  • multiple sclerosis
• Cancer
• Insulin Resistance
  • Altered glucose metabolism and prediabetes
  • Diabetes, type 2
  • Altered Fat metabolism / lipid metabolism
  • Heart disease (coronary artery disease)
  • Hypertension (high blood pressure)
  • Obesity
  • the above symptoms are part of the Metabolic Syndrome (Syndrome X)
  • * Alzheimer’s & Dementia also appear linked to insulin resistance
• Kidney disease
• Liver disease
• Mental Illness such as Depression, Anxiety, Bipolar Disorder, Schizophrenia
• Osteoporosis and reduced bone mass
• Stroke

Posts #1 to #4: How Perinatal Trauma Affects Risk

The first 3 posts of this series look specifically at the effects of stress during pregnancy, birth and infancy.

Post #1 looks at what we’ve learned about the effects of trauma from antibodies and autoimmune diseases. I describe what I learned from research in type 1 diabetes and share studies I then found about risk for other autoimmune diseases. One of the most intriguing details I learned was how researchers discovered that risk begins years before the onset of a chronic illness and, in fact, starts before birth.

Post #2 deepens our understanding of how the same kinds of stressful events that increase risk for autoimmune diseases are also risk factors for asthma and other diseases. It delves more deeply into how stress and trauma affect a mother’s (and father’s) ability to bond with their baby and how this, in turn, affects risk. I share a wonderful story of how one researcher accidentally cured a child’s asthma and figured out why. The science has helped me make sense of my own experiences of asthma as well to reduce my symptoms significantly.

Post #3 introduces some of the most exciting research I’ve found to date. It describes landmark studies showing HOW early stressors affect us. They do so by altering both a mother’s and her baby’s gene function through epigenetics. The good news is that some epigenetic changes can be reversed. This and other studies and experiences suggest that some symptoms and chronic diseases can be prevented or onset delayed.

Post #4 is a recap and short overview of risk factors for chronic illness in pregnancy, birth and infancy.

You can also get an ABE Fact Sheet and learn about the detailed science in this post on adverse babyhood experiences.

V. Diseases Affected by Adverse Childhood Experiences (ACEs) and Trauma in Childhood

Adverse childhood experiences (ACEs) refer to 10 types of trauma occurring before 18 years of age. ACEs are known to increase risk for many chronic illnesses, including autoimmune diseases ⁽⁴⁾Dube, S. R., et al. (2009). “Cumulative Childhood Stress and Autoimmune Diseases in Adults.” Psychosomatic Medicine 71(2): 243-250.

The first ACE study had over 17,000 patients and was published in 1998 ⁽⁵⁾Felitti, V. J., et al. (1998). “Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study [see comments].” American Journal of Preventive Medicine 14(4): 245-258. Hundreds of other ACE studies have been published since.

The 10 items represent the tip of an iceberg. Other types of trauma in childhood also increase risk for disease.

Some of the chronic diseases found to be increased by the 10 types of ACEs or other types of trauma in childhood include:

• Autoimmune diseases, of which the 5 most common found were
  • type 1 diabetes also known as insulin-dependent diabetes mellitus (23.1%)
  • rheumatoid arthritis (18.8%)
  • autoimmune thrombocytopenia purpura (16.7%)
  • idiopathic pulmonary fibrosis (9.1%)
  • systemic lupus erythematosus (8.1%)  (lupus)
• Asthma
• Same Diseases as affected by perinatal risk factors
  • cancer
  • metabolic syndrome (obesity, insulin resistance and type 2 diabetes, high blood pressure and lipids)
  • fractures (perhaps also linked to issues with bone mass)
  • liver disease
  • stroke
• Addison’s Disease
• ADHD, Behavioral problems in children, problems concentrating in school
• Celiac disease
• Chronic Fatigue (ME/CFS)
• Chronic Pain
• COPD (chronic obstructive pulmonary disease)
• Dermatomyositis
• Fibromyalgia (FMS)
• Irritable Bowel Syndrome (IBS)
• Inflammatory Bowel Disease (IBD)
• Lung Disease (Asthma, COPD)
• Migraines
• Multiple Sclerosis
• Myasthenia Gravis
• Psoriasis
• Scleroderma
• Sjogren’s
• Sleep Disorders
• Thrombocytopenia purpura
• Wegener’s granulomatosis

Posts #5 to #6: How Childhood Trauma Affects Risk

Post #5 shares the resistance doctors and others have had in recognizing links between chronic illness and trauma. It also introduces some of the reasons many still think the effects of trauma are only psychological. Knowing the science puts you in an informed position even if your doctor hasn’t yet been trained about the research.

Post #6 summarizes the first 25 years of research showing that trauma is a common trigger for the onset of type 1 diabetes. The findings in this post are relevant to other chronic diseases, as found in the adverse childhood experiences (ACE) studies.

Two additional posts are not specifically part of the series but provide helpful additional information on ACEs.

Introduction to Adverse Childhood Experiences (ACEs) includes the questionnaire to determine if you’ve experienced the 10 types of trauma, a summary of the many effects of ACEs, an example from the movie Boyhood, and that ACEs increase risk for autoimmune and other diseases.

ACE Fact Sheets to Educate Your Doctor provides facts and stats about ACEs, free downloadable one-page fact sheets you can use to inform your doctor (as well as other health care professionals, teachers, lawyers, social workers, employers and others) and includes tips for doctors on how to screen for ACEs in clinical practice based on what others are starting to do. It includes a video of Dr. Vincent Felitti, the internist who co-founded the first ACE study, talking about ACEs in what is typical of the heart warming, reassuring and compassionate ways understanding trauma helps makes sense of chronic illness and helps your doctor become your ally.

There are more posts to come in the series.

VI. Healing Trauma and Chronic Illness

Our growing understanding of how adversity affects risk for disease opens the door to new tools for healing.

Here are my favorite books and therapies for healing trauma. The somatically based trauma therapies I recommend support healing nervous system perceptions of threat and the cell danger response. These are different from cognitive, behavioral therapies and exposure therapies, which are not designed to work with trauma and make symptoms worse for many.

Explore the 10 most helpful tools that science supports for healing the effects of inflammation, trauma and nervous system dysregulation. These also work with the nervous system and perceptions of threat.

The read the next post in this discovery series introducing the science:

#1 How Understanding Trauma Makes Sense of Autoimmune and Other Chronic Diseases

You can also learn more:

through my other free downloadable ebooks