This is the second post on survey results from the Health and Adverse Life Events (HALE) questionnaire, a Chronic Illness and Trauma Pilot Study. The first blog post summarized the main chronic illness survey results and listed the most common chronic illnesses and mental health conditions that you had.
This post describes:
- Slight differences in age between those of you in good health and with chronic conditions
- 50% of you had both a chronic illness and a mental health condition (I describe implications of this)
- Younger age of onset for people with mental health conditions
- Younger age of onset with greater adversity with mental health, metabolic syndrome and sensitivities
This small pilot study assessed whether those of you with chronic conditions experienced more adversity or trauma compared with those of you in good health.
I wondered whether your personal experiences were similar to the research I present on this blog.
202 of you took the survey.
186 of you had one or more chronic physical or mental health conditions
16 of you were in good health.
This was enough to get statistically significant survey results.
Table of Contents
1. Slight Differences in Age
There were some differences in age between the two groups in the survey results. A few more of you in good health were slightly younger with 10% being 30 years old or less compared with 7% with chronic conditions. There were, however, also more of you in good health in the 51 – 60 and 71 to 80 year old age groups.
Since chronic conditions can begin or add up over the years, this may be an indication that those of you in good health weren’t just in young age groups that might have had lower risk of having a chronic condition.
This will be worth exploring in more detailed surveys in the future.
2. Both Physical and Mental Health Conditions
Do you now have or have you ever had a chronic health condition? Chronic physical conditions include more than 3 months of a condition such as high blood pressure, high cholesterol, being overweight, cancer or experiencing chronic pain regardless of the cause. They also include chronic illness such as multiple sclerosis, fibromyalgia, Parkinson’s, autoimmune disease and more. Chronic mental health conditions include more than 3 months of symptoms such as anxiety or depression, ADHD, PTSD, bipolar disorder etc.
More than 50% of you had both a chronic physical illness and a mental health condition.
We tend to keep these two types of health conditions separate in our medical understanding and treatment approach – one group of diseases being “in the body,” and one “in the mind.”
Research in trauma shows us, however, that the effects of trauma are not limited to mental health conditions. The science tells us that emotional and physical trauma also increase risk for chronic physical illness.
The fact that so many of you had both a physical and emotional condition supports the growing understanding that conditions of all kinds are likely the result of contributions from trauma or adversity. It supports the new paradigm that different health conditions may have similar causes – rather than different causes for different diseases.
The understanding that trauma and supportive experiences shape health offers hope.
Health conditions are affected only partly by genes and the effects of trauma play a role in turning those genes on and off. It gives us tools for prevention, tools to nip early symptoms in the bud or use them as indicators of potential risk, and ways to heal the effects of trauma as a new approach for working with and healing both chronic illness and mental illness.
3.Younger Onset with Mental Health Conditions
How old were you when your health condition began (not when you were first diagnosed since it can take many years to get a diagnosis)?
Although it was not possible to tell for certain, this pilot study suggests that mental health conditions may begin at a younger age than other chronic conditions.
This introduces an important question to explore in future surveys.
It brings up the additional question of whether having a mental health or emotional condition such as depression or anxiety may be an early warning sign.
The research in trauma suggests that chronic states of emotional distress are early indicators of a nervous system that is dysregulated. That they are symptoms and effects of unresolved trauma.
Another finding in the survey results was that the very first chronic condition, whether mental or physical, began before the age of 51. While we couldn’t tell which chronic condition was the first to begin at the youngest age, it showed that chronic conditions did not start, for the first time, “out of the blue” in people who were entirely in good health, after the age of 51.
This may be additional information to help us explore how the effects of trauma show up in a variety of different symptoms and ages.
4. Younger Onset with More Adversity
In this pilot study I asked a single question for each of 6 different types of adversity (in contrast to asking all 10 questions for the ACE score, for example). We gave one point for each type of trauma for a score from 0 to 6:
- Adverse Babyhood Experiences (ABEs)
- Adverse Childhood Experiences (ACEs) (10 types of ACEs give a score from 0 to 10)
- Adverse Childhood Experiences Plus (ACEs+) included other types of adversity beyond the 10 ACEs
- Adverse Childhood Relationship Experiences (ACREs) also known as complex PTSD or developmental trauma
- Adverse Life Experiences (ALEs)
- Adverse Multigenerational Experiences (AMEs)
As the number of different exposures to adversity increased, the age of onset of mental health conditions decreased.
Although we didn’t have the data to know for sure, it looked like the age of onset got lower as exposure to adversity increased.
An earlier age of onset with increasing adversity appears to be particularly true for people with:
- Mental health conditions
- Metabolic syndrome (high blood pressure, high cholesterol, high weight, diabetes, heart disease)
- Sensitivities (to food, mold, and people with multiple chemical sensitivities aka “MCS”)
You see ever greater numbers of respondents with onset in each age group as adversity scores increase (see an additional graph in the downloadable pdf of this post).
Research in the science of trauma finds that the severity of symptoms is worse when people have experienced more severe trauma or a larger number of exposures or longer duration of adversity. This has been seen in the Adverse Childhood Experiences (ACEs) studies, for example (Felitti, 1998; Dube, 2009).
Age of Onset
It has also been noted that a greater number of ACEs is linked to a younger age of onset (see Shaw, 2017 study in Multiple Sclerosis and Anda, 2008 study on hospitalizations for chronic obstructive pulmonary disease or “COPD”). Our survey results are consistent with this finding.
The effects of trauma or adversity are known to be “additive” or “compounding” and the amount of exposure is sometimes referred to as “dose.”
The age of onset may also be delayed or the onset of disease even prevented when there are more support systems, resources, and nurturing relationships that “buffer” the effects of trauma. This has been seen in a small study showing that family members with diabetes-related antibodies did not progress to the onset of the disease when they experienced more support (Robinson, 1989).
The role of resources and support are important to include and we will drill down for more detail on the different types of adversity in future surveys.
11 Tools that Support Healing Effects of Trauma
Therapies for Healing Effects of Trauma
Books for Understanding Trauma and Chronic Illness
Summary of How Trauma Shapes Health
Adverse Childhood Experiences and Chronic Illness (and calculate your ACE score)
Anda, R. F., et al. (2008). “Adverse childhood experiences and chronic obstructive pulmonary disease in adults.” American Journal of Preventive Medicine 34(5): 396-403. Abstract
Dube SR, Fairweather D, Pearson WS, et al. Cumulative childhood stress and autoimmune diseases in adults. Psychosom Med 2009;71(2):243-50. Abstract and PDF
Felitti VJ, Anda RF, Nordenberg D, et al. 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]. Am J Prev Med 1998;14(4):245-58. Abstract and PDF
Robinson, N., et al. (1989). “Psychosocial factors and the onset of Type 1 diabetes.” Diabetic Medicine 6: 53-58. Abstract
Shaw, M. T., et al. (2017). “Adverse Childhood Experiences Are Linked to Age of Onset and Reading Recognition in Multiple Sclerosis.” Frontiers in Neurology 8: 242. Abstract and PDF