Traumatic experiences and stressors in childhood have historically been overlooked as predisposing factors in the development of various chronic pain disorders and psychiatric conditions, including fibromyalgia, irritable bowel syndrome, insomnia, depression, anxiety, post-traumatic stress disorder, and chronic fatigue syndrome. However, the tide is turning as research is revealing a significant correlation between childhood trauma and adult health.
The central nervous system is rapidly developing during childhood and being conditioned to respond to various stimuli and stressors that are encountered in life. As an assortment of environmental stimuli are encountered, new pathways are created between the cells of the brain in response to each stimulus. For example, a pleasurable experience such as a hug from a parent or a sweet food creates pathways that teach the brain to respond pleasurably to those stimuli. Likewise, a frightening experience will create and exercise pathways that respond in fear. This process of creating new pathways in response to stimuli is referred to as neuroplasticity. As we age, neuroplasticity decreases, meaning it is more difficult to develop new pathways and adjust our brain’s responses to stimuli. Children are at a distinct advantage in possessing a high degree of neuroplasticity. However, this also highlights the importance of delivering meaningful stimuli to the developing brain, to ensure the development of positive pathways.
In the presence of a strong support system and normal, short-lived stressors, a child’s stress responses are appropriately activated and buffered through supportive relationships. In this way, positive pathways are developing in the brain and training the nervous system how to appropriately respond to the normal stressors of life. As the brain encounters various stressors, a healthy resilience is built so that increasingly stressful circumstances are able to be experienced with normal biological responses.
In the absence of supportive relationships or in the presence of extreme and/or long-standing stressors, the stress response is inappropriately activated and may negatively impact the development of the brain and neurological system. As regions of the brain that are responsible for fear, anxiety and impulsive responses are activated, neural pathways are developed to favor these regions of the brain. Subsequently, regions of the brain that are responsible for reasoning, planning and behavioral control may lack appropriate pathways, leading to a propensity toward negative emotions such as fear, anxiety, panic attacks, and depression.
The human stress response elicits a cascade of events that impact the brain, neurological system, and various endocrine glands and hormones, explaining its broad influence over health. The stress response begins with neurons experiencing environmental stressors or stimuli, translating the stimuli into messages, and sending those messages along pathways to various regions of the brain for interpretation and response. During these activities, the production of brain chemicals, known as neurotransmitters, are triggered. Neurotransmitters deliver messages to other regions of the brain and other organs. These chemicals communicate with the adrenal glands (of the endocrine system), which then produce hormones such as cortisol and epinephrine (adrenaline). These hormones are responsible for the traditional “fight-and-flight” response to traumatic or dangerous stressors. While these are helpful if we need to dodge a ball or car accident, chronic activation of these hormones can weaken the health of the immune system, the gut, energy systems, and pain perception, contributing to various health issues such as irritable bowel syndrome, chronic fatigue syndrome, and fibromyalgia. When the stress response is over activated during childhood, it becomes hypervigilant and has difficulty maintaining balance in adulthood.
According to the National Child Traumatic Stress Network, the most common traumatic stressors affecting children include, accidents, physical trauma, abuse, neglect, and exposure to domestic and community violence. Other impactful stressors include death of a family member, divorce, drug or alcohol abuse, and natural disasters. When encountered during childhood, these traumatic stressors precondition the neurological system and the stress response system to produce exaggerated responses to normal stimuli. Fibromyalgia and irritable bowel syndrome are two examples of hypervigilant neurological responses. Normal stimuli such as wind blowing in the face or clothing rubbing against the skin can produce painful sensations in those with fibromyalgia, illustrating an exaggerated pain response. Normal stressors triggering the neurological system to inappropriately stimulate the muscles of the intestine, leading to alternating constipation and spastic diarrhea, is a classic sign of irritable bowel syndrome. The pain response is also heightened in those with irritable bowel syndrome, causing abdominal pain.
Currently, specific causes of conditions associated with chronic pain and fatigue, such as fibromyalgia and chronic fatigue syndrome, are unknown; however, nearly two decades of research has strongly pointed to early childhood stressors as significant risk factors for initiating these conditions. While not every child who has been exposed to traumatic stressors will experience emotional and physical health calamities, research shows that children exposed to traumatic events or long-standing stressors are 2.7 times more likely to experience functional somatic conditions (functionally debilitating conditions for which no distinct cause can be determined), such as fibromyalgia, chronic fatigue syndrome, chronic pain, irritable bowel syndrome and others. Additionally, these conditions commonly exist with psychiatric conditions such as anxiety and depression. The age at which trauma or stress is experienced, its duration, and even the type of trauma does not appear to shift this alarming statistic.
Considering the increasing prevalence of functional somatic conditions, emotional and psychiatric problems, it is important to consider the influence of childhood experiences in the development of these conditions. Dwelling upon past trauma is not always helpful in supporting health and healing, and may actually be counterproductive; however, understanding its influence upon health is helpful in being able to appropriately identify elusive health conditions such as fibromyalgia. It is also important to understand for the purpose of protecting future generations from the debilitating effects of childhood trauma and stressors. Finally, it serves as a good illustration of the success of a functional medicine approach, which relies on a thorough health and lifestyle history to put together the “story” of an individual’s health and gain insight into the root causes of health problems.
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- National Scientific Council on the Developing Child. (2005/2014). Excessive Stress Disrupts the Architecture of the Developing Brain: Working Paper 3. Updated Edition. http://www.developingchild.harvard.edu
- The National Child Traumatic Stress Network (2010.) Early Childhood Trauma. Retrieved from http://www.nctsn.org/content/scope-problem
- Burke, N.N., Finn, D.P., McGuire, B.E., & Roche, M. (2016). Psychological stress in early life as a predisposing factor for the development of chronic pain: Clinical and preclinical evidence and neurobiological mechanisms. Journal of Neuroscience Research. doi: 10.1002/jnr.23802.
- Zouikr, I., Bartholomeusz, M. D., & Hodgson, D. M. (2016). Early life programming of pain: focus on neuroimmune to endocrine communication. Journal of Translational Medicine, 14, 123. http://doi.org/10.1186/s12967-016-0879-8
- Afari, N., Ahumada, S. M., Wright, L. J., Mostoufi, S., Golnari, G., Reis, V., & Cuneo, J. G. (2014). Psychological Trauma and Functional Somatic Syndromes: A Systematic Review and Meta-Analysis. Psychosomatic Medicine, 76(1), 2–11. http://doi.org/10.1097/PSY.0000000000000010