Can stress or trauma cause chronic illness? Or trigger onset? Answers are still hard to find despite links between stress, trauma and chronic illness that have been observed for millenia.
For example, people have been sharing their stories for almost 2000 years about how type 1 diabetes (T1D), the less common autoimmune form of the disease, started after a serious life event. Research from the past 40 years has also suggested that severe life events can induce the disease and is not just a trigger.
Despite the growing evidence, however, individuals with T1D and other chronic diseases are still regularly told that life events play no role in shaping risk. The same is seen for many living with chronic, life-altering, often debilitating diseases. Or if it’s believed that there is a link, they are judged or blamed and told their illness is psychological or psychosomatic. In other words, when we have a history of trauma, we run the risk of being judged as having an illness that “is all in our heads.”
I’ve been learning a great deal about how life events affect long-term health since I left medicine 20 years ago, retrained as a somatic psychotherapist and developed more refined skills for listening to the language of the body, including my own.
The chronic illness I developed along the way has been tremendously useful in helping me test and explore what I’ve been finding in library stacks and in the vast database of online research. But the first reason I started delving into the research in type 1 diabetes and many other chronic diseases was out of curiosity. And I had the same question I now see so frequently in forums, blog posts, on quora, and from clients I have worked with and others, “Can trauma and adverse life events cause or trigger the onset of my (fill-in-the-blank) chronic disease?”
A broad body of research from a wealth of different disciplines – including embryology, child and brain development, attachment and complex trauma, brain plasticity, epigenetics, psychophysiology, traumatic stress, epidemiology, the adverse childhood experiences studies, neurobiology, critical periods, fetal programming, and more – suggest the answers are a resounding yes and yes.
Despite the research and our increasing knowledge base, we continue to dismiss the effects of adverse life events and long-term health conditions, especially in medicine and with regards to chronic physical diseases.
An email I recently received from woman whose son was diagnosed with type 1 diabetes in his teens is representative of this problem. She asked his doctors whether stressful events she had observed in his childhood, well before onset, could have affected his risk. She asked this question of every endocrinologist she’s every consulted in the 10 years since his diagnosis and has always been told no, there is no connection.
If you google “trauma type 1 diabetes” today, one of the articles on the first page of results is from a highly respected leader in research, education and patient care. It is titled “Ask Joslin: Could Trauma Have Caused My Diabetes? and addresses the question, “Can a traumatic experience or a hospital stay be the cause of my diabetes?”
The answer, posted in 2014, states that links to trauma are merely a coincidence and that the belief it might cause type 1 diabetes has steadily lost support. It cites a journal article written by Dr. Joslin in 1943.
This is a common problem for anyone looking for answers about potential links between adverse life events and chronic physical symptoms.
The research in type 1 diabetes is just one example of what we know about serious life events and risk for chronic illness. As many of us who are familiar with the adverse childhood experiences (ACE) studies now recognize, such events are not just risk factors for one particular disease. ACEs and other adverse life events are risk factors for all kinds of chronic illnesses, from heart disease, obesity, and liver disease to lupus, MS, inflammatory bowel disease and other autoimmune diseases, to type 2 diabetes (the more well known and more common type of diabetes), and many more.
As I eventually came to realize through direct personal experience and in-depth trauma work, adverse life experiences have also contributed to my own debilitating chronic illness.
The kind of events that I have gradually linked to my symptoms include subtle adverse events from pregnancy, birth and infancy; multigenerational trauma (events in my parents’ and grandparents’ lives); seemingly ordinary and unrecognized events from my childhood (I have an ACE score of 0), and a number of stressful and traumatic events in the years before my first symptoms began.
Healing the effects of these frequently disregarded adverse events has been the most powerful set of tools I’ve found in beginning to heal my chronic illness. It’s been slow and I’m not fully recovered yet, but the trauma perspective remains the largest and most comprehensive paradigm I have yet seen for making sense of my chronic health conditions as well as those of many I’ve worked with, spoken to and met. I know I’m not alone in recognizing this link.
There are many reasons we dismiss the links between trauma and chronic illness. One of the most commonly stated beliefs is that all effects of trauma are psychological. The emerging science, however, is helping us understand how life experiences influence long-term physical as well as emotional and mental health and more. It’s because experiences and life events shape our developing brains, immune systems and other growing organ systems. It’s because life events interact with our genes to affect if, when and how they express themselves.
On the flip season, another common reason we frequently overlook or denigrate trauma as a risk factor for chronic illness is that we have come to focus almost exclusively on the perception that chronic physical diseases are caused by equally physical issues – such as from predisposing or mutated genes, faulty enzymes, missing proteins or the specific organ system identified with the disease (such as the pancreas in diabetes).
The view that emotional experiences lead only to mental health conditions and that chronic illnesses are caused only by biological issues is out of date and inaccurate.
We have long used additional arguments to dismiss links between adverse life events and chronic disease. I did it unconsciously for many years even as I was reading about traumatic stress, training as a trauma therapist and wondering if I had experienced even subtle adverse events in my own life.
We also frequently disregard the emerging links in medical practice and in hospital settings. We dismiss it in occupational medicine and worker’s compensation plans. And we dismiss it in our lives because no one has ever reflected the emerging facts back to us.
The more we understand why and how we mistakenly dismiss the evidence for the chronic illness and trauma connection, the faster we can start making changes in our personal lives and the lives of our loved ones. That’s why I blog about the research explaining how adverse life experiences affect risk for many different kinds of chronic physical health conditions. Learn more about the top 7 reasons we mistakenly dismiss trauma as a risk factor for chronic illness in my blog post.
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