Does childhood stress affect mental health, too?
You might have noticed that when something bad happens in your life – you lose a job, go through a breakup, or someone close to you passes away – you’re more likely to feel sad. It probably doesn’t take a psychologist to point that one out! However, the more bad things that happen to you, especially the bad things that are really severe (like being abused or having your parent go to jail), the more likely you are to develop depression. It’s really well established that when bad things happen, you’re more likely to become depressed.
*Side note: When psychologists talk about depressive symptoms, they’re referring to symptoms that all of us can have on a given day, like feeling sad, losing your appetite, or not feeling pleasure in certain things that you used to. When we talk about depression, or clinical depression, that’s something more severe and likely long-lasting. For example, you have to report a minimum number of symptoms for a certain amount of time to be classified as depressed. Feeling sad when bad things happen is totally normal. Feeling extreme sadness and not being able to function for a long period of time is not. The same thing can be said for anxiety symptoms versus an anxiety disorder, etc.
However, how does that work for other mental health issues? Does stress make us more likely to have an anxiety disorder? Or conduct disorder (i.e., when people repeatedly hurt others or damage others’ property)? Or even schizophrenia?
The answer: Yes, childhood stress makes us more likely to develop a number of mental health problems both during childhood and later on in adulthood.
Here are some examples of mental health problems that are related to childhood stress:
· Anxiety and post-traumatic stress disorder (PTSD): Just like the findings for physical health, the greater stress a child experiences, the more mental health and behavior problems they are likely to have in childhood and into adulthood. One study estimates that around 22% of anxiety disorders in women and 20% of anxiety disorders in men are the result of adverse experiences in childhood. Likewise, PTSD can be seen during childhood following traumatic stress, and it can also appear in adulthood. Symptoms of PTSD in children can include irritability, extreme temper tantrums, a loss of interest in things that used to bring them joy, detachment from loved ones, and extreme distress. Adults who experienced childhood trauma can have similar symptoms and often struggle with persistent thoughts about the trauma, distorted beliefs (e.g., "I am a bad person" or "Everything in the world is dangerous"), and being overly vigilant about potential threats. Changes in the brain have been found in individuals who experienced high levels of stress as children, and researchers are trying to understand whether there may be ways change how the brain functions to reduce risk for PTSD and anxiety disorders following early stress!
· Conduct problems and substance abuse: Childhood abuse increases the risk of conduct problems in childhood and during the teen years. Conduct problems include acting out, destroying property, theft, and hurting people or animals. Experiencing more stress during childhood also increases the risk of substance abuse in adolescence and adulthood. Adults who reported multiple adverse experiences during childhood had a two- to four-fold risk of drinking heavily, being an alcoholic or marrying an alcoholic compared to adults who reported no serious adverse experiences in childhood. Similarly, the more stressful childhood experiences, the greater risk for illegal drug use during adulthood. Adults who reported 5 or more adverse childhood experiences had a 7- to 10-fold increase in their illicit drug use compared to those who had no adverse experiences!
· Schizophrenia: Evidence that childhood adversity makes you more likely to develop schizophrenia is a bit more controversial. However, a meta-analysis (which looks at a lot of studies on the same topic and uses statistics to combine results of all the studies) showed that across these studies, people with schizophrenia reported higher rates of childhood adversity than people without schizophrenia. Researchers think that early stress may affect different parts of the brain, including our memory systems, and how our bodies respond to future stressful experiences, which increase risk for schizophrenia particularly during our teenage and early adult years.
Why do we develop problems under stress?
You might be wondering: why do we develop these problems when stressful things happen? Wouldn’t our bodies want to protect us knowing that our world is stressful? These are questions that a lot of psychologists and researchers are trying to figure out! It doesn’t make sense that our body would respond to stress by developing problems that decrease our quality of life and our productivity – but yet that is often what happens.
But as my grad school advisor wisely says, “Mother Nature didn’t set the world up to make sense to psychologists.” And that means that WE have to figure it out (woooo science!), even if it doesn’t always seem to make much sense to us.
One of the reasons we think mental health issues happen after stress is that our brains and our bodies are responding to stress over and over again. And after a while, it’s harmful to us.
An example I like to use is thinking about a zebra that’s being hunted by a lion. It’s really helpful for a zebra to respond to the stressful experience of seeing a hungry lion and running away – otherwise that zebra will probably get eaten! However, it’s really tiring for our bodies to respond to stress all the time. For a child that’s living in an abusive household, it’s extremely stressful to have to respond to a potentially life-threatening situation at any time. Humans are also unique in that we will replay stressful things in our heads (such as the death of a loved one) and our bodies might respond just like the stressful situation is happening again. It takes A LOT of energy to respond to stressful things, and it changes how our bodies respond to future stressful things if we’re CONSTANTLY experiencing stress – whether it’s real or we’re reliving something stressful. Over time, this over-responding to stress can damage our brains and our bodies.
Here's an example of one way we think childhood stress increases risk for mental health problems. Part of what makes stress so toxic is that if we have anxiety about future stress, we can keep responding to threats even if they're not there, which damages our brains and our bodies.
Another interesting explanation for why we might develop mental health issues when stressful things happen is that our brain and our bodies are taking in information about the world and learning from it. When a bunch of really stressful things happen, we start to learn that the world is a stressful place and that we should always be prepared to deal with stress since it can happen anytime. We start to become really aware of our surroundings, always looking out for threatening things, and when something does happen, our bodies might kick into hyper-gear (or they might fail to respond when we need them to!). These changes might help prepare us to deal with stress in the short-term, and keep us alive in a really stressful situation, but they might not be helpful for us in the long run, leading to problems with mental health. For example, always looking out for threats might lead to anxiety or PTSD!
For a real life example of how constantly looking out for threats can increase risk for PTSD and other problems, here's an article by a pediatrician about how the threat of deportation influences children's health.
Again, it’s hard to understand WHY our bodies react the way they do, but it’s so important to think about when we try to figure out why we humans are the way we are!
RESILIENCE: Figuring out why some people do well in the face of adversity
You’re probably thinking of stressful things that happened in your life and in the lives of people you know, and you probably know of people who don’t have any major mental health issues even if they had a stressful childhood. And that’s something that should be really interesting to all of us! We call the process of doing well in the face of stress “resilience” and we study why some people do well even after experiencing stress and why others develop mental health issues.
If we can figure out WHY certain people do well, we can use their “secrets” to help others who are experiencing a lot of stress.
So why do some people do well after something really stressful and others don’t? It’s really complicated, but we have identified some reasons why. This is definitely not a full list, and I’ll talk about other protective factors in the future, but these are helpful to get us thinking about resilience:
1. Our genes! We are on the tip of the iceberg of understanding how our genes affect how we respond to stress, but we do know that many psychological problems run in families. So you may be more likely to develop depression if it runs in your family and you have certain genes that make your risk for depression higher. If you have something really stressful happen to you AND your genes increase your risk for a disorder, that might make you even more likely to develop a disorder. On the other hand, you may have genes that protect you in some ways from developing a disorder. Note: Genes are really complicated and there’s no gene or set of genes that makes you develop depression. Your experiences matter, too, not just your genes!
2. Coping skills! We may not be able to control what happens to us, but we do have some control over how we respond to challenges. Coping involves how we deal with the problem and also how we regulate our emotions in the face of stress. Our ability to manage problems and regulate our emotions influence our risk for mental health problems. We must also be flexible in our coping skills since we have to deal with different types of challenges (family problems vs. a natural disaster vs. losing a job) by taking advantage of different resources that are available to us (e.g., people who can help, community services, or our savings account). Using our coping skills effectively when facing challenges helps us to become resilient in the face of stress.
3. Social support! There's a ton of research showing that people who have good quality relationships are less likely to have mental health problems when they experience stress. Reliable and loving family members and friends are there to help you by talking to you so you can cope with your problem emotionally, making you feel happy (or at least less sad or mad), and actually helping you solve your problem! My research shows that friends and family can even help your body produce less of the stress hormone cortisol during a stressful public speech, so your social support network can even affect your biology. However, certain people can also make your body respond more sometimes. How crazy is that?!
4. Community support! Some communities have resources like Head Start, TANF (Temporary Assistance for Needy Families), SNAP (Supplemental Nutrition Assistance Program), free and reduced lunch programs, or other early childhood programs that help families when stressful things happen. These community supports can help stressed families and can also improve children’s health and brain development during important stages of development!
Notice how resilience isn’t all about our genes and isn’t all about our environment. Biology, our individual skills, our friends and families, and our greater communities all impact us in very real ways.
Why does this matter? When we understand that people's childhood experiences impact their mental health, we have a better understanding of why individuals may struggle with their mental health or why it may be hard for people to break out of bad behaviors (like alcoholism or drug abuse). Even though we have a certain amount of control over our future behaviors, understanding that stress changes our brain and our bodies can help us to understand ourselves and others more fully. It also helps us to act in ways that reduce trauma for today's children -- by volunteering, donating money, and working to improve public policy. We can also work to get children who have experienced trauma the support they need.
Coming up: I’ll post more about resilience and responding to stress in the next few weeks since they’re such interesting topics. And if you’re starting to think that this blog might just be a downer – I promise that I’ll have a lot more on positive topics in the future! I want to set the stage about why these topics are important before talking about what we can do about them. :)
-Jena