Understanding the Long-Term Effects of Childhood Trauma
Uchenna Umeh knew she needed to file for divorce in 2009. The relationship was not working, and she did not want her three children, then ages 9, 7, and 2, to grow up in that environment. As a pediatrician, she also knew divorce can cause childhood trauma, so she put all three in therapy. Two of her three boys struggled at first but overcame the trauma as they moved into adulthood. Her middle child didn't show outward signs of trauma until he turned 19 and began having outbursts.
"He just had a different way of processing it," says Dr. Umeh, author of A Teen's Life: Looking at Teens' Lives Through Their Daily Struggles.
Divorce is one of several Adverse Childhood Experiences (ACEs), or potentially traumatic events that occur before a child is 17 years old. Bullying, witnessing or experiencing violence or abuse, the loss or incarceration of a parent, and car accidents are a few others. About 61 percent of adults surveyed across 25 states experienced at least one ACE, and 1 in 6 adults reported exposure to multiple, according to the Centers for Disease Control and Prevention (CDC).
The consequences are wide-ranging. As Dr. Umeh's sons showed, they may appear in different ways based on the person. This can make it difficult for parents and even those in the mental health community to recognize, diagnose, and treat childhood trauma. It also makes it important to have continuous discussions about it, regardless of a person's initial reaction to an event.
"Children don't have the understanding or complexity an adult may have," says Noel Hunter, Psy.D., a clinical psychologist at MindClear Integrative Psychotherapy based in New York, and author of Trauma and Madness in Mental Health Services. "The stories they may have around what happened may be distorted and self-blaming and can snowball over time into a story that is self-destructive…and much harder to change as an adult."
Effects of Childhood Trauma
Childhood trauma can lead to a variety of issues in adulthood. People who have experienced trauma may have difficulty maintaining healthy relationships, show poor academic or job performance, and develop post-traumatic stress disorder (PTSD), substance abuse disorder, suicidality, disordered eating habits, depression, anxiety, and insomnia.
Trauma puts a person at higher risk for physical health problems, including obesity, chronic pain, heart disease, diabetes, and premature death. Stress-related disorders, such as PTSD, are also associated with autoimmune disorders, which can appear without biological cause, according to a study published in the Journal of the American Medical Association (JAMA) in 2018.
New research published by the American Psychological Association in August 2020 also found childhood trauma from abuse or violence can make the body age faster. Findings show children who experience early violence or abuse are more likely to enter puberty early and experience accelerated cellular and brain aging.
Trauma Should Be Treated on a Case-By-Case Basis
Someone can experience childhood trauma regardless of gender, sexual orientation, race, religion, or socioeconomic status. And though women are twice as likely as men to have PTSD, both Dr. Hunter and Dr. Umeh caution that parents and medical professionals should treat each child on a case-by-case basis.
That's because one's personality can determine how they handle trauma. For example, extroverts may present signs of effects earlier, which makes the pain more noticeable, but can also result in damaging labels, such as "troublemaker."
"Then you get additive effects of being ostracized by your friends or peers at school, having problems with authority because you are always in trouble, getting messages that you are a bad kid," says Dr. Hunter.
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Children who internalize the pain, on the other hand, may present later in life, after years of spinning a false narrative.
How to Help a Child Through Trauma
Regardless of the circumstance, experts say it's important to attempt to understand where children are coming from and let them know it's OK to be upset. Delegitimizing anyone's experience as "not that bad" is dangerous, says Dr. Hunter. "We tend to put these outside judgments onto things, and it leaves people feeling invalidated," she says. "Sometimes, it's the unseen, more subtle things that can be more damaging long-term."
And instead of pigeonholing a child who is struggling to behave or perform well, schools and authorities are beginning to take more trauma-informed approaches. Parents can try this as well. "When a kid is acting out or having trouble, instead of saying, 'I'm going to punish you,' they can turn around and ask, 'What is going on to make you do these things?'" says Dr. Hunter. "Try to make sense without shame, and help the kid learn new ways to express themselves that aren't destructive."
Importantly, when a parent knows their child has experienced a traumatic event, they should have him talk to a therapist or trusted adult, regardless of whether they appear to be reacting. They should explain it's not because they are "in trouble" or because "they did anything wrong," says Dr. Hunter. "Telling a kid it's not their fault can help them open up more."
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Helping a kid through trauma can be difficult for parents, particularly if they feel they caused their child's pain, such as by filing for divorce or being at-fault in an accident. In moments like those, says Dr. Hunter, parents should "step out of their own emotional reaction and be aware enough to say, 'I might be upset about this, but I have to be a parent right now.'"
For Dr. Umeh, that meant getting her own therapy and surrounding herself with positive people. If you miss a sign and it manifests itself later in a child's life, forgive yourself, she urges parents.
"There's no textbook," says Dr. Umeh. "You're winging it most of the time."
The Bottom Line
Untreated Adverse Childhood Experiences (ACEs) can lead to various problems in adulthood, including poor job performance, chronic pain, and even premature death. But by taking the proper steps after a child experiences trauma, parents can help them overcome their difficulties and thrive in the future.