Trauma and its Link to Chronic Illness

This article explains the connection between prolonged trauma exposure and the onset of physical diseases, focusing on the body’s stress response.

What is prolonged trauma exposure?

Prolonged trauma exposure refers to a situation in which an individual is subjected to traumatic events, experiences, or circumstances over an extended period rather than as a one-time or short-term occurrence.

This type of trauma is characterized by its ongoing and chronic nature, which can have profound and lasting effects on a person’s physical, emotional, and psychological well-being.

It may involve the repetition of traumatic experiences, such as ongoing abuse, harassment, or violence. These repeated exposures can compound the traumatic impact on an individual.

Prolonged trauma exposure can be complex, involving multiple stressors and a variety of traumatic events. This complexity can make it particularly challenging for individuals to cope with and recover from.

The effects of prolonged trauma exposure can be severe and multifaceted. They may include symptoms of post-traumatic stress disorder (PTSD), such as flashbacks, nightmares, and hypervigilance, as well as physical health issues, emotional distress, and disruptions in daily functioning.

Long-term exposure to trauma can also lead to the development of other mental health conditions, such as depression and anxiety disorders.

Prolonged trauma exposure can also interfere with an individual’s ability to process and heal from their experiences, making it challenging to regain a sense of safety and control in their lives.

The cumulative impact of repeated traumatic experiences can be especially damaging, as each new trauma can compound the effects of previous ones. This can create a cycle of ongoing distress and impairment.

How does the body respond to stress?

When the body experiences stress, it initiates a complex cascade of physiological responses designed to help the individual respond to perceived threats. These responses are often collectively referred to as the “fight-or-flight” response.

Here’s a description of the physiological changes that occur during stress, including the activation of the fight-or-flight response:

1. The brain’s amygdala plays a crucial role in processing emotions and becomes highly active, detecting potential threats. The hypothalamus, another brain structure, is activated, releasing corticotropin-releasing hormone (CRH) in response to stress.
2. CRH signals the pituitary gland to release adrenocorticotropic hormone (ACTH). ACTH then stimulates the adrenal glands on top of the kidneys to produce and release stress hormones, primarily cortisol and adrenaline (epinephrine).
3. Adrenaline causes an increase in heart rate and blood pressure, redirecting blood flow to essential organs and muscles. Blood vessels constrict in non-essential areas like the skin and digestive system to prioritize blood flow to the muscles and brain.
4. Breathing becomes faster and shallower to provide more oxygen to the muscles and brain, preparing the body for action.
5. Muscles tense up to prepare for physical activity, which can lead to increased strength and agility.
6. Cortisol increases the release of glucose (sugar) into the bloodstream to provide quick energy for the body. Digestion temporarily slows down as blood is diverted away from the digestive system.
7. The senses become more alert and focused as the brain prioritizes sensory information relevant to the perceived threat.
8. The body’s sensitivity to pain can decrease during stress, which may help individuals in emergencies.

The fight-or-flight response is a system designed to respond quickly to life-threatening situations. While it can be a crucial survival mechanism, chronic or excessive activation of this response due to ongoing stress can have negative health consequences.

Prolonged exposure to stress hormones like cortisol can contribute to various health issues, including anxiety disorders, cardiovascular problems, and immune system dysfunction.

What is the role of stress hormones in the body’s response to trauma?

Cortisol is a crucial hormone synthesized by the adrenal glands, primarily responsible for regulating various essential bodily processes, particularly in stress reactions. Its vital functions include the maintenance of blood sugar levels, metabolism, and immune system responses.

Additionally, cortisol facilitates the body’s ability to react to stressful situations by heightening alertness and energy levels. Please refer to our comprehensive guide for further information on reducing cortisol levels and mitigating stress hormones.

Cortisol also plays a role in managing inflammation and influences the body’s response to injuries or infections. Its secretion follows a natural circadian rhythm, with higher levels in the morning that gradually decrease throughout the day, contributing to the regulation of sleep-wake cycles.

How does chronic stress affect the body’s immune system?

The connection between prolonged stress and immune system suppression, which can make the body more susceptible to diseases, is a complex physiological response. This phenomenon is often referred to as “stress-induced immune dysregulation.” Here’s how it works:

• Hormonal response: When the body perceives stress, it activates the hypothalamic-pituitary-adrenal (HPA) axis, a neuroendocrine system that controls the body’s stress response. This leads to the release of stress hormones, primarily cortisol, into the bloodstream^[1].
• Cortisol and immune function: Cortisol is known to have potent anti-inflammatory and immunosuppressive effects. In the short term, this can be beneficial, as it helps the body manage immediate threats and inflammation. However, when stress is chronic or prolonged, and cortisol levels remain consistently elevated, it can negatively affect the immune system.
• Immune system changes: Prolonged exposure to high levels of cortisol can lead to several detrimental effects on the immune system:
  Decreased inflammation response: While cortisol can suppress inflammation, chronic suppression can hinder the body’s ability to respond effectively to infections and injuries.
• Reduced immune cell activity: Cortisol can reduce the activity of immune cells, such as T-cells and B-cells, responsible for identifying and attacking pathogens.
• Altered immune cell distribution: Cortisol can also cause a shift in the distribution of immune cells, favoring cells that are less involved in immediate immune responses.
• Susceptibility to diseases: Due to these changes, the immune system becomes less efficient at defending the body against infections, viruses, and other pathogens. This increased vulnerability can lead to a higher risk of developing various diseases, including viral infections, bacterial infections, and autoimmune disorders.
• Chronic inflammation: Paradoxically, chronic stress can lead to low-grade inflammation in some individuals. This ongoing inflammation is associated with an increased risk of various chronic diseases, such as cardiovascular disease, diabetes, and certain autoimmune conditions^[2].

It’s important to note that the impact of stress on the immune system varies among individuals. Factors like genetic predisposition, the type of stress experienced, and an individual’s coping mechanisms can influence how stress affects immune function.

Are there specific physical diseases associated with prolonged trauma exposure?

Chronic stress and trauma have been linked to a wide range of diseases and health conditions. The effects of chronic stress and trauma on health can be complex and multifaceted, impacting various systems in the body.

Here are some of the diseases and health conditions that have been associated with chronic stress and trauma:

Mental Health Disorders

• Post-traumatic stress disorder (PTSD): Traumatic experiences can lead to the development of PTSD, characterized by symptoms such as flashbacks, nightmares, hypervigilance, and emotional distress.
• Depression: Chronic stress and trauma can increase the risk of developing depression, a mood disorder characterized by persistent feelings of sadness, hopelessness, and loss of interest or pleasure.

Cardiovascular Conditions

• Hypertension (high blood pressure): Prolonged stress can contribute to elevated blood pressure, increasing the risk of hypertension and its associated cardiovascular problems.
• Heart disease: Chronic stress has been linked to an increased risk of coronary artery disease and heart attacks.

Immune System Disorders

• Increased susceptibility to infections: Chronic stress can weaken the immune system, making individuals more susceptible to infections and illnesses.
• Autoimmune diseases: Stress has been associated with the onset and exacerbation of autoimmune disorders like rheumatoid arthritis, lupus, and multiple sclerosis.

Gastrointestinal Issues

• Irritable bowel syndrome (IBS): Chronic stress can exacerbate symptoms of IBS, a digestive disorder characterized by abdominal pain, bloating, and changes in bowel habits.
• Gastric ulcers: Stress can contribute to developing and worsening gastric ulcers.

Metabolic Conditions

• Type 2 diabetes: Chronic stress may increase the risk of developing type 2 diabetes by affecting blood sugar regulation and insulin sensitivity.
• Obesity: Stress can lead to overeating and weight gain, increasing the risk of obesity and related health issues.

Pain Syndromes

• Chronic pain: Trauma and chronic stress can exacerbate chronic pain conditions, such as fibromyalgia and chronic headache disorders.
  Muscle tension: Stress can lead to muscle tension and contribute to tension headaches and temporomandibular joint (TMJ) disorder.
• Cognitive impairment: Chronic stress has been associated with cognitive impairment and an increased risk of neurodegenerative diseases like Alzheimer’s disease.

Sleep Disorders

• Insomnia: Stress and trauma can disrupt sleep patterns and contribute to insomnia, which can, in turn, worsen other health conditions.

Addiction

• Substance abuse: Individuals experiencing chronic stress or trauma may turn to substances like alcohol or drugs as a coping mechanism, increasing the risk of substance abuse disorders.

What is the connection between stress hormones and mental health disorders?

Research suggests experiencing childhood traumatic stress can elevate the risk of being hospitalized with a diagnosed autoimmune disease many years into adulthood, as indicated by multiple studies^[3].

Imbalances within the HPA axis have been correlated with various mental health conditions, including but not limited to depression, alcoholism, and eating disorders^[4].

Conditions such as PTSD, stress-related somatic disorders (such as idiopathic pain syndromes), and chronic fatigue syndrome seem to be linked to reduced HPA activity, leading to decreased adrenal gland functionality.

Can protective factors mitigate the physical health effects of trauma?

• Managing the impact of trauma on physical health is crucial for an individual’s overall well-being. Several factors, such as social support, resilience, and coping strategies, can play a significant role in helping individuals better navigate the challenges posed by trauma.
• Having a solid network of family and friends who offer emotional support, understanding, and a sense of belonging can provide a buffer against the adverse physical effects of trauma.
• Similarly, participating in support groups with individuals who have experienced similar traumas can offer a sense of community, shared understanding, and valuable coping strategies.
• Building a therapeutic relationship with a mental health professional can provide a safe space to process trauma, gain insights, and receive guidance on managing its physical and emotional impacts.
• Learning resilience-building skills can help individuals rebound from adversity. These skills include problem-solving, emotional regulation, and adapting to new situations.
• Developing a positive self-concept and self-esteem can enhance resilience. When individuals believe in their capacity to overcome challenges, they are better equipped to cope with trauma’s physical and emotional toll.
• Being adaptable and open to change can contribute to resilience. Adapting to new circumstances and seeking new growth opportunities is a hallmark of resilience.
• Learning to manage and express emotions in healthy ways can prevent the build-up of chronic stress and its physical consequences. Techniques such as mindfulness meditation and deep breathing can effectively regulate emotions.
• Cognitive coping strategies involve reframing negative thoughts and beliefs related to the trauma. Cognitive-behavioral therapy (CBT) is an evidence-based approach for addressing distorted thought patterns.
• Regular physical activity, a balanced diet, and sufficient sleep can improve physical health. Exercise, in particular, has been shown to reduce stress and improve mood.
• Practicing relaxation techniques, such as progressive muscle relaxation or guided imagery, can help reduce physical tension and promote relaxation.
• When trauma’s physical impact is severe or chronic, seeking professional guidance from healthcare providers, including specialists in trauma or pain management, is crucial.

Support for trauma and chronic illness

If you’ve been grappling with persistently high levels of stress, reducing your cortisol levels independently may pose a challenge. In such situations, seeking professional mental health assistance can prove invaluable.

Similarly, there is support available for those who have endured trauma impacting both their physical and mental well-being. At The Center • A Place of HOPE, we’ve crafted a unique trauma recovery program rooted in our established Whole Person Care approach.

Our commitment extends beyond addressing the trauma itself, as we deeply respect and honor your individuality and identity. Our seasoned clinical team is equipped with practical strategies to help you lower stress.

Our treatment encompasses all facets of your health and overall wellness. We won’t just guide you in cultivating new mental habits; we’ll also focus on ensuring you maintain a balanced diet, enjoy restorative sleep, and nurture healthier relationships.

1. Buckingham, J.C. (1985) ‘Hypothalamo-pituitary responses to trauma’, British Medical Bulletin, 41(3), pp. 203–211. doi:10.1093/oxfordjournals.bmb.a072052.
2. Lacourt TE, Vichaya EG, Chiu GS, Dantzer R, Heijnen CJ. The High Costs of Low-Grade Inflammation: Persistent Fatigue as a Consequence of Reduced Cellular-Energy Availability and Non-adaptive Energy Expenditure. Front Behav Neurosci. 2018 Apr 26;12:78.
3. Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB. Cumulative childhood stress and autoimmune diseases in adults. Psychosom Med. 2009 Feb;71(2):243-50. doi: 10.1097/PSY.0b013e3181907888. Epub 2009 Feb 2. PMID: 19188532; PMCID: PMC3318917.
4. Ehlert, U., Gaab, J. and Heinrichs, M. (2001) ‘Psychoneuroendocrinological contributions to the etiology of depression, post-traumatic stress disorder, and stress-related bodily disorders: The role of the hypothalamus–pituitary–adrenal axis,’ Biological Psychology, 57(1–3), pp. 141–152. doi:10.1016/s0301-0511(01)00092-8.