Do you remember this scene from Raiders of the Lost Ark: After Indiana Jones takes an improbable pounding chasing the bad guys, we find him a little worse for wear in the berth of a ship with the enamoured Karen Allen. Her glow is met by his fatigue, her kiss by his snore, but just before he sleeps she scolds him, “You’re not the man I knew ten years ago”, to which he replied, “It’s not the years, honey, it’s the mileage”.
True that. What might we learn if we were each fitted with a sort of life odometer that displayed our ‘mileage’, the amount of wear and tear we accrue as the months and years bounce by?
One thing we would see is that chronic stress gets that odometer ticking. And a remarkable body of research is showing that stress gets under our skin, so to speak, during sensitive periods of our development and changes our long-range vulnerability to depression and anxiety, addiction, social isolation, disease, injury, dementia and death. Ughh!
The biological processes of a developing child’s body and mind are shaped and changed by the conditions that the child encounters. Early life adversity, as it’s called, such as physical, sexual, and emotional abuse, harsh discipline, parental unresponsiveness and neglect, poverty and witnessing violence subjects a child to an environment full of threat, shock and danger.
Danger is biologically important information. Evolution has it that we naturally adjust in whatever ways those adjustments can be made so that we can most optimally meet future conditions. Because nature doesn’t have a crystal ball, the adjustments that get made are based in the conditions that are commonplace in the child’s life. Development tunes the body and mind, reflecting the way it is. Human and animal research has clearly established that if danger is present with some frequency, then the developing stress and immune systems learn and morph to mirror the requirement to deal with danger, and these changes can persist apparently for the duration of the individual’s life.
Adults who had suffered early life adversity react with more and longer lasting fear and have stronger and longer stress reactions. The diseases and problems of adulthood that are clearly associated with stress, such as heart disease, are more prevalent in those who suffered childhood adversity. A Johns Hopkins Medical School study followed medical students/physicians for 40 years and found, in that affluent and educated population, that those who had suffered childhood adversity had 2.4 times the rate of coronary heart disease by age 50.
Childhood maltreatment is borne through a person’s life at the levels of cells and systems; it becomes a part of how we are. Chronic childhood stressors program changes in certain types of immune cells that result in over-responding to injuries and infections. These changes get embedded in the way DNA cranks out the battle materials when threats from viruses and wounds occur. These and other changes produce more inflammation and less responsiveness to the signals that would down-regulate the stress response.
Behavioural changes also get baked in to the cake and further undermine long-term health. Effected adults more often participate in unhealthy, high mileage lifestyles including poor diet, smoking, alcohol abuse and less exercise. They tend to be more socially isolated due to the learned tendency for vigilance to threat and mistrust of others.
No child is responsible for the conditions in which they grow up and so it’s most important that health policy catch up with what science is telling us about stress, emotional health and physical health. I’m sorry to say that the Conference Board of Canada, self-described as,”The foremost independent, not-for-profit, applied research organization in Canada” mentioned “stress” only once, as an afterthought, in their Canadian Heart Health Strategy document from January 2010. Their slogan, “Insights You Can Count On”, suggests instead that we cannot yet count on seeing policies that embrace the reality that emotional health is a major and very costly public health issue.