Could Childhood Trauma Be A Cause Of Fatigue?

Adverse events that occurred in your childhood could be affecting your energy levels today!

Does it seem far-fetched that a childhood illness could be affecting you as an adult?

I’m sure if you ask any adult who overcame polio in their youth they would tell you that polio had a dramatic effect on their current or adult health/wellbeing. In illnesses like polio, it’s easy to see the effect the disease had on the body.

But when children go through adverse events, there are often no obvious signs (at least to the untrained eye). Yet, the events that occurred in your childhood are likely affecting your health today. In fact, the events you experienced as a child could actually predispose you to develop chronic fatigue syndrome (and many other chronic illnesses!).

Your childhood’s effect on your health

The beginning of a ground-breaking study began in the late nineties. Researchers called this study the ACE (adverse childhood events) study. The Ace study tracked over 17,000 participants for a number of years in order to identify a potential link between childhood trauma(s) and chronic disease. The findings of this study were nothing short of breathtaking: (1)

• Adverse childhood events were not rare (remember, this study was done in the first world).
• 28% of study participants reported physical abuse and 21% reported sexual abuse.
• Adverse childhood events usually occur in clusters.
• If you experience one adverse event, there’s an 87% chance another will occur.
• There is a dose-response relationship between adverse childhood events and your health.
• Meaning that the more frequent and/or severe the adverse event, the greater effect it will (negatively) have on your health.

What exactly is an adverse childhood event?

Adverse childhood events are defined as stressful or traumatic events, including abuse and neglect. They may also include household dysfunction such as witnessing domestic violence or growing up with family members who have substance abuse disorders. (2) Examples of adverse events include:

• Physical abuse
• Sexual abuse
• Emotional abuse
• Physical neglect
• Emotional neglect
• Intimate partner violence
• Mother treated violently
• Substance misuse within a household
• Household mental illness
• Parental separation or divorce
• Incarcerated household member

If you have experienced any one (or, a combination) of the above events you’re at an increased risk. But what exactly do these events put you at risk for?

The effect adverse events have on your health

It turns out that what happened to you as a child is an incredible predictor of what may happen to your health as an adult. The following (startling) statistics illustrate the incredibly strong connection between adverse events during childhood and your health:

• If you were subject to physical, sexual, or psychological abuse as a child, you’re at a significantly increased risk of developing a substance abuse disorder. (3)
• The higher your ACE score, the more likely you are to smoke cigarettes. (4)
• Tobacco smoke has been shown to damage your mitochondria. (4) And if you’re at all familiar with my work, you know just how important healthy mitochondria are to overcoming fatigue.
• Any sort of adverse childhood event increases your likelihood of attempting suicide by 2–5 times. (5)
• Exposure to adverse childhood events increases your risk of developing depression. (6)
• And I’m confident you know how strongly depression is linked to fatigue.
• Those with a history of ACEs are at increased risk for developing sleep disorders like insomnia. (7)
• It should come as no surprise that if your sleep is negatively affected, you’re going to experience fatigue.
• ACEs increase your risk of developing long-term negative health outcomes like heart disease and diabetes. (8)
• What’s one of the main symptoms associated with heart disease and or diabetes? You guessed it, fatigue.

This is the strong research available at the time of this writing. I’m confident that as we begin to learn more about adverse childhood events we’ll soon see them linked to many more chronic diseases. In fact, a new study has already begun illustrating the connection between ACEs and chronic fatigue syndrome.

How your childhood affects your energy

Now you know just how dramatic of an effect adverse events during your youth can affect you today. But so far I only discussed how these events are linked to chronic illness(es) and substance abuse/addiction; not how they relate to fatigue and energy levels. Fortunately, a study published in 2017 explored this question:

What are the effects of childhood trauma on fatigue and physical functioning in those with chronic fatigue syndrome?

Well, there are a number of research journals that suggest childhood trauma is associated with a 4x increased risk of developing chronic fatigue syndrome. Even when accounting for co-morbid conditions! (10, 11, 12, 13) Trauma aside, researchers found that children who experienced high levels of stress were far more likely to develop fatigue as adults. (14, 15, 16)

How does trauma or stress as a child affect you as an adult?

Childhood trauma and/or stressful events cause a dysfunction in the way your body processes stress. Do you remember the hypothalamic-pituitary-adrenal (HPA) axis? The HPA axis is your body’s stress-management system. The HPA axis is what’s in control of your fight-or-flight response. If this axis gets triggered early in life through trauma or a highly stressful event, it can remain in the “on” position throughout your life. (17, 18, 19) Should your HPA axis remain in the “on” (fight-or-flight) position for a long period of time, you’ll likely experience adrenal fatigue (hypocortisolism).

What’s the number one symptom of low cortisol levels?

Fatigue. I want to clarify that adrenal fatigue (hypocortisolism) is not necessarily the cause of chronic fatigue. It can certainly be a part of the problem (and sometimes it is the cause) but often chronic fatigue syndrome has a more complex cause than just low levels of cortisol.

What sort of adverse event(s) impact fatigue levels?

Before presenting you with the current understanding and research on adverse events and fatigue, I want to be clear that this is preliminary research. The first research paper on this topic was published in 2017. So, I suspect as the research progresses we’ll have a much more thorough and in-depth understanding of the connection between fatigue and adverse childhood events. At the time of this writing, I’m presenting to you what the research currently suggests. This, as always, is subject to change.

With that out of the way, let’s dig into the current research. In one study done with 155 participants, researchers were able to successfully correlate the development of chronic fatigue syndrome with childhood sexual harassment. None of the other adverse childhood events (physical abuse, sexual abuse, neglect, substance abuse, etc.) were strongly correlated with chronic fatigue syndrome. (20)

What does this mean for you?

Well, if you were subject to childhood sexual harassment (bullying or coercion of a sexual nature) you’re at increased risk of developing chronic fatigue syndrome. Researchers were able to connect fatigue levels and poor physical function to sexual harassment. (21) In this study, 50% of CFS participants had experienced at least one type of trauma and 32% of participants had experienced two or more types of trauma.

One the many effects of trauma are that victims often are unable to recall the event. In these cases, people will report that they have never experienced a traumatic event. This is the inherent issue with self-reporting. Sometimes your brain doesn’t want you to remember — it’s too stressful to relive that memory. So, it gets repressed. With that in mind, the prevalence of trauma in our society as a whole as well as within the chronic fatigue community is likely far higher than researchers think.

Clearly, there’s a connection between trauma and chronic fatigue syndrome. But what are you supposed to do about it?

How to treat chronic fatigue syndrome in the context of trauma or adverse childhood event(s)

I want you to remember that chronic fatigue syndrome is a multi-system illness. Meaning that many of your body’s systems are affected by the illness. Remedying chronic fatigue is not a simple process — there are many moving parts. In this post, I outline the part childhood trauma plays in the development of chronic fatigue. But please keep in mind that this is (likely) just one piece of the puzzle. There are likely other pathologies that are also keeping you from regaining your energy.

Don’t get discouraged if a treatment doesn’t cure your fatigue. Remember, there are multiple causes of chronic fatigue syndrome. The remainder of this post will illustrate the best research-backed methods for helping your HPA axis overcome childhood trauma.

Eye movement desensitization and reprocessing (EMDR)

EMDR is a form of psychotherapy in which the person being treated is asked to recall distressing images while generating one type of bilateral sensory input, such as side-to-side eye movements or hand tapping. (21) EMDR is a recommended therapy for post-traumatic stress disorders (PTSD) and is, therefore, a stellar modality for anyone who has experienced an adverse childhood event. (22, 23)

Some studies have shown EMDR to be more effective than antidepressant medication (SSRIs) (24) as well as cognitive behavioral therapy (CBT). (25) At the time of this writing, there are still a number of critics of EMDR therapies. While I think it is important to remain inherently critical of any modality, there is sufficient research supporting the efficacy of EMDR. Especially in the context of trauma. (26, 27)

Yoga

Are you familiar with heart rate variability (HRV)?

HRV is a way to measure whether your body is in a fight/flight response (sympathetic nervous system) or a rest/digest (parasympathetic nervous system) response. Ideally, these two systems work together to maintain a state of engagement with your environment — you’re neither too stressed nor too relaxed.

Those with PTSD have incredibly low heart rate variability. This may manifest as an over-response to seemingly minor stress(es). In PTSD, your nervous system is hyper-vigilant in detecting threats in your environment. Unfortunately, this can result in gross over-reaction to small stimuli. (28) Enter yoga as a way to improve HRV.

Yoga and the breathing techniques combined with the physical practice of poses (pranayama) has been shown to improve heart rate variability. (29) In one study, more than 50% of participants who had been diagnosed with PTSD no longer experienced PTSD symptoms after attending a weekly sixty-minute yoga class for ten weeks. (30)

When yoga classes are not available, a simple app or heart rate variability device (like heart math) can be used at home to improve your HRV. Regular practice of yoga or an HRV app will improve your body’s ability to balance it’s stress and relaxation responses.

Neurofeedback

Neurofeedback is a process of gaining greater awareness of your physiological functions primarily using instruments that provide information on the activity of those same systems. In neurofeedback one typically uses real-time displays of brain activity — most commonly electroencephalography (EEG) — to teach self-regulation of brain function. Typically, sensors are placed on your scalp to measure brain activity, with measurements displayed using video displays or sound. (31)

The objective of neurofeedback is to gently coax your brain into producing synchronous or harmonious rhythms/oscillations. When your brain is working in harmony or coherence, there is order — you’re able to think clearly and make decisions. But when these brain rhythms become erratic and incoherent, you experience trouble concentrating, focusing, problem-solving and other seemingly mundane daily tasks.

Those with a history of adverse events or trauma will often experience incoherent brain waves. More specifically, there is excessive activity in the right temporal lobe. This area is the “fear center” of your brain. This is coupled with an excess of slow-wave activity in the frontal lobe. Combined, the brainwaves produce a pattern of hyperarousal — a chronic state of fight or flight. (32)

Neurofeedback has been shown to help calm both the temporal and frontal lobe activity. Resulting in a decrease of the stress response and an increased ability for these individuals to experience the rest and digest aspect of their nervous system. (33)

Trauma resolution in the context of chronic fatigue

There is not a cure-all for adverse childhood events or trauma. The above three therapies I introduced are by no means a comprehensive list of all that exists. Please remember that if you do not respond to a particular therapy it does not mean you are incurable. You need to continue trying different therapies until you find the one that works best for you.

Whether you are a practitioner or patient, please always keep trauma resolution in the back of your mind when treating CFS. If you (or your patient) is not responding to physical treatments (diet alterations, gut health, toxicities, infections, etc.) it is time to look at mental health. Perform a traumatic antecedents questionnaire. While always remembering that your conscious mind may not recall a traumatic event. And please find an incredible mental health practitioner to help you (gently) work towards resolution.

This is difficult work. It should be done at a pace that is comfortable for you.

Do you need help improving your fatigue?

Originally published at Fatigue to Flourish.