From Donna Jackson Nakazawa, Science Journalist and Author of Childhood Disrupted – How Your Biography Becomes Your Biology and How You Can Heal
Why Girls Who Face #ToxicStress are More Vulnerable to Adult Illness : The Shocking Relationship Between Being Female #ACEs #AutoimmuneDisease and #Depression.
To get personal for a moment, the reason I focus so strongly, as a science journalist, on this intersection between neuroscience, immunology, emotion, toxic stress, and being female is, in part, due to my own autoimmune history. I’ve struggled most of my adult life with the lingering physical effects of having been paralyzed twice with Guillain Barre Syndrome. I’ve had a pacemaker since I was 28. I’ve struggled with medical issues throughout my adult life.
But I’m hardly alone in all this; so many of you have faced similar and often much more difficult health issues than I have. My own experience is merely what lead me, as a career science journalist, to investigate the intersection of neuroscience, immunology and the deepest inner workings of the human heart.
What KEEPS ME GOING is the way I’ve been moved, time and again, by the hundreds of thousands of female readers who’ve shared with me their struggles, in the face of #trauma, #autoimmunedisease, #chronic illness, #depression. Wanting to help ease that suffering propels ME to uncover new understanding, new answers and insights that can change lives.
The reason I shine an up-close light on how women’s bodies, brains and immune systems are impacted in unique ways by toxic stress and emotion, and other environmental triggers, is because the science in this area is exciting and also under-reported. And the reason this science is under-reported is because it can be complex and hard to unpack in a media era that all too often relies on simplistic, broad-brush headline-centric, click-bait reporting.
If you follow my work you already know that research shows that #ACEs, such as being chronically put down or humiliated, living with a depressed, mentally ill, or alcoholic parent, losing a parent to divorce or death, being emotionally neglected, physically or sexually abused, as well as many other types of toxic childhood stressors, are linked to a much greater likelihood of developing autoimmune disease, heart disease and cancer in adulthood. Having experienced 6 categories of childhood adversity can take 20 years off your lifespan.
That’s because toxic stress changes the way our immune system responds to stressors in the future. When kids and teens experience chronic adversity, inflammatory chemicals begin to flood a child’s body and brain, plunging the body into a state of chronic hypervigilance.
Our genes are ALWAYS in a back and forth dance with our environment. If you’re a child growing up in an environment that is chronically stressful, and don’t have reliable adults to turn to, that meets the definition of toxic stress.
Toxic childhood stress begins to cause changes in the architecture of the developing brain, and it engenders profound epigenetic changes in the genes that oversee the stress response. In fact, Yale researchers recently found that children who’d faced Chronic Unpredictable Toxic Stress (what I term C.U.T.S.) demonstrate changes “across the genome” in genes that oversee the stress response. These changes re-set the stress response to “high” for life.
They also showed changes in genes that play a role in developing autoimmune disease, cancer, depression, anxiety and so on. This correlation is particularly stark for WOMEN. For each category of #ACEs a girl faces, her chance of developing a serious autoimmune disease in adulthood increases by 20 percent. For instance, a girl who faces three categories of Adverse Childhood Experiences has a 60 percent greater chance of developing an autoimmune disease so serious she requires hospitalization as an adult woman, as compared to a girl who grows up without #toxicstress.
For every category of #ACEs a man has faced, his chances of being hospitalized with an autoimmune disease increases by about 10 percent – still a significant and disturbing correlation and one we also need to pay attention to.
We also know that girls face more #ACEs growing up in general. In fact, girls are 50% more likely to have experienced 5 or more categories of childhood adversity. These include sexual and physical abuse, emotional or physical neglect, growing up being chronically humiliated, or growing up with a parent with a drug/alcohol problem or mental illness, or losing a parent to divorce/death.
These higher rates of #ACEs for girls mostly revolve around the fact that girls are physically smaller than men and have less societal power or equality in family life – and are more vulnerable to, and likely to be victims of, physical, sexual and emotional abuse, and harassment.
Just think of today’s #METOO movement. It’s all about systemic emotional, sexual, physical harassment and humiliation and abuse based on being in a situation in which men in the culture (and “culture” can include members of your family of origin) are more powerful than you.
We also know that girls who experience 2 or more categories of #ChildhoodAdversity are twice as likely as boys who experience 2 or more types of childhood adversity to develop autoimmune disease in adulthood.
In fact, the relationship between being female, facing adversity as a teenager or child, and later developing an #autoimmunedisease, is so strong it resembles the link between smoking and cancer, or drunk driving and having a car accident.
Again, the more childhood adversity a girl grows up with, the higher her risk becomes for adult disease, and the more likely she is to end up in the hospital at some point in her adult life in order to be treated for a serious autoimmune condition. As a science journalist, when I saw these statistics I wanted to know: WHY are women who experience childhood adversity twice as likely to suffer from disease as adults, compared to men?
What happens in a girl’s body, in response to #toxicstress, that leads girls to be more likely to be ill as adult women? EVERY WOMAN WAS ONCE A GIRL. So, we should figure this conundrum out, right?
Every Woman Was Once a Girl: Why We Need to Talk About the Biological Effects of #FemaleAdversity on Women’s Bodies and Brains
Female Adversity: The Female Body and Brain on Toxic Stress
(CRUCIAL NOTE HERE BEFORE YOU READ: Boys’ immune systems become dysregulated in response to #toxicstress too, and that leads to disease and changes to the brain that we also need to talk about more openly AND compassionately. Today I’m focusing on girls’ unique immune response to #toxicstress.)
So, exactly what happens in a girl’s body, in response to #toxicstress, that leads girls to be more likely to be ill as adult women? EVERY WOMAN WAS ONCE A GIRL. So, we should figure this conundrum out, right?
Well, it turns out that girls’ developing immune systems react differently to toxic stress than boy’s do. This is because of some basic physiological differences between women and men. Women are, generally, physically smaller than men and our hearts and lungs are much smaller in size. Yet our anatomy makes added room to carry a fetus in order to create new human life.
Our smaller heart, lungs, and organs still have to be able to do everything a human male does – pump oxygen, circulate blood, run fast, think fast, be awake 16 or 17 hours a day – and have the necessary fuel to carry a child to term. We have to do double duty, on half the machinery.
Women can do so much more on less because we also have higher baseline levels of the hormone estrogen. Estrogen acts as a kind of messenger, carrying information between groups of our cells. Say we are stressed, or catch a flu, or get a vaccine – estrogen helps us, as women, have a more robust immune response. This more robust immune response is also thanks to steroid hormones known as glucocorticoids (or GCs). Glucocorticoids are produced by the adrenal gland and are anti-inflammatory. They help regulate inflammation.
If a woman is pregnant, glucocorticoids help us to keep our baby safe and carry it to term, even if we come down with the flu, or have a physical injury. Our immune system is poised, all the time, to protect our ability to carry another life.
This heightened female immune response also means that when our immune system sets out to fight off any foreign invader, such as a virus or bacteria, as women we also produce more of what are called antibodies, or fighter immune cells. That’s good. BUT it can also be a problem. As women, when we produce more antibody fighter cells, we also produce more autoantibodies. Autoantibodies are rogue fighter immune cells that can mistakenly attack the body’s own tissue or organs, in what we refer to as friendly fire. As in #autoimmunedisease.
When women, ESPECIALLY GIRLS, repeatedly face #toxicstress during the developmental years, over time, their stress response begins to be dysregulated. Glucocorticoids, or GCs, become less able to properly regulate a healthy, appropriate immune response, which leads to more inflammation.
Now remember, in the face of threats that prick up the immune system (which includes infections, physical injury, AND social threats and stressors), girls ALSO make more antibodies AND more rogue autoantibodies – again, because we have so much more estrogen.
This leads to a double whammy. It’s a simple equation:
A : Glucocorticoids stop regulating a proper immune response in face of #toxicstress
+ B : Estrogen leads to production of more autoantibodies, which can attack the body itself
= C : When girls face toxic stress, rogue autoantibodies can run amok, promoting slow-brew inflammation, and later disease
This means that, over time, a woman’s immune system is a lot more likely to begin to attack her own body. This accounts for the fact that #autoimmunediseases strike women at three times the rate of men. For some illnesses that ratio is far higher. Examples. Women develop Hashimoto’s thyroiditis at a rate of 10:1 compared with men. In lupus, that rate is 9:1. In Sjögren’s syndrome, 9:1. #AutoimmuneDisease is one of the top ten leading causes of death in women under the age of sixty-five.
Fifty million Americans have an autoimmune disease, and three-quarters of these are women.
Women are also twice as likely as men to have chronic pain syndromes. Women with an ACE score of 3 are significantly more likely to have chronic pain syndromes including headaches, back and neck problems. Women are also more likely to have “contested conditions” – meaning the medical profession is still debating whether these autoimmune conditions are real or just psychosomatic — such as #chroniclyme, #chronicfatigue and #fibromyalgia.
A heightened inflammatory stress response also affects the architecture of the #femalebrain differently than the male brain. A girl’s brain, on adversity, is a vulnerable brain in unique ways. For instance, both boys and girls who grow up with #toxicstress demonstrate, on brain scans, fewer neural connections between the pre-frontal cortex (the decision-making center of the brain) and the hippocampus (an area of the brain that helps us to make sense of our emotions and experiences). But, in girls who grow up with #toxicstress and #ACEs, another area of neural connectivity is affected. It goes offline. Synaptic connections between an area of the brain known as the amygdala (the fear-and-alert center of the brain) and the pre-frontal cortex are also weakened.
This means that girls who experience #ACEs are more likely to grow up in a chronic state of hypervigilance. Fight or flight. Feeling that life is an emergency. This contributes to the fact that girls and women are more likely to suffer from anxiety and depression as adults than are men. Stats bear this out. One third of men with an #ACE Score of 4 later develop depression—already a high and disturbing figure—while nearly 60 percent of women with 4 #ACEs develop chronic depression in adulthood.
That means that the risk that growing up with #toxicstress and #adversechildhoodexperiences will lead to neuroinflammatory diseases such as depression and anxiety disorders is, as with autoimmune disease, TWICE AS HIGH for women as it is for men.
Physical inflammation is increasingly linked to mental health disorders. Cutting-edge research shows us that our body and brain’s immune responses function in tandem. Still, it can take years, sometimes decades, for toxic childhood stress to translate into symptoms, much less visible physical disease. A young girl can face a lot of chronic #toxicstress at the age of 12. BUT it may take 30 years or longer for the inflammation unleashed by that chronic adversity to progress to disease symptoms. At that late date, the link between a stressed little girl and the ill woman she’s become is invisible to the patient – and her physician.
This plays into why so many doctors miss autoimmune disease in women. Recent studies show that the average woman sees five doctors over four-and-a-half years before receiving a proper diagnosis—and nearly half of women are labeled and dismissed as “chronic complainers” in the early stages of their illness.
This means that women who’ve faced #femaleadversity and who also face #autoimmunedisease often get dismissed TWICE. From early on in life, they know if they meet up with any type of #femaleadversity or CHILDHOOD TRAUMA– sexual harassment, date rape, sexism, abuse, at home, school or work — if they report it their version of events, what they say may very well be dismissed. Disbelieved. Their self-reports are very likely to be distrusted. Years later, in a doctor’s office, when they report their PHYSICAL #auatoimmune or #chronicpain symptoms, they get dismissed or disbelieved all over again.
The past repeats itself.
RAYMOND’S OWN NOTES : these words will form part of Donna’s next book “The Angel and the Assassin”, hopefully in 2019. Donna’s above text was meant to have a third part, but cannot wait any longer. This shorter version shows with abundant clarity that WOMEN REQUIRE MORE CARE AND ATTENTION– and this, throughout their whole lives. It is down to our society and communities to take this message on-board and actively provide more support. And also for women to take this information seriously and act accordingly with better care and self-care. (posted by R.Lambert December 2018 )
The past is never dead – It’s not even past. William Faulkner
Why Girls Who Face #ToxicStress are More Vulnerable to Adult Illness : The Shocking Relationship Between Being Female #ACEs #AutoimmuneDisease and #Depression.
To get personal for a moment, the reason I focus so strongly, as a science journalist, on this intersection between neuroscience, immunology, emotion, toxic stress, and being female is, in part, due to my own autoimmune history. I’ve struggled most of my adult life with the lingering physical effects of having been paralyzed twice with Guillain Barre Syndrome. I’ve had a pacemaker since I was 28. I’ve struggled with medical issues throughout my adult life.
But I’m hardly alone in all this; so many of you have faced similar and often much more difficult health issues than I have. My own experience is merely what lead me, as a career science journalist, to investigate the intersection of neuroscience, immunology and the deepest inner workings of the human heart.
What KEEPS ME GOING is the way I’ve been moved, time and again, by the hundreds of thousands of female readers who’ve shared with me their struggles, in the face of #trauma, #autoimmunedisease, #chronic illness, #depression. Wanting to help ease that suffering propels ME to uncover new understanding, new answers and insights that can change lives.
The reason I shine an up-close light on how women’s bodies, brains and immune systems are impacted in unique ways by toxic stress and emotion, and other environmental triggers, is because the science in this area is exciting and also under-reported. And the reason this science is under-reported is because it can be complex and hard to unpack in a media era that all too often relies on simplistic, broad-brush headline-centric, click-bait reporting.
If you follow my work you already know that research shows that #ACEs, such as being chronically put down or humiliated, living with a depressed, mentally ill, or alcoholic parent, losing a parent to divorce or death, being emotionally neglected, physically or sexually abused, as well as many other types of toxic childhood stressors, are linked to a much greater likelihood of developing autoimmune disease, heart disease and cancer in adulthood. Having experienced 6 categories of childhood adversity can take 20 years off your lifespan.
That’s because toxic stress changes the way our immune system responds to stressors in the future. When kids and teens experience chronic adversity, inflammatory chemicals begin to flood a child’s body and brain, plunging the body into a state of chronic hypervigilance.
Our genes are ALWAYS in a back and forth dance with our environment. If you’re a child growing up in an environment that is chronically stressful, and don’t have reliable adults to turn to, that meets the definition of toxic stress.
Toxic childhood stress begins to cause changes in the architecture of the developing brain, and it engenders profound epigenetic changes in the genes that oversee the stress response. In fact, Yale researchers recently found that children who’d faced Chronic Unpredictable Toxic Stress (what I term C.U.T.S.) demonstrate changes “across the genome” in genes that oversee the stress response. These changes re-set the stress response to “high” for life.
They also showed changes in genes that play a role in developing autoimmune disease, cancer, depression, anxiety and so on. This correlation is particularly stark for WOMEN. For each category of #ACEs a girl faces, her chance of developing a serious autoimmune disease in adulthood increases by 20 percent. For instance, a girl who faces three categories of Adverse Childhood Experiences has a 60 percent greater chance of developing an autoimmune disease so serious she requires hospitalization as an adult woman, as compared to a girl who grows up without #toxicstress.
For every category of #ACEs a man has faced, his chances of being hospitalized with an autoimmune disease increases by about 10 percent – still a significant and disturbing correlation and one we also need to pay attention to.
We also know that girls face more #ACEs growing up in general. In fact, girls are 50% more likely to have experienced 5 or more categories of childhood adversity. These include sexual and physical abuse, emotional or physical neglect, growing up being chronically humiliated, or growing up with a parent with a drug/alcohol problem or mental illness, or losing a parent to divorce/death.
These higher rates of #ACEs for girls mostly revolve around the fact that girls are physically smaller than men and have less societal power or equality in family life – and are more vulnerable to, and likely to be victims of, physical, sexual and emotional abuse, and harassment.
Just think of today’s #METOO movement. It’s all about systemic emotional, sexual, physical harassment and humiliation and abuse based on being in a situation in which men in the culture (and “culture” can include members of your family of origin) are more powerful than you.
We also know that girls who experience 2 or more categories of #ChildhoodAdversity are twice as likely as boys who experience 2 or more types of childhood adversity to develop autoimmune disease in adulthood.
In fact, the relationship between being female, facing adversity as a teenager or child, and later developing an #autoimmunedisease, is so strong it resembles the link between smoking and cancer, or drunk driving and having a car accident.
Again, the more childhood adversity a girl grows up with, the higher her risk becomes for adult disease, and the more likely she is to end up in the hospital at some point in her adult life in order to be treated for a serious autoimmune condition. As a science journalist, when I saw these statistics I wanted to know: WHY are women who experience childhood adversity twice as likely to suffer from disease as adults, compared to men?
What happens in a girl’s body, in response to #toxicstress, that leads girls to be more likely to be ill as adult women? EVERY WOMAN WAS ONCE A GIRL. So, we should figure this conundrum out, right?
Every Woman Was Once a Girl: Why We Need to Talk About the Biological Effects of #FemaleAdversity on Women’s Bodies and Brains
Female Adversity: The Female Body and Brain on Toxic Stress
(CRUCIAL NOTE HERE BEFORE YOU READ: Boys’ immune systems become dysregulated in response to #toxicstress too, and that leads to disease and changes to the brain that we also need to talk about more openly AND compassionately. Today I’m focusing on girls’ unique immune response to #toxicstress.)
So, exactly what happens in a girl’s body, in response to #toxicstress, that leads girls to be more likely to be ill as adult women? EVERY WOMAN WAS ONCE A GIRL. So, we should figure this conundrum out, right?
Well, it turns out that girls’ developing immune systems react differently to toxic stress than boy’s do. This is because of some basic physiological differences between women and men. Women are, generally, physically smaller than men and our hearts and lungs are much smaller in size. Yet our anatomy makes added room to carry a fetus in order to create new human life.
Our smaller heart, lungs, and organs still have to be able to do everything a human male does – pump oxygen, circulate blood, run fast, think fast, be awake 16 or 17 hours a day – and have the necessary fuel to carry a child to term. We have to do double duty, on half the machinery.
Women can do so much more on less because we also have higher baseline levels of the hormone estrogen. Estrogen acts as a kind of messenger, carrying information between groups of our cells. Say we are stressed, or catch a flu, or get a vaccine – estrogen helps us, as women, have a more robust immune response. This more robust immune response is also thanks to steroid hormones known as glucocorticoids (or GCs). Glucocorticoids are produced by the adrenal gland and are anti-inflammatory. They help regulate inflammation.
If a woman is pregnant, glucocorticoids help us to keep our baby safe and carry it to term, even if we come down with the flu, or have a physical injury. Our immune system is poised, all the time, to protect our ability to carry another life.
This heightened female immune response also means that when our immune system sets out to fight off any foreign invader, such as a virus or bacteria, as women we also produce more of what are called antibodies, or fighter immune cells. That’s good. BUT it can also be a problem. As women, when we produce more antibody fighter cells, we also produce more autoantibodies. Autoantibodies are rogue fighter immune cells that can mistakenly attack the body’s own tissue or organs, in what we refer to as friendly fire. As in #autoimmunedisease.
When women, ESPECIALLY GIRLS, repeatedly face #toxicstress during the developmental years, over time, their stress response begins to be dysregulated. Glucocorticoids, or GCs, become less able to properly regulate a healthy, appropriate immune response, which leads to more inflammation.
Now remember, in the face of threats that prick up the immune system (which includes infections, physical injury, AND social threats and stressors), girls ALSO make more antibodies AND more rogue autoantibodies – again, because we have so much more estrogen.
This leads to a double whammy. It’s a simple equation:
A : Glucocorticoids stop regulating a proper immune response in face of #toxicstress
+ B : Estrogen leads to production of more autoantibodies, which can attack the body itself
= C : When girls face toxic stress, rogue autoantibodies can run amok, promoting slow-brew inflammation, and later disease
This means that, over time, a woman’s immune system is a lot more likely to begin to attack her own body. This accounts for the fact that #autoimmunediseases strike women at three times the rate of men. For some illnesses that ratio is far higher. Examples. Women develop Hashimoto’s thyroiditis at a rate of 10:1 compared with men. In lupus, that rate is 9:1. In Sjögren’s syndrome, 9:1. #AutoimmuneDisease is one of the top ten leading causes of death in women under the age of sixty-five.
Fifty million Americans have an autoimmune disease, and three-quarters of these are women.
Women are also twice as likely as men to have chronic pain syndromes. Women with an ACE score of 3 are significantly more likely to have chronic pain syndromes including headaches, back and neck problems. Women are also more likely to have “contested conditions” – meaning the medical profession is still debating whether these autoimmune conditions are real or just psychosomatic — such as #chroniclyme, #chronicfatigue and #fibromyalgia.
A heightened inflammatory stress response also affects the architecture of the #femalebrain differently than the male brain. A girl’s brain, on adversity, is a vulnerable brain in unique ways. For instance, both boys and girls who grow up with #toxicstress demonstrate, on brain scans, fewer neural connections between the pre-frontal cortex (the decision-making center of the brain) and the hippocampus (an area of the brain that helps us to make sense of our emotions and experiences). But, in girls who grow up with #toxicstress and #ACEs, another area of neural connectivity is affected. It goes offline. Synaptic connections between an area of the brain known as the amygdala (the fear-and-alert center of the brain) and the pre-frontal cortex are also weakened.
This means that girls who experience #ACEs are more likely to grow up in a chronic state of hypervigilance. Fight or flight. Feeling that life is an emergency. This contributes to the fact that girls and women are more likely to suffer from anxiety and depression as adults than are men. Stats bear this out. One third of men with an #ACE Score of 4 later develop depression—already a high and disturbing figure—while nearly 60 percent of women with 4 #ACEs develop chronic depression in adulthood.
That means that the risk that growing up with #toxicstress and #adversechildhoodexperiences will lead to neuroinflammatory diseases such as depression and anxiety disorders is, as with autoimmune disease, TWICE AS HIGH for women as it is for men.
Physical inflammation is increasingly linked to mental health disorders. Cutting-edge research shows us that our body and brain’s immune responses function in tandem. Still, it can take years, sometimes decades, for toxic childhood stress to translate into symptoms, much less visible physical disease. A young girl can face a lot of chronic #toxicstress at the age of 12. BUT it may take 30 years or longer for the inflammation unleashed by that chronic adversity to progress to disease symptoms. At that late date, the link between a stressed little girl and the ill woman she’s become is invisible to the patient – and her physician.
This plays into why so many doctors miss autoimmune disease in women. Recent studies show that the average woman sees five doctors over four-and-a-half years before receiving a proper diagnosis—and nearly half of women are labeled and dismissed as “chronic complainers” in the early stages of their illness.
This means that women who’ve faced #femaleadversity and who also face #autoimmunedisease often get dismissed TWICE. From early on in life, they know if they meet up with any type of #femaleadversity or CHILDHOOD TRAUMA– sexual harassment, date rape, sexism, abuse, at home, school or work — if they report it their version of events, what they say may very well be dismissed. Disbelieved. Their self-reports are very likely to be distrusted. Years later, in a doctor’s office, when they report their PHYSICAL #auatoimmune or #chronicpain symptoms, they get dismissed or disbelieved all over again.
The past repeats itself.
RAYMOND’S OWN NOTES : these words will form part of Donna’s next book “The Angel and the Assassin”, hopefully in 2019. Donna’s above text was meant to have a third part, but cannot wait any longer. This shorter version shows with abundant clarity that WOMEN REQUIRE MORE CARE AND ATTENTION– and this, throughout their whole lives. It is down to our society and communities to take this message on-board and actively provide more support. And also for women to take this information seriously and act accordingly with better care and self-care. (posted by R.Lambert December 2018 )
The past is never dead – It’s not even past. William Faulkner
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