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How does childhood trauma affect people's life and health?
Nadine Harris's Deep Well Effect is a book recommended by Taiwan Province Zhou Zhijian. I saw the title and placed an order to buy it. I want to see it for no reason. After receiving the book, I sat down and picked it up, and I couldn't put it down. I wanted to read it all at once and know the ending immediately, but it took me two weeks to read it word for word. The first time you read a book in traditional Chinese, the content may be wonderful. Read it slowly and you will find that the more you read it, the smoother it will be. Thank you, Mr. Zhou, for letting me read this good book, and thank you, Harris, for his research contribution to this subject!

This is a very valuable book, which helps to understand the influence of childhood injuries. So I sorted out the main contents of this book, hoping to show it to more people and help more people. There are a lot of cases and biological experiments in the book. Maybe I prefer biology and believe in science, so I am interested in experiments and data, but these experiments and cases are omitted here. Anyone who is interested must read this book.

We have all heard that people who suffered from childhood can overcome this obstacle when they grow up-even gain strength from painful experiences. For those who can't get rid of the shadow of childhood and various long-term effects, these words may cause shame or despair.

In fact, the story of childhood adversity is not that simple.

The latest research evidence shows that even after many years, people who overcome the shadow of childhood by self-reliance will still be defeated by their own bodies. Many people were unhappy when they were young, but then they went to college with excellent grades, overcame many difficulties and started their own world ..... and then they began to get sick or depressed. Why do people without bad hobbies start to get sick?

The author of this book tells how childhood adversity hurts people's body and mind in the process of their growth, and studies how to deal with the vicious stress caused by this adversity. It is not so much a book as a paper. The author opened a community pediatric clinic in San Francisco Bay Scenic Area, USA. In the course of practicing medicine, he found a topic: What is the relationship between illness and childhood adversity? He began to read the literature, collected cases, and spent more than ten years exploring and verifying, and put forward a plan to promote screening and deal with malignant stress.

What is childhood adversity? The author gives a clear test table:

/kloc-Before the 0/8th birthday:

1, do parents or other adults in the family often swear at you, insult you, despise you or humiliate you, or act as if they are afraid of getting hurt?

2. Do parents or other adults in the family often push you, scratch you, slap you, throw things at you or hit you hard, causing you injuries or scars?

3. Have you ever been touched or caressed by an adult or someone five years older than you, or asked you to touch his body in a way related to Xing, or tried or done Xing with you?

4. Do you often feel that no one in your family loves you or that you are very important and special, or that family members don't take care of each other, get close to each other and support each other?

Do you often feel that you don't have enough to eat, that you have to wear dirty clothes without protection, or that your parents are too drunk or too excited to take care of you or take you to the doctor when you need it?

6. Have your parents ever left or divorced?

7. Is the mother or stepmother often pushed, scratched, slapped or thrown, or sometimes kicked, bitten, beaten or hit with a hard object, or repeatedly beaten within a few minutes, or threatened with a gun or knife?

8. Have you ever lived with people who are addicted to alcohol, alcohol or drugs?

9. Does anyone in the family suffer from depression or other mental illness, or try to commit suicide?

10, is anyone at home in prison?

These are all childhood adversity experiences. 1998, according to the statistics of a large number of cases in middle-class residential areas, Felidi concluded that the incidence of the above four childhood adversity experiences was higher, with coronary heart disease being 2.2 times that of ordinary people, cancer 1.9 times, chronic bronchitis or emphysema 3.9 times, stroke 2.4 times, diabetes 1.6 times, and attempted suicide/kloc.

Childhood adversity leads to malignant stress. How does malignant stress cause diseases? How does the pressure response system work?

The members of the pressure system are as follows:

Amygdala: the center of the brain to manage fear;

Prefrontal cortex: located in the front of the brain, it has cognitive and control functions such as regulating criticism, emotions and feelings;

Hypothalamus-pituitary-adrenal axis (HPA axis): The adrenal gland begins to produce cortisol (long-acting stress hormone).

Sympathetic-adrenal medullary axis (SAM axis): Adrenal gland and brain begin to produce adrenaline and norepinephrine (short-acting hormone);

Hippocampus: the key part for processing emotional information and strengthening memory;

Noradrenergic nucleus of locus coeruleus: the stress response system in the brain, which regulates mood, irritability, exercise, arousal, attention and shock response.

Let's see how the stress response system works. We think that stress is like meeting a bear in the forest. When we saw the bear, the amygdala immediately issued an alarm to tell the brain: the bear is terrible, so be afraid quickly. At this time, the brain will start the SAM axis and HPA axis to launch a fight or flight response. Under the action of adrenaline, the heart will beat faster and harder, allowing blood to flow to all parts that need blood; The respiratory tract will be smoother, allowing you to inhale more oxygen; Blood pressure will rise, allowing blood to leave the small muscles that close the bladder and concentrate on the skeletal muscles needed for running and jumping (which is why some people are afraid of wetting their pants). Adrenaline also turns fat into sugar, which supplies the body with energy. The SAM axis will also start thyroidectomy in locus coeruleus, which is the stress response center of the brain and is responsible for "kicking". Adrenaline and norepinephrine are powerful stimulants, which can help the brain think clearly, find a course of action, and make you feel happy and omnipotent.

At the same time, the HPA axis will make the brain produce hormones, especially cortisol, to start the chemical signal transmission chain. If we live in a forest full of bears, cortisol will help the body adapt to recurrent or long-standing sources of stress. It will raise blood pressure and blood sugar, make you unstable and make your sleep unstable. Unlike adrenaline, cortisol won't make you lose your appetite or burn fat, but it will make your body accumulate fat and make you want to eat high-sugar and high-fat foods. High concentrations of cortisol can also inhibit reproductive function.

Once you flee to a safe place, the SAM and HPA axes will automatically shut down, and the body will use an adjustment mechanism called feedback inhibition to shut down the stress response system after the battle. This is the normal mechanism of stress response system.

So what adverse effects will stress have on the body? Under what circumstances will there be negative effects?

It is found that if a person starts the stress response for too long, or the stimulus that causes stress is too strong, the body may lose the ability to turn off HPA and SAM axis, which is called feedback inhibition interruption. Just like a person's pressure regulator is broken, the body should have kept a certain pressure, but after the balance point, the body still secretes cortisol and can't stop. Like tadpoles in the experiment, children are particularly sensitive to repeated stress stimuli. If they experience too many negative events, it will not only affect the structure and function of the brain, but also affect the developing immune system and endocrine system, and even change the way cells read and copy DNA. Once the stress response system is out of balance, it will produce a chain of biological reactions, and various problems will occur in the organs of the body.

Among them, Dr. Karin's research is very meaningful. Children aged 65,438+00-65 and 438+06 were divided into two groups, with or without childhood adversity (other things are basically the same). The brain was scanned by magnetic resonance imaging, and the cortisol content in saliva was detected four times a day. The results showed that the more symptoms of stress syndrome in children, the higher cortisol concentration and the smaller hippocampus. A year later, the hippocampus of the children was measured for the second time, and it was found that the hippocampus of these children who had experienced trauma shrank again. They no longer experience trauma, but the brain area responsible for memory and learning has been shrinking, so the stress of the past is still damaging the nervous system.

Once the stress response is out of balance, how can the members of the stress response system play a role?

The amygdala is the instinctive response of the owner to fear and danger. When we are exposed to stressors for a long time, the amygdala is always stimulated and will be overactivated. Some researchers scanned the severely abused children in orphanages with magnetic resonance imaging and found that the amygdala of those children was unusually large. In addition, if the amygdala is stimulated for a long time or repeatedly, it will begin to confuse harmless things with things that it is really afraid of, and it will also alert other areas of the brain when it encounters things that should not be afraid.

Locus coeruleus is an area of the brain that makes us fierce and aggressive. When locus coeruleus loses its balance, it will release too much norepinephrine, making people more anxious and irritable. At the same time, it will also use a lot of endocrine to keep you awake, seriously affecting the sleep cycle.

The prefrontal cortex is responsible for coordinating rational judgment, planning and decision making. When children are affected by malignant stress, the function of prefrontal cortex will be inhibited in two aspects: 1 The prefrontal cortex is required to reduce its activity level because of the over-activation of amygdala, so don't let reason affect the survival rate, and then start rational thinking after the danger is relieved; It is norepinephrine secreted by locus coeruleus that makes the prefrontal cortex unable to ignore impulses and instincts as usual. The frontal lobe is responsible for suppressing impulses. When the child's brain has been suppressed, the brain always tells him to "act quickly." It's really difficult for the child to sit in class. Every child's reaction is different, some will be unable to concentrate on solving problems, and some will become impulsive and violent.

The hippocampus is responsible for creating and maintaining memories. When we are under great stress, the amygdala becomes active and sends information to the hippocampus, disrupting its function of connecting neurons-making it more difficult for the hippocampus to create short-term and long-term memories. For example, scanning the brains of patients with Alzheimer's disease will reveal that their hippocampus is severely damaged. This part of the brain is one of the learning centers. Those children can't recite multiplication tables fluently. The problem of spatial memory is due to the problem of hippocampus.

The ventral tegmental area is responsible for reward, motivation and addiction. The key factor is dopamine, a neurotransmitter that makes you feel great. If your body's stress response system is repeatedly overactivated, your dopamine receptor will become insensitive. It used to take a little dopamine to feel happy, but now it takes a lot of dopamine to feel happy. When the ventral tegmental area has undergone biological changes, we will crave something that can stimulate the body to secrete dopamine, such as something high in sugar and oil or engage in some dangerous behaviors. In other words, if normal people have love and exercise, they can secrete dopamine and make people feel happy. People with a variety of childhood malignant stress are more likely to rely on cigarettes, alcohol or heroin to strongly stimulate the body to secrete more dopamine to experience pleasure because they are not sensitive to dopamine receptors.

Endocrine system, stress affects our endocrine system, indirectly affecting menstrual cycle, sexual desire and even our waistline. Endocrine is the chemical messenger of the body, responsible for triggering a variety of biological effects. The main biological effects are growth, metabolism, sexual function and reproductive function. The endocrine system is very sensitive to stress. When encountering stress, the concentrations of growth hormone, sex hormone, thyroxine and insulin will all decrease. So under pressure, we will see ovarian and testicular dysfunction, short psychosocial stature and obesity. Research shows that 33% of newly imprisoned women have menstrual disorders. Long-term stress will affect the ventral tegmental area of the brain, making people crave high-sugar and high-oil foods. The high concentration of cortisol makes it difficult to metabolize sugar and easy to store fat. In addition, when the body reacts to stress, the concentrations of obesity hormone and growth hormone will also rise. Together, they strengthen your appetite, and together with cortisol, they destroy your body.

The immune system is responsible for monitoring internal and external relations and protecting the body from external threats. The immune system is like a diplomat and defense minister of the body. The body will meet many different enemies and allies, and sometimes it is difficult to distinguish them. The immune system must become a diplomatic expert, knowing that protein on the surface of bacteria or viruses is not good, and these microorganisms in protein are enemies; But it also knows that the protein of lungs, nerves and blood cells is good, and it can't attack them. When the immune system is working normally, always check whether there are infected, damaged or cancerous cells in the body. If there is, the immune system will sound an alarm and launch an army to attack the intruder. Once the body is exposed to stress hormones for a long time, one part of the immune system will be suppressed and the other part will be activated, both of which are not good. Stress can weaken the immune function responsible for fighting colds, tuberculosis and some tumors. Stress disorder may aggravate inflammatory reaction, cause allergic reaction (allergy, eczema and asthma), and even cause autoimmune diseases (such as Graves' disease), that is, the immune system begins to attack one's body. When the concentration of adrenaline and cortisol in our body is too high, the immune system's ability to distinguish between friend and foe will be disturbed. If such interference occurs in childhood, the immune system will change forever. ) The Minister of National Defense sends troops to attack the invading enemy, and will attack himself after misjudgment. The more serious the body inflammation, the higher the probability that the immune system will attack its own tissues. When the immune system attacks itself, we will suffer from autoimmune diseases, such as rheumatoid arthritis, intestinal inflammation and multiple sclerosis.

The mechanism of malignant stress on DNA means that malignant stress will be passed down from generation to generation?

Let's take a look at an interesting experiment made by Professor Meney.

Usually, after the young mice are touched by researchers, the mother mice will lick their frightened children and comfort them by grooming them, which is equivalent to human hugs and kisses. Interestingly, every female mouse spends the same time licking her baby and combing her hair. Some will lick it all the time, and some will eat it after licking it. The researchers found that the development of young rats' response to stress is directly related to their mothers who love licking and those who don't. The more young rats are licked, the lower the stress hormone is. For babies who love to lick their mothers, pressure regulators are more sensitive and effective. In contrast, babies who don't like licking their mothers have higher cortisol concentration when they are scared, and it takes a long time to turn off the stress response. In the first ten days of the baby mice's life, the frequency of mother licking them and grooming their hair will affect their life-long stress response. These stress reactions will be postponed to the next generation, because these babies who love licking their mothers will also become "licking their mothers" after having children. Later, the researchers did an experiment to replace the civet cat with a prince when the baby mouse was born, and to exchange the baby who loves licking his mother with the baby who doesn't love licking his mother. After the exchange, the DNA methylation status of mice became the same as that of adoptive mothers, and they also behaved more like adoptive mothers. After the baby who loves to lick his mother is raised by the baby who doesn't love to lick his mother, the baby mouse becomes an anxious adult mouse with higher stress hormone concentration.

This experiment found that licking mice by their mothers when they were young (the first ten days after the baby was born in the experiment) would have a great impact on their lives.

The licking action of the mother mouse did give the baby some information and changed the baby's stress response. The way of change is not gene change, but epigenetics (mainly studying heritable gene expression or mechanism change without changing DNA sequence).

Today, there are still many people who regard genes and environment as completely irrelevant things, and think that they are born with a set of their own genes to determine their health and biological composition, and the experience after birth will shape their personality and values. It is precisely because many people think that genes and environment should stay out of it that people have been discussing whether it is innate or acquired for many years. But with the progress of science, scientists are almost certain that we can't separate genes from environment, and we also know that genes and environment will shape our biological composition and behavior. We finally know that our appearance, the way our bodies work, and who we really are are all determined by our environment and genes.

We know that DNA is our genetic material, and our bodies will use DNA codes to generate protein, and protein will form new cells and ensure that all functions in the new cells work normally. In our cells, in addition to the genome (complete gene code), there is also the so-called epigenome-a layer of chemical markers on the surface of ——DNA, which will determine which genes are translated into protein and which genes will not be read by cells at all. Epigenes are similar to labeling how genomes are transcribed. Epigenes are influenced by everyone's experience and may also be rewritten by the environment.

So how does the environment change the epigenetic genes in cells? The main method is to start the stress response. When the body tries to adapt to the stress brought by adversity, it will turn on and off some genes, especially those that regulate how to respond to stress in the future.

So how will long-term stress affect the DNA sequence?

Professor Blake Ben and Professor Appleby, the Nobel Prize winners in physiology and medicine who discovered the telomere mechanism, mentioned that telomere (DNA sequence at the end of chromosome) can protect DNA and prevent it from being damaged, leading to premature aging and death. They found that stress has a great influence on telomere length and health, which indirectly reflects people's risk of getting sick.

A very important function of telomere is to protect DNA and ensure that every time a cell replicates DNA, the new version is the same as the old version. You can think of telomeres as buffers or buffers at both ends of DNA. Telomeres are very sensitive to the environment. Anything in biochemistry that may damage DNA (such as stress) will damage telomeres. When telomere is damaged, it will send a message to the whole cell, telling the cell that it is too damaged and needs the cell to respond. There are two ways for cells to react: 1 means that when telomeres are too short, cells will age and the aging cells will retire and stop working. For example, the fibroblasts responsible for producing collagen have retired, so you look older than your actual age. It's no big deal that cells age or die, but if too many cells die in one place, your body will be unhealthy. For example, if a large number of pancreatic cells die, then you can't secrete enough insulin and you will get diabetes. The damage or shortening of telomere of 2 cells will also make the cells cancerous. At this time, cells can't copy DNA correctly, and new cells are produced from scratch, and then the cells will replicate out of control and mutate into growing tumors. Therefore, if telomeres are destroyed too much and become too short, it will lead to premature cell aging, diseases and even cancer.

Appleby and others surveyed more than 4,000 people, and the data showed that there was a significant relationship between adversity accumulated from childhood and telomere shortening, but telomere shortening was mostly caused by childhood adversity. The data showed that the probability of telomere shortening increased 1 1% with each childhood adversity. Negative events at home (such as abuse or parents drinking or taking drugs) are more related to telomere shortening than financial pressure.

The good news is that even if your telomere is short, as long as you stay healthy, you can prevent it from shortening and increase the number of telomerase. You can increase the amount of telomerase through drugs or exercise and slow down the shortening of telomeres. This is a relatively new study.

So, what are the treatment options for stress response disorder?

Go to sleep. Childhood adversity will significantly increase the probability of people having various sleep disorders. Sleep will help the body to regulate HPA axis and SAM axis normally. During sleep, the concentrations of cortisol, adrenaline and norepinephrine will all decrease—in other words, poor sleep is related to stress hormones, which will call the brain, hormone system, immune system and epigenome to start stress response, so it is difficult to fall asleep. In addition, during sleep, the immune system will upgrade and calibrate our defense system. Lack of sleep is also related to the decrease in the concentration of growth hormone, and if it happens to children, it will also cause dysplasia.

Regular exercise can make the body release a kind of protein called brain-derived neurotrophic factor. This protein is the fertilizer for the brain and nerve cells. It will act on hippocampus and prefrontal cortex, which are important brain areas for learning and memory, and enhance muscle strength and brain power. Regular exercise can also reduce pro-inflammatory cells in the body and regulate stress response. It can also help the immune system decide when to fight and when to stay put. Exercise regularly for one hour every day, running, swimming, etc.

Nutrition. For example, when the body is inflamed, we can eat more foods containing omega-3 fatty acids, antioxidants, fruits and vegetables to slow down the inflammatory reaction and restore the balance of the immune system. If you eat too much sugar, starch or saturated fat, inflammation may become serious and the immune system will be unbalanced. It can be seen that a healthy diet is very important.

There are many ways of mental health, and psychological counseling is effective for childhood malignant stress experience.

Healthy interpersonal relationships, when we hug, have close contact with others or have healthy interpersonal relationships with others, our bodies will release oxytocin (yes, oxytocin produced by mothers during childbirth). Oxytocin can inhibit HPA axis-the stress response circuit of brain and body-and buffer stress response, and it also has antidepressant effect.

Meditation and observation. Meditation will activate our rest and digestive system (parasympathetic nervous system). The parasympathetic nervous system is responsible for slowing the heartbeat and lowering blood pressure, which is contrary to the effect of stress response. Dealing with stress disorder is certainly effective.

Thanks to Nadine Harris and many scholars for their research on this topic!