What is Adverse Childhood Trauma? Does It Adversely Impact Physical as well as Mental Health?

According to research on the topic and the CDC, Adverse Childhood Traumatic events (ACEs) may include:

1) Physical, sexual, and emotional abuse;

2) Emotional and physical neglect;

3) Living with a family member with mental health or substance use disorders;

4) Witnessing domestic violence;

5) Sudden separation from a loved one;

6) Poverty;

7) Racism and discrimination; and

8) Violence in the community.

The ACE Study looked at the effect of childhood abuse and neglect on adult and asked more than 17,000 adults about their childhood experiences and current health status and behaviors. Other studies have also linked adverse experiences like racism, oppression, intergenerational trauma, and community violence with long-term health problems. It's thought that cortisol levels are impaired (either too high in acute stress, or persistently low with chronic stress) leading to Post Traumatic Stress Disorder and other mental illnesses, substance use disorders, and chronic medical illnesses such as cardiovascular disease and diabetes.

Trauma can alter DNA and is transmitted to future generations leading to a phenomenon called Intergenerational Trauma. It's estimated that at least 25% or adults experienced trauma and certain groups are more likely to experience childhood trauma and more vulnerable to trauma such as Blacks, Latinos, and the LGBTQ+ communities.

The good news is that good parental attachment and supportive family can mitigate trauma in childhood and adolescence. For example, a child whose has a parent who is nurturing and emotionally available can help a child struggling with the absence of another parent (eg. military deployment, prison, death).

It's also critical that children and adolescents experiencing trauma have structure to develop resilience to stressors like trauma. What does that mean? It means having predictable routines and schedules. Having a reliable and predictable parent is especially critical to do this well and consistently, so it's key to both acknowledge and cope with your own feelings as a parent/caregiver. It's like putting on your oxygen mask on first before the child's during an airplane emergency. If you're passed out on a plane then you're of little help for your child; likewise in times of stress.

Other strategies to encourage resilience are:

Ensuring that your child feels safe;

Encouraging a sense of belonging and connection to family, friends, school, and community;

Helping children identify and regulate their emotions;

Teaching coping skills (eg. abdominal and mindfulness),

Helping children identify and acknowledge their feelings;

Supporting children in developing problem solving skills;

Praising children for their efforts in developing resilience; and,

Emphasizing predictable routines and schedules.

If you find yourself dealing with trauma and/or its consequences, I can offer the help you need tailored for your symptoms. My unique Ivy League education and training in psychiatry, pediatrics, preventive medicine and public health means that I take an integrative life cycle and developmental approach. Importantly, I use attachment theory and a bio-psychosocial lens in the diagnosis and treatment of trauma. In addition to holistic psychiatric approaches, I offer Trauma-focused-Cognitive Behavioral Therapy.

Please see the reference below for more information on the topic.

https://eclkc.ohs.acf.hhs.gov/publication/trauma-adverse-childhood-experiences

Does illicit use of ADHD 'study drugs' really help?

https://publications.waset.org/10013487/association-between-adhd-medication-cannabis-and-nicotine-use-mental-distress-and-other-psychoactive-substances

Students with a valid diagnosis of ADHD do much better socially and academically with legally prescribed stimulants. These drugs improve inattention, impulsivity, and hyperactivity in people with ADHD, and also increases central dopamine and norepinephrine activity. According to a survey of college students, illicit use of ADHD 'study drugs' might help with short term cramming and getting a 'high' similar to cocaine, but the risks might well outweigh the short term benefits. Moreover, children, teens, and adults with ADHD who really need the drug to perform at school, work, and home are often denied medication or are forced to switch to another stimulant formulation (such as from long acting to short acting), or to a new stimulant medication altogether, because of the well known national shortage of these medications.

Not only has illicit stimulant use been on the rise, but so has cannabis use and nicotine use. People use cannabis to ease emotional distress such as anxiety or to seek relief from acute stressors such as dating, sex, and academics. Studies have documented respiratory, cardiac and adverse brain effects such as poor memory and poor mental health. We all know that nicotine is similar in its adverse respiratory and cardiac effects. Smoking has been associated with depression, anxiety, alcoholism, and eating disorders too.

The misuse of ADHD and other drugs represents an opportunity for the health care and the college education communities to teach effective coping skills to better deal with life stressors. These include exercise, adequate sleep of at least 7-8 hours a night, meditation, journaling, and mindfulness. Read the study to find out more and to see original references.

Why does developing a Family Media Plan make sense?

https://www.healthychildren.org/English/family-life/Media/Pages/screen-time-and-temper-tantrums-helpful-tips-for-parents.aspx

Like most parents, you probably worry about your child's device use. Studies show that children 8-12 years old spend an average of 5 1/2 hours daily on social media, and teens spend an average of 8 1/2 hours a day! Low income and children of color spend even more time on social media.

Imagine, on average, teens spend the equivalent of a work day on activities that fuel their brain's dopamine fueled pleasure centers. While some of the content they're consuming might be educational, screen time has been associated with sleep problems, obesity, school performance, behavioral problems, cyberbullying, sexting and other risky behaviors, as well as addictive internet use.

The young brain is not fully developed until 25 years old and we do not know what device use and social media is doing to the developing brain. What is clear is that I see children in my psychiatric practice with poor self esteem and self image, and even with symptoms of depression, anxiety, phobias, and addictive internet use fueled by social media. Remember, by definition, children and teens are vulnerable because they are more impulsive, lack problem solving skills, and the lack good judgment adults possess. Moreover, teens especially want to fit in and might push some initial qualms aside to please their peers, other teens, or an unknown adult they've met online and call 'friend'.

So, create a family media plan, and learn how to monitor your child's device and social media use. Unfortunately, legislation and social media platforms are woefully behind addressing this important societal issue, but you can be in the forefront of this matter for your family.