Health experts have long understood that untreated trauma can have a profound negative impact on a person’s well-being. For example, people who have a history of trauma may be at increased risk for a variety of physical, mental, and behavioral health concerns.
In recent years, research into the effects of trauma has shed new light on the relationship between childhood trauma and quality of life among adults who have bipolar disorder and schizophrenia.
What Is Childhood Trauma?
When the term “trauma” is used in a mental health context, it typically refers to the psychological impact of a life-threatening or otherwise horrific event.
People of all ages, including children, can develop trauma in the aftermath of one terrifying event, multiple traumatic occurrences, or continued exposure to certain distressing experiences over an extended period of time. Trauma can result from direct involvement as well as from witnessing traumatic events that occur to someone else.
Examples of events that can lead to trauma include physical assault, sexual abuse, verbal attacks, domestic violence, extreme neglect, serious illnesses, acts of terrorism, and the death of parent, partner, or other significant person.
Sources of childhood trauma are sometimes referred to as adverse childhood experiences, or ACEs. According to the U.S. Centers for Disease Control and Prevention (CDC), more than 60% of adults lived through at least one adverse childhood experience, and more than 15% of adults report having four or more ACEs before they reached their 18th birthday.
Effects of Childhood Trauma
Among the general public, posttraumatic stress disorder, or PTSD, is perhaps the most widely known effect of trauma. But PTSD is far from the only disorder or concern that can occur in the aftermath of traumatic events or other adverse childhood experiences.
Since 2009, the CDC has collected data on childhood trauma through the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS, which was launched in 1984, is an annual randomized telephone survey of adults in the United States.
Information gathered through the BRFSS reveals an association between childhood trauma and significant physical, mental, behavioral, and social challenges later in life. Adults who have a history of childhood trauma may be more likely to experience the following negative effects:
- Depression
- Substance abuse
- Heart disease and other medical problems
- Lower educational advancement
- Unemployment
Additional research has demonstrated a relationship between childhood trauma and the development of mental health concerns such as bipolar disorder and schizophrenia during adolescence or adulthood.
In addition to putting people at elevated risk for developing these disorders, childhood trauma may also increase the likelihood that people who have bipolar disorder or schizophrenia will experience more severe symptoms.
Childhood Trauma & Bipolar Disorder
A 2016 study in the International Journal of Bipolar Disorders found that childhood trauma is associated with an earlier onset of bipolar disorder as well as an elevated risk of certain symptoms and effects, including impaired cognition, substance abuse, and suicidal behaviors.
“Childhood trauma leads to alterations of affect regulation, impulse control, and cognitive functioning that might decrease the ability to cope with later stressors,” the study’s authors wrote. “Childhood trauma interacts with several genes belonging to several different biological pathways … to decrease the age at the onset of the disorder or increase the risk of suicide.”
These findings were supported by a 2020 study from the journal Neuropsychiatric Disease Treatment. This study, which was led by Yann Quide of the School of Psychiatry, University of New South Wales, found that exposure to childhood trauma is associated with the following effects among adults who have bipolar disorder:
- More severe clinical presentation of the disorder
- Increased severity of depressive and manic symptoms
- Increased severity of delusions
- Deficits in verbal and visual recall memory
- Less effective inhibitory control
- Diminished cognitive performance
- Diminished ability to identify anger
The 2020 study also noted that adults who had both bipolar disorder and a history of childhood trauma often show evidence of decreased volume in certain areas of the brain, including the corpus callosum, amygdala, right dorsolateral prefrontal cortex, and right thalamus.
Childhood Trauma & Schizophrenia
A March 2019 study in the journal Frontiers in Neuroscience explored the association between childhood trauma and schizophrenia.
This study, which was led by David Popovic of Ludwig Maximilian University of Munich (Germany), reported that “[c]hildhood trauma can be assumed to be a severe form of stress that renders individuals more vulnerable to developing schizophrenia.”
The study’s authors also noted the following about how childhood trauma’s effect on the brain can lead to cognitive deficiencies among people who have schizophrenia:
“In a theory of mind task reflecting social cognition, childhood trauma was associated with activation of the posterior cingulate gyrus, precuneus, and dorsomedial prefrontal cortex in patients with schizophrenia.
In addition, decreased connectivity was shown between the posterior cingulate/precuneus region and the amygdala in patients with high levels of physical neglect and sexual abuse during childhood, suggesting that disturbances in specific brain networks underlie cognitive abilities.”
According to the March 2019 study, exposure to adverse childhood experiences and other sources of trauma can also lead to dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis.
The HPA axis is part of the endocrine system. Among its functions, the HPA axis regulates the production of cortisol, which is a hormone that can help the body respond to stress.
HPA axis dysfunction can also negatively impact mood and cognition, with possible effects including anxiety, depression, decreased ability to concentrate or focus, and impaired memory retrieval.
Treatment Options for Childhood Trauma, Bipolar Disorder, & Schizophrenia
Effective mental health treatment must address the full scope of the client’s needs. If a person with bipolar disorder or schizophrenia has a history of childhood trauma, then appropriate trauma treatment must be included in their care plan.
Cognitive behavioral therapy (CBT), prolonged exposure therapy, and eye movement desensitization and reprocessing (EMDR) therapy are among the recommended approaches for people who have PTSD or who have been otherwise affected by untreated trauma.
Comprehensive treatment for bipolar disorder and schizophrenia often involves various forms of psychotherapy as well as certain prescription medications.
CBT and dialectical behavior therapy (DBT) have proved to be effective therapeutic elements for people who have bipolar disorder. Depending on the nature and severity of the symptoms that a person has been experiencing, the medication component of their bipolar disorder treatment may include antidepressants, antipsychotics, or mood stabilizers.
Among people who are receiving care for schizophrenia, CBT and behavioral skills training may be particularly beneficial. Antipsychotics are typically the most effective medications for easing the symptoms of schizophrenia.
Many other therapies and services can also have a significant positive effect on the quality of life of someone who has a history of trauma in addition to bipolar disorder or schizophrenia. What’s most important is finding a provider that will conduct a thorough assessment, then select the elements of care that align most closely with the individual’s needs and goals.
If someone that you care about needs personalized outpatient treatment for trauma, bipolar disorder, and schizophrenia, please contact Crownview Psychiatric Institute today. A member of our team can answer all your questions and help you make the most informed decision for your loved one.
Gianna Melendez
Jodie Dahl, CpHT