May 24, 2017

Why we Need to Know about the ACE Study.


*Editor’s note: Elephant is not your doctor or hospital. Our lawyers would say “this web site is not designed to, and should not be construed to provide medical advice, professional diagnosis, opinion or treatment to you or any other individual, and is not intended as a substitute for medical or professional care and treatment. Always consult a health professional before trying out new home therapies or changing your diet.” But we can’t afford lawyers, and you knew all that. ~ Ed.


Since I was a child, I’ve battled health issues—like asthma attacks and ear infections.

When I was 17, I was diagnosed with multiple autoimmune diseases that compromised my spleen and liver. I had no family history and wasn’t a drinker. I was an athlete preparing to play collegiate soccer at a top university.

The whites of my eyes and my skin had turned yellow from jaundice (due to the excessive destruction of red blood cells). My organs became so inflamed they were visibly noticeable and painful to touch. I was told not to play contact sports, warned I would need a liver transplant by 25, and advised I’d be on medication for the rest of my life.

I was in shock. How could this be?

On the day of my high school graduation, I was released from the hospital. I accepted my diploma in a wheelchair. Several weeks later, I left for college.

Against my doctor’s orders and several weeks after leaving the hospital, I played college soccer and took part in summer training. By August of 2004, my freshman year of college began. I felt tired, distracted, and depressed, and had trouble sleeping.

I searched far and wide for answers. If I had no family history of this disease, how did I get it? Why is my body attacking healthy cells? Why do I need blood transfusions? Why do I need a liver transplant?

Between classes and soccer practice, I investigated. I needed to know why. I looked in medical journals and health books. I sought relief in positive psychology courses and therapy. I wanted to know: Can I get better without medications? Will I ever feel better?

Throughout college, I struggled. After visiting the doctor on campus, I began taking anti-depressants and sleeping medication while trying to nurse my liver back to health. I bought every self-help book, began juicing, and dedicated myself to a strict vegetarian diet. I bought essential oils to aid my rest, adopted a dog to ease my sadness, and began to practice meditation.

But at the age of 20, with so much ahead of me, I wanted to end my life.

After writing my tear-drenched suicide note, I tucked it away in a desk drawer and told myself, “Just get through today.” I continued to do this day after day. Ten years later, I’m here to tell my story.

“Adverse childhood experiences are the single greatest unaddressed public threat facing our nation today.” ~ Dr. Robert Block, former President of the American Academy of Pediatrics

In the 1990s, the Center for Disease Control and Prevention (CDC) and Kaiser Permanente published a study on adverse childhood experiences (known as the ACE study).

According to the study, the categories of adverse childhood experiences are abuse (psychological, sexual, physical), household dysfunction (substance abuse, mental illness, domestic abuse, incarceration), death of a parent, divorce, alcoholism, and neglect. For those with a higher ACE score, they have triple the risk of developing heart disease and lung cancer, as well as a 20-year difference in life expectancy.

Why is adversity in childhood different?

For starters, children are especially sensitive to trauma. Their brain, immune system, nervous system, and hormonal system are still developing. High doses of adversity create real concern in the amygdala, the brain’s fear response center.

The adversity a child faces doesn’t have to be severe in order to create deep, biophysical changes that lead to chronic health conditions later in life. Living with a parent who drinks too much, puts you down, or is constantly depressed or angry can leave a profound imprint on your brain and immune responses.

Most Americans have one ACE.

For a person with an ACE score of four or more, the relative risk of chronic obstructive pulmonary disease is three times higher than that of someone with an ACE score of zero. For hepatitis, it is two and a half times greater. For lung cancer, it is three times greater. For heart disease, is is three and a half times greater. For depression, it is four and half times greater, and for suicide, it is 12 times greater.

After taking the questionnaire to determine my ACE score, I felt profound validation. I began to understand why my mind, body, and soul were struggling so much. My ACE score is 7. After all these years of searching for answers, I know why my immune system shut down. My body, mind, and soul are proof that the physical and sexual abuse I survived as a child lived in my body long after the abuse stopped.

The results of the study came out in the 1990s. Why had I not been screened sooner? I have been visiting specialists, gynecologist, therapists, and other medical professionals for decades and had never heard of this study prior to my own quest for answers.

Suicides have become the second-leading cause of death among teenagers in the United States, surpassing homicide deaths, which dropped to third place. Recent studies have showed that death by suicide among girls between the ages of 10 and 14 has been increasing. Though young girls make up a small portion of the total suicides, the rate in that group has jumped the most—it experienced the largest percent increase, tripling over 15 years from 0.5 to 1.7 per 100,000 people.

In a candid article, Dr. Nancy Hardt shares that the most important thing she did not learn in med school was the ACE study. Hardt says:

“To be sure, had I understood them the way I do now, I would have been a better and more compassionate physician. Importantly, I would have avoided lots of mistakes. I never understood the addictions to food, drugs, alcohol and cigarettes, are imperfect solutions to the effects of toxic stress resulting from adverse childhood experiences. Toxic stress sets up pathways in the brains of traumatized children, pathways which persist into adulthood. We don’t outgrow these pathways, so as we get older, we try ‘home remedies’ to treat them.”

Dr. Hardt’s transparency in what her medical training lacked helps us shape change in future medical training. The information we have today concerning childhood adversity and the connection to adult illness can inform all of our efforts to heal. Childhood adversity is not going to end, and sadly, child abuse is not going to stop. But we can improve the care we provide survivors.

We must.

Teachers, coaches, caretakers, parents, health professionals, and therapists should screen the children and teens in their path for ACEs. We can give them a chance of finding health and healing after being dealt such arduous circumstances.

Knowledge is power and knowing your ACE score is powerful!


Additional resources:

Center for Youth Wellness
Suicide Prevention Lifeline
The Body Keeps the Score, Bessel Van Der Kolk, M.D.
Childhood Disrupted, Donna Jackson Nakazawa


Author: K. Martinez
Image: Author’s Own; Alexandre Chambon/Unsplash
Editor: Catherine Monkman

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