Posted 2/22/2010 8:20 AM CST on livestrong.com Community
I am a survivor of childhood abuse. I fell into substance abuse (alcoholism) as an adult, made it into recovery and have been sober for nearly 4 years. I stared down death a couple of times during this dark period of my life. Today, I feel very fortunate that I am alive and standing on solid ground. I cannot put into words how grateful I am for the unwavering support of my family, friends and psychotherapists. I have been on a journey of recovery and self-discovery for the past four years and could not be any happier with my opportunity to live a more enriched life, going forward.
I estimate that I have put over 200 hours into reading, researching and studying science and medical papers on the subject that I would like to share in this post. I find it tragic that with all the recent discoveries in neuroscience and the associated links to addiction and substance abuse; the medical community and, peripherally, the addiction treatment community, have yet to gain any sort of deep understanding that would allow them to adapt and deploy treatment options.
There is an age-old debate whether alcoholism is a disease. I ponder the thought that any evidence of this claim has not been found conclusive. With all the research money and time spent by drug companies, employing molecular biologist to hunt for genetic markers tied to alcoholism, it seems likely that any evidence would have emerged by now. I have read that drug companies have invested in excess of a billion dollar hunting for any sign of genetic markers that show a link to alcoholism.
To me, it seems more likely that some sort of “psychological stress”, seemingly leading to a wide spectrum of mental illnesses, is more aligned on a path that is conducive for substance abuse and addiction. I have read that there is an undeniable association of childhood stress, or varying degrees of abandonment, that link those who predominantly fall victim to substance abuse and addiction. In my readings, abandonment defined is a trauma experienced in the developmental years of our youth. Examples noted were childhood abuse, broken homes, domestic violence, molestation, incest and so on.
There are many forms of childhood abandonment that I read about. Pertaining directly to me, I was physically and emotionally abused by my father. I grew up in a corporal punishment environment that many times, went beyond spanking or your garden variety head slapping or ear flicking. For as long as I can remember, tracing back through my youth, I always had my guard up. I lived in a hyper-vigilant state of always being on guard. After much work, that internal churning is now gone. Free at last, after 48 years!
I have read a great deal about the devastating impact that a constant state of arousal (hyper-vigilance) can deliver to a developing brain. I learned about the HPA-axis, also called the “negative feedback loop”. The HPA-axis defined, is the hypothalamic-pituitary-adrenocortical axis that is part of the endocrine and autonomic systems within our body. In a nutshell, the HPA-axis gives us that “fight or flight” ability by producing the necessary amounts or more of adrenaline and cortisol hormones that will move us away from any real or perceived threat. There is evidence linking the constant state of arousal to mental illnesses that will never completely leave us. Here is an excerpt that I pulled from a study done on the neuroendocrinology of stress.
* Comprehending the mechanistic of the stress response and the increasingly serious sequelae of its deregulation is pivotal to recognize and combat any abnormalities in the stress system. To overcome pathologic hyperactivity of the stress response, it is essential to protect juveniles from trauma and abuse. The more secure the environment, the less likely an individual will experience a stress-related illness. A secondary measure is training stress-prone patients to improve their coping skills, minimizing their reactivity to future stress. In-depth understanding of the neuro-circuitry of stress has provided novel tools to manage hyperactivity of the stress system. Hundreds of original articles and many laboratories have repeatedly implicated corticotropin-releasing hormone (CRH) in enhancing the organism’s sensitivity to nocuous stimuli and in mobilizing almost the entire cascade of the stress response. By virtue of its broad interactions with the endocrine and autonomic systems, CRH virtually influences every cell in the body. Hyperactivity of CRH is a serious condition that is likely to underlie the pathophysiology of melancholic depression, anxiety, psychosexual disorders, diabetes mellitus, and functional gastrointestinal disorders.
Serotonin is important for adequate coping with stress. Aberrant serotonin function is implicated in the etiology of major depression and anxiety disorders. Dysregulation of the hypothalamic-pituitary-adrenocortical axis, involving raised corticotropin-releasing hormone activity, also plays a role in these stress-related illnesses.
I use to have a terrible problem with giving presentations to an audience or even just impromptu talks in front of a group. My problem and symptoms went well beyond the normal nervousness and presentation anxiety that are often present before speaking. The physical symptoms that I experienced were rapid heart beat, abnormal sweating, shortness of breadth and an overwhelming sense of confusion. My autonomic system went into overdrive. One day, after describing this scenario to a psychiatrist, he prescribed the drug Inderal to see if it made an impact toward combating my symptoms.
Inderal is a beta-blocker that temporarily shuts down the adrenaline response. The impact was profound. When I take a very small dosage (5mg) before public speaking, I no longer have any problem nor suffer any of the symptoms that I once did. My “pathologic hyperactivity of the stress response” (but of course) is under control today, thanks to the drug Inderal. I just wish I would have figured this out 20 years earlier in my sales career.
Furthermore, during a routine CT scan of my abdomen, for an unrelated matter, doctors discovered that I have an adrenal cortical adenoma (huh), (benign tumor..oh!) on my adrenal gland. I have read evidence that an adrenal adenoma can develop as a result of over stressing the HPA-axis due to the constant hyperactive and prolonged exposure to cortisol. I believe that the environment that I grew up in had something, if not everything, to do with this adenoma.
Referencing a paper prepared by The Office of Trauma Services, Maine Department of Behavioral and Developmental Service’s State House Station, gives further illustration to the harmful and lifelong impact of childhood abuse:
Childhood abuse can result in adult experience of shame, flashbacks, nightmares, severe anxiety, depression, alcohol and drug use, feelings of humiliation and unworthiness, ugliness and profound terror. (Harris, 1997; Rieker&Carmen, 1986; Herman, 1992; Janoff-Bulman & Frieze, 1983; van der Kolk, 1987; Brown & Finkelhor, 1986; Rimsza, 1988)
Adults abused during childhood are more than twice as likely to have at least one lifetime psychiatric diagnosis almost three times as likely to have an affective disorder almost three times as likely to have an anxiety disorder almost 2 ½ times as likely to have phobias over ten times as likely to have a panic disorder almost four times as likely to have an antisocial personality disorder (Stein et al, 1988).
It appears conclusive that child abuse affects the neural pathways of a developing brain. The resulting effect appears to be damaging to the neuro-circuitry that can no longer efficiently carry the neurotransmitters that travel the connected network of the brain. In the neuro-circuitry, three mono-amine neurotransmitters cited as being affected were serotonin, dopamine and nor epinephrine….neurotransmitters that play a significant role in depression and anxiety.
On a personal level, I have worked with two doctors to come up with the right mix of therapy (Cognitive Beharioural Therapy – CBT) and medication. Currently, I go to therapy sessions with a Psychologist and I have a Psychiatrist that has worked with me to prescribe the right mix of medication. I take the antidepressant Pristiq, Deplin – which is a prescribed “medical food” that helps regulate all three mono-amines neurotransmitters, a GABA supplement, a highly concentrated form of Omega-3 supplement and a high-potency multivitamin supplement. All pills are directed at improving brain function as it relates to neurotransmitters. In addition, I exercise daily, manage my nutritional advice and make sure that I get plenty of sleep. It’s not easy. Working this regime has been a challenge. But, I am committed to it.
The results so far have been awesome. I have never felt better in my life and I have been depression free ever since going on the regiment that I described above. As I travel my sober journey, I look forward to living each day knowing that I am doing all the right things to support a healthy mental balance. I also take part in maintenance visits for psychotherapy, which I highly recommend adjunct to medical treatment.
* Neuroendocrinology of stress by Habib KE, Gold PW, Chrousos GP. Clinical Neuroendocrinology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA. firstname.lastname@example.org
Endocrinol Metab Clin North Am 2001 Sep; 30(3):695-728