What if depression wasn't a disease, but a normal response to trauma? That's one of the questions [Dr. Vincent Felitti, co-founder of the Centers for Disease Control and Prevention's ACE Study, posed this week in a webinar he did for SAMHSA -- the Substance Abuse and Mental Health Services Administration. SAMHSA is a federal agency whose goal is to reduce the impact of substance abuse and mental illness on America's communities.
He says our current approach to helping people get over addiction is all wrong. "You have to look at the benefits [of drugs, alcohol, food, etc.] rather than the risk," he said. People who are addicted to alcohol, cigarettes, drugs, food regard them as a solution, not a problem.
He showed several videos of his patients, including one who called the 200 extra pounds she carried "a protective barrier". When she was a child her grandfather sexually abused her. A man who had ended his addiction to alcohol and other drugs would not give up smoking. "It keeps a door closed to the past."
Why are addictions so difficult to treat? In this country, said Felitti, if someone has had a traumatic experience, perhaps decades ago, our attitude is "just get over it." But that's difficult, as he pointed out with this image of the brains of two children. The one on the left is a healthy 3-year-old American boy. The one on the right is a three-year-old Romanian boy who lived in one of the many Romanian orphanages that were known for severely neglecting children, thousands of whom were imprisoned in cribs and rarely given attention.
With no activity in a brain that is supposed to be making 700 new synapses a second, the experience of neglect, in this case, is sure to alter the brain architecture, said Felitti, which means its formation, and thus its function will be damaged. Traumatized children aren't able to concentrate in school. They have difficulty learning how to interact socially, because they're in flight, fight or freeze mode. They grow up using substances that offer relief from their situation, or to keep a door closed on the past, as Felitti's patient said. And the more types of trauma they experienced -- the higher their ACE score -- the more likely the addictive behavior.
Among the substances that help people cope with their traumas are alcohol.
The nicotine in cigarettes suppresses anger, is an anti-depressive, and helps with anxiety and hunger.
The consequences of child trauma also include addiction to anti-depressants. Felitti noted that methamphetamine was the first anti-depressant put on the market in the 1940s by Burroughs Wellcome Company under the brand name Methedrine. Noting the current rampant addiction to methamphetamines, Felitti said he doesn't think it's coincidental that so many people are addicted to an anti-depressant.
The behavioral outcomes of trauma and addiction include domestic violence. What's surprising in this graph is that the higher a woman's ACE score, the more likely that she will be a perpetrator, said Felitti. Women's victims are their children.
With trauma and addiction affecting people's work lives, poverty is an outcome of child trauma, said Felitti.
This is the fifth in a series of posts that accompany questions from the simple version of the ACE Study questionnaire developed by the Centers for Disease Control and Prevention. There are 10 questions on the simple ACE Study questionnaire; we've posted them in five polls this week and we'll post the rest next week. Today is the fifth question. Each day I'll take a look at some of the research — ACE, brain development, and epigenetic — to provide more information and context. I encourage you to take the simple ACE test for yourself. There's also a link to the full 200-question survey.