The Oscars are this Sunday, and as war movies and films about repressed male feelings take center stage, I’ve been thinking about why Greta Gerwig’s Little Women had me wiping away tears during the last 30 minutes of the film – something that also happened to me while watching another Gerwig film, Lady Bird.Continue reading Big Women, Little Women, Small Oscars
(CRUCIAL NOTE HERE BEFORE YOU READ: Boys’ immune systems become dysregulated in response to #toxicstress too, and that leads to disease and changes to the brain that we also need to talk about more openly AND compassionately. Today I’m focusing on girls’ unique immune response to #toxicstress.)
So, exactly what happens in a girl’s body, in response to #toxicstress, that leads girls to be more likely to be ill as adult women? EVERY WOMAN WAS ONCE A GIRL. So, we should figure this conundrum out, right?
(For more on the scientific link between toxic childhood stress, being female, and later developing autoimmune disease, depression and other conditions, please read PART I of this essay, Why Girls Who Face Toxic Stress are More Vulnerable to Adult Illness: The Shocking Relationship Between Being Female, #ACEs, Autoimmune Disease and Depression)
Well, it turns out that girls’ developing immune systems react differently to toxic stress than boy’s do. This is because of some basic physiological differences between women and men. Women are, generally, physically smaller than men and our hearts and lungs are much smaller in size. Yet our anatomy makes added room to carry a fetus in order to create new human life.
Our smaller heart, lungs, and organs still have to be able to do everything a human male does – pump oxygen, circulate blood, run fast, think fast, be awake 16 or 17 hours a day – and have the necessary fuel to carry a child to term. We have to do double duty, on half the machinery.
Women can do so much more on less because we also have higher baseline levels of the hormone estrogen. Estrogen acts as a kind of messenger, carrying information between groups of our cells. Say we are stressed, or catch a flu, or get a vaccine – estrogen helps us, as women, have a more robust immune response. This more robust immune response is also thanks to steroid hormones known as glucocorticoids (or GCs). Glucocorticoids are produced by the adrenal gland and are anti-inflammatory. They help regulate inflammation.
If a woman is pregnant, glucocorticoids help us to keep our baby safe and carry it to term, even if we come down with the flu, or have a physical injury. Our immune system is poised, all the time, to protect our ability to carry another life.
This heightened female immune response also means that when our immune system sets out to fight off any foreign invader, such as a virus or bacteria, as women we also produce more of what are called antibodies, or fighter immune cells. That’s good. BUT it can also be a problem. As women, when we produce more antibody fighter cells, we also produce more autoantibodies. Autoantibodies are rogue fighter immune cells that can mistakenly attack the body’s own tissue or organs, in what we refer to as friendly fire. As in #autoimmunedisease.
When women, ESPECIALLY GIRLS, repeatedly face #toxicstress during the developmental years, over time, their stress response begins to be dysregulated. Glucocorticoids, or GCs, become less able to properly regulate a healthy, appropriate immune response, which leads to more inflammation.
Now remember, in the face of threats that prick up the immune system (which includes infections, physical injury, AND social threats and stressors), girls ALSO make more antibodies AND more rogue autoantibodies – again, because we have so much more estrogen.
This leads to a double whammy. It’s a simple equation:
A (Glucocorticoids stop regulating a proper immune response in face of #toxicstress)
+ B (Estrogen leads to production of more autoantibodies, which can attack the body itself)
= C (When girls face toxic stress, rogue autoantibodies can run amok, promoting slow-brew inflammation, and later disease)
This means that, over time, a woman’s immune system is a lot more likely to begin to attack her own body. This accounts for the fact that #autoimmunediseases strike women at three times the rate of men. For some illnesses that ratio is far higher. Examples. Women develop Hashimoto’s thyroiditis at a rate of 10:1 compared with men. In lupus, that rate is 9:1. In Sjögren’s syndrome, 9:1. #AutoimmuneDisease is one of the top ten leading causes of death in women under the age of sixty-five.
Fifty million Americans have an autoimmune disease, and three-quarters of these are women.
Women are also twice as likely as men to have chronic pain syndromes. Women with an ACE score of 3 are significantly more likely to have chronic pain syndromes including headaches, back and neck problems. Women are also more likely to have “contested conditions” – meaning the medical profession is still debating whether these autoimmune conditions are real or just psychosomatic — such as #chroniclyme, #chronicfatigue and #fibromyalgia.
A heightened inflammatory stress response also affects the architecture of the #femalebrain differently than the male brain. A girl’s brain, on adversity, is a vulnerable brain in unique ways. For instance, both boys and girls who grow up with #toxicstress demonstrate, on brain scans, fewer neural connections between the pre-frontal cortex (the decision-making center of the brain) and the hippocampus (an area of the brain that helps us to make sense of our emotions and experiences). But, in girls who grow up with #toxicstress and #ACEs, another area of neural connectivity is affected. It goes offline. Synaptic connections between an area of the brain known as the amygdala (the fear-and-alert center of the brain) and the pre-frontal cortex are also weakened.
This means that girls who experience #ACEs are more likely to grow up in a chronic state of hypervigilance. Fight or flight. Feeling that life is an emergency. This contributes to the fact that girls and women are more likely to suffer from anxiety and depression as adults than are men. Stats bear this out. One third of men with an #ACE Score of 4 later develop depression—already a high and disturbing figure—while nearly 60 percent of women with 4 #ACEs develop chronic depression in adulthood.
That means that the risk that growing up with #toxicstress and #adversechildhoodexperiences will lead to neuroinflammatory diseases such as depression and anxiety disorders is, as with autoimmune disease, TWICE AS HIGH for women as it is for men.
Physical inflammation is increasingly linked to mental health disorders. Cutting-edge research shows us that our body and brain’s immune responses function in tandem. (I’m writing more about that in my next book, out in 2019, so stay tuned for The Angel and the Assassin: The Tiny Cell That Changed the Course of Medicine. I think it’s the most important book I’ve ever written.)
Still, it can take years, sometimes decades, for toxic childhood stress to translate into symptoms, much less visible physical disease. A young girl can face a lot of chronic #toxicstress at the age of 12. BUT it may take 30 years or longer for the inflammation unleashed by that chronic adversity to progress to disease symptoms. At that late date, the link between a stressed little girl and the ill woman she’s become is invisible to the patient – and her physician.
This plays into why so many doctors miss autoimmune disease in women. Recent studies show that the average woman sees five doctors over four-and-a-half years before receiving a proper diagnosis—and nearly half of women are labeled and dismissed as “chronic complainers” in the early stages of their illness.
This means that women who’ve faced #femaleadversity and who also face #autoimmunedisease often get dismissed TWICE. From early on in life, they know if they meet up with any type of #femaleadversity or CHILDHOOD TRAUMA– sexual harassment, date rape, sexism, abuse, at home, school or work — if they report it their version of events, what they say may very well be dismissed. Disbelieved. Their self-reports are very likely to be distrusted. Years later, in a doctor’s office, when they report their PHYSICAL #auatoimmune or #chronicpain symptoms, they get dismissed or disbelieved all over again.
The past repeats itself.
(Later this week, I’ll be adding more to this thread, in PART THREE.)
If this topic interests you personally, because it speaks to your experience, or because you work with, teach, mentor, or are parenting girls, or if you work in #ACEAwareness or #trauma prevention, sign up for my blog and newsletter now. If you haven’t yet signed up for my mailing list and/or my blog, you might want to now.
(To sign up for my mailing list and newsletter, click on the link below, and see the “Mailing List” subscription box to your right. To sign up for my blog, scroll down on the right hand side of my website’s blog page to “Never Miss a Blog Post and sign up there.)
Three things I wanted to let you know about: later this weekend I’ll be posting a three part essay about women, toxic stress, and the female immune system — and why this topic matters now more than ever (more on that below!); an update on my next book, The Angel and the Assassin; and upcoming speaking events!
One thing readers know about the work I do and the books I write, including Childhood Disrupted, The Autoimmune Epidemic, and The Last Best Cure, is that I focus on the intersection of neuroscience, immunology and emotion – while shining a spotlight on WOMEN’s experiences. Connecting these dots is always an underlying theme in my work. Women, girls, toxic stress, the female brain and immune system, autoimmune disease and chronic physical and mental illness — if you care about any of these, keep an eye out for my upcoming three-part blog series in which I delve into the scientific links between them all.
I’ve written this upcoming blog, and am offering it up freely, because I think it’s crucial that we address the unique way in which the female brain and immune system respond to environmental influences, including #ACEs, and how, in turn, this unique female brain-immune response contributes to girls being several times more likely to later develop autoimmune diseases, depression, anxiety disorders, and so many other chronic illnesses.
I’m going to break down for you, in a way no one else has, or will, how and WHY Adverse Childhood Experiences and toxic childhood stress are a #metoo issue of the greatest magnitude. For girls and for the adult women they become.
If you haven’t yet signed up for my mailing list and/or my blog, you might want to now. (To sign up for my mailing list and newsletter, see the “Mailing List” subscription box to your right. To sign up for my blog, scroll down on the right hand side of this page to “Never Miss a Blog Post and sign up!)
I’m calling this three-part exploration:
Growing Up With Female Adversity: The Female Body and Brain on Toxic Stress. In it, I’m offering up the term — and hashtag — #FemaleAdversity — to refer to the chronic societal stress girls face growing up. Girls not only come of age with higher rates of #AdverseChildhoodExperiences, including verbal, emotional, sexual and physical abuse, girls also have to find their way to a healthy adulthood and sense of self amidst cripplingly narrow societal expectations regarding what is acceptable female beauty and behavior. All this is intensified, 24/7, by images of effortless female perfection on social media and in media in general. Meanwhile, girls are witnessing the sexual harassment and sexism so many adult women endure. Over time, this #FemaleAdversity can take a toll on girls’ and women’s immune systems, bodies, and brains in unique ways.
So, in this series I’ll be delving into:
Part One: Why Girls Who Face #ToxicStress are More Vulnerable to Adult Illness: The Shocking Relationship Between Being Female, #ACEs, #AutoimmuneDisease and #Depression.
Part Two: Every Woman Was Once a Girl: Why We Need to Talk About the Biological Effects of #FemaleAdversity on Women’s Bodies and Brains.
Part Three: #FemaleAdversity is a Unique Form of #ToxicStress — One We Haven’t Been Paying Enough Attention To — And We’d Better Start Soon.
If this topic interests you personally, because it speaks to your experience, or because you work with, teach, mentor, or are parenting girls, or if you work in #ACEAwareness or #trauma prevention, sign up for my blog and newsletter now.
2. Here, too, is a very brief update about my next book THE ANGEL AND THE ASSASSIN: The Tiny Cell That Changed the Course of Medicine, and Gives us a Radically New Way of Looking at Human Well-Being, which will be out with Ballantine Books (Random House) in Fall 2019. I’m writing as fast as I can! And what I’m researching and reporting on is as promising for human health as it is mind-blowing. I’m happy to say, I’ve already turned in the first 200 pages.
In THE ANGEL AND THE ASSASSIN, I’m on a mission to de-stigmatize brain-related health challenges, and to show how chronic conditions like depression, anxiety, learning disabilities, mood disorders, memory issues, and Alzheimer’s all involve one tiny, overlooked (and all too often, overactive) brain immune cell called microglia, which functions as the “white blood cell of the brain.” These tiny glial cells are in constant dialogue with the body’s immune system, and can be all too easily triggered by physical or emotional trauma, toxic stress, environmental toxins, infections, and inflammation in the body itself. All of these can, in turn, cause microglia to become agitated and destroy brain synapses and circuitry, generating neuroinflammation — in much the same way that rogue immune cells in the body can generate a slow brew inflammatory process that leads to the body attacking itself, as in autoimmune disease.
This truly amazing discovery – and the new understanding that the brain is an immune organ, ruled by these little reactive immune cells called glia — is one of the most revolutionary discoveries in the history of science, and it’s changing everything, including leading to exciting new avenues for treating seemingly intractable life-altering disorders.
Once again, in The Angel and the Assassin, as in all my books, I’ll be examining what this means specifically for women and girls, who suffer disproportionately from trauma, toxic stress, autoimmune disease, depression, and so many chronic illnesses. Stay tuned!
3. Finally, for those who are interested in knowing about my upcoming events, here are a few of the venues where I’ll be lecturing over the next few months. Both of these events offer CME and CPE Credits for professionals who want to be trauma-informed, learn about ACEs Science, and the latest science on resiliency.
Keynote, Rutgers University DIS[RU]PT TRAUMA Conference, Thursday, May 31st, 9 a.m. – 12:00. I’ll also be offering a break out workshop.
Golisano Children’s Hospital 16th Annual Pediatric Conference, Saturday June 9th, 1:30, at the Sanibel Harbour Marriott Resort & Spa.
Hope to see you at one of these events!