Adverse Childhood Experiences (ACEs): How Early Trauma Impacts Mental and Physical Health
Many people come to therapy saying something like, “My childhood wasn’t that bad,” or “Other people had it worse, why am I struggling now?” Downplaying early experiences is incredibly common, especially when stress or conflict were frequent growing up. However, one of the most important discoveries in mental health research is that early adversity influences not just emotional well-being, but physical health as well. These early experiences are known as Adverse Childhood Experiences, or ACEs.
What Are Adverse Childhood Experiences?
Adverse Childhood Experiences (ACEs) refer to stressful, harmful, or frightening events that occur before age 18. The original ACE study identified ten categories of early adversity:
Abuse
Physical abuse
Emotional abuse
Sexual abuse
Neglect
Emotional neglect
Physical neglect
Household Stressors
Domestic violence
Substance abuse in the home
Mental illness in the home
Parental separation or divorce (especially high conflict)
Incarceration of a household member
Other important forms of adversity—like community violence, discrimination, bullying, chronic medical trauma, or losing a caregiver—are now also recognized, even if they were not in the original study.
It’s important to know that ACEs are very common. Roughly two-thirds of people report at least one ACE, and many have several. But a major finding from this research is the dose-response effect – which means more ACEs = higher risk for health problems.
How ACEs Affect Emotional Well-Being
A child’s brain and nervous system are developing rapidly, and they depend on safety, stability, and nurturing relationships to build resilience. When early experiences involve chaos, fear, or emotional inconsistency, the nervous system learns to adapt for survival.
These adaptations can show up later as:
chronic worry or anxiety
emotional numbing
difficulty trusting others
people-pleasing or avoiding conflict
quick emotional reactivity
trouble identifying or expressing needs
These are reasonable responses to environments that didn’t consistently feel safe. However, they are not unchangeable. If any of these resonate with you, therapy can help create new patterns.
How ACEs Affect Physical Health
The most eye-opening findings from the research on ACEs is how strongly early stress is linked to long-term physical health outcomes. When a child grows up in a chronically stressful or unsafe environment, the body stays in “fight-or-flight mode” more often than it should. Over years, this kind of stress activation can affect hormones, inflammation, the immune system, and even the way genes turn on and off.
This helps explain why higher ACE scores are associated with increased risk for certain medical conditions in adulthood, such as:
Chronic health conditions
Heart disease
High blood pressure
Stroke
Diabetes
Obesity
Stress-related and inflammatory conditions
Chronic pain
Autoimmune diseases
Fibromyalgia
Irritable bowel syndrome (IBS)
Migraines
Immune system vulnerabilities
Frequent infections
Slower recovery from illness
To reiterate this important research - simply by having more ACEs, you are more likely to have these chronic conditions. My hope, by emphasizing this, is to reduce shame and self-blame that often accompany these conditions.
People with higher ACE scores are also statistically more likely to struggle with smoking, overeating, substance use, or sleep difficulties. These behaviors can further increase health risks over time.
It’s important to emphasize: ACEs do not guarantee medical problems, and having medical issues does not mean you had ACEs. But early stress increases vulnerability, especially when it wasn’t buffered by supportive caregiving or later healing. Understanding this connection can be empowering.
“But My Childhood Wasn’t That Bad…”
Many people hesitate to explore early experiences because they feel disloyal, guilty, or unsure. You can have complicated feelings about your caregivers and still acknowledge that certain experiences shaped you. ACEs are about understanding, not blame.
Even subtle or unintentional emotional wounds can influence how your nervous system develops. Therapy provides space to explore this gently and without judgment.
The ACE Score: Useful but Limited
The ACE questionnaire is a simple tool that counts how many of the 10 original ACE categories you experienced. It can highlight risk factors, but it doesn’t account for:
how long the experience lasted
the severity
whether someone outside the home was supportive
additional adversities not included in the original list
A low ACE score doesn’t indicate a stress-free childhood, and a high score doesn’t mean you’re doomed. It’s simply a means for understanding your experiences and their potential impact.
Healing From ACEs
The most hopeful part of ACE research is this: healing is possible at any age, and supportive relationships are one of the most powerful antidotes to early stress.
Therapy can help you:
1. Understand your patterns with compassion
Seeing your reactions as adaptations reduces shame and increases self-understanding.
2. Regulate your nervous system
Somatic tools, grounding, breathwork, and mindfulness help retrain the body’s stress response.
3. Rewrite relational patterns
Therapy gives you a safe, consistent relationship where you can practice boundaries, emotional expression, and trust.
4. Address both emotional and physical wellness
Understanding the stress–body connection helps you make choices that support long-term health.
5. Build resilience moving forward
Healing doesn’t erase the past, but it can open new pathways for the future.
If you see pieces of your story in the ACEs framework, that awareness is the beginning of healing. Your past may have shaped you, but it doesn’t define your future. With support, compassion, and intentional work, both your emotional and physical well-being can improve in meaningful ways.
Trauma Therapy Denver, Colorado
If reading about ACEs brought up questions, emotions, or moments of recognition, you don’t have to navigate that awareness alone. The therapists at Authentic Connections Therapy and Wellness specialize in helping adults gently explore how early experiences have shaped their nervous system, relationships, and overall well-being—without judgment or pressure. Therapy can be a space to make sense of your story, reduce shame, and develop tools that support both emotional and physical health. If you’re ready to take the next step in your healing journey, we invite you to connect with one of our therapists and learn how supportive, trauma-informed care can help you move forward.
