Trauma, longevity and health

Recently Andrew Pelequin wrote this interesting article in the Longevity Journal. I may not agree that this is true in all cases as I have experienced many of the childhood traumas mentioned in the article and have not suffered from the many consequences...HOWEVER, I have had extensive work in the trauma release department through energy balancing, counseling, meditation and lots of deep internal work to let go and heal these traumas as I am so very grateful that I chose to go on the healing journey and dive deeply into what and why I think, act, speak and behave the way that I do.

I investigate every response or trigger I experience and see it as an opportunity to heal.

I am by no means perfect as I believe healing is still part of my journey within and health is what I chose on a daily basis. Some days I hit the goal and some days I miss and on those days I give myself grace and kindness.

I hope you find this article as interesting and thought provoking as I did.

Seek help when you need it. IT is NOT a sign of weakness. It is a sign of immense courage and it is a BIG step in taking your power back and choosing health and wellbeing for yourself and your circle of life. 

In one study conducted by the CDC of nearly 14,000 adults [1], more than 50% had at least one type of childhood trauma (or Adverse Childhood Experience, a.k.a. ACE), while more than 25% reported more than two types of trauma.

According to the study, there were seven types of trauma:

1. Physical abuse
2. Sexual abuse
3. Psychological abuse
4. Living with members of the household who were drug addicts, alcoholics, or substance abusers
5. Witnesses violence against their mother
6. Living with members of the household who were ever incarcerated
7. Living with members of the household who suffered from mental illness or were suicidal

People who had experience multiple types of traumas during their childhood experienced a number of seriously negative long-term effects, including:

• Higher alcoholism risks
• Higher drug abuse risks
• Higher depression rates
• Higher suicide attempt rates
• Higher rates of STDs
• Severe obesity and reduction in physical activity
• Higher rates of adult diseases, including liver disease, chronic lung disease, cancer, skeletal fractures, and heart disease

All of these contribute to accelerated biological aging, leading to the breakdown of the body at a much faster rate than would be expected of the chronological age of those in the study.

Another meta-analysis from 2020 [2] further reinforced the theory that “early life adversity” (in the form of those types of trauma listed above) led to accelerated biological aging.

Combing through data from more than 50 studies, the meta-analysis examined various aspects of biological aging that were caused by trauma, including:

• Telomere shortening
• Increased DNA methylation age
• Cortical thinning
• Reduced functional connectivity between the amygdala and prefrontal cortex
• Accelerated pubertal timing (among children going through puberty)

These are concrete biomarkers that prove beyond a shadow of a doubt that trauma can contribute to increased biological aging.

It’s important to understand that many of these things begin to show up during adolescence and young adulthood, sometimes even as early as childhood. As the study’s senior author said in an interview [3], “The fact that we see such consistent evidence for faster aging at such a young age suggests that the biological mechanisms that contribute to health disparities are set in motion very early in life. This means that efforts to prevent these health disparities must also begin during childhood.”

How to Deal With Your Trauma

The American Psychological Association [4] offers some effective strategies for helping you (and your children, if they have been exposed to adverse childhood experiences) cope with trauma you may have suffered in response to traumatic events.

Be patient. Your body can’t heal from mental or psychological wounds any faster than from physical wounds. On the contrary, traumatic events may taken even longer to heal from. Give yourself time and space to recover, and be patient if recovery doesn’t happen overnight.

Face what you’re feeling. Hiding from or ignoring the feelings won’t make them go away; you’ll just end up leaning on unhealthy coping and ignoring mechanisms. A bit of avoidance is normal, but don’t let it go on too long or it will begin to affect your life in far greater ways than the trauma itself.

Get help. Whatever you’re going through, you need to know you can’t heal alone. Just like you’d go to a doctor for a physical wound, you need to seek professional help for the wound to your psyche. Talk to a therapist, counselor, psychologist, or psychiatrist.

Lean on your friends and family. Fight the urge to withdraw and isolate; that’ll only make things worse. Instead, rely on your social connections for support during the difficult time.

Traumatic events don’t have to affect your longevity or ruin your life. The damage they cause can be temporary; it’s up to you to take the steps that will lead you down the path forward to recovery, both in body and mind.

Folic Acid Tied to a 44% Reduction in Suicide Attempts

 

Folic Acid Tied to a 44% Reduction in Suicide Attempts

Folic acid/vitamin B9, may provide a safe and effective approach for decreasing suicidal ideation, new research suggests. After adjusting for multiple factors, results from a large pharmaco-epidemiological study showed taking folic acid was associated with a 44% reduction in suicide events.

"These results are really putting folic acid squarely on the map as a potential for large-scale, population-level prevention," lead author Robert D. Gibbons, PhD, professor of biostatistics, Center for Health Statistics, University of Chicago, Illinois, told Medscape Medical News.

"Folic acid is safe, inexpensive, and generally available, and if future randomized controlled trials show this association is beyond a shadow of a doubt causal, we have a new tool in the arsenal," Gibbons said.

Having such a tool would be extremely important given that suicide is such a significant public health crisis worldwide, he added.

The findings were published online September 28, 2022 in JAMA Psychiatry.

Previous Research "Fairly Thin"

Folate, the naturally occurring form of B9, is essential for neurogenesis, nucleotide synthesis, and methylation of homocysteine. Past research has suggested that taking folate can prevent neural tube and heart defects in the fetus during pregnancy — and may prevent strokes and reduce age-related hearing loss in adults.

In psychiatry, the role of folate has been recognized for more than a decade. It may enhance the effects of antidepressants; and folate deficiency can predict poorer response to selective serotonin reuptake inhibitors (SSRIs).

This has led to recommendations for folate augmentation in patients with low or normal levels at the start of depression treatment.

Although previous research has shown a link between folic acid and suicidality, the findings have been "fairly thin," with studies being "generally small, and many are case series," Gibbons said.

The current study follows an earlier analysis that used a novel statistical methodology for generating drug safety signals that was developed by Gibbons and colleagues. That study compared rates of suicide attempts before and after initiation of 922 drugs with at least 3000 prescriptions.

Its results showed 10 drugs were associated with increased risk of suicide attempts after exposure, with the strongest associations for alprazolam, butalbital, hydrocodone, and combination codeine/promethazine. In addition, 44 drugs were associated with decreased risk, many of which were antidepressants and antipsychotics.

"One of the most interesting findings in terms of the decreased risk was for folic acid," said Gibbons.

He and his colleagues initially thought this was because of women taking folic acid during pregnancy. But when restricting the analysis to men, they found the same effect. Their next step was to carry out the current large-scale pharmaco-epidemiological study.

Prescriptions for Pain

Researchers used a health claims database that included 164 million enrollees. The study cohort was comprised of 866,586 adults with private health insurance (81.3% women; 10.4% aged 60 years and older) who filled a folic acid prescription between 2012 and 2017.

More than half of the folic acid prescriptions were associated with pain disorders. About 48% were for a single agent at a dosage of 1 mg/d, which is the upper tolerable limit for adults — including in pregnancy and lactation.

Other single-agent daily dosages ranging from 0.4 mg to 5 mg accounted for 0.11% of prescriptions. The remainder were multivitamins.

The participants were followed for 24 months. The within-person analysis compared suicide attempts or self-harm events resulting in an outpatient visit or inpatient admission during periods of folic acid treatment vs during periods without treatment.

During the study period, the overall suicidal event rate was 133 per 100,000 population, which is one fourth the national rate reported by the National Institutes of Health of 600 per 100,000.

After adjusting for age, sex, diagnoses related to suicidal behavior and folic acid deficiency, history of folate-reducing medications, and history of suicidal events, the estimated hazard ratio (HR) for suicide events when taking folic acid was 0.56 (95% CI, 0.48 to 0.65) — which indicates a 44% reduction in suicide events.

"This is a very large decrease and is extremely significant and exciting," Gibbons said.

He noted the decrease in suicidal events may have been even greater considering the study captured only prescription folic acid, and participants may also have also taken over-the-counter products.

"The 44% reduction in suicide attempts may actually be an underestimate," said Gibbons.

Age and sex did not moderate the association between folic acid and suicide attempts, and a similar association was found in women of childbearing age.

Provocative Results?

The investigators also assessed a negative control group of 236,610 individuals using cyanocobalamin during the study period. Cyanocobalamin is a form of vitamin B12 that is essential for metabolism, blood cell synthesis, and the nervous system. It does not contain folic acid and is commonly used to treat anemia.

Results showed no association between cyanocobalamin and suicidal events in the adjusted analysis (HR, 1.01; 95% CI, 0.80 - 1.27) or unadjusted analysis (HR, 1.02; 95% CI, 0.80 - 1.28).

Gibbons noted this result boosts the argument that the association between folic acid and reduced suicidal attempts "isn't just about health-seeking behavior like taking vitamin supplements.”

Another sensitivity analysis showed every additional month of treatment was associated with a 5% reduction in the suicidal event rate.

"This means the longer you take folic acid, the greater the benefit, which is what you would expect to see if there was a real association between a treatment and an outcome," said Gibbons.

The new results "are so provocative that they really mandate the need for a well-controlled randomized controlled trial of folic acid and suicide events," possibly in a high-risk population such as veterans, he noted.

Such a study could use longitudinal assessments of suicidal events, such as the validated Computerized Adaptive Test Suicide Scale (CAT-SS), he added. This continuous scale of suicidality ranges from sub-clinical, signifying helplessness, hopelessness, and loss of pleasure, to suicide attempts and completion.

As for study limitations, the investigators note that this study was observational, so there could be selection effects. And using claims data likely underrepresented the number of suicidal events because of incomplete reporting. As the researchers point out, the rate of suicidal events in this study was much lower than the national rate.

Other limitations cited were that the association between folic acid and suicidal events may be explained by healthy user bias; and although the investigators conducted a sensitivity analysis in women of childbearing age, they did not have data on women actively planning for a pregnancy.

"Impressive, Encouraging"

Commenting for Medscape Medical News, Shirley Yen, PhD, associate professor of psychology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, described the new findings as "quite impressive" and "extremely encouraging.”

However, she noted "it's too premature" to suggest widespread use of folic acid in patients with depressive symptoms. Yen, who has researched suicide risks previously, was not involved with the current study.

She did agree with the investigators that the results call for "more robustly controlled studies. These could include double-blind randomized controlled trials that could "more formally assess" all folic acid usage as opposed to prescriptions only, Yen said.

The study was funded by the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Center of Excellence for Suicide Prevention (US Department of Veterans Affairs). Gibbons reported serving as an expert witness in cases for the US Department of Justice; receiving expert witness fees from Merck, GlaxoSmithKline, Pfizer, and Wyeth; and having founded Adaptive Testing Technologies, which distributes the Computerized Adaptive Test Suicide Scale. Yen has reported no relevant financial relationships.

Reference: JAMA Psychiatry. Published online September 28, 2022. doi:10.1001/jamapsychiatry.2022.2990. Association Between Folic Acid Prescription Fills and Suicide Attempts and Intentional Self-harm Among Privately Insured US Adults <https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2796907?guestAccessKey=9b279b0a-926b-4561-8b55-e943fd904f8e&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamapsychiatry&utm_content=olf&utm_term=092822>