Just days before students came back for the new school year this August, Houston Independent School District teachers gathered at Houston Baptist University. They were there learning things like how to better track student data and prepare kids for standardized tests. Mary Young was there to talk to teachers about trauma. Young is a school behavioral-health trainer with Mental Health America of Greater Houston.
“How many kids do you think have experienced any type of trauma, including everything?” Young asks the teachers. “So, we know that over two out of three – so almost every kid has experienced at least one traumatic event in their life.”
Young is an energetic speaker and somehow finds a way to make a very sensitive topic interesting to the dozen or so teachers listening. That’s because she can directly relate. As a kid, Young’s mother lived with bipolar disorder and she neglected and emotionally abused Young. Today, Young is thriving with a family of her own, but she still lives with the scars of childhood.
“Especially when I was a younger adult [it] made relationships difficult because I was … insecure, you know, are you going to stay, are you not going to stay?” she says in a phone interview. “We know that the effects of trauma last throughout our lives.”
We know that primarily because of a landmark study by Kaiser Permanente and the Centers for Disease Control and Prevention – known as the Adverse Childhood Experiences, or ACE study. It was published exactly 20 years ago and was the first study to document the relationship between childhood trauma and the increased risk for things like heart disease, cancer or lung disease later in life.
Dr. Judith Herman is a Harvard psychiatrist who’s studied trauma for decades. She says early trauma can also contribute to mental health problems, and for some, it can be the root of problems like addiction, depression or suicide.
“In the mental health population … they have very high rates of childhood trauma,” Herman says.
Herman says people who were traumatized as children can experience a complex from of post-traumatic stress disorder that’s often misdiagnosed.
“You’ll end up with people with multiple different diagnoses and multiple different medications and treatments that don’t see the forest for the trees,” Herman says.
Herman says that’s probably because their trauma was never discussed.
“They’ll say, nobody ever talked to me about trauma, nobody ever put together that my symptoms are not just because I, for some unexplained reason have borderline personality disorder,” she says. “[They’ve] never had the kind of childhood care that helps children learn to regulate their emotions.”
Many kids who experience trauma move into adulthood without adequate support or tools to deal with its effects. Mary Young says mental health care in Texas is just starting to catch up with people’s needs. She says there’s only a small cohort of mental health professionals in Texas who treat adults with childhood trauma.
“There’s not [a] significant amount of training that you can go to to get that additional skills …. When we’re thinking about even more specialized therapists, you’re then even more so raising the cost,” Young says.
That’s despite just how common childhood trauma is. More than half of the thousands of people who responded to the ACE survey in the late ‘90s said they had at least one adverse childhood experience. That includes sexual, verbal emotional or physical abuse.
Kristina is a social worker and new mom who lives in Kyle. She’s one of two people in this story who we’re referring to only by first name for privacy reasons. Kristina says it took a lot of trial and error – and misdiagnosis – before she got proper help.
“By the time I finally found a counselor who understood, I was able to do many things different. Not be on all the medication for bipolar and be able to actually treat the trauma symptoms,” Kristina says.
Kristina used heroin off and on for years before she found trauma therapy. She says heroin made her feel better for a time, but it was also destroying her life.
“When you have overwhelming symptoms or things that you just can’t cope with or don’t know how to handle, you become willing to kind of do whatever to help. And so whether that means go to treatment or pick up drugs,” Kristina says.
Another reason PTSD from early childhood trauma goes unrecognized is because it doesn’t fit the diagnosis for classic PTSD – that’s the kind we associate with military veterans. Megan, who’s a graduate student in her 30s, was sexually abused by a relative, and both her father and stepfather were abusive and controlling. She says the health-care system is just starting to recognize people like her.
“I, at seven years old was diagnosed with ADD … I did not have ADD. Looking back at my childhood, I’m like, I was sleep deprived, I was sleeping on people’s floors,” Megan says.
Megan says despite the common symptoms shared by trauma survivors, recovery is a very personal process.
“Everything about my childhood says I should die 20 years early. I should have a heart attack or drug addiction or become a hooker …. And so I have to come back to a place of like, what does healing look like for me? What does it look like for me to be successful?” Megan says.
For her right now, it’s pursuing a master’s degree in clinical mental health at the Seminary of the Southwest in Austin.
“I was trying to decide between mental health and priesthood, and I met with someone who said ‘Why not both?’” Megan says.
Helping others seems to be a common path for trauma survivors: Nearly half of the more than two dozen people who participated in research for this story are either mental health professionals themselves or mental health advocates. Kristina, for example, has worked for ten years as a social worker in juvenile justice.
And then there’s Mary Young. Her professional life has been devoted to helping kids.
“I finally had an opportunity to have a safe and secure home, and [was] really shown the love that I had wanted as a young individual. And then went to college and became a social worker to help support kids,” Young says.
Back at the teacher training, Young asked the Houston ISD teachers to say the negative words that came to mind when they thought of mental health. They shouted out words like “crazy,” “unstable,” “space cadet.”
“No wonder we don’t learn about it or we don’t think about them getting treatment because our society doesn’t think this way first,” she tells the teachers. “Really think about how, as a society, can we can erase the mental health stigma?”
That’s a long-term, societal goal, but there are signs of slow improvement now. Seton Shoal Creek Hospital in Austin recently started its RESTORE program, which treats PTSD in adults with trauma. Its Medical Director Valerie Rosen says she also hopes to start a larger trauma-treatment program at UT’s Dell Seton Medical Center.
“I knew we had an untapped need,” Rosen says.
That’s because Rosen says evidence-based treatment programs for PTSD in Texas are mainly for military veterans.
Support for Texas Standard’s ”Spotlight on Health” project is provided by St. David’s Foundation.