Do Severe Psychological Traumas Have Long-Term Negative Effects on Physical Health?

Dr. Salih Murat Paker - Clinical Psychologist - Psychotherapist

According to the psychotraumatology literature, the long-term (20+ years) visible psychological effects of severe psychological traumas that are not instantaneous but have persisted over a period—such as genocide, war, and torture—tend to diminish significantly for most survivors. However, their negative impact on physical health is striking and well-documented. These effects are explained through mechanisms such as chronic stress, dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, and systemic inflammation. If we summarize the most common long-term effects of severe psychological traumas on physical health:

1. Cardiovascular Diseases

• Increased risk of hypertension, heart disease, and stroke
• Studies on Holocaust survivors and war veterans show higher rates of coronary artery disease and stroke.
• Chronic activation of the autonomic nervous system (ANS) and HPA axis dysregulation leads to increased cortisol and pro-inflammatory cytokines, which are linked to cardiovascular conditions.

2. Metabolic Disorders

• Higher prevalence of Type 2 Diabetes and Metabolic Syndrome
• Trauma exposure is linked to insulin resistance, abdominal obesity, and metabolic dysregulation.
• Holocaust survivors have been found to have a higher risk of diabetes and metabolic dysfunction in old age.

3. Immune System Dysregulation

• Chronic trauma exposure leads to systemic inflammation, reducing immune efficiency.
• Higher prevalence of autoimmune diseases such as rheumatoid arthritis, lupus, and inflammatory bowel disease (IBD).
• Increased risk of chronic infections and impaired wound healing due to immune suppression.

4. Neurological Disorders & Neurodegeneration

• Severe trauma is linked to cognitive decline and dementia, particularly Alzheimer’s disease.
• PTSD-related hippocampal atrophy contributes to memory deficits and cognitive dysfunction.
• Greater prevalence of chronic pain syndromes, migraines, and neurological disorders.

5. Gastrointestinal Disorders

• Higher rates of Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD)
• Chronic trauma and stress are linked to altered gut microbiota, increasing susceptibility to GI disorders.

6. Respiratory Disorders

• Studies have found increased rates of asthma, chronic bronchitis, and COPD in individuals with severe trauma histories.
• Holocaust survivors have higher rates of chronic respiratory diseases, possibly due to prolonged stress exposure altering immune and inflammatory responses.

7. Cancer Risk

• Higher rates of certain cancers, including breast, lung, and colorectal cancer, have been found in trauma survivors.
• Chronic inflammation and immune dysregulation are key mechanisms.
• PTSD has been associated with shorter telomeres, a marker of accelerated aging and cancer risk.

8. Accelerated Aging & Increased Mortality Risk

• Trauma survivors show biological aging markers (shorter telomeres, epigenetic changes).
• Increased all-cause mortality, mainly due to cardiovascular diseases and metabolic disorders.

9. Chronic Pain & Musculoskeletal Disorders

• Fibromyalgia and chronic widespread pain syndromes are more common in trauma survivors.
• Increased rates of arthritis, osteoporosis, and chronic back pain.

10. Sleep Disorders

• Higher prevalence of chronic insomnia, nightmares, and sleep apnea.
• Sleep disturbances exacerbate cardiometabolic and immune dysfunctions.

Mechanisms of Physical Health Deterioration

• HPA Axis Dysregulation → Chronic cortisol imbalances contribute to inflammation, metabolic disease, and immune dysfunction.
• Autonomic Nervous System Hyperactivation → Leads to hypertension, heart disease, and chronic pain.
• Epigenetic Changes → Trauma can alter gene expression related to stress regulation, immunity, and aging.
• Chronic Inflammation & Oxidative Stress → Linked to most chronic diseases, from heart disease to neurodegeneration.

Conclusion

The long-term effects of severe psychological traumas (war, torture, genocide) on physical health are profound and widespread. Therefore, it is essential to implement psychological and physical health services holistically for trauma survivors. Even in cases where trauma survivors do not exhibit dramatic psychological difficulties, addressing underlying chronic stress-anxiety mechanisms through integrative psychotherapy approaches is crucial for preventing or mitigating long-term physical health problems.

Turkey, unfortunately, is a country of traumas. During the September 12, 1980 period (a 3-year-long military dictatorship) alone, around one million of our citizens were detained for political reasons, almost all of whom were subjected to torture, while tens of thousands spent years in prison under conditions akin to concentration camps. When we consider the ongoing armed conflicts since the 1970s, acts of violence, massacres, tens of thousands of murders, forced village evacuations, and severe negligence leading to disasters like earthquakes, fires, and floods that repeatedly reach catastrophic levels—all together, millions of our citizens have been subjected to severe psychological trauma. As a society, we pay the physical health costs of these traumas every day, often without realizing it. It is like the curse of a socio-political system that perpetually generates trauma…

#trauma #psychotraumatology #physicalhealth #genocide #war #torture

 

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