Trauma: The Lasting Imprint on Body and Mind

For decades, medicine has focused on treating the symptoms of disease. While this approach has been highly successful for many acute diseases, chronic diseases develop slowly over time, and adverse life events that often are the root cause of the presenting symptoms are often overlooked. However, overwhelming evidence shows that we must look deeper; into the wounds of trauma as a major risk factor for our most common diseases.

Unaddressed trauma is now recognized as a hidden cause of many preventable illnesses. The UCSF Center to Advance Trauma-informed Health Care notes that it contributes to eight of the ten leading causes of death, including heart disease, cancer, stroke, diabetes, suicide, and overdose.

The landmark CDC–Kaiser Adverse Childhood Experiences (ACE) study revealed that early abuse, neglect, or household dysfunction set the stage for toxic stress or allostatic load, which is the chronic physiological strain that disrupts the homeostasis of one’s mind and body. According to this study, children with four or more early adverse experiences are 2–2.3 times more likely to suffer from stroke, cancer, or heart disease, 5 times more likely to develop major depression, and 37 times more likely to attempt suicide as adults.

“Each additional childhood trauma increased the odds of having short telomeres by 11%.”

Research confirms that while the conscious recollection of early trauma may dissipate into the background, trauma’s physiological imprint does not fade with age. A UCSF-led study found that persistent poverty through early and mid-adulthood predicted weaker memory and slower processing speed by age 50, suggesting that a history of adversity in the form of early trauma is an important pathway to early cognitive aging.

At the cellular level, chronic stress accelerates aging. In a nationally representative study, Puterman and colleagues showed that cumulative adversity, especially in childhood, was linked to shortened telomeres, the protective caps on chromosomes that regulate cell aging. Each additional childhood trauma increased the odds of having short telomeres by 11%, indicating a biological pathway to disease risk later in life.

A UCLA-led study found that individuals with a history of early life adversity showed disruptions in the brain–gut–microbiome system. Specifically, trauma was linked to lower levels of key gut-regulated metabolites including glutamate and altered connectivity in brain networks involved in stress and emotion regulation. These changes were strongly associated with higher symptoms of anxiety, depression, and perceived stress in adulthood.

“Trauma is not the external event itself but what happens inside you as a result of what happens to you.”

This past week I attended the Integrative Medicine for Mental Health – (IMMH) 2025 Conference in San Diego, California. It was here that I learned that trauma is pervasive in our society and is often ignored by medicine and psychiatry. Famous author and lecturer Dr. Gabor Maté gave a keynote presentation at the conference to an enthusiastic audience. He defined trauma not as the external event itself, but “what happens inside you as a result of what happens to you.” He emphasized that trauma can wound children and ripple across generations.

Trauma can even begin before birth. UCSF researchers have shown that maternal stress hormones can shape fetal development, increasing risk for future disease even in utero. As Dr. Maté has observed in both his clinical work and personal life, trauma that goes unresolved doesn’t simply disappear with time, even though it often fades from explicit memory. It influences how people feel about themselves, how they react to stress, the relationships they form, and the chronic illnesses they may develop. As he famously puts it: “Don’t ask why the addiction, ask why the pain.”

“The CDC estimates that preventing ACEs could avert up to 1.9 million cases of heart disease.”

The costs of trauma ripple far beyond individual suffering. The CDC estimates that preventing ACEs could avert up to 1.9 million cases of heart disease and 21 million cases of depression nationwide. Economically, ACEs and their consequences cost hundreds of billions of dollars each year in healthcare spending and social services.

This burden is not distributed equally. Low-income and marginalized communities face higher exposure to adversity, from racism and violence to financial hardship and housing insecurity. These structural traumas compound biological ones, driving health inequities.

“The good news is that healing is possible.”

The good news is that healing is possible. UCSF’s Child Trauma Research Program is investigating interventions that support parents and children together, such as Child-Parent Psychotherapy, which may reverse biological markers of adversity and change a child’s developmental trajectory.

In adult care, trauma-informed models, spearheaded in UCSF’s Women’s HIV Program, show that creating safe, supportive environments can improve outcomes in depression, substance use, chronic pain, and even immune regulation.

“For me, this is not just abstract science; it is personal.”

For me, this is not just abstract science; it is personal. Growing up, I witnessed gang violence and the trauma inside my home. I didn’t fully understand the weight of those experiences until much later. Reading Dr. Mayer’s The Mind-Gut Connection was the first time I realized how trauma leaves an imprint not only on the mind, but also on the body, shaping stress responses, risk of chronic disease, and long-term health.

That realization was both painful and liberating: painful in recognizing how much my past had shaped me but liberating in knowing that these patterns are not permanent. Becoming conscious of past personal traumas, and learning behavioral strategies to avoid automatic responses to everyday stressors and cope with them in an adaptive way are key steps everybody can take to mitigate the risks of adult mental and physical diseases.