Many adults carry experiences from childhood that still shape how they feel, react, and relate to others. Abuse, neglect, household violence, or a parent’s mental illness or substance use can leave lasting effects long after the events end. Understanding childhood trauma effects in adults can be a turning point, because it helps explain patterns that might otherwise feel confusing or shameful. This guide explains adverse childhood experiences, how they affect mental health, and how adults can heal.
What Are Adverse Childhood Experiences?
Adverse childhood experiences, or ACEs, are potentially traumatic events that happen before age 18, such as abuse, neglect, witnessing violence, or growing up with a household member who had mental illness, substance use problems, or was incarcerated. They also include parental separation or divorce.
ACEs are common. A CDC report using data from all 50 states found that 63.9% of U.S. adults reported at least one ACE, and 17.3% reported four or more. Four or more ACEs were most common among women (19.2%) and adults aged 25 to 34 (25.2%).
Share of adults reporting at least one ACE and four or more ACEs, 2011–2020.
What an ACE Score Means
An ACE score is the total number of different categories of adverse childhood experiences a person reports, and a higher score is linked to a greater risk of health and mental health problems later in life. The CDC notes a graded dose-response relationship between ACEs and negative health and well-being outcomes: the more ACEs, the higher the risk.
An ACE score is a research and screening tool, not a diagnosis or a prediction of your future. Many people with high scores do well, especially with support, and many kinds of adversity aren’t captured by the standard questions. Its main value is helping explain patterns and guide care.
| Category | Examples |
|---|---|
| Abuse | Physical, emotional, or sexual abuse |
| Neglect | Unmet basic or emotional needs |
| Household challenges | Domestic violence, substance use, mental illness, incarceration |
| Family disruption | Parental separation or divorce |
Childhood Trauma and Depression, Anxiety, and PTSD
Childhood trauma is linked to higher risk of depression, anxiety, PTSD, substance use, and relationship difficulties in adulthood, partly because early stress affects how the brain’s threat and stress systems develop. Adults may notice heightened alertness to danger, difficulty trusting others, intense emotions, or a harsh inner critic.
Childhood trauma is especially linked to complex PTSD. A U.S. population study found cumulative childhood trauma was more strongly associated with complex PTSD than with PTSD, and that abuse by caregivers was a key risk factor. Our guide to complex PTSD vs PTSD explains the difference.
What happened to you as a child isn't your fault. How you heal as an adult can be your choice.
Still carrying what happened growing up?
A trauma-informed evaluation can help. By telehealth across South Carolina and New York.
How Childhood Trauma Shows Up in Adult Life
Childhood trauma often shows up in adult life through patterns rather than memories: difficulty with trust or closeness, people-pleasing or fear of conflict, intense reactions to criticism, feeling unsafe even when things are calm, or trouble identifying and managing emotions. Some people have clear memories of what happened; others have gaps.
- Relationships: fear of abandonment, difficulty trusting, or repeating painful patterns.
- Emotions: overwhelming feelings, numbness, or quick shifts in mood.
- Self-image: persistent shame, guilt, or feeling fundamentally flawed.
- Body: chronic tension, sleep problems, or being easily startled.
Share reporting four or more ACEs overall, among women, and among adults aged 25 to 34.
Healing From Childhood Trauma
Healing from childhood trauma is possible at any age, usually through trauma-informed therapy that builds safety and emotional skills and, when ready, helps process painful memories, sometimes alongside medication for depression, anxiety, or sleep problems. Treatment is paced carefully, and you stay in control of what you share.
- Establish safety. Build stability in daily life and a trusting relationship with a clinician.
- Learn coping skills. Practice ways to manage intense emotions and stress.
- Understand patterns. Connect current reactions to past experiences without self-blame.
- Process memories when ready. Work through painful experiences at a safe pace with a trained therapist.
- Build connection. Strengthen supportive relationships over time.
Our guides to PTSD in adults and psychiatrists vs therapists explain the kinds of treatment and who provides them.
Old experiences, current struggles
Depression, anxiety, or relationship patterns that seem tied to what happened growing up.
A trauma-informed evaluation
A careful, paced assessment that connects the past to present symptoms without blame.
Healing at your own pace
Therapy, and medication when helpful, that builds safety, skills, and connection.
Dr. Gabriella Farkas, MD PhD
Board-certified adult psychiatrist with a PhD in neuroscience. Dr. Farkas provides trauma-informed evaluations and coordinates with therapists experienced in trauma treatment.
About Dr. Farkas →When to Get Help
Get help when the effects of childhood experiences, such as depression, anxiety, relationship struggles, nightmares, or using substances to cope, are affecting your life today. You don’t need to remember everything, or be sure what happened, to benefit from care.
A comprehensive adult psychiatric evaluation can help sort out what you’re experiencing and build a plan. Our overview of anxiety and depression together covers common overlapping conditions. If you’re having thoughts of suicide or feel unsafe, call or text 988 in the US, or go to the nearest emergency room.
Key Terms
- Adverse childhood experiences (ACEs)
- Potentially traumatic events before age 18, such as abuse, neglect, or household dysfunction.
- ACE score
- The number of ACE categories a person reports; higher scores are linked to greater health risks.
- Trauma-informed care
- An approach that recognizes the effects of trauma and emphasizes safety, choice, and trust.
- Complex PTSD
- An ICD-11 diagnosis often linked to prolonged childhood trauma.
Common Questions About Childhood Trauma
How does childhood trauma affect adults?
Childhood trauma can affect adults through higher risk of depression, anxiety, PTSD, and substance use, along with patterns such as difficulty trusting, intense emotions, or persistent shame. Early stress shapes the brain's threat systems. Effects vary widely. Many people do well. Treatment helps at any age. You don't have to face it alone.
What are adverse childhood experiences?
Adverse childhood experiences are potentially traumatic events before age 18, such as abuse, neglect, witnessing violence, or living with a household member with mental illness, substance use, or incarceration. They're common. They can affect health later. They're not your fault. Support can reduce their impact. You don't have to face it alone.
How common are ACEs?
ACEs are very common; CDC data from all 50 states show that 63.9% of U.S. adults reported at least one ACE and 17.3% reported four or more. Rates were higher among women and younger adults. You're not alone. Many people heal. Help is available. You don't have to face it alone.
What does my ACE score mean?
An ACE score counts how many categories of adverse childhood experiences you had, and higher scores are linked to greater health risks, but it isn't a diagnosis or a prediction of your future. Many people with high scores thrive. Support makes a difference. It helps explain patterns. It can guide care.
Can you heal from childhood trauma as an adult?
Yes, you can heal from childhood trauma as an adult, usually through trauma-informed therapy that builds safety and skills and, when ready, processes painful memories. Medication can help related symptoms. Healing takes time. You set the pace. Many people improve substantially. You don't have to face it alone. A trauma-informed clinician can help.
Do I need to remember my trauma to get help?
No, you don't need clear memories of childhood trauma to get help; treatment can focus on the patterns and symptoms affecting you now. Memory gaps are common. You don't have to be certain what happened. A good clinician won't pressure you. Care starts where you are. You don't have to face it alone.
Can I get help for childhood trauma by telehealth?
Yes, Dr. Farkas provides trauma-informed evaluations by secure telehealth for adults in South Carolina and New York and coordinates with therapists experienced in trauma treatment. Telehealth can feel safer for some people. You'll need a private space. A device with a camera works well. Follow-ups use the same platform. You don't have to face it alone.
Healing is possible at any age.
Trauma-informed care, at your pace.
Sources
- Swedo EA, Aslam MV, Dahlberg LL, et al. “Prevalence of adverse childhood experiences among U.S. adults — Behavioral Risk Factor Surveillance System, 2011–2020.” Morbidity and Mortality Weekly Report, 2023;72(26):707–715. https://www.cdc.gov/mmwr/volumes/72/wr/mm7226a2.htm
- Centers for Disease Control and Prevention. “Behavioral Risk Factor Surveillance System ACE Data.” CDC Violence Prevention. https://www.cdc.gov/violenceprevention/aces/ace-brfss.html
- Cloitre M, Hyland P, Bisson JI, et al. “ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder in the United States: a population-based study.” Journal of Traumatic Stress, 2019;32(6):833–842. https://orca.cardiff.ac.uk/121658
Educational content only. This article does not constitute medical advice and does not establish a doctor-patient relationship. If you are in crisis, call or text 988 (Suicide & Crisis Lifeline) or call 911. Treatment decisions should be made with a qualified clinician familiar with your circumstances. Last reviewed: September 2026.