I’m an adult now, why is this back? Sexual Trauma Part 2.

I cannot explain the pain I have witnessed over the years as patients have recounted past experiences that occurred years or even a half-century ago. Conversely, it is truly a beautiful, almost spiritual experience watching someone heal from the pains they have carried. Often many of these pains are carried having never been discussed with anyone prior, and then sometimes never acknowledged by those who actually knew. It truly shows the depth of destruction that occurs when such things happen when we are young and frequently that destruction may not be evident or begin to destabilize and dysregulate until decades later.

A large body of research has shown that early-life sexual abuse can create lasting effects on mental and physical health. Even if many years have passed, it’s not unusual for certain experiences or life changes to bring old traumas back to the surface. Below is an overview of why this happens and how these issues can appear and reappear in adulthood.

Pictures, reunions, children reaching the age you were when the abuse occurred, and everyday triggers—like certain sights, sounds, or smells—can suddenly stir up old wounds that are frequently unhealed. It’s common to feel confusion or emotional dysregulation in these moments. Society often portrays “strength” as no longer being affected or simply forgiving the abuser, and while these can be meaningful steps, they don’t necessarily signify deep healing. The same can be said of previously going through therapy, having therapy does not equate with healing. True healing involves self-compassion for who you are now and gentle understanding for the person you were back then. Processing the impact with this framework is key and very often professional help is needed.

1. How Childhood Trauma Affects Adult Mental Health

One of the key insights from trauma research is that negative experiences in childhood—such as sexual abuse, physical abuse, or neglect—are linked to higher risks of mental health conditions in adulthood. These can include depression, anxiety, post-traumatic stress disorder (PTSD), and substance use disorders. Studies consistently show that the more adverse childhood experiences a person has, the greater the likelihood of later problems.

Importantly, the impact often goes beyond mental health and extends to physical health issues like heart disease, diabetes, and chronic pain. This wide-ranging effect highlights how deeply trauma can shape a person’s life, both emotionally and physically.

2. Changes in the Brain

The Role of the Hippocampus

Early trauma can affect parts of the brain responsible for memory and emotional regulation, such as the hippocampus. When the hippocampus is disrupted, it can become more difficult to properly store or process memories, which helps explain why some survivors experience partial or fragmented recollections of abuse. These memories may stay buried for years and then surface suddenly when triggered by current events.

The Role of the Amygdala

The amygdala, another key area involved in handling fear and strong emotions, may become overly reactive due to childhood abuse. This heightened sensitivity can lead to intense responses even in safe situations, contributing to ongoing anxiety, mood swings, or a chronic sense of being “on guard.”

3. Epigenetics: When Experience Changes Gene Expression

Epigenetics is the study of how certain experiences, including traumatic events, can influence the way genes are expressed—without changing the underlying DNA. This means that trauma can “switch on” or “switch off” certain genes related to stress and emotion regulation, potentially increasing a person’s risk for conditions like PTSD or depression. While the genetic code itself remains the same, the way the body reads and responds to that code may be altered.

Researchers have found that these epigenetic changes often revolve around how the body manages stress hormones. For instance, if someone endures repeated or severe trauma, their biological “stress response system” may become overly sensitive. Over time, this can leave them prone to heightened anxiety, difficulty calming down after stressful events, and a greater tendency to develop trauma-related disorders.

4. The Body’s Stress Response System

The body’s stress-response system, often referred to as the HPA axis (hypothalamic-pituitary-adrenal axis), is designed to help us cope with threats by releasing hormones like cortisol and adrenaline. However, in individuals with a trauma history—especially from childhood—this system can become stuck in overdrive. This leads to a lingering “fight or flight” mode, even when no immediate danger is present.

Living in this chronic state of alarm can affect nearly every aspect of health. People may experience constant restlessness, sleep difficulties, and a heightened awareness of potential threats. Over the long term, excessive stress hormone production can also harm the body’s immune system, making survivors more vulnerable to infections and chronic illnesses.

5. Why PTSD Can Appear Later in Life

Not all survivors of childhood sexual abuse display signs of PTSD right away. In many cases, symptoms can remain hidden—or remain mild enough to be overlooked—until a significant event in adulthood triggers those buried memories. This trigger could be a relationship challenge, the birth of a child, or even everyday pressures that echo certain aspects of the original abuse.

Such triggers can stir up old emotional wounds, sometimes leading to flashbacks, nightmares, or a sudden overwhelming sense of fear. It’s not uncommon for survivors to feel blindsided when this happens. However, understanding that PTSD can “wait” until adulthood before fully manifesting can help individuals recognize what’s happening and seek appropriate support.

6. Parenting and Reawakened Trauma

Becoming a parent, especially when a child reaches the age at which the parent was abused, can powerfully reactivate unresolved trauma. On an emotional level, parents might find themselves reliving aspects of their own childhood, whether consciously or unconsciously. Day-to-day caregiving demands—changing diapers, managing tantrums, and providing emotional support—can dredge up forgotten memories or intense emotions tied to the past.

These experiences can be unsettling and may lead to increased anxiety, mood swings, or a sense of being overwhelmed. On a positive note, this reawakening can also open the door to new insights and healing. By seeking therapy or support groups, survivors can learn healthier coping mechanisms, break unhealthy family patterns, and build more nurturing environments for their children.

7. How Trauma Can Be Passed to the Next Generation

Trauma can affect families in more ways than direct abuse. Children of survivors may be influenced by the emotional patterns their parents learned during childhood, picking up on heightened fears or certain ways of relating to others. This can happen through everyday interaction, where children observe and mimic their parents’ behaviors, stress responses, and coping styles.

Additionally, emerging research in epigenetics shows that trauma-related changes in gene expression can be passed from parent to child. This might mean that even if a child is not directly abused, they could still show some of the same stress-related tendencies as their parent. Recognizing this cycle is a vital step in ending it: with therapy, self-awareness, and supportive relationships, families can break free from the lingering effects of trauma and begin to heal across generations.

Conclusion: Understanding Pathways to Healing

The resurfacing of trauma in adulthood is not a sign of personal failure or weakness. Rather, it reflects the way our brains and bodies store and process painful experiences. While these effects can feel overwhelming, many evidence-based treatments—including talk therapy, trauma-focused therapy, and mindfulness approaches—can help survivors work through difficult memories and regain a sense of control.

Recovery is a process that requires patience, self-compassion, and, often, professional support. Recognizing that trauma can influence both the mind and body in long-lasting ways is the first step toward moving forward. By understanding the roots of these struggles, survivors can approach their healing with empathy for themselves and confidence that real change is possible.