Asked by Mimi
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Hi Class,
The hormone released during the fight or flight response is cortisol. Experiencing high levels of cortisol for a long period of time can cause many issues. Some being, severe depression or weight gain. It can even cause high blood pressure and an increased risk of heart disease. Things that would be considered an ACE would be a dysfunctional home life or physical, emotional, and sexual abuse. It's important to be aware of these because of how early stress can really affect brain development and long-term health. Coming from someone who can attest to how much these things can shape you as a person, I am obviously very empathetic and understanding of patients who have experienced these things. It is important to be calm and not very reactive to people who have experienced ACE. I believe it is detrimental to brain development, and having patience is important. Being able to give patients the right tools to help with the effects is really helpful, like grounding techniques or even being able to give them resources they can use to seek help.
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Answered by
GPT-5 mini
AI
Hi — thank you for sharing this; I appreciate how open and empathetic you are about such a difficult topic.
A small clarification first: the "fight-or-flight" response involves fast-acting catecholamines (epinephrine/adrenaline and norepinephrine) from the sympathetic nervous system and a slower HPA-axis response that releases cortisol. Both systems contribute to the immediate and long-term physiological effects you mentioned (blood pressure, weight changes, mood, cardiovascular risk, etc.).
I agree with your points about ACEs and their long-term impact — early, chronic stress can alter brain development, HPA-axis regulation, immune function, and increase risk for mental and physical health problems across the lifespan. Your emphasis on remaining calm, patient, and nonreactive is exactly in line with trauma-informed care. Some practical things that clinicians and caregivers can use include:
- Brief grounding tools (5-4-3-2-1 sensory grounding, paced breathing, box breathing) to reduce acute dysregulation.
- Skills-based interventions (CBT, DBT skills, mindfulness) and stabilization before trauma processing.
- Screening (ACE questionnaire or trauma-informed intake) and routine, sensitive inquiry about trauma history.
- Referrals to evidence-based trauma therapies when appropriate (trauma-focused CBT, EMDR) and to psychiatric care if medication or complex management is needed.
- Helping patients build safety plans, social supports, and access community resources (hotlines, support groups, case management).
Also keep trauma-informed principles in mind: ensure safety, build trustworthiness and transparency, offer choice and collaboration, empower patients, and practice cultural humility. Your empathy and willingness to provide tools and resources will make a big difference for patients who’ve experienced ACEs.
If you’d like, I can draft a short, patient-facing handout with grounding exercises and local resource links you could share.
A small clarification first: the "fight-or-flight" response involves fast-acting catecholamines (epinephrine/adrenaline and norepinephrine) from the sympathetic nervous system and a slower HPA-axis response that releases cortisol. Both systems contribute to the immediate and long-term physiological effects you mentioned (blood pressure, weight changes, mood, cardiovascular risk, etc.).
I agree with your points about ACEs and their long-term impact — early, chronic stress can alter brain development, HPA-axis regulation, immune function, and increase risk for mental and physical health problems across the lifespan. Your emphasis on remaining calm, patient, and nonreactive is exactly in line with trauma-informed care. Some practical things that clinicians and caregivers can use include:
- Brief grounding tools (5-4-3-2-1 sensory grounding, paced breathing, box breathing) to reduce acute dysregulation.
- Skills-based interventions (CBT, DBT skills, mindfulness) and stabilization before trauma processing.
- Screening (ACE questionnaire or trauma-informed intake) and routine, sensitive inquiry about trauma history.
- Referrals to evidence-based trauma therapies when appropriate (trauma-focused CBT, EMDR) and to psychiatric care if medication or complex management is needed.
- Helping patients build safety plans, social supports, and access community resources (hotlines, support groups, case management).
Also keep trauma-informed principles in mind: ensure safety, build trustworthiness and transparency, offer choice and collaboration, empower patients, and practice cultural humility. Your empathy and willingness to provide tools and resources will make a big difference for patients who’ve experienced ACEs.
If you’d like, I can draft a short, patient-facing handout with grounding exercises and local resource links you could share.
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