When trauma shows up in the body: Physical symptoms in adopted children

For many adoptive parents, the first sign that something is wrong is not emotional at all. It's physical. It starts with stomach aches that appear most mornings before school. Headaches that arrive in the late afternoon and vanish by bedtime. Nausea that has no obvious trigger. A child who complains of feeling unwell so often that parents begin to question whether they are missing something serious, or whether they are being overly cautious. Medical appointments follow. Blood tests are taken. Food is ruled out. Sleep is adjusted. Screens are reduced. Doctors reassure. Nothing concrete is found. And yet the symptoms continue, often in cycles, often intensifying at certain times and easing at others. For many adopted children, trauma does not first appear as fear, sadness, or anger. It appears as a body that hurts, resists, reacts, or shuts down.

Why does trauma so often bypass emotion and show up physically?

Emotional awareness is not something children are born with. It develops slowly, through thousands of early interactions in which an adult notices a child’s distress, responds to it, and gives it meaning. A baby cries, and someone comes. A toddler trembles, and someone holds them. Over time, sensation becomes emotion, and emotion becomes language. When those early experiences are disrupted by neglect, stress, loss, or inconsistency, that process can stall. Sensations are still felt, but they are not translated into named emotions. The body remains the primary place where distress is experienced.

This is why some adopted children do not say “I feel anxious” or “I feel scared.” They say “my tummy hurts,” “I feel sick,” or “I’m tired.” These are not evasions. They are accurate descriptions of what is happening internally. Parents often notice that when they gently ask what is wrong, the child genuinely does not know. There is no story, no clear cause, just discomfort. The body is carrying what the mind has not yet learned to organise.

Are trauma-related physical symptoms really “all in a child’s head”?

This question often appears quietly, usually after months or years of medical reassurance. Parents may not say it out loud, but they begin to wonder whether anxiety, avoidance, or habit is playing a role. The reality is more complex. Trauma alters the chemistry of the body. Stress hormones such as cortisol and adrenaline affect almost every system, including digestion, muscle tone, immune function, and pain sensitivity. When these hormones are released too often or remain elevated for long periods, the body does not return easily to baseline.

A child who has spent long periods in a state of alertness may carry tension without being aware of it. Muscles stay slightly braced, breathing becomes shallower, and the body rarely fully settles. Over time, this ongoing strain can show up as headaches, not because of an underlying neurological condition, but because rest has never quite become the body’s default.

The digestive system is particularly sensitive. Many parents notice that stomach pain appears without warning, disappears during weekends or holidays, and then returns during school weeks. This does not mean the pain is imagined. It means the gut is responding to internal stress signals the child cannot articulate. The absence of medical findings does not mean the absence of pain. It means the pain is coming from regulation, not disease.

Why do sleep problems so often sit alongside physical symptoms?

Sleep is one of the first places trauma shows itself, and one of the last to recover. For a body that learned early to stay alert, sleep requires a leap of trust. Darkness, quiet, and separation from caregivers can all feel subtly threatening, even when a child insists they are not afraid. The body does not always agree with the words. Parents often describe long settling times, frequent night waking, or children who wake early already tense and irritable. Some children resist bedtime without being able to explain why. Others fall asleep quickly but wake repeatedly through the night.

Poor sleep amplifies physical symptoms. A child who has slept lightly is more likely to wake with a headache, feel nauseous in the morning, or become overwhelmed by small frustrations. Over time, sleep deprivation and physical discomfort begin to feed into one another, creating a cycle that feels hard to break.

Why does my child seem to get ill at emotionally loaded times?

Many parents notice patterns long before they understand them. Symptoms spike before school. They worsen around birthdays, holidays, or contact arrangements. They appear just before trips, family gatherings, or changes in routine. The child may insist nothing is wrong. They may even seem excited about what is coming. And yet their body reacts as if under threat. Emotional stress does not need to be conscious to affect the body. Anticipation alone can activate stress responses. The immune system becomes less efficient. Inflammatory processes increase. A minor virus becomes a full illness. Over time, parents begin to recognise that timing matters. The body is responding to emotional load that has not yet found a psychological outlet.

What does it mean when a child says “I feel sick” instead of “I feel scared”?

For children whose early experiences were overwhelming or unpredictable, emotions are often experienced first as sensation. Fear may register as nausea. Anxiety may feel like pressure in the chest or pain in the stomach. Overwhelm may appear as exhaustion or dizziness. When adults push for emotional explanations too quickly, children can feel confused or pressured. They are not withholding insight. They genuinely do not experience their distress in emotional language yet.

Some parents notice that when they stop asking “what are you worried about?” and instead respond to the physical experience - rest, warmth, slowing down- the child becomes calmer more quickly. Emotional understanding often follows later, once the body feels safer. Listening to the body is not avoidance. It's often the first step towards emotional integration.

Should physical symptoms still be medically investigated?

Yes. Always. Trauma-informed understanding should never replace medical care. Physical symptoms deserve proper assessment, and parents are right to pursue answers. What changes is what happens after serious illness has been ruled out. Repeated normal results can leave families feeling stuck. Parents may worry they are overreacting, while children feel unheard. The risk at this point is dismissal. A more helpful stance is one of dual recognition: we have checked your body carefully, and we also know that bodies can react strongly when things feel hard inside. This keeps the door open to care, rather than closing it with reassurance alone.

Why does reassurance rarely make these symptoms disappear?

Reassurance often falls short because it speaks to understanding, while these symptoms sit deeper, in the body itself. Being told that everything is fine does not immediately change how stress hormones behave, how muscles hold tension, or how digestion responds. What makes a difference instead is what happens repeatedly and quietly: being met, being soothed, being allowed to slow down.

Over time, parents often notice small changes rather than sudden improvements. A headache appears less often. A stomach ache passes more quickly. Sleep stretches a little longer before disruption returns. These shifts can be easy to overlook, but they matter. They reflect a body beginning, gradually, to loosen its grip on constant protection. Healing rarely arrives all at once. More often, it shows up as a softening that builds with time.

A body that learned early how to survive

Physical symptoms in adopted children are not signs of weakness, exaggeration, or poor coping. They are signs of adaptation. A body that learned early to protect itself does not immediately stop doing so when circumstances improve.

When parents understand this, the question shifts. Instead of asking why a child keeps feeling unwell, they begin to ask what the body has learned to expect. For many families, that shift changes everything. It replaces frustration with curiosity, and urgency with patience. The body is not broken. It's doing exactly what it learned to do.

And with enough safety, it can learn something new...

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Any questions on this topic please don't hesitate to get in touch.

The Walk Together Team