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Bullying can have harmful effects on childhood development, and the latest research reveals those detrimental influences may even stretch into adulthood, depending on how victims handle the trauma.

Studies have documented higher rates of anxiety and panic attacks among victims of bullying, and such experiences are increasingly linked to mental health and behavior problems later in life. The latest look at the legacy of bullying reveals its more practical consequences on everything from employment to social relationships.

In the new research published in the journal Psychological Science, a team of researchers from the University of Warwick and Duke University Medical Center studied 1,420 children between the ages nine to 16 who reported being victims of bullying, acting as bullies, or both (bully-victims). They also looked at a children not involved in bullying as a control group. The students were questioned four to six times during the study, and when they were between 24 to 26 years old, they were evaluated on certain psychiatric measures, whether they engaged in risky or illegal behaviors, their wealth, and the status of their social relationships.

(MORE: Lasting Legacy of Childhood Bullying: Psychiatric Problems In Adulthood)

The scientists found that people who were bullied were two times less likely to hold down a job and also had difficulty maintaining meaningful social relationships compared to those who did not experience bullying. The bullied participants also reported having a hard time keeping long term friendships and staying in touch with their parents. Interestingly, the group that admitted to having the most problems with employment and relationships were the bully-victims. Previous work suggested that those who were bullied as children may become bullies themselves; part of the psychological legacy of bullying could include lack of emotional control or healthy coping mechanisms that may perpetuate the harmful behavior. The bully-victims had the highest rates of serious illness and unhealthy behaviors such as smoking.

(MORE: The Relationship Between Bullying and Depression: It’s Complicated)

“The intensity of the emotional pain bullying elicits, and the fact that other people underestimate how much hurt they feel makes being bullied an incredibly traumatic experience that can leave significant emotional scars,” says psychologist Guy Winch, and author of “Emotional First Aid: Practical Strategies for Treating Failure, Rejection, Guilt, and Other Everyday Psychological Injuries.”

And that emotional damage can have painful consequences; some brain imaging studies have shown that the sense of rejection caused by bullying activate the same pathways in the brain linked to physical pain.

(MORE: What if My Son Is a Bully? — What You Need to Know About Bullying)

Such lasting effects of bullying highlight the importance of not only preventing it but helping victims to develop proper coping mechanisms, say experts. The relationships children have at home, for example, can be critical for minimizing the lasting harm bullying can have, and addressing instances of bullying early can also limit profound psychological damage.

According to Winch, addressing four potential harms of bullying can support victims in overcoming the experience and in holding back the negative effects:

Find ways to revive their self-esteem and not descend into shame and self-hatred

Heal from the severe emotional pain

Manage the surges in anger and aggression they are likely to feel, which can directed not only to others but to themselves as well

Restore their sense of belonging to reinforce feelings of being accepted, valued, and loved

“Some people are more resilient and tend to do some of these healing and curative things naturally. They might seek out their close friends and get emotional support from them, and by doing so remind themselves that they’re accepted and appreciated,” says Winch.

For others, however, such strategies may be harder to adopt, and some children may instinctively withdraw and isolate themselves as a way to protect themselves from further rejection. “But by doing so, they leave their psychological wounds untreated and increase their feelings of isolation,” explains Winch. “It is this latter group that is more likely to develop problems that are long lasting.”

When it comes to addressing the effects of bullying, timing is everything, says Winch. As with other psychological trauma, recovery is more effective if healing begins as soon after the damaging experience as possible, before negative and harmful strategies can take hold. While victims of bullying can still heal from this trauma later in life, that path to recovery is far more difficult than finding healthy ways of coping soon after the bullying occurs.