What does it mean that the body holds trauma? Trauma is not what happened to you. It's what happened inside of you in response. And that's exactly what we see in the physiology. When we have experienced a trauma, our body is not getting what it needs to reset to safety. It's almost like it puts on glasses, and these glasses see danger everywhere. You've mentioned brain fog and you've mentioned lethargy, sleep problems, chronic pain. You also talk about migraines and you talk about irritable bowel syndrome. There is so much nervous system regulation behind every physical health symptom, condition and diagnosis. These last lasting effects of trauma start to an endow effect, not just the cells, but our metabolism, our immune system, our digestive system. We have some specific data that will blow your mind. IBS is a result of early childhood experiences where our nervous system would have fluctuated

very quickly between the two survival states.

It's this common theme of,

I didn't know that I was going to be okay.

That is the formation of a biology of trauma

that becomes auto-immunulator on.

What actually is the way to process trauma? Let me show you one of the ones that I would teach them. Hi, I'm Miami-Alic. I'm Jonathan Cohen. And welcome to our breakdown. What if most illnesses can be prevented? If you're struggling with a physical condition, with a mental condition, if you're anxious, if you're languishing, if you've lost your purpose in life, it could be because of something that most doctors will not tell you about. Our guest today is going to explain how eight out of ten of the leading causes of death are because of this. In addition, what if 70% of US adults have experienced something that your average doctor is not even going to be able to understand or explain to themselves much less to you? There's a word that many of us have become very comfortable using and we see it all over the place. Trauma. Trauma. Post-traumatic stress disorder. I have trauma. That traumatized me. I was re-traumatized. What if our understanding of trauma is actually not the entire story? We're going to be speaking today with a functional medicine doctor and specialist in somatic work and in addiction. And what she's going to teach us is that the biological processes that are occurring in your cells are mimicking and in many cases giving indicators of what your larger body processes and emotional experiences are going to be. Dr. Amy Apigen is a double-board certified physician in preventative and addiction medicine, and she has a specialization in biochemistry and public health. And in addition, she specializes in understanding behavioral disorders and how they are related to the cellular processes that underlie what many of us think of as irreversible autoimmune conditions. We're going to talk about irritable bowel syndrome. We're going to talk about menopause. We're going to talk about thyroid conditions. We're going to talk about the process of depression and anxiety and how the cellular mechanisms are actually falling under a larger umbrella that has many roads in. And for so many of us, we've been told there's only one way down this autoimmune road. There's only one way down this mental health road. In fact, it's a lot more complicated and so much of it focuses on safety in your nervous system and things that we've talked about here with Gabor Mate, who wrote the forward to her book, The Biology of Trauma. If you're familiar with the work of Stephen Porges that we've discussed here, Polly Vagal Theory. Her work incorporates that, somatic experiencing the work of Peter Levine. She combines functional medicine with somatic understanding and biological specification so that literally we can start to understand trauma really as a process of life. And we start talking about how to actually begin to heal. Her book, The Biology of Trauma, how the Body Holds Fear, Pain and Overwhelm and How to Heal It is available September 23rd. Dr. Amy also has a podcast, Biology of Trauma, which has every single episode is a little slice of understanding trauma on a biological cellular level. It's a pleasure to welcome to the breakdown, Dr. Amy Apakin. Break it down. Thank you. I am really excited to be here. We're so excited to talk to you about a particular lens on trauma that we find incredibly fascinating. Gabor Mate is a friend of the podcast, and he's been on here, and we see that he wrote the forward for your book, which is incredibly significant. I wonder if you can sort of get us started. Can you explain for people who want to start from kind of ground zero? What do you describe as trauma? And in particular, what is the biology of trauma? It really takes me back to when I thought I knew trauma and I didn't know anything about trauma. I had come through medical school training and been taught about the adverse childhood experiences. And so I had this lens of I'm looking for something bad that happened to you or I'm looking for gross neglect. I became a foster parent and then adopted and my son had been to severe neglect. And so I was looking at it through that lens. But then I discovered in the process that my body was holding trauma. We could maybe go into how I discovered that.

But it was at that point that I realized, wait a second.

I don't know.

I don't really understand what categorizes a trauma for the body. I've been looking at it more just a mental breakdown. What actually creates that trauma. But for the body, it's different. And as a physician, I started seeing all of these chronic health conditions, symptoms, diagnoses that are related to adverse child experiences, but people, including myself, were saying, I don't think my childhood was that bad. I mean, sure, my family had some quirks. But trauma, that would not be a word that I would use. But their body had a different story. So that's when I really went back into the biochemistry of it. I have a master's in biochemistry, so I love this idea of show me what's happening, help me understand how is the cell responding to the stress, what is exactly happening? And that's when I saw actually there is a very specific biology of stress and a biology of trauma and they are very different. And so we can categorize what constitutes a stress for a body and what constitutes a trauma based on the internal experience. Which ultimately is what people have been saying for the longest time. Even Gov. Ramata, one of his famous quotes is, trauma is not what happened to you. It's what happened inside of you in response to something. And that's exactly what we see in this physiology. You know, one of the notions that Vandercock and that, you know, Mate talked about, Peter Levine talks about, and we had him on the podcast talking about it as well, what does it mean that the body holds trauma? I thought that when I adopted my son, that he was out of his trauma, and so he'd be able to move on, he'd be able to have a great life. I had rescued him from the foster care system, And so his life now had a bright future because his trauma was in the past. And what I came to realize was that the body needs specific things in order to repair what's been broken, in order to resolve what still feels incomplete and what still will create patterns of responses. That doesn't go away just when you are done with an experience. It doesn't go away if you move out of your childhood home and a family and toxic environment. It doesn't just go away. It doesn't automatically stay in the past. So this was a big question for me for why does the body hold on? And it's actually the whole second section of my book because I feel it's so important for people to understand this so that we then know what to do. But why does the body hold on? Why does the body keep score? Why do, in the words of Peter Levine and Somatic experience, and why does this charge and this activation and this somatic implicit memory stay here? And it really comes down to the nervous system's role in keeping us alive. And the nervous system is designed to remember things so that it can protect us and predict the future. And it runs an equation in the background. If you've heard Steve, poor just talk about his polyvagal theory, you might know the word neuroception, this idea that our nervous system runs an equation in the background. And that equation is constantly running, even when we're sleeping, even when we're eating, when we're socializing, it's always running in the background. And it's the equation of danger versus safety. And when we have experienced a trauma, our body is not usually getting what it needs to reset to safety, which means it stays in danger mode. And that means that it sees danger everywhere. It's almost like it puts on glasses and these glasses see danger everywhere so that a person can be like my son in a good home now and a stable home. I love him. He has everything that he needs. But he still saw danger everywhere because that was his nervous system had not received the reset to safety. This is actually one of the first things I learned from Peter Lumin in his training is this idea that the body has a response that it needs to complete and we haven't always been taught that. Even in medical school I was not taught this aspect of the body and the nervous system that when it starts a survival response it needs a sense of oh and, and it's over, and a sense of completion. And when it doesn't get everything that it needs to reset to safety, it stays in danger mode, seen danger everywhere. And that is how we bring our past with us. So our past is still our present moment. We're still living the experiences of our past. So beautifully explained. Now my ambiance right there and is supported by by optimizers. 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decrease... day, no questions asked money back guarantee. Magnesium breakthrough is a huge breakthrough to improve hormonal balance, to help with focus, decrease brain fog, improve sleep hygiene overall. Bi optimizers makes it very easy. Jonathan, what do they get when they go to bi optimizers.com slash breaker and use the code breaker? You get 15% off your entire order and a free bottle of massimes. Bi optimizers best digestive enzyme, that'll be added to your order automatically when you use our exclusive code. That's a $20 product free on top of your discount already. This is a limited time offer and while supplies last, you can't get it on Amazon, you can't get it in stores. This offer exists in one place. Our link, our code, that's it. So maybe you were already thinking about it. This is the sign. Go to bioptimizers.com slash breaker. Use the code breaker, grab it before it's gone. Make 2026 the year. You finally start sleeping again. How I want you to go one level deeper? What's happening on a cellular level that is producing this because so many of us, especially if we're on social media, we're seeing trauma this and trauma that and autonomic nervous system this and regulate like this. But you know on a deeper level, not just that we can prove that someone is experiencing trauma versus stress, but you're also proposing that there is a way to understand a cellular mechanism for repair so that we get out of that frozen, terrified, hyper-vigilant state and can try and actually heal trauma. This is one of the things that, for me, excites me the most. And I love to talk about it because it brings in the hope. Trauma can be otherwise a very bleak topic to talk about. And here I am. I'm like, I love to talk about trauma because once we understand what's happening to the celluliv, or it brings in tools that we can use, it brings in levers that we can change the outcome of what has been up until now. Just this is what's going to happen to you. Going back to the adverse childhood experiences studies, these were studies that came out of Dr. Vincent Paletti's work in San Diego at Kaiser working with people who were obese and they were losing weight. And he found that so many of them had these adverse childhood experiences, but it exploded into this huge research project that's now, I mean, papers are still being published all around the world about this idea that what happens when we're younger becomes our adult diseases. And it all comes down to what's happening at the cellular level during a trauma response. It's one of the aspects of how the body holds on to trauma. And when we look at a cell in a microscope, it's like a busy, metropolis city. There is so much that's happening and everything has its proper place and its systems and proteins are being made over here and then they're being shipped over here to get tags and then they're being shipped off to where they're supposed to go based on the tags. It is an incredible metropolis. And in a time of stress, what happens is if you're looking at that microscope and the cell, you'll see that it hunkers down. It hunkers down in a way it's like, we need to be even better. We need to make even more energy. We need to be even more efficient at our processes. And the idea is that if we are in stress there's some type of challenge demand. Maybe it's an actual danger or a threat, but we are hunkering in in order to overcome. That's what happens at the cellular level for stress. But there comes a breaking point. And I don't know how deep you want to go into the physiology. I'll go in, keep going. Go ahead. Because we understand what are the triggers for this crossing of the line. It's the breaking point. And emotionally we can tell that we have a breaking point, but there is a cellular breaking point and that's what creates the emotional breaking point or the psychological breaking point. And what is happening is that we have a sympathetic nervous system that drives the stress response. That sympathetic nervous system is a chain of nerves that runs down our spine and it is releasing adrenaline. Adrenaline is what drives that stress response. People like to say that cortisol is the stress hormone. No, no, no, no, no. Adrenaline is the real hero of the stress response. And depending on the size of danger or threat that's in front of us will depend on the amount of adrenaline that our sympathetic nervous system generates. It's a brilliant strategy. If we only have to jump over a creek in order to be okay, I don't need that much adrenaline. But if I have to scale a mountain to outrun a bear, I need a lot of adrenaline because it's the adrenaline that's going to change the cells in my mitochondria to make more ATP or energy. And so it's responding to the size of the danger with the amount of adrenaline that then changes my cells in my mitochondria. But what happens to that adrenaline? Because adrenaline is actually dangerous. It's so powerful. It's dangerous. Adrenaline damages our tissues. Adrenaline surrounds ourselves to give that signal to go, go, go. And if our cells look at the amount of adrenaline and say, we can't go that far. We can't go that much. We can't up level ourselves to the degree that you're asking us to, then we're going to shut down. So adrenaline is coordinating all of this and it is the signal that says that our body responds to and says, what you're asking me to do, I can't do. I can't give you that level. And if I can't give you that level, I've exceeded my capacity and I'm just going to shut

down. And now this is the trauma biology and you can watch it on the microscope that mitochondria, those cells, they're no longer hunkering down to give us more. They're falling apart. Membranes are falling apart. Proteins are falling, proteins are being sent to our nucleus that are

signaling to send out messages and other proteins that will just decompensate things. And that's interesting enough, what a person feels like emotionally. I was just, so I was just going to say that. I think that's sort of the, you know, for, For those of us of us who love science, what you see, right? The kind of phenotype, right? It's actually just an expression of what's going on on a genetic level, on a molecular level, on a biochemical level. And it's interesting the words that we use to describe this, it's not a coincidence that what the person experiences is exactly that. I feel like I'm breaking down. I feel like I can't do it. But what's more interesting to me is that step before when you talk about the difference between jumping over a creek or scaling a mountain, what do people who are in a deep traumatized or PTSD or complex PTSD state, what do they act like? They act like every creek is a mountain because everything hurts. Everything is too much. Everything is too much to and and other people will look at them and say, it's just a creek, like just step over it. And they're like, I cannot. My legs won't move. I can't do it. I'm going to start crying. And then they'll generate a whole list of other problems with the creek because their body thinks it's a mountain. So one of the other things that people talk about is, you know, like being in this kind of traumatized state or post traumatized state, It feels like you're constantly being pursued by a predator, right?

You have to maintain this state of kind of vigilance. I'm curious like why it's not enough when we see people having trauma and breaking down why that hasn't been enough, right, for people to rally around this kind of support and why it's like we need to know on a cellular level. Yes, it's trauma. Before we go into the solution set, I think there's still a really interesting exploration here about the biology. Talk to us about what it feels like for people who are breaking down on a biological level before they get into a chronic

disease state. And this is what I would wish everyone would know because if we can identify it at this stage, we can prevent so much of the chronic health conditions. People wouldn't need to wait like me to get auto immunity to get chronic fatigue. They'd be able to recognize the signs much earlier and say, oh, my body's needing some serious help. This is now an emergency. Let me take care of it now and not let it progress further. So this idea that there is biology happening underneath the service and what would they feel like? What does that feel like? These lasting effects of trauma

start to now affect not just the cells, but our systems.

So we now move from talking about mitochondria, DNA,

proteins to our metabolism,

our immune system, our digestive system.

We go to system level and that's what's showing up. In our metabolism, the trauma response shuts down our metabolism. In the stress response, it upregulates our metabolism. So there's a very big difference between the body holding on to trauma response

and being in this functional freeze if you want to use that terminology because the impact on the systems is going to be in the background. But what I see happening is that people are so uncomfortable with that sensation of exhaustion.

Depression, hopelessness, that they are finding ways to not feel that, to avoid it, distract themselves, and a lot of times this is coming down to some version of giving themselves adrenaline. That should not surprise us after our conversation about adrenaline, because adrenaline is what can pull someone out of that low trauma state and into the stress where I feel alive. I feel like I have energy. My cells are working for me. Well, so examples of this would be addiction or codependency, workaholism, caffeine, right, all of these risky behaviors, right? Like, I'm okay. I just like to do a lot of cocaine and dance all night, right? You're seeking adrenaline. And to clarify, people are seeking this adrenaline because on a biological level, they're having a slowdown, a shutdown that in the background is impacting them on a system level, meaning that the small points of their cell, they're no longer making energy the way they need to, and so they have to look to an external source to drive their adrenaline in order just for them to feel at a baseline, and if they slow down enough, what they're going to do is they're going to hit a bottom and they're going to say, there's something really wrong. The problem with hitting that bottom is that there aren't really available solutions for them because you're going to go to your Western doctor, they're going to run a panel of tests and they're going to say, you are absolutely fine. There's nothing to look at here. But really what's going on is a huge warning sign. It's a red flag area. Yes. And one way that I describe it is it's like our body is like a machine. So it's like a car. And if you took your car into the mechanic because you're like it's just it's slow. It's slow to start in the mornings. It's slow. I have to put on so much gas to just get it down the road. I didn't have to use to do that. Tell me what's wrong. And he looks at the engine, he looks at the transmission, he looks at the tires, and he's like, everything looks fine, must be in your head. And yet the problem is actually, he didn't check that the emergency break was on. The emergency break is on. That's the equivalent of this trauma response. It's communicated through the nervous system. And in the form of it's changing our whole inner state. It's changing our whole operating system. So it's not that one thing is malfunctioned. It's just the message, the whole operating system is in shutdown mode. And so we're having to come in and give it extra gas to just be able to do what we used to do. One of the things that I hear my people say so often and I even ask for it now because it's such a telltale sign. When you first wake up in the morning, what is your very first thought? And often what they tell me is my first thought, honestly. I don't want to get up. I don't like my life. I don't want it to be morning. I want to just be able to go back to sleep. Knowing our lives and our responsibilities. That is not an option. So if that is not an option, well, then what is your other option? Your other option is let me find the energy to keep going one more day. And so we start our day with coffee. We often are drinking coffee on an empty stomach. Do you know why? That actually creates more adrenaline than if we drink coffee with food. So all of these, I mean it's just a way that our brain has learned how to help us live another day that we don't want to be living by understanding, oh, if I do this, I feel this way and that's what I want. I need more energy. So let me lay in bed so that now I'm stressed because I'm going to be late for work. There's some adrenaline. So people who procrastinate, they're often the ones who have this functional freeze in our story and trauma because they need the adrenaline of having procrastinated to get them to take action and do something. Let's add on the caffeine. Let's add on some sugar for our breakfast.

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