I sit down for a heart to heart with Functional Medicine doctor Yousef Elyaman, MD, founder of Absolute Health in Ocala, FL, to discuss how previous physical and emotional traumas affect addiction, habits, and mental health.
Trauma doesn't have to be something grossly horrible. It can be small events that are perceived as trauma.
How genetics, epigenetics, traumas, and emotional state when the trauma is experienced all contribute to mental health issues.
When we talk about mental health disorders, there's a food component and then there's another component that I want to dive into, which is previous trauma component to it. It's interesting because most people don't even recognize that they had some sort of emotional trauma in the past that's triggering their behaviors. Can you go kind of go into how earlier events, whether they're traumatic or not traumatic events really affect how someone is , uh, in the current state?Dr. Elyaman:
Yeah, absolutely. The younger that these traumatic events happen, the more of an impact it'll have on the person. So the, one of the big challenges for me was as a physician, to me, trauma was maybe somebody or something horrible happening, like an accident or many people dying in an accident or someone's limb being ripped off or rape or just something horrible like that. And it turns out that the body processes other events that may not seem traumatic to me and you, but to an individual, which seems traumatic, so you can find that classified as "little t" trauma. So there's "big T" trauma with a capital "T", little "t" trauma. Little "t" can be a divorce, psychological abuse; It could be not feeling like they're getting enough love, like those little things. So there are things that we may not think that are traumatic that are traumatic for that individual. The second point is, is that why is it that some people have a traumatic event happen and they seem completely fine and other people have the same traumatic event and it really affects them? Three components, three things to look at. Number one, genetics: So we have a genetic predisposition to acting a certain way or being effected by these traumatic event events. But that's not the only thing. So it's number one is genetics. Number two is the actual trauma and that you can have compounded trauma. So you can have multiple traumatic events happening in a sequence. Right. So the emotional state of the person when, when that traumatic event happens . So if they are under in that fight-flight state already, if they don't have healthy coping mechanisms and then the traumatic event happens that is very different than someone that is very healthy mentally. And then the traumatic event happens. And then the fourth one, which I kind of threw in and , and, and, and added in there is from, from from a trauma point of view: the support system . So if you don't have a good support system around you, yes. Yeah. No, thank you. So a support system around you. So if a traumatic event happens to me and I don't feel like I can discuss it and talk to anybody and process it and I have to hold in. That's, that's impactful. And what's nuts is you'll find, I mean, it's not really nuts, but what's interesting is you'll find people actually had parents that were supportive, but they didn't know that they could go to their parent or they could go to their friends with that and they felt like some reason they could keep it in and when they keep it and holding it in and not being able to process it is huge. So those are the four things. I know they were all over the place.Dr. Ruan:
Yeah. And maybe I can even add a fifth thing into there is actual physical trauma too in terms of the concussions for example. So I've had nine. Okay. And then I have a gene that predisposes me to Alzheimer's disease called ApoE4. I have one of two copies. And so , after each concussion, the next concussion became much easier. So our brain has a primary mechanism, our immune system of our brain and we call these glial cells and astrocytes. Um, so they go into almost a , a characteristic called the M1 phenotype, which is primed for that reinjury. Now as it turns out , just because there's no head trauma doesn't mean that you can't get a concussion either, right? So t here's secondary trauma, whiplash and stuff like that. And the other thing is sometimes when we eat inflammatory foods, it's also causing the same priming mechanism that are in the brain that's mediated by t hese cytokines that we talk about, mediated by t heir immune system. And so, you know, for me what happened and my story is, you know, about four or five years after my last concussion, I developed a lot of like tics and tremors and stuff like that. And then my short term memory became impaired. And then , um, what's interesting is that the way I spoke was very different. My word, even my word choice is very different. And then I have had a huge lapse in just thinking about, "okay, what am I trying to say here?" And that created, this downward spiral where that trigger me to remind myself that when I first came to America and had a really hard time assimilating. I was a tall Asian kid trying to assimilate into a Mexican American culture because that's the neighborhood I grew in. And then also ultimately going to the American culture cause I was an ESL, "English as a second language." So I actually learned a lot of Spanish first prior to English , um , being in Houston. And so that created a whole downward spiral where I kept thinking going back to that. But I didn't think it was a traumatic for me, but because I developed these neurological symptoms, because I had a lot of these brain trauma, that kind of became a thing for me where my identity was no longer as solid as it was just by reverting back to that. These, do you see that a lot?Dr. Elyaman:
I do. And uh, and I actually want to , I want to talk about that. The trauma of , of leaving that you came from China coming from China to America. And I mean that's traumatic for a child anyway, that's you're displacing their whole environment. Everything kind of changes. But I'm back to traumatic brain injury. Yes, that makes things worse. And actually one of the things that we think happens is that you hit the brain where you hit the head and the brain kind of moves and the brain gets afraid or parts of it gets afraid that it's not getting enough oxygen because it decreases blood flow and those parts of the brain can go into a hibernation state, not a death state. So they hibernate and then the brain doesn't work as well. And when you do certain things to help tell the brain, it's okay, you can, you're not in danger anymore and turn it back on. That can be life changing, but sometimes that never happens and it never gets that signal and it just stays hibernated and it gets atrophied. So then it just stops growing.Dr. Ruan:
That's just not being used. Yeah, that's, that's scary. So what are, what are the tricks to start this process of the healing process to get that part of the brain out of hibernation and gets you optimized.Dr. Elyaman:
from physical trauma?Dr. Ruan:
Uh , from both. Yeah.Dr. Elyaman:
Okay. So from physical trauma, definitely nutrition, exercise, working on your psychological, spiritual state. But exercise will increase blood flow to the brain. So hopefully it will oxygenate you more so it'll give more oxygen to that area. So the brain realize it's okay. And then for some patients, I recommend hyperbaric oxygen. Hyperbaric oxygen is used in America. It's approved for wounds, but it's used in other countries for other things. And basically what happens is that you end up getting oxygen under pressure and then not just your red blood cells, but the water in your blood gets oxygen. And then that now you have all this extra oxygen flowing to that area of the brain so it can wake up. So that's , that's physical trauma, psychological trauma. There's different types of mind-body trauma work that can be done. And I would say one of the biggest things to do is to get comfortable , learn how to get comfortable with being uncomfortable.Dr. Ruan:
What does that mean?Dr. Elyaman:
Okay, so what happens is, is that usually here's, here's the problem with trauma. Trauma will lead to the way that we react to our environment. So if you had a lot of physical trauma, if you had a parent that was physically, let's say, physically abusing, then what happened is, now that child kind of learns that at any second. The people that should be taking care of them can harm them, right? So what the so, so that some kids will end up physically fighting back, which usually that's like a death sentence, but some will physically fight back no matter what. And if the parent doesn't take it too far, when they're older, they're always angry and they're always going to that anger state and always go into that fight back state. But when you get angry, that's a form of flight. So the other thing that they can do is they can freeze. That child could freeze up. And when they freeze up, it's also a defense mechanism because if you have this overwhelming force, then your body freezes up and hopefully who or whatever is giving you that trauma will get bored and leave you alone. And then the third thing is flight: running away. So now that, that, that grown man or grown woman that's went through that trauma as a child is now an adult. Right now something happens and they feel uncomfortable. Maybe, maybe too many stressors and not enough stress mechanisms. Okay. Maybe, maybe something happens where, where somebody says something and it makes them feel insecure. Somebody says something that angers them and they don't feel right. They don't feel comfortable, they don't feel happy. What happens is instead of just sitting and in that emotion and feeling that negative emotion, cause negative emotions have benefit as well, right ? So instead of feeling that negative emotion, if somebody dies and it's sad, so they feel that, so then they go to their go-to switch so they could, they could pick a fight. So that goes, that's going into fight.Dr. Ruan:
So that's learned from the previous trauma.Dr. Elyaman:
Yes, learned from the previous ones. So when you're sad and you flip it to anger, sometimes anger feels better than said, especially sometimes gender stereotype, man, it's not okay for them to be sad. They have to be tough, right? Everybody's different. But that's kind of, that's kind of one of them. Or if they froze up, now that person just freezes up, right? And then: flight. Now, the interesting thing about flight or running away, you can mentally run away and freezing up is a way of mentally running away. So how can you mentally run away? You can eat food and when you eat food, your body releases different neurotransmitters that make you feel better. You can play a video game for hours and hours and hours. You can get caught up in work. That's, that's a form of flight. And actually fight is a form of flight too , because you're not dealing with the feeling of the issue. You're running away from it. So that's why I'm saying what you really want to do is learn how to be comfortable with being uncomfortable. Learning how to sit there and to feel it and to analyze and to not make, learn your body to where you're not making major life decisions. You're not picking a fight with your loved one. To where you're able to sit, you're able to breathe through it. You're able to hold it and feel it and not run away from it. Because when you run away from it, it becomes bigger, right? That shadow gets bigger. But if you face it on and you say, okay, what am I feeling? And you honor that feeling. It dissipates.Dr. Ruan:
Right! So it's like the old saying that "you can't teach a dog new tricks". You can, as long as the dog's willing to accept the new tricks coming in and not behaving from a previous primed mechanism as a puppy. So in animal training, which I took courses on that. When my two dogs were puppies. That's part of the deal is that as you bring your puppies up, make sure they're open to a lot of experiences and it become frightened about something. Make sure the dog knows it's okay to be frightened and they move on. And so , um, it's funny cause it kind of developed with my kids. My kids are three and five currently and so, you know, everything that they feel like it's a fighting experience, we talk through it and it makes them hates under, it's okay to cry. It's okay to whatever, which is very opposite of my childhood growing up in China was very different. Um, where, you know, I was a very, very large kid and I'm still a very large kid, but I was an exceptionally large kid. I broke the record for the longest and heaviest baby in the medical school system that I was born into. And because of my size, my grandmother told me that my job, you know, me as a three year old is to be a man and for me to not show emotion to be this strong because you're built like an ox. So your mind has to be like an ox. Right. Which that is uh, that created a lot of expectations for me as a kid. And that cascaded into very unachievable expectations for myself as an adult. And then so all of a sudden I'm in that flight stage where I have, oh, :I have to do this, I have to do this, I have to conquer this" and almost be a perfectionist in some standards. But at the same time , if it doesn't achieve the way I want to, I go back into reverting that trauma as a child in flight for me . You know.Dr. Elyaman:
What's interesting is so that traumatic event happened, which led you do who you are today and now look at societal benefit. You are successful in your practice. You're an author of two books, you've influenced large amounts of people so there is a benefit of that trauma. But what ends up happening is, and what I would often see that's happening, and I know you've done a lot of your work as well, your own personal work. But, what can happen is that everybody looks at you and sees this extremely successful person, but inside it's not enough. O r you're an author, right? A nd it makes you stand apart from how many people? How many people are not authors, what percentage of the population are authors? You're a physician. You're, you are an internet sensation, right? So all of these people that you're influencing, but inside, at some point, if you don't do your work, you can't, you won't be able to turn it off. So trauma, t here i s a benefit to i t. Y ou n eed t o drive. If nobody has any type of trauma in their life, if they have nothing bad ever happens, and they always get what they want, not challenged. If they're not challenged, then what's the point?