Can cptsd affect metabolism?

[zen_racer]

The more I read about this, the more it seems incredible (in a bad way) how much cptsd can affect in our lives.  I've commented previously about doing 200 sit ups every other night when I was a pretty young kid.  I'm wondering if doing that much exercise at too early of an age, plus being hyper vigilant and activated all the time could cause the metabolism to get crazy fast.

Maybe I am just a freak in this regard, and I'm not really expecting that trauma caused the issues I've had most of my life.  I'm just curious.  But I'm about 6 feet tall, I'd say decently fit.  I weighed 190 pounds before I got sick with my gallbladder (have had multiple issues from this, but better now finally).  But that's just to have a frame of reference.  When I graduated from high school, I was almost this tall, but only weighed 120 pounds.  My body fat was tested, and it was absurdly unhealthy.  I was at 0.5% body fat.  I got cold so easily that I'd wear a jacket in 100+ degree days because if I started sweating and a breeze hit my skin, I'd cool off so fast I'd start shivering and turn blue.  I've always gotten cold easily.  I'd have trouble eating enough in a meal, but I had to eat almost constantly throughout the day, or take medicine to calm down my stomach acid.  There were a few years where I'd eat as large of a meal as I could right before bed, and would still wake up starving in the middle of the night and have to eat another meal.  If I didn't get to eat within about 15 minutes of getting hungry, I would get sharp stabbing pain in my stomach from the acid eating away at my stomach lining.

I've never gotten any explanation from doctors about why my metabolism was so fast, just that it was much faster than a fast metabolism.

I almost wonder if there's more about the trauma from childhood that would explain why I couldn't eat enough that I just don't remember.  I'm either dissociating again, or I'm too tired from ignoring self care like going to sleep early enough.

[NarcKiddo]

If you haven't come across Bessel van der Kolk's book "The Body Keeps the Score" it's worth a read. Also Gabor Mate's "When the Body Says No".

[zen_racer]

I'm struggling to wrap my head around this.  I will check out that book, but in the mean time, I've done some more searching on this.  I asked one of the AI web searches if exercising too much at too early of an age and hyper alertness and hyper vigilance from untreated trauma could lead to a metabolism faster than normal.  The answer I got and have seen on various sites is yes, it can absolutely cause hypermetabolism.  In almost all of the things I've read, it talks about it as if it is normally caught and lasts for days, weeks, or maybe months.  It has been a constant source of pain and problems nearly my entire life.  My appendix and gallbladder failures might have been caused by this.  The trauma didn't just steal my mental health, it stole my physical health too.  I even used to get yelled at because of the issues I had with this.  I'd be punished and not allowed to participate in family events because of the side effects of the trauma they caused.  I'm getting so angry towards my family, towards the doctors that never did anything.  Everything about how I used to act, and now apparently even my appearance of being starved were all signs of severe trauma, and no one ever questioned it. 

"Hypermetabolism is defined as an elevated resting energy expenditure (REE) > 110% of predicted REE.[1] Hypermetabolism is accompanied by a variety of internal and external symptoms, most notably extreme weight loss, and can also be a symptom in itself, being generally caused from severe trauma, leaving the body in a state of constant energy deprivation."

I don't even know what to do with this or how to process it.  I am getting more and more angry towards the people that caused all this.  This last part makes me feel like giving up on trying to get better, like there's not much of a real life left worth fixing.

I reached out to the friend that said he'd listen.  He's on his way here.

[dollyvee]

The other day I asked our good friend AI if there was any scientific evidence to support Gabor Mate's claims and it said yes and no. To me, like the AI summary, there is a lot of overreach and causality that trauma can be the sole source of everyone's physical problems. To me, I think it's an effective explanation that makes one feel good about having answers to where they are at now. What I also find interesting is that one of the sources linked, it talks about Mate being a contemporary counterpart to Jordan Peterson. I think it's helpful to maintain the frame of reference that these ideas are happening in a time and place with Peterson at one end of the spectrum and Mate at another. Again, to me, what is important is to what extent the evidence exists to support all these claims, and is not just an idea to give one emotional comfort, which can then lead to misinformation. Again, just my two cents. dolly

Yes — but with an important distinction: some of Gabor Maté's core ideas are broadly consistent with mainstream psychology and neuroscience, while many of his stronger claims go well beyond what current evidence can reliably support.

A fair summary is:
* Well-supported: trauma and adverse childhood experiences can strongly affect mental and physical health, including addiction risk.
* Partially supported but debated: trauma as a major contributor to ADHD, chronic disease, or most psychological suffering.
* Weakly supported or controversial: claims that trauma is the primary root of nearly all addiction, ADHD, autoimmune disease, or cancer.

Here's how the evidence breaks down.

What mainstream science strongly supports

There is robust evidence that:
* childhood adversity increases risk of later mental illness,
* trauma can alter stress-response systems,
* addiction is strongly associated with emotional pain, neglect, and adverse environments,
* social isolation and chronic stress affect health outcomes.

These ideas are not fringe at all. They're widely accepted in:
* developmental psychology,
* psychiatry,
* attachment theory,
* trauma research,
* addiction medicine.

For example, large bodies of research show strong correlations between childhood trauma and later substance abuse. (Nature)
Maté's emphasis on compassion, context, and asking "what happened to this person?" rather than simply "what's wrong with them?" is also influential in trauma-informed care.

Where he becomes controversial

The criticism is mainly about overreach and causality.

Maté often presents trauma as the central explanatory mechanism behind:
* addiction,
* ADHD,
* chronic illness,
* autoimmune disease,
* even some cancers.

Many researchers think this stretches the evidence too far.

For example:
* ADHD has one of the strongest genetic components in psychiatry, with high heritability estimates across many studies.
* Maté has argued ADHD is primarily developmental and trauma-related rather than inherited.
* Critics say this conflicts with the broader evidence base in behavioral genetics and neurodevelopmental research. (Frontiers)

Similarly, while stress and trauma can influence immune function and health behaviors, the evidence that trauma directly causes diseases like cancer is much weaker and often correlational rather than causal. (tolerance.ca)

A major scientific criticism: "everything becomes trauma"

A recurring critique from psychologists and psychiatrists is that Maté sometimes treats trauma as a near-universal explanation.

Nick Haslam (psychology professor at Melbourne) criticized his work as overly broad and unbalanced. (tolerance.ca)

Some critics argue this creates problems:
* normal suffering gets medicalized,
* complex disorders get reduced to one cause,
* biology and genetics get underplayed,
* people may begin interpreting all distress through a trauma lens.

That doesn't mean trauma is unimportant — only that most modern researchers prefer a biopsychosocial model, where:
* genetics,
* temperament,
* neurobiology,
* family environment,
* culture,
* stress,
* trauma,
all interact together.

Why many people still find him valuable

Even many critics acknowledge that Maté is:
* compassionate,
* articulate,
* insightful about suffering and addiction,
* helpful for reducing shame.

His books resonate because he speaks to lived experience in a way many clinical models do not.

A lot of clinicians would say:

His questions are often valuable, even when his answers are too sweeping.

The bottom line

Scientifically:
* Trauma matters enormously → strongly evidence-based.
* Trauma contributes to addiction and mental illness → strongly evidence-based.
* Trauma explains most ADHD, chronic illness, or addiction → controversial and not established consensus.
* Trauma is the main cause of diseases like cancer → weak evidence.

So he's probably best understood not as a pseudoscientist, but as a clinician-author who blends:
* legitimate trauma science,
* clinical observation,
* philosophy,
* social critique,
* and speculative interpretation.

The problem is that he often presents speculative interpretations with more certainty than the evidence warrants.

[Blueberry]

How are you doing, zen_racer? I hope your friend came and could be a supportive presence for you. 

[NarcKiddo]

I hope your time with your friend was helpful.

My opinion is that the body and mind are one unit. If something is off somewhere there cannot help but be knock on effects elsewhere. Even something as minor as a small cut on a finger will attract some attention from your brain while you deal with it, adjust your movements to compensate etc. I also bear in mind that absolutely everything we experience is processed by the brain. I read a book on chronic pain (purely for interest) and the consultant who wrote it pointed out that the body does not have "pain receptors". It recognises things like chemicals, heat and touch. But not "pain" per se. So in cases where pain persists once the injury has healed, something else is going on. The author was at pains to say it is not exactly "all in the mind" as in the patient is making it up, but that something has likely gone awry with a brain circuit and throwing painkillers at the problem is not necessarily the answer.

The brain is also very adept at focusing its resources where they are needed. I am interested in art, and have noticed that the more you look at something the more you see. This is the Reticular Activating System at work. It filters all of the information around you and only lets you perceive what is important. If you look at a chair you see a chair. If you are drawing that chair you keep staring at it. The brain concludes there is something important about the chair so allows more information through. You notice more details in the wood grain. You see its colour is not a uniform brown. There are bits of green, and yellow and purple in there. I guess that's why blind people are able to rely on their other senses more. We all have the ability - we just don't need it so don't use it.

If the brain is busy protecting you from annihilation (as it perceives trauma) I think it simply cannot give the closest of attention to everything else. If resources are going towards the possible physical necessity of fight, flight, freeze they are not available to calm your metabolism. In fact that would, I assume, be the opposite of what your body needs unless your brain has decided you need to play dead.

Once you have processed the anger, which is a totally understandable and reasonable reaction, it is worth trying to consider where you are from a more dispassionate standpoint and consider how you can improve things. I'm also angry that nobody ever questioned things in my childhood. There were signs and I could have been helped but I wasn't. I didn't know I needed help, so obviously did not ask for it. I do not blame my FOO for the basics of physical issues I have such as really bad lung function. I can't in all fairness blame them for all their smoking and the polluted atmosphere of 1970s London, because that's what things were like back then. I do think somebody could maybe have noticed struggles around exercise and investigated rather than labelling me idle and unsporty. But that was then and this is now. I'm trying not to let anger keep consuming me because I need to concentrate on me, not them. There is absolutely a time and a place for anger and it looks like you are in that place now. But please try not to let it fool you into thinking it is not worth trying to get better. It so is.

 

[zen_racer]

Thank you everyone.  I am doing better.  The friend came over.  He actually wasn't very good at listening, but when he did it, he wasn't argumentative or anything, and he did validate what I was saying.  I think it helped mostly as a distraction.

Blueberry, thank you for asking how I'm doing.  I usually love learning about things, so I'm not discounting the other responses.  I can't explain why, but your message asking how I was and wishing well for me kind of instantly softened things inside my mind.

dolly, that was a lot of information.  I will read through the response again to get more out of it.  I did take note of making sure things are evidenced based.  I know that's sometimes an issue with AI, and why I typically go read what it lists as sources, and also check out other sites with related information.  I also agree with later points about being careful that I don't start looking at everything through a trauma lens.  I am not in any way thinking you were suggesting that in this specific case as any kind of negative thing against me.  The part about possibly causing my appendix and or gallbladder issues is potentially reaching, and I know that.  But the part about the trauma directly being partially responsible for my metabolism, with the other side of it being my exercising at too early of an age, which was also a response to the physical trauma, is the only possible explanation I've seen.  I have constantly just been told that I must be a freak, there's no reason for it, that there's actually nothing wrong and I'm making things up despite the fact that it was evident from how thin I was.

... I don't know why I'm explaining it like this again.  I promise I'm not taking any part of your post the wrong way or thinking that I have to prove myself.  I'm just used to over explaining for people that always chose to not hear me regardless of what I said.  I think this is part of how I start trying to understand how finally having an answer that makes sense changes the perspective and ripples through time considering how much of my life had this physical reality I couldn't escape from be the focus.  Thank you for all the information.

NK, the time with my friend did help.  Maybe not in the way I wanted, but it helped none the less, and maybe in a way more like what I needed.  I think the second paragraph is interesting, but also highlights why I think the trauma likely did have an impact on my metabolism.  If what you wrote there is how things work for normal people, that explains why I'm unusually good at recognizing patterns and details.  Maybe that filter is broken, but I do look at every detail possible, all the time, about everything.  I've always practically been superpowered at things like finding 4 leaf clovers, even while not looking for them, even while doing things like riding a bike on a bike path and noticing a 4 leaf clover in a patch while moving at speed.  I recognize the patterns in flooring or ceiling tiles almost everywhere I go.  I'm so good at fixing machines where I work because I notice every detail.  I see bolts that are barely loose, a small cable connector where the collar is cross threaded and not fully seated.  I'm hyper aware, hyper vigilant all the time.  Back then, I think I was also physically always tense, ready to try to jump out of the way or brace for impact because I never knew when my brother was hiding to jump out and beat me.

Maybe it would help to think of it as all the trauma did cause me so many problems, but also gave me actual real life super powers.

I resonate quite a bit with the first paragraph as well.  Ever since I studied philosophy on my own in high school and later took martial arts and got into the more philosophical and intellectual side of that, I've believed similar about the brain not having specific pain receptors.  In my mind, I thought of it more like all the nerves are just sending electrical/chemical impulses, and it's up to our brain to turn those signals into meaning.  For a long while, while still around my brother back then, I used the power of the mind over the power of the body to get to where I could ignore the pain and endure anything.  Sometimes during physical abuse, sometimes by challenging myself or just seeing how much I could take.  I think I did that more and more as the physical abuse I had gotten used to tapered off.  Like I had gotten used to the pain as being part of life, and missed it.  I think that's some of why I turned to self harm around that same point.

And you're right about the anger as well.  I won't let it trick me into thinking it's not worth trying to get better.  I was overwhelmed by recognizing another pattern, and seeing how much of an influence it's been on some of the things I've had the most trouble with my entire life.  But to be fair, I turn 50 very soon, so it feels like it has stolen most of my life already.

 

[Kizzie]

To me, like the AI summary, there is a lot of overreach and causality that trauma can be the sole source of everyone's physical problems.

Just wanted to note here that I don't think anyone is suggesting that trauma is the sole source of ill health DollyVee. It may be as you say that "Maté sometimes treats trauma as a near-universal explanation" but he is only one person. The point is that there is an evidence based correlation between exposure to protracted traumatic stress and a higher incidence of certain types of illness/disease. It's not surprizing when you think about all the cortisol, adrenaline, etc being pumped into our systems because our traumatic stress is ongoing. We weren't built to have all that constantly flowing around our systems.

Trauma is a possible explanation for your symptoms Zen racer, but the medical community receives little to no training about complex trauma so right the moment you aren't likely to find informed care. (See our healthcare project "Closing the Gap"). Were healthcare professionals better trained, they just might have some real answers for you.

I'm sorry you're dealing with health problems and I hope you are able at some point to find someone in medicine who does know how to help you.

[dollyvee]

It may be as you say that "Maté sometimes treats trauma as a near-universal explanation

Not to be pedantic, but that was the AI summary. My blurb is at the top.

Again, I think the more pertinent part of what I wrote was, "what is important is to what extent the evidence exists to support all these claims, and is not just an idea to give one emotional comfort, which can then lead to misinformation." So, in that it would be the nuts and bolts of how this works. Yes, trauma does lead to increased cortisol etc, but how that cortisol then effects people with different genetic inheritability needs to be studied and not dismissed, which people like Mate do. Yes, he's one person, but a powerful voice in the community that many point to for "eveidence" of the link between trauma and health.

So, maybe I'm just being thick, I still don't understand how educating doctors about trauma is going to provide that evidence or be helpful, if only to let them know what state we're at now. Because even if trauma is the source of the disease we're carrying, how does that help them treat the disease that has developed?

dolly

[Blueberry]

It may be as you say that "Maté sometimes treats trauma as a near-universal explanation

I still don't understand how educating doctors about trauma is going to provide that evidence or be helpful, if only to let them know what state we're at now. Because even if trauma is the source of the disease we're carrying, how does
that help them treat the disease that has developed?

In my experience when doctors and even paramedics understand more about psychological trauma, that changes the way they talk to me and otherwise interact with me. So, when I went into anaphylactic shock last year, the paramedics listened to what I said on mitigating further medical trauma. They didn't roll their eyes, treat me like some hysterical woman or clueless child, and do what they always do. Despite the real emergency, they made minor changes in their procedure to trigger me as little as possible. Where I live I'm noticing more and more changes like that among medical staff of whatever sort who don't work in a psych capacity. For me, that's helpful and I know of others with cptsd who say the same.

For instance medical staff are more likely to take me seriously, especially when I say something like there's no way I can follow through with all those steps or that regularity or whatever to heal some physical problem. They're less likely to say something like "well, if you don't want to get better...". Not understanding how depleted some of us are chronically, they misinterpret my "I can't" as "I don't want to" and are incapable of seeing that they themselves have the wrong end of the stick. Them having the wrong end of the stick leads to frustration and even more exhaustion for me. It also wastes time and money- for them.

You may not have any experience like this, dollyvee, and that's fine because obviously not everybody with cptsd has the same experiences, otoh I also know I'm not the only one.

So I'm now too exhausted to continue. Maybe someone else has something useful to add, or maybe I'll manage more later.

[NarcKiddo]

Because even if trauma is the source of the disease we're carrying, how does that help them treat the disease that has developed?

To me it seems there are two possible prongs.

One is the physical possibility that stress hormones are continuing to feed into the progress of the disease. You have quite rightly pointed out that research is needed into the immediate effects of the cortisol on diseases but I think the effects are likely wider than that. If the medics are aware of the situation they can consider recommending additional treatment approaches. For example, it is well known that anxiety can hugely impact breathlessness or can cause muscle tension in the very same muscles that may be recruited as accessory breathing muscles where the diaphragm is not fully functional. Medics can (and do) dole out drug therapy and then wonder why it is not working as well as it might when, if they were aware of trauma reactions they could consider things like physiotherapy, or psychological therapy. These are interventions that already exist that can be tried without the need for a research study.

The other is the point Blueberry has already made, which is the attitude of medics towards patients. I've had my share of big health issues over the last couple of years and my experiences would have been much more therapeutic if I had not had to bulldoze my way through. My trauma history did not enable me to inform the medics of my trauma history, though I would have done so had they asked. Indeed it appeared on a questionnaire at one place but was clearly a tick box exercise because nothing was ever said about me saying I likely have CPTSD and no accommodations were made or suggested. There is also the situation where patients simply dissociate the heck away from the consultation and their passivity is simply taken as a sign that all is well. I think I have been generally unlucky with the medics I have encountered, with a few honourable exceptions, but if trauma education featured a little more in their training I think things may have been better.

[zen_racer]

I appreciate everyone's view point on this thread so far, and I think everyone has had some good things to say or questions asked.

As a way of practicing standing up for myself, I would like to point out that confrontation is a very large trigger for me, and at one point, I considered deleting this topic.  I fully understand that because of my background, I may have been taking things wrong.

As for why I initially started this topic, I was just looking for answers I've never gotten.  I don't think understanding that my metabolism issues were based or started by trauma is going to fix anything.  It's too late to fix anything for my appendix or gallbladder.

But, the same sources of information also include other inflammatory issues, gut/digestion issues, etc.  The way I see it is that if my metabolism has been running at 20-30% above redline for 40+ years, that would explain why the organs ended up having issues.  But that is still going on in my system now.  Perhaps with understanding this, and treating the trauma, I could maybe prevent or delay other health issues by simply taking my foot off the gas, in a sense.

I also agree that it is a good mindset to not always look at everything medical through a trauma lens.  Of course treatment of anything could be better for the patient if protocols can be shifted in a trauma-informed way if needed, but that's not how I took that statement.  To me, that was more a way of saying to keep an open mind when finding the root cause of an issue, for finding what needs to actually be treated. 

[dollyvee]

Dear Blueberry and NK, thank you for your responses and I get what you're saying. However, it still does not address that way trauma actually shows up as disease and whether or not trauma can specifically be linked back to the illnesses without more research. Just saying that we have more coritsol pumping in our systems and maybe that's why your metabolism is now high, is not research and/or proven. I am aware of ACE studies and the effects of high cortisol, but I don't think there is a specific study relating high metabolism to high cortisol? We are living in an age where information is plentiful, but the actual scientific method and truth of achieving these things is thin on the ground. Again, speaking from personal experience, cortisol can also be raised through high histamine and genetics. When the body's histamine levels are high, it creates a state of inflammation, which is then suppressed by cortisol. This is also the same with infections in the body. It's not always trauma that creates these situations.

Blueberry - I fully understand that educating doctors on trauma affects the treatment of patients and that's not the point I raised. The point was whether or not trauma can be pinpointed to a lot of the physiological issues that people have and whether or not is a mix of varying factors - ie genetics, inflammation from diseases etc and as outlined by AI as well.

NK - I also recognize that deep breathing helps, but it's not a way to treat disease. I think discussion and clarity on this is warranted as these are serious issues that affect peoples' lives and saying, maybe it all relates back to cptsd is dismissive of physical issues. Furthermore, one of my main issues with this is that a lot of these issues such as MCAS or food sensitivities/gut issues etc can replicate anxiety and/or depression (even leading to ongoing hormonal and thyroid issues which can then reinforce these feelings) and people will think that it's just my trauma, which is why I think it's a disservice to immediately link everything back to trauma.

ZR, I don't take what you said as dissmissive and my post was meant to caution against turning everything back to trauma, not be confrontational, because I have also been the freak of having issues that no one explained until recently and it wasn't trauma. But I think there are some strong opinions on both sides, which again warrant discussion and evidence.

What actually started helping me was taking medication and altering my diet and living conditions. Doctors told me that it was all in my head and I have even been told a couple of times on this forum that maybe the issues were trauma, not physical. I think that when we're in a vulnerable place where we don't have closure from our families and can't be angry with them, it can be comforting to hold on to the idea that an illness is the legacy from a bad childhood. I feel like the illness then becomes an allowable anger, which is wholly understandable. For me, I would just want the firm studies and the proof that the link exists and it's not just a wholly emotional one. Again, these are just my two cents so please take and leave as needed.

I'm glad that living through your experiences has helped turn you in to a stronger person.

Sending you support,
dolly

[Blueberry]

As a way of practicing standing up for myself, I would like to point out that confrontation is a very large trigger for me, and at one point, I considered deleting this topic.

Thank you for writing that. Good on you for standing up for yourself!
I did wonder whether or not to continue discussing with dollyvee and I was aware that I was hijacking your thread a bit and perpetuating the hijack by continuing to engage. So I'm sorry about that and will try to not do that again. Especially since confrontation is such a large trigger for you. And you being fairly new on the forum too. My deepest apologies.

[zen_racer]

I'm not upset with anyone, and I didn't take any responses to me in a bad way.  I'll also say again that my sense of what was going on might not match up with reality or rational takes on what constitutes confrontation.  It was actually how many people were responding to dollyvee.  And I get the logical reasons.  I understand Kizzie has or feels an obligation to this forum and to make sure information is accurate.  It just seemed like there may have been a misunderstanding, and then more and more people piling on.  I've seen that in other forums, and in my own family where people would just start grouping together against me for no rational reason.

That might not be what was happening.  Again, my sense of scale might need to be recalibrated once I can work on some of the reasons why I shut down with confrontation.  In all honesty, if it was something directed at me, I probably wouldn't have said anything.  And I'm sorry if I made something out of nothing.  But it was triggering me.  I never want to be a reason why anyone else would be subjected to what I went through.  Maybe I should find it odd that I can stand up for someone else easily, but it's so difficult to do for myself.