Trauma can profoundly affect people’s psychological well-being. This is not controversial. But when we move from psychology to physiology and fitness, a lot of claims start floating around that are simply not supported by scientific evidence.
I am not a mental health professional (although I have written a book on how to improve anxiety using exercise, diet, and supplements), so when I hear people talk about trauma, I just shut up. But when I hear how mental/emotional trauma affects fitness, my ears perk up and my skeptical brain starts asking questions, the ultimate skeptic’s questions:
- Is this claim BS?
- Does it spread due to sheer ignorance (blind leading the blind), wishful thinking (“I’m a compassionate person, and this claim sounds compassionate”) or one endures profit from spreading a particular myth?
As a geek skeptic, my next instinct is to start scientific research to answer these questions.
In this article, we will dispel several of the myths related to how trauma affects fitness. And no, this article is not at all about how to deal with trauma. Again, I’m not a mental health professional, but if you’re looking for an excellent psychotherapist, reach out to my friend, Mike McKinnon. And no, I’m not getting paid to say this. He’s just a good dude.
With that out of the way, let me crack my knuckles and start busting myths.
Myth #1: Trauma raises your cortisol levels
On the surface, this seems logical: trauma is stressful. Cortisol is the stress hormone. So cortisol increases in times of stress. Nice, pure logic. Let’s put a bow on it and send it off.
But the research tells a more nuanced story:
- A study he really showed it some (not all, and not the majority) trauma survivors actually have elevated cortisol levels.
- Another study in fact it showed the opposite: that trauma survivors have reduced cortisol levels.
- A third study showed no difference in cortisol levels between trauma survivors and non-trauma survivors (and this study used genocide survivors to study trauma. This is serious stuff).
In addition to the inconsistencies in research about what happens to the cortisol levels of trauma survivors, there is the much larger problem of cortisol testing. For example:
- Cortisol naturally fluctuates throughout the day. Even in a non-traumatized person, cortisol peaks about 45-50 minutes after waking and falls sharply thereafter. A study showed that even waiting 60-65 minutes after waking up, the cortisol level is no longer the same, or even close.
- Another study also showed that there are so many things that affect cortisol, including:
- If measured daily or weekend
- When you wake up
- Caffeine
- Exercise and activity levels
- Your mood
- Body mass index/body fat percentage
- If you had a nightmare
- If you experience joint pain
…and more.
- Even within the same person who has the same routine from day to day, cortisol fluctuates wildly, according to this study.
Overall, cortisol is an interesting hormone to study on a population basis, where you get a lot of people and it smooths out any abnormalities. But on an individual basis, it varies so much that it doesn’t make sense unless you take 3 readings a day for 2-6 days as suggested in this study.
If scientists still don’t understand what happens to the cortisol of trauma victims, what hope does the general public have of claiming with certainty that trauma increases cortisol? Virtually none. However, they do state it, and they do so confidently. However, the scientists themselves who study this material are not even confident.
Some trauma survivors have higher cortisol, some lower, and many show no difference.
Myth #2: Trauma impairs metabolism
I believe this comes from the observation that Some people who suffer from mental/emotional trauma have excess body fat. But the thing is, there are plenty of people without trauma who also have high levels of body fat.
THE study only that directly examines the metabolisms of people with PTSD (post-traumatic stress disorder) showed that their metabolism goes at the same speed as people without PTSD.
Your metabolism is largely determined by just 2 factors:
- Your body weight (especially your lean mass – which is anything that isn’t fat)
- Your thyroid hormone levels
Your emotional state has nothing to do with your metabolism.
Myth #3: The body stores fat as protection after trauma
I think this myth comes from trying to empathize with the traumatized person, with mantras like;
- You don’t need to lose body fat – you are beautiful just the way you are
- You don’t have to work hard to lose fat. It doesn’t make sense. You need to heal your trauma first and then you will lose body fat (we’ll talk about this in myth #4).
Trauma is indeed associated with higher levels of body fat, but you are an experienced reader of my articles. You already know that correlation does not mean causation. And trauma is not the cause of fat gain. Trauma can cause you to engage in later behaviors that lead to fat gain, such as:
- I eat more/emotional food
- Stress eating
- Less exercise
- More alcohol use
- Worse sleep
However, if you are both traumatized and overweight, but start engaging in behaviors that promote fat loss, you will lose body fat. It’s that simple.
Now, yes, dealing with your trauma can make it easier for you to engage in these behaviors, but my point is that Trauma itself is not the ultimate cause of fat gain. The downstream effects of trauma can be – for some people. There are many people who suffer from injuries and lose their appetite and therefore lose weight (including muscle mass).
Myth #4: Injury means you need gentle workouts
This comes from misplaced compassion. The thinking is “if you’ve been through trauma, you need to take it easy on yourself.” But another school of thought says that if something really bad has happened to you, you should exorcise those demons. You do this with high-intensity exercise, especially boxing, kickboxing or martial arts.
Which one is correct? It turns out that both are right.
In a studylow-intensity exercise was used (although it did not have a second group that did high-intensity exercise) as a treatment for PTSD, and indeed, it was effective.
In another studyThe researchers recruited 40 people with PTSD and divided them into 2 groups:
- Group 1: high intensity training
- Group 2: low intensity training
At the end of the study, Both groups improved anxiety and depression symptoms by very similar amounts.
Finally, a third study gives us a more nuanced picture. There are times when low intensity exercise is best for an injury and times when high intensity exercise is best for an injury.
Low volume is most appropriate when:
- The trauma is very recent
- One feels detached (kind of like watching one’s life from a third-person perspective)
- They have problems with emotional regulation
- They have low initial fitness levels.
High-intensity exercise is most appropriate when:
- One has symptoms of hyperarousal (hypervigilance, exaggerated startle response, irritability, sleep disturbance, etc.)
- Someone who has gone through the recent stage of trauma
Myth #5: You have to heal trauma before you can get healthy
Many times when we hear that someone has been through trauma, we put on baby gloves around them. Sometimes it is justified and sometimes it is not.
For example, a meta-analysis saw that treatment for PTSD improved insomnia. There were fewer nightmares, less interrupted sleep, and more time in bed was actually spent sleeping (this is called “sleep efficiency”).
Another study found that treatment for PTSD improved chronic pain. In this study, treatment included psychiatric and pain medications.
But trauma treatment doesn’t directly help other health problems, such as:
- Portliness
- Dyslipidemia (low cholesterol and triglyceride profiles)
- Diabetes
- Osteoporosis
- Inflammation
Perhaps the greatest trauma story is the story of resilience. There are no direct negative physical consequences (occurring indirectly or downstream). In a studyresearchers recruited 753 women who reported having traumatic experiences. However, most of them had no negative changes in their health after the trauma. They didn’t gain body fat, their inflammation levels didn’t increase, they didn’t develop diabetes or other health problems. They were able to compartmentalize the trauma without engaging in negative health behaviors.
Here’s another perspective: maybe if someone was unhealthy before the traumatic experience, perhaps working on their physical health is healing for the trauma itself. A healthy (and fit/strong) body makes it easier to deal with negative mental and emotional experiences.
For some people who have had negative health consequences as a result of trauma, perhaps healing the trauma makes it easier for them to begin engaging in positive health behaviors.
But there’s no reason why wound healing and health can’t happen at the same time. They don’t have to be consecutive.
It’s not like trauma makes someone completely unresponsive to positive health behaviors just because they’ve been through trauma. Approaches that work for people who have never been through trauma also work for those who have been through trauma. Regardless of one’s traumatic experience, if you are trying to lose body fat, you should reduce your calories (or increase your activity levels), eat more protein and participate in strength training. This is true regardless of whether one has been through trauma or not.
Want to improve your cholesterol levels? Do strength training, eat adequate fiber, eat 50 grams of nuts/day and either eat oily fish or take fish oil. This is true regardless of whether someone is traumatized or not.
