Episode 99: Stress In The Body: Trauma-Informed Medicine & Why Dysregulation Should Be Included In Every Assessment with Dr. Jorina Elbers

When Your Tests Are Normal But You're Not

You've seen multiple specialists for your collection of symptoms. Neurologist for migraines. Gastroenterologist for digestive issues. Sleep specialist for insomnia. Psychiatrist for mood problems. Every test comes back normal. Each doctor treats their specialty in isolation. Nobody connects the dots or sees the pattern underlying all your symptoms.

What if these seemingly unrelated symptoms all stem from nervous system dysregulation that standard tests can't detect?

Why should medicine consider trauma as a diagnosis of inclusion rather than only checking for it when nothing else is found? Not as a last resort after everything else has been ruled out. But from the beginning of the diagnostic process.

The failure to recognize stored trauma drives many patients' health challenges with profound consequences. It perpetuates ineffective care that doesn't address root causes. It worsens patient outcomes through years of inappropriate treatment. It undermines the entire healthcare system through wasted resources and ongoing suffering. As a medical physician and someone who's been this type of patient, this episode matters deeply to me. The Trauma-Informed Medicine Project coming from this work represents something important that could change healthcare.

One key problem involves how trauma manifests in diverse ways across multiple bodily systems. This makes it difficult to identify trauma as the common thread connecting disparate symptoms. Patients present with migraines, chronic pain, digestive issues, sleep problems, mood disorders that seem unrelated. Rather than recognizing these as interconnected signs of nervous system dysregulation, the medical system compartmentalizes symptoms referring patients to various specialists who each treat symptoms in isolation. This creates a "medical merry-go-round" where patients bounce from provider to provider, test after test, never getting to the root.

Dr. Jorina Elbers joins me today as a neurologist board certified in neurology with a masters in epidemiology. Former assistant professor and pediatric neurologist at Stanford University, she's authored over 25 research articles and book chapters. She focuses on what's happening in the nervous system regarding stress and trauma and how to recognize it. She's currently director of the Trauma Recovery Project at the HeartMath Institute and runs her own trauma-sensitive neurology clinic.

Understanding Medicine's Blind Spot

Why should medicine consider trauma as a diagnosis of inclusion from the beginning? Not as a diagnosis of exclusion after everything else fails. Understanding this fundamental shift changes the entire diagnostic process from searching for structural problems to recognizing functional dysregulation that standard tests miss.

Dr. Elbers' discovery journey began when she uncovered the critical link between trauma, stress, and neurological disorders through her neurology practice. How she started asking better questions of her patients. Uncovering family trauma stories that explained seemingly inexplicable neurological symptoms. The patterns became undeniable once she knew what to look for and ask about.

What do you do when labs and imaging show nothing wrong but patients are clearly sick? Dr. Elbers explains the approach that works when conventional testing fails. How to recognize nervous system dysregulation even without positive diagnostic tests. The signs exist in autonomic function, symptom patterns, and patient history rather than in structural findings that imaging reveals.

Understanding the Biology of Trauma® alongside neurology reveals why standard medical testing misses trauma-based illness. Tests look for structural abnormalities, tissue damage, or pathological findings. But nervous system dysregulation from trauma is functional rather than structural. Your nervous system operates abnormally without showing damage on scans. This fundamental limitation of conventional testing leaves trauma survivors undiagnosed and untreated.

The Medical Merry-Go-Round

The medical merry-go-round describes how patients bounce from specialist to specialist without improvement. Each specialist treats one symptom in their domain of expertise. Nobody sees the larger pattern connecting all symptoms. The common thread of nervous system dysregulation from trauma remains invisible when each specialist looks only at their particular system.

Compartmentalized symptom treatment represents how the medical system treats migraines separately from digestive issues. Sleep problems get addressed separately from mood disorders. Pain management happens in isolation from immune dysfunction. But they're all connected through the nervous system that trauma dysregulated. Treating each symptom separately while missing the underlying dysregulation ensures ongoing failure.

Asking better questions changes everything about uncovering true causes. Dr. Elbers teaches how to ask questions that reveal trauma history behind seemingly inexplicable diagnoses. The right questions about early life experiences, major stressors, and onset timing reveal patterns that standard medical history questions miss. When doctors ask about trauma specifically, patients often share relevant history they didn't think to mention.

Tools for healthcare practitioners that Dr. Elbers shares include specific approaches practitioners can integrate into consultations. Screening questions that uncover patients' trauma history sensitively. Why this trauma-informed assessment is so important for accurate diagnosis rather than remaining optional or reserved for mental health contexts alone.

Shifting the Paradigm

Including trauma in differential diagnosis from the beginning changes outcomes dramatically. Especially when conventional medical tests don't reveal clear structural causes for symptoms. Not treating trauma as last resort after everything else fails. But considering it alongside other possibilities from initial assessment onward. This inclusion changes the entire diagnostic approach and treatment planning.

Moving beyond neurotransmitter treatment alone means stopping symptom treatment at the neurotransmitter level. Starting to treat the whole nervous system instead. This represents a paradigm shift from symptom suppression through medication to nervous system regulation through comprehensive trauma-informed care. The neurotransmitter imbalances are symptoms rather than causes requiring their own treatment.

Understanding autonomic nervous system function changes the diagnostic approach fundamentally. Your automatic functions like heart rate, digestion, temperature regulation, and sleep reveal dysregulation patterns. Dr. Elbers explains what to look for in autonomic symptoms that standard neurological exams miss. These autonomic indicators point directly to nervous system dysregulation even when imaging and labs are normal.

Heart rate variability measures nervous system flexibility and regulation capacity objectively. Low HRV indicates dysregulation and reduced adaptability to stress. This is measurable biology rather than subjective psychology. HRV provides concrete data showing nervous system state that correlates with trauma history and predicts health outcomes. Yet most physicians don't measure or understand it.

Medical Trauma and System Failures

Medical trauma from procedures and treatments themselves contributes significantly to symptom burden. Procedures and diagnostic testing create additional trauma for already dysregulated nervous systems. Medical trauma worsens chronic conditions through repeated activation without support. The healthcare system inadvertently creates suffering it's supposedly treating through traumatizing approaches to care.

The profound consequences of failing to recognize trauma perpetuate ineffective care indefinitely. Medicine continues treating symptoms without addressing causes. It worsens outcomes through years of inappropriate interventions. It wastes tremendous resources on expensive testing and specialist visits. It keeps patients suffering unnecessarily while blaming them for not improving.

Why this matters personally to me as both a physician and a patient who experienced this medical merry-go-round creates a unique perspective. I understand the frustration from the patient side. The medical gaslighting when tests are normal but you're not. The desperation of seeking help from a system that can't see your actual problem. And I understand from the physician side how medical training creates these blind spots.

The Trauma-Informed Medicine Project emerging from this work aims to change how medicine approaches chronic illness systemically. Making trauma-informed assessment standard from the start rather than afterthought. Teaching physicians to recognize nervous system dysregulation. Creating protocols that include trauma screening in initial evaluation. This project could transform healthcare for trauma survivors.

Moving Forward

Interconnected signs that appear as multiple separate symptoms are actually expressions of one underlying problem. Multiple symptoms aren't coincidental separate conditions requiring separate specialists. They're interconnected manifestations of nervous system dysregulation from stored trauma. Recognizing this connection allows comprehensive treatment rather than fragmented specialist care.

The failure of current medical systems stems from design that isn't equipped to see trauma or functional dysregulation. Medicine is designed to find structural problems through imaging and labs. Dysregulation doesn't show on standard tests because it's functional rather than structural. This fundamental limitation means trauma-based illness remains invisible to conventional diagnostic approaches.

Dr. Elbers' trauma-sensitive neurology clinic allows her to practice medicine the way it should be practiced. Where she can take time to understand full history. Ask trauma-informed questions. Recognize dysregulation patterns. Treat the whole nervous system rather than isolated symptoms. Her clinic demonstrates what's possible when trauma-informed principles guide medical practice.

For medical professionals, understanding why patients bounce between specialists without improvement requires recognizing the trauma piece medicine misses. Your frustrated patients with normal tests but ongoing symptoms likely have nervous system dysregulation from trauma. Learning to recognize and address this changes outcomes dramatically for complex patients conventional medicine abandons.

This Episode Is For:

✓ Medical professionals seeing patients bounce between specialists without improvement 

✓ People frustrated by the medical merry-go-round 

✓ Anyone whose tests come back normal but they're still sick 

✓ Practitioners wanting to understand trauma-informed medicine 

✓ Those who've been medically gaslit about their symptoms 

✓ Anyone ready to understand the trauma-illness connection

What You'll Learn

Listen to understand why trauma should be included in every medical assessment from the beginning rather than as last resort and how asking better questions reveals the nervous system dysregulation behind seemingly unrelated symptoms. Discover what HRV reveals about nervous system state. Learn how to recognize when patients need trauma-informed care.

Your collection of unexplained symptoms might all stem from nervous system dysregulation that standard tests can't detect.

Listen to Episode 99 with Dr. Jorina Elbers →

Disclaimer

This podcast is for educational purposes only and is not a substitute for professional medical or mental health advice, diagnosis, or treatment. The information shared reflects my clinical expertise and research, but every person's biology and healing journey is unique. Always consult with qualified healthcare providers before making changes to your treatment plan or starting new interventions. If you're experiencing a mental health crisis, please contact emergency services or a crisis helpline immediately.

Join the Conversation

I'd love to hear your thoughts on this episode. What resonated with you? What questions came up?

Please keep comments respectful and supportive. This is a community of people committed to healing. We welcome diverse perspectives and honest questions, but we don't tolerate personal attacks, spam, or content that could harm others on their healing journey.