Not Fixed, Still here

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"The body keeps the score."

That phrase — from Dr. Bessel van der Kolk's 2014 book — has become shorthand for something millions of trauma survivors already knew. That what happened to them didn't just live in their memories. It lived somewhere else too. In the tension that arrived before the mind caught up. In the physical responses that made no sense in the present but made complete sense in the past.

The phrase resonated because it named something real.

This episode asks — what does the science actually say about that something? Where is the evidence solid, where has it been challenged, and what does the distinction matter for people who are living inside it?

We look at what the autonomic nervous system actually does, and what prolonged trauma does to it. We examine what a November 2025 BJPsych Bulletin review of 122 claims from the book found — and what a 2026 paper titled "The Body Does Not Keep the Score" actually argues (it is not what you might think). We look at functional somatic syndromes — fibromyalgia, CFS/ME, IBS — and the documented connection between childhood trauma and these conditions through neuro-immune pathways. And we look at what the evidence shows about approaches that work at the level of the nervous system rather than primarily the mind.

The body is involved in trauma. The evidence for that is robust. What precisely is happening, and how — that is a more complex story than any single phrase can hold.

Not Fixed, Still Here. Episode 13.

Resources referenced in this episode:

Scheeringa, M. — Review of 122 claims in The Body Keeps the Score — BJPsych Bulletin (November 2025)

Kotler, Mannino, Fox & Friston — The body does not keep the score — Frontiers in Systems Neuroscience (2026): frontiersin.org

Simply Psychology — Is Trauma Stored in the Body? (February 2026): simplypsychology.com

Meade & Garvey — Neuro-Immune Interaction in Chronic Pain and Functional Somatic Syndromes — IJMS (2022/2025): pmc.ncbi.nlm.nih.gov

Nizzero et al — Fibromyalgia and the immune system — Exploratory Immunology (August 2025)

If anything in this episode brought something up for you, support is available 24/7.

Call or text 988 — Suicide and Crisis Lifeline — free and confidential, any time.

Text HOME to 741741 — Crisis Text Line — free and confidential, any time.

NAPAC — National Association for People Abused in Childhood — 0808 801 0331 — free support line for adult survivors.

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In England and Wales in 2024, three quarters of all suicide deaths were male. The highest proportion in twenty-five years.

Suicide is the leading cause of death for men under fifty. Not cancer. Not heart disease. Suicide.

And yet men account for only 36% of referrals to psychological therapy in the UK. 40% of men don't talk about their mental health at all.

Those two things — the highest death rate and the lowest help-seeking — are not a coincidence. They are a system failing a population in ways that are documented, specific, and not yet adequately addressed.

This episode looks at that system honestly. It covers the scale of the problem in the current data. It examines masculine depression — the clinically documented phenomenon in which men's depression presents differently from the standard criteria, and a significant number of men are being missed by the measurement tools designed to find them. It looks at what the research shows about why men don't seek help and why they leave treatment early when they do. And it examines the growing evidence for what works differently.

This is not a cultural commentary. It is a clinical and systemic one. The data tells a specific story. This episode tells it.

Not Fixed, Still Here. Episode 12.

Resources referenced in this episode:

ONS — Suicides in England and Wales: 2024 registrations: ons.gov.uk

Scientific Reports — Masculine depression and acute mental health burden (April 2026): nature.com

PMC — Gender-biased diagnosis and treatment of depression (July 2025): pmc.ncbi.nlm.nih.gov

Eggenberger et al — Men's suicidal thoughts and behaviors and conformity to masculine norms — Heliyon (2024)

Men's Counselling Service — Key Men's Mental Health Statistics: menscounsellingservice.com

If anything in this episode brought something up for you, support is available 24/7.

Call or text 988 — Suicide and Crisis Lifeline — free and confidential, any time.

Text HOME to 741741 — Crisis Text Line — free and confidential, any time.

CALM — Campaign Against Living Miserably — 0800 585 858 — free, 5pm to midnight daily.

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There is a kind of sadness that doesn't have a name in ordinary conversation.

Not the sadness after a death. Not the sadness that comes with a clear before and after that other people can recognise and acknowledge. It is the sadness of something that was never there. The childhood that should have been safe and wasn't. The parents who should have been present and couldn't be. The version of yourself you might have been if things had been different.

This kind of sadness has no funeral. No ritual. No socially sanctioned space to mourn it.

And because it has none of those things, it often goes completely unrecognised — even by the person carrying it.

This episode looks at the neuroscience of grief — including a 2026 finding from Trends in Neurosciences that grief activates the brain's reward and attachment circuits, not primarily its pain system. It looks at two clinical frameworks that name the grief that goes unrecognised: disenfranchised grief, described by Dr. Kenneth Doka as "hidden sorrow" — grief that is not openly acknowledged, publicly mourned, or socially supported. And ambiguous loss, Dr. Pauline Boss's framework for loss without closure.

According to APA 2025 data, 68% of adults reporting disenfranchised grief cite non-death losses as their primary struggle. Only 22% of published grief therapy protocols include structured modules for these experiences.

If you have ever felt a sadness with no clear source — a heaviness that arrived without explanation, an ache watching something warm in someone else's family, grief that you couldn't justify because there was no grave — this episode is for you.

Your losses were real. Your grief is legitimate. You are allowed to mourn.

Not Fixed, Still Here. Episode 11.

Resources referenced in this episode:

Bryant et al — Prolonged grief disorder and the reward system — Trends in Neurosciences (February 2026): cell.com/trends/neurosciences

Doka, K.J. — Disenfranchised grief: New directions, challenges, and strategies for practice (2002)

Boss, P. — Ambiguous Loss: Learning to Live with Unresolved Grief — Harvard University Press (1999)

CPTSD Foundation — When Grief Has No Grave (April 2025): cptsdfoundation.org

PESI — Understanding Traumatic, Ambiguous, and Disenfranchised Loss (April 2026): pesi.com

If anything in this episode brought something up for you, support is available 24/7.

Call or text 988 — Suicide and Crisis Lifeline — free and confidential, any time.

Text HOME to 741741 — Crisis Text Line — free and confidential, any time.

NAPAC — National Association for People Abused in Childhood — 0808 801 0331 — free support line for adult survivors.

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There is a particular experience that many survivors of complex trauma share.

Not a flashback. Not a crisis. Just the ordinary experience of being in a room with people who feel safe — and feeling completely unable to trust it. Not because anything is wrong. But because your nervous system learned something very early about what safety means. And what it can turn into.

This is not PTSD in the way most people understand it. It is something more pervasive. Something that touches identity, relationships, and the most fundamental sense of who you are.

It has a name now — Complex PTSD, formally recognised in the ICD-11 by the World Health Organisation. It affects between 1 and 8% of the general population. Up to 50% of people in mental health facilities meet its criteria. In clinical populations, it is more commonly observed than standard PTSD.

This episode looks at what complex PTSD actually is and how it differs from single-event trauma. What prolonged, repeated, relational trauma does to the developing brain and nervous system. Why standard treatments often don't fit — and why that is the treatment's problem, not yours. And what the evidence is increasingly showing about what actually helps.

If you have ever been told you are treatment-resistant, or difficult, or not responding as you should — this episode is for you.

Not Fixed, Still Here. Episode 10.

Resources referenced in this episode:

UK Trauma Council — PTSD and Complex PTSD: uktraumacouncil.org

The Lancet — Complex post-traumatic stress disorder (2022): thelancet.com

APA Monitor — When trauma becomes complex (March 2025): apa.org/monitor

European Journal of Psychotraumatology — Treating complex PTSD with Schema Therapy, EMDR and Imagery Rescripting (October 2025)

APA Clinical Practice Guideline for the Treatment of PTSD in Adults — Version 2 (2025): apa.org

If anything in this episode brought something up for you, support is available 24/7.

Call or text 988 — Suicide and Crisis Lifeline — free and confidential, any time.

Text HOME to 741741 — Crisis Text Line — free and confidential, any time.

NAPAC — National Association for People Abused in Childhood — 0808 801 0331 — free support line for adult survivors.

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It is Tuesday at 11pm. The anxiety won't let you sleep. Your therapist's next available slot is three weeks away. And there, immediately available, is an AI chatbot.

Over 40 million people worldwide are now using AI-powered mental health tools every month. 1.2 million people per week are using ChatGPT specifically to discuss suicide.

AI is already doing some genuinely useful things in mental health. The Thera bot randomised controlled trial published in NEJM AI showed a 51% reduction in depression symptoms. Wysa has 45 peer-reviewed publications and FDA Breakthrough Device Designation. The evidence for specific, purpose-built tools is real.

But a clinically validated mental health tool and a general-purpose chatbot are not the same thing. And most people using AI for mental health support are using the latter.

This episode covers the full landscape — what the evidence actually shows for AI tools that have been properly studied, and what the research is now documenting about what happens when the wrong tool meets the wrong moment. Including the sycophancy problem. The self-diagnosis trap. The crisis response failures. And the lawsuits.

Not Fixed, Still Here. Episode 9.

Resources referenced in this episode:

Therabot RCT — 51% depression reduction — NEJM AI (March 2025)

Wysa clinical evidence library: wysa.com/clinical-evidence

Cheng, Lee & Jurafsky — AI sycophancy study — Science (March 2026)

Frances & Whiteside — Preliminary Report on Chatbot Iatrogenic Dangers — Psychiatric Times (February 2026): psychiatrictimes.com

Brown University — 15 ethical risks in AI mental health responses (March 2026)

AI Therapy Clinical Evidence Scorecard 2026: bestaitherapy.ai

If anything in this episode brought something up for you, support is available 24/7 — from a human being, not a chatbot.

Call or text 988 — Suicide and Crisis Lifeline — free and confidential, any time.

Text HOME to 741741 — Crisis Text Line — free and confidential, any time.

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Your gut and your mood move together. You've probably noticed.

The stomach that doesn't feel right when you're anxious. The appetite that disappears when the depression is heavy. The physical dimension of something that's supposed to live entirely in the mind.

You were noticing something real.

Approximately 95% of the body's serotonin is produced in the gut — not the brain. The gut communicates with the brain through the vagus nerve, the immune system, and microbial metabolites that directly influence brain chemistry. And a 2025 Mendelian randomization study — one of the most rigorous designs for testing causation — found that gut microbiota dysbiosis is a causative factor in depression and anxiety, not merely a side effect of them.

This episode goes into what the gut-brain axis actually is, what the serotonin finding really means, what the research on probiotics and the microbiome genuinely shows — and where the honest limits of all of it are.

The science here is significant. And some of what's being sold on the basis of it moves faster than the evidence. Both things are true.

Not Fixed, Still Here. Episode 8.

Resources referenced in this episode:

Lai & Xiong — Gut microbiota dysbiosis as a causative factor in depression and anxiety (Frontiers in Microbiology, 2025): frontiersin.org

BMC Psychiatry — Probiotics, prebiotics, and synbiotics for anxiety and depression: systematic review and meta-analysis (November 2025): link.springer.com

PMC — The Immune Mind: Dietary Patterns, Microbiota, and Psychological Health (2025): pmc.ncbi.nlm.nih.gov

Frontiers in Psychiatry — The gut-brain-circadian axis in anxiety and depression (2025): frontiersin.org

If anything in this episode brought something up for you, support is available 24/7.

Call or text 988 — Suicide and Crisis Lifeline — free and confidential, any time.

Text HOME to 741741 — Crisis Text Line — free and confidential, any time.

Support the show

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Last episode we looked at one device. One company. One gap between promise and proof.

This episode is the pattern behind it.

The mental wellness industry is now worth $166 billion globally — and growing. It is extraordinarily sophisticated at finding people in a specific psychological state: exhausted from trying, let down by systems that were supposed to help, and still, despite everything, looking for something that might work.

That state has a name in psychology. It's called hope fatigue. And this episode looks at what the research says about why it makes us more — not less — susceptible to claims that outpace their evidence.

We go into the psychology of miracle cure culture: the cognitive biases specific to chronic illness, the neuroscience of why testimonials outweigh trials in our mental calculations, and the six recurring features that show up across products, protocols, and promises — regardless of what they're selling.

And we end with five questions worth asking before you spend your money, or your hope, on anything claiming to help.

Not Fixed, Still Here. Episode 7.

Resources referenced in this episode:

Global Wellness Institute — The Global Wellness Economy, 2024 Report: globalwellnessinstitute.org

Hope fatigue research — Steffen et al (2019) / Grigoras & Ciubara (2024)

Cognitive biases in chronic illness — Savioni & Triberti, Frontiers in Psychology (2020): pmc.ncbi.nlm.nih.gov/articles/PMC7655771

Health misinformation susceptibility — Peng & Shen, Health Psychology (2025)

If anything in this episode brought something up for you, support is available 24/7.

Call or text 988 — Suicide and Crisis Lifeline — free and confidential, any time.

Text HOME to 741741 — Crisis Text Line — free and confidential, any time.

Support the show

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The vagus nerve is real. The research is promising. And neither of those things is the problem.

Nurosym is a wearable device that stimulates the vagus nerve through the ear. The science underlying it has genuine potential. Early-stage research is showing signals worth watching.

The problem is the distance between "worth watching" and "trusted, proven, easy" — which is how Nurosym markets itself, at up to £449, to people who have already tried most things.

This episode looks at that distance honestly. What the research actually shows. What it doesn't. What the CE mark really means. And what it costs — beyond the money — when a company's promise outpaces its proof.

Resources referenced in this episode:

Clinical trial NCT07198542 — Nurosym device study, estimated completion December 2028: clinicaltrials.gov

Nurosym product information: nurosym.com

taVNS scoping review — 109 studies across 21 clinical populations: Taylor & Francis, Disability and Rehabilitation (2024)

Research limitations in taVNS — Sun et al, Frontiers in Neurology (2025)

If anything in this episode brought something up for you, support is available 24/7.

Call or text 988 — Suicide and Crisis Lifeline — free and confidential, any time.

Text HOME to 741741 — Crisis Text Line — free and confidential, any time.

Support the show

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Send us Fan Mail

Sources:

Treatment Resistance & Diagnostic Critique McIntyre et al. — Treatment-resistant depression: definition, prevalence, detection, management — World Psychiatry (2023) Karabulut & Düzgün — Treatment-Resistant Depression Rates: Pilot data from Türkiye — PMC (2025) Treatment-resistant depression: a problematic illness or a problem in our approach? — British Journal of Psychiatry, Cambridge Core. Paganin — Treatment-resistant depression: time to rethink current definitions and clinical practice — Frontiers in Psychiatry (January 2026) Parker — A critique of ICD-11 criteria for the mood disorders — PMC (July 2025) Access, Structure & Policy European Psychiatric Association — Action Plan 2025-2027: Leaving No One Behind — PMC (2025) WHO — A new roadmap for mental health policy reform — PMC (October 2025) The Marburg Declaration — The future of psychological treatments — ScienceDirect (2024) Delgadillo et al. — Stratified care vs stepped care for depression: a cluster-randomised clinical trial — JAMA Psychiatry (2022) Precision & Personalised Psychiatry Restoring the missing person to personalized medicine and precision psychiatry — PMC (2023) Psychiatry Redefined — The Tipping Point for Functional Psychiatry on the Road to 2026 (2026) APA Monitor — The promise of precise, personalized mental health care (September 2025) Kas et al. — Precision psychiatry roadmap: towards a biology-informed framework — Molecular Psychiatry (August 2025) Crisis Resources — Include in Every Episode Description: Call or text 988 — Suicide and Crisis Lifeline (24/7, free, confidential) Text HOME to 741741 — Crisis Text Line (24/7, free, confidential). Not Fixed, Still Here · Episode 5.

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Was I always going to be like this?

It's the question that shows up at 3am. When nothing else is working. Somewhere between despair and accusation.

This episode goes looking for a real answer — not reassurance, not false hope, but what the science actually says.

We go into genetics and what heritability really means for depression and anxiety. We go into epigenetics—the genuinely significant discovery that chronic stress and early experience can change how genes are expressed without changing your DNA. And we go into neuroplasticity—what the evidence shows about the brain's capacity to change and what that means for the question of whether any of this is fixed.

This is the most scientifically complex episode in the series so far. It doesn't offer a clean answer. But it offers something more honest than the question you started with.

Not Fixed, Still Here. Episode 4.

If anything in this episode brought something up for you, support is available 24/7. Call or text 988 or text HOME to 741741.

Genetics & Heritability 

Tabrizi et al.—Heritability and polygenic load for comorbid anxiety and depression—Translational Psychiatry (March 2025) 

Wray et al.—Genome-wide association analyses identify 44 risk variants for major depression—Nature Genetics (2018) 

Adams et al.—Genome-wide study of major depression in 685,808 diverse individuals—medRxiv (2024) 

Molecular Psychiatry — Genetic nurture effects in depressive and anxiety disorders (2025) 

Epigenetics 

Kretzschmar, Boldt, Targa — The genetics and epigenetics of mental health — Frontiers in Genetics (April 2024) 

Franklin et al.—Epigenetic regulation of brain development, plasticity, and response to early-life stress—Neuropsychopharmacology (2025) 

Talarowska — Epigenetic mechanisms in the neurodevelopmental theory of depression — PMC (2020) 

Frontiers in Psychiatry — From trauma to depression: epigenetic and molecular pathways (2025) Frontiers in Psychiatry — Clinical use of epigenetics in psychiatry (2025) 

Neuroplasticity 

Huizenga, Neuroplasticity and mental health: implications for depression and anxiety treatment, Journal of Cognitive Neuroscience (2025) 

Radulescu, Dragoi, Trifu—Neuroplasticity and depression: rewiring the brain's networks—Experimental and Therapeutic Medicine—PMC (2021) 

Journal of Neuropsychiatry and Clinical Neurosciences — The dynamic brain: neuroplasticity and mental health (2012 / updated 2025) 

Axis Mental Health—How neuroplasticity improves mental health (2026) 

Crisis Resources — Include in Every Episode Description 

Call or text 988 — Suicide and Crisis Lifeline (24/7, free, confidential) Text HOME to 741741 — Crisis Text Line (24/7, free, confidential) 

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