Peptides to Combat Stress and Overwhelm

Aimie Apigian, M.D.

Absolutely. Thank you for having me. I’m excited

Kent Holtorf, M.D.

About our conversation today. Yeah, we were talking beforehand. I’m, I’m, I’m very excited because this is a problem that so many people have, and I think kind of our culture is it is suck it up. Right, right. So we’re going to hear a lot of, uh, new things, new ways to deal with this and underlying physiology to get better. So I’m looking forward to it. Um, and I’m sure I’m going to learn, learn a lot. And again, so thank you for being on, so a little bit about dr. Amy, uh, she’s fondly called by our patients and clients. She’s a preventive medicine physician. She specializes in trauma and attachment and during medical school at Loma Linda university in California, and she fostered and then adopted a four year old boy. Uh, that’s pretty brave to do that during medical school at the se, um, which ultimately changed her life and career. 

Aimie Apigian, M.D.

Um, as she continued to struggle with, uh, his emotional behavior issues, despite trying everything that conventional medicine and therapy had to offer, uh, she was committed to finding answers on how to heal from attachment and childhood trauma. Um, uh, exam six exhausting years later, the pieces came together or which is awesome for us. Healing started helping other families so they could get the chains and the connection much sooner. And I think that’s awesome how that works. And I think so many doctors that get into this space, whatever we call it, I hate alternative because people think it means no evidence, which is the opposite functional, or I think it’s really just being a better doctor. Right. Um, I, then she started to struggle with their own chronic fatigue and autoimmune issues and discovered our own childhood attachment trauma as the underlying cause she started looking for solutions. 

And how do we wire these attachment trauma patterns as an adult. Now she runs an online program and a three-day live and intensive for women and moms are living with the effects of attachment trauma and want the healing for themselves and their children. And she has written a roadmap To trauma healing, um, accelerated. So, wow. I think that’s such a, a huge monumental thing. And I think you got the people that know they need the help, but I think even more, is there so many people out there that don’t even know yet that that’s a core of their problem? Absolutely. And that was me, right? Like here, I had adopted a son from the foster care system, so his issues were very clear. And so imagine my shock when I realized that all of the symptoms and issues that I’m having with my health are all associated with early childhood stress. And I’m like, no, this isn’t me. Right? Like I’m already a doctor. Like I’m, I would never have thought that I had childhood trauma. And so it’s been a real opener for me in terms of learning the nervous system, the different States of the survival patterns that can be developed and wired into our system. 

And we have these patterns and don’t realize the amount of that it has affected us because I imagine it’s like, you’re very successful. I can imagine, look, you have achieving the highest levels of success. What kind of travel can you have? Like give me a break. Exactly. And, and yet I would say that it’s usually the higher performers that I am finding, have these patterns wired into their nervous system and part of what they have learned. And part of what is their pattern is to push through things, to deny the fact that their body has needs and to learn how to manage and cope and just get through by working harder. And what that results though is a real lack of true joy in their life. So yes, they’re able to manage, they’re able to cope, but they’re not experiencing the true joy that, you know, I would want to have a part of their life, especially a part of everything meaningful that they’re doing.

Kent Holtorf, M.D.

And I think it’s really interesting. And I think of like the people that commit suicide, it’s like, you always think like why would this person commit suicide? And it just have a, you know, it’s amazing. I was watching some of these documentaries on like Johnny Depp and other people. I mean, they have everything, they have power thing, you know, and all the money they could want and they talked about committing suicide and you’re just like, what, you know, so it’s, it’s crazy. And then you look at, you know, every, every level of so many people going through this, right. And in fact, just yesterday, I met with one of the top media people in the United States and very influential in that space. And again, else looking

Aimie Apigian, M.D.

In on his life with think that he’s got it all, he’s got it all together and they’re looking up to him for that leadership. And yet what’s going on in his nervous system is a very different story and he’s barely hanging on. And the picture that he’s presenting to others of course is one of, Hey, I’ve, I’ve, I’ve got it together. I’m making the decisions. And yet the amount of internal stress and tension that he’s experiencing having to make these decisions, not feeling like he’s in a great place, feeling stressed, feeling overwhelmed, feeling insecure. And, and this is how it presents an even those people who are very high performers or have a lot on their shoulders or are big leaders. These are patterns that most people have, especially those people who have gone to the top.

Kent Holtorf, M.D.

And I think that, you know, changed to kind of my perception. It’s kind of like, or I don’t have my own kids, but I kind of got an instant family with a girlfriend. And it’s like you say, what do you want for your kids? I want them to be successful. I want them to do this, but now I think I just want them to be happy, happy, you know? And it’s interesting. And I sign up for a course. It was on like basically the science of happiness, you know? And it’s, it’s such a difference in kind of like, I don’t care what you do. You know, if you’re happy, I don’t think you can be happy doing nothing and not achieving anything. It just doesn’t go with the human psyche. But being super successful does successful. Doesn’t make you happy either.

Aimie Apigian, M.D.

Exactly. Yeah. And, and it’s often because we’re not in a place where we’re experiencing that happiness and that joy that pushes people to work harder, achieve more because it’s out of this baseline insecurity rather than coming from a baseline, just creativity and connection and a liveliness same. It can look the same. The outcome can look the same, but the driving force behind it can be very different. And when we’re coming from a place of insecurity and needing to accomplish in order to feel worthy, then that is where we can recognize that a person has these patterns, whether or not you want to say that you’ve had trauma or stress or, you know, childhood stuff. It really doesn’t matter because we really just look at what’s happening in your body and reading the message that your body has to tell us, not what your mind, not what your memory has, but what story would your body tell us

Kent Holtorf, M.D.

Was that big, a big problem that I was a guy, whatever biting your parents, you know, uh, and all this. And I, and I think to kind of people like if I just buy this car, I’m going to be happy. Or if I just get this house I’m going to then bam, I didn’t work. I need, you know, I need this. So like, so kind of how does all this, Uh, you know, is it start from, you know, stress does it, how they perceive the stress, how they deal with distress or kind of given the underlying kind of beginnings of this.

Aimie Apigian, M.D.

Absolutely. And that’s a great place to start is understanding stress and the different types of stress. And when we think of stress, it’s often outside factors that we think of, but there can be just as much internal stress. And so people can be born with genetics that create biochemical imbalances that make their nervous system more sensitive, more reactive. And so that is an internal stress. If people have inflammation in their body, that is an internal biological stress, and the body can only handle so much stress, whether it’s inside or outside of us. And once it reaches its limit of stress, then it goes into actually a completely different biological state, which is overwhelmed. So we can talk about the difference between that, but in terms of just understanding stress on the body and why people have different levels of stress that they can tolerate, that is why it’s because it’s a combination of everything in our environment around us, but also what’s going on inside of us, that is all a stress on our body. And we each have that limit, have that line of where a stress becomes overwhelmed.

Kent Holtorf, M.D.

Gotcha. And I think it matters where you start, correct? Because I absolutely no study showing if the mom is stressed in utero, it turns on those same genes and the baby, and really a stressed out mom can pass those on epigenetically. Exactly. Not only are kids and kids, kids, and unless you have something done to reprogram.

Aimie Apigian, M.D.

Absolutely. Yeah. So let’s talk about childhood because that is where most of our patterns get started, at least. And like you say, there are epigenetics that can set us up for internal stress. There are genetics that can set us up for internal stress. And so w whatever combination of those, we come into the world, then whatever the environment influences and that’s the relationships, that’s the, even the, like the air quality, the food quality, right? Like all of that is considered environmental and can be either a resource or a stress and many people, just the way that we are raised now, many people are not getting the level of emotional connection and what we call regulation that is needed to help the nervous system develop in a healthy, flexible, coherent way. And so I threw in a big there regulation, and this is a word that has come out of the attachment work. 

So John Bowlby started the attachment work and identified along with Mary Ainsworth, the different types of attachment styles that a person can have. And those styles are actually established already by 12 months of age. So we’re talking very early patterns and your attachment style in a general sense is whether you feel secure and safe in the world, knowing on a gut level that Hey, things are going to be okay. Or if you have an insecure attachment style where you don’t know that everything is going to be okay, you don’t automatically trust people. You, you have, uh, this idea perception of the world that the world is not safe, that you are not inherently lovable. 

You have to do something or be something in order to be loved, that all would fall under an insecure attachment. And now that we understand what attachment is, which is really regulation, then dr. Allen shore talks about that connection. Regulation is all about the nervous system and a regulated nervous system is one that feels connected. It feels safe. It feels secure. It’s fully present in the moment. It’s where we are able to play. It’s where we are able to be our best self. And that state of regulation is in contrast to the dysregulated States, which happens as a result of any of the insecure attachment styles. And so for whatever reason, and again, we don’t need to blame parents. We don’t need to blame anybody because there’s lots of different factors that go into this. But for whatever reason, um, mom does not provide enough of the support that is needed to regulate that child infants nervous system. It starts from early childhood, the first few months of life to already be in that dysregulated state, which is a survival state and feeling unsafe in the world. And so then,

Kent Holtorf, M.D.

And I just think of like, uh, uh, the very kind of quintessential, you know, Excellere example as like you take a feral cat, and if you bring it in right away and treat like, it’s fine. But if you wait too long, that cat will never feel safe, you know? And so it’s hard wired. And you think of that with humans, it’s, it’s like, damn, you know, uh, hard to unwind. Yeah,

Aimie Apigian, M.D.

It is. And many of us can think back in terms of our childhood and say, no, I didn’t experience abuse or neglect or trauma, but what was the message that I received, whether it was spoken or not, was the message that my needs were okay to be expressed or were my needs somehow stressful and overwhelming to my parents who already had so much going on that they just needed me to, you know, do my thing, be quiet, don’t bother them because I was too much for them. So we can all have these messages from our childhood that if there are anything, anything that set us up for feeling insecure or not loved just as we are, or if we’re too much, or if we’re not enough, if we’re not enough to make our parents happy, that can be another common message that gets imprinted in our nervous system from early childhood that we carry into life. And we don’t realize that it actually is affecting our health, our immune system, our endocrine system, and obviously the nervous system

Kent Holtorf, M.D.

And, and well, and can’t, I imagine it matters with, you know, you put two kids, same parents are treated the same. Well, they’ll both perceive things very, very differently. Well, one needed something very different than the other one.

Aimie Apigian, M.D.

Exactly. And even just, if you want to make a contrast between a, a healthy infant and one with cholic, same parents, same environment, everything is the same. And yet the colicky baby is experiencing a very different childhood and message. Then a baby who doesn’t have colic. And so a colleague who baby is not usually not getting the amount of touch of regulation, of support there they’re always in pain. And so it’s never going to be enough. Whatever is done for them to feel completely safe and secure. It’s not their fault. It’s not their parent’s fault. Right. And so same thing here. You can apply that to really anything else where there’s so many other factors involved in this, that two children in the same family, same household can walk away with very different nervous systems, very different belief systems, very different insecurities, very different perceptions of themselves and of the world. Then there are other siblings.

Kent Holtorf, M.D.

Well, and yeah, because like parents always do the best that they know how you know, I hope so in general. Yeah. In general, but no one mind reader, what the child really needs.

Aimie Apigian, M.D.

The problem is that we’ve been taught to parent in a way that’s not really helpful. And this is part of our society that, uh, you know, teaches, well, at least has taught at some point where you let your children cry it out. If they don’t fall asleep, you let them cry it out. Or, you know, meals are only on a schedule. And so here is a very young infant, a very young child they’re experiencing what they feel is hunger. They go and they ask for something to eat. And the answer is no. Like even those basic simple type of things that we don’t even wouldn’t even think of are, are important yet to a young child who doesn’t understand the future is only in the present moment. They’re being told that their needs cannot be met.

Kent Holtorf, M.D.

Like they should not eat. Exactly.

Aimie Apigian, M.D.

You should not be feeling hungry right now. Well, I am feeling hungry, but you should not be feeling hungry. Like they don’t even know what to do with that. They don’t

Kent Holtorf, M.D.

Have the maturity

Aimie Apigian, M.D.

Or even, you know, having them cry themselves until they fall asleep. Right. Like that’s not going to be restful great sleep for them. Their nervous system is going to be in survival mode and they went to bed feeling unsafe. And so small things like that actually end up being pretty big things. When we’re talking about the development of the nervous system in a young child.

Kent Holtorf, M.D.

Yeah. I don’t want to get too personal, but I have a brother and again are what we remember from childhood. It’s so different. And he brings up what you were just saying, the smallest little thing that was so traumatic to him. And I’m like, are you crazy? Like, you know, and, um, but he, it, I think it’s really messed him up. You know, I hope he doesn’t watch this lecture.

Aimie Apigian, M.D.

I mean, it sounds like for him, they, they were actually big things that, that did cause him a sense of overwhelm and feeling unsupported and without the resources that he needed to, to get through for whatever reason. Right.

Kent Holtorf, M.D.

Yeah. And it’s, it’s, it’s affected in the needs classic. And again, the same parents saying, you know, uh, anything, but wow. And like what percent of the population, I guess everything’s, uh, you know, is a, is a continuum. Um, but I just see what are the typical characteristics of someone that has this issue?

Aimie Apigian, M.D.

Sure. Well, we can look at two different things to find this out, and we can look at their behaviors and actions, especially in relationships, but it shows up in absolutely every area of their life, because this is how their nervous system is wired. This is how they move through the world. So it shows up in every area of their life, which is why it can be easy to notice and look for those patterns, the other place that we can find it is in their health. So there are certain health issues and conditions that they will develop over time. It accumulates. So it’s over time that if they have those, then we’re pretty sure that they have these types of patterns in their nervous system. And that is, you know, just kind of as a side note, it’s really helpful when we see these patterns, because we don’t need to understand this story. We don’t need to go into analyzing it. Like we really don’t have to be in, uh, in the head and the logic we get to just understand what is the body saying? And so how can we work with that? Which is obviously what I’m talking about.

Kent Holtorf, M.D.

Yeah, that’s right. It’s exactly who the heck cares where it came from. This is where you are. Right. I think I really liked like that approach. So, so what is, what does stress do?

Aimie Apigian, M.D.

Yes. So with stress, the stress is not always what’s bad. And when we talk about stress, we even know that there are forms of good stress. So it’s not that the stress is bad. It’s just, how is your body equipped to deal with the stress? And usually with a stress, your body can come back after that period of time and come back to a place of health. So it’s not stress per se. That’s bad. What is bad is when it becomes overwhelming. And when something has become overwhelming, you start to hear words like it’s too much. I can’t take it anymore. I’m I’m done with it. I can’t do this anymore. Those are words of overwhelm. And that’s what really changes our biology. It’s not so much the stress, it’s the overwhelm. So there’s two reasons for overwhelm. One is that a stress is too much for too long or something happens too fast. It’s too much and too fast. So those are the two reasons for overwhelm and that’s what is really going to affect our health and our work, our relationships, our energy, because that’s when our body starts to shut down. 

We talk about the dorsal vagal response. So dr. Stephen Porges kind of brought this to light, where he separated the fight and the, and the flight response, right? The runaway or fight survival response. And he separated that from the freeze response, they are two completely different biological approaches. And when we talk about stress, we’re talking more about the fight or flight. And when we talk about overwhelm, we’re talking about the freeze two completely different things. And the freeze is what has even the most impact and lasting effects on our system. Stress has acute system, acute changes to our system, overwhelm and freeze have lasting effects on our system. And on our health,

Kent Holtorf, M.D.

God, I, I know that I get like overwhelm. I can’t do anything. I’m like, I got so much to do. What’s right. It’s like, yeah, it’s too much. Wow. Yeah. And I think, yeah, more and more, it’s just you it’s commonplace

Aimie Apigian, M.D.

Is, and this has become really common. And that’s why we do want to bring up these topics about even childhood, because when people have this default pattern to overwhelm and they go pretty quickly to overwhelm, we know that that pattern started in early childhood. In those first 12 months of life, meaning they will not have a memory of this. This is something that, that their nervous system developed already having this programmed response to overwhelm in it. And so it’s very common, very common. And I think even just this year with everything that’s hit our world, we have seen how much, how much fear there is and how much overwhelm there is, where people have very little resilience to stress. They go very quickly into overwhelm and, and lashing out and doing very overreactive things in response to overwhelm.

Kent Holtorf, M.D.

Yeah. It’s that everything’s piled on. Exactly.

Aimie Apigian, M.D.

Yeah. When we go, yep. When we go into overwhelm, we have very strong reactions that are overreactions. We’re not responding to the situation. We are reacting. We are overreacting in fact, because of, of these patterns in our nervous system.

Kent Holtorf, M.D.

Gotcha. And so do you work on recovering from the past stress or managing current stress?

Aimie Apigian, M.D.

Both. Both. Both. Both. Yeah. So we want to definitely stop the progression of accumulating more stress and more overwhelm in our body. And, and this is stored in our body, right. And we want to stop accumulating more, but we also need to rewire our nervous system so that it has more capacity for stress. And doesn’t go into that overwhelm and reactive and just shutting it all down in order to get through. We need to rewire that in order to really arrive to a place of full health, because otherwise we continue to live with that wired into our system. And it, it compromises our health. 

It compromises our physical health by causing more inflammation and oxidative damage and stress. It causes a compromise to our mental health. So we’re struggling with insecurities that may even lead to depression or anxiety. And along with that is compromising our emotional health and our ability to handle stress and respond, uh, be able to interact with other people and, and not lash out, not get triggered by what they’re doing. And so all of our relationships are compromised in some degree, if we don’t go back and process and rewire, what has already been accumulated.

Kent Holtorf, M.D.

Yeah. And I, and I just think, you know, so many stress related illnesses, and I think it gets discounted by physicians and say, Oh, it’s a stressed out woman. You know, it’s like, and especially with like chronic Lyme disease and fibromyalgia it’s stress plays such a huge part. If they don’t have stress, they probably won’t get these other things, handle it, but it sets so many things into this vicious cycle. And you can’t really say, okay, just don’t be stressed or stay out of a stressful situation where they all have kids, they got this, like, what are you do lock yourself up, but that’s pretty stressful itself. I mean, how they deal with that stress are able to do that.

Aimie Apigian, M.D.

Exactly. And even when a person has these types of patterns in their nervous system, these insecurities that lead to overwhelm, we create stress. Right. So, you know, even, even just a recent example for me, right? Like I’ve done a lot of work on myself and I’m in such a better place. But even just this week where I was feeling insecure in a relationship, and there was no need to, but I had created it in my head of why didn’t they call me back right away? Why aren’t they, you know, responding to my texts, there must be something wrong. They, they must have found out something about me. Like they must, right. Like we create, we create the stress based off of our insecurities. And so until we actually rewire those insecurities, we’re going to have, we’re going to be constantly living in that, you know, when we’ve had these, yes. 

We’ll always have that tendency to go back to those. And we need to maintain, maintain a place of health, which, you know, that was my work to do this week. But, but without doing that work, we’re constantly living in those insecurities and second guessing everything, you know, why, why is my boss calling me into his office? I must have done something wrong. Or you know, that I wonder how long I’m going to be at my work. They, they must be, you know, thinking of firing me or if I’m running my own business, you know, something’s going to happen. What, what’s the next thing that’s going to happen? Is someone gonna Sue me? Right. Like we create our own stress from our insecurities. And so we really need to work with our nervous system, optimize it

Kent Holtorf, M.D.

And way to live. And when people’s accurate, it’s become our way to live. You kind of are, you know? Yeah. Yeah. And I see that in myself and we just to say, my mom was not happy unless she was worried about something, you know?

Aimie Apigian, M.D.

Right. And yeah, we don’t think of this being stress and trauma, but that’s what it is. It’s stress and overwhelm. That is a patterned into our nervous system. And so we recreate that constantly in our life without even realizing it.

Kent Holtorf, M.D.

Wow. That’s uh, that’s fascinating stuff. And so it’s, so how do you address this? You can say, you know, peptide, so what are the things do you do when we’ve recognized this pattern? Um, do you look at their immune system? Do you, or what type of things do you do to evaluate tree? Yeah.

Aimie Apigian, M.D.

So as, as simple as it is, it’s a big integrated,

Kent Holtorf, M.D.

You made it sound very simple. You’ve broken it down, but it’s yeah. I mean, it’s so complex, but you it’s awesome. Now you can make it be very understandable.

Aimie Apigian, M.D.

Yeah. Yeah. And, and what we’re doing is literally just rewiring the nervous system. So if you keep that in mind, that is our end goal. And so everything that will help us rewire the nervous system, help it to feel a sense of safety, security, uh, what I call a calm, a liveliness. And you know, when we go into the overwhelm, oftentimes we get to a place where it’s like, life has been so much, we don’t want to really be alive. There’s a part of us that just wants to go lay in our bed, pull a blanket over our head, not get up in the morning. I’m done, I’m done. Right. And so it’s this a liveliness, it’s this calm a liveliness that we want to be living from. And so we just need to rewire the nervous system for that. And like you say, just exactly. Yeah. Yeah. So everything that I’m going to talk about is for optimizing the nervous system to rewire it. 

So yes, there’s a lot of different pieces that I’m going to talk about, but the big picture is it all comes together to help rewire the nervous system from these patterns, these insecurities stress and overwhelm. So one of the big things that I like to start with is, Hey, let’s talk about the therapies. Cause when we’re talking about, you know, stress and overwhelm and insecurities, people naturally just think, Oh, I need to go see a therapist for that. So let’s talk about therapies and let’s just get that out there. There are many therapies that do not work for this type of thing. And the reason is because this has become our survival system. And when we talk about something, it’s really only in our frontal cortex, it’s not reaching the STEM, the limbic system, the autonomic nervous system where our body turns on these survival responses. And once our body turns on a survival response, it overrides overrules, any thought, any logic it’s going to survive, which is the beauty of our body, right? Like it knows how to survive

Kent Holtorf, M.D.

No outta here.

Aimie Apigian, M.D.

Exactly. So, so what we really have to do is work directly with the nervous system and with these survival systems. So talk therapy is number one on the therapies that don’t even bother because it’s not going to work, what therapies work. So there are specific body-based neurological based therapies that are very effective. So MADEC experiencing is one category of them that has been extremely useful in my life. And now I use it with all of my patients and I’ve got, you know, a course that will, that will teach people the basics for that. So somatic experiencing is a trauma therapy where we’re working directly with the nervous system and letting it process and resolve, uh, stored stress, stored patterns. Now, what can happen is that even if a person goes to these types of body-based therapies,

Kent Holtorf, M.D.

You describe that therapy. What that entails a little more

Aimie Apigian, M.D.

And for people who want more information, dr. Peter Levine is the one who founded this form of therapy. And so it’s a two year training program that I completed. And now I’m in my advanced training. I’m working with dr. Eileen LA pier for neuro effective touch now. So there’s just so much depth and richness here for what you can actually learn to do with the body. But what it is is that you are, uh, you’re not going into the story. So there’s not as much talking you’re experiencing actually what’s happening in your body and letting your body complete the survival cycle of whatever you’re working on in the moment. 

So for example, people who’ve been over in the military and in a place where they have seen, seen somebody get killed, right? Like that is, that is a trauma that is a shock to the body. And, and that gets stored in their body and less and less we process it. And so how we would address that in somatic experiencing is that we would have them just think of that time. They don’t need to tell us about it. They don’t need to tell any of the details about it. In fact, and immediately you see them start to sweat, they start to breathe faster, their, uh, their feet start to move. Cause they’re getting restless there just by thinking about that situation. Their body goes back into that moment and the emotional state and the survival state.

Kent Holtorf, M.D.

Well, let me think. I’m thinking of my ex wife. No,

Aimie Apigian, M.D.

Right? Like, I mean, there’s, so there’s so many different things, but we, we start with something, we start with something concrete and then we see what the body does. And usually what the body does is it is it starts to bring in everything from the past. That’s also correlated and part of that, and that’s where a lot of the childhood stuff can come into the middle of therapy because we thought we were working with, you know, when your dog died. And now all of a sudden we’re working with, when you felt abandoned by your mom or, you know, some something that’s somehow your body equated to a past experience,

Kent Holtorf, M.D.

But it’s not someone you have to figure it out. You already know, or they may not even know, but they go to that place.

Aimie Apigian, M.D.

Yes. And that’s really the cool thing about this is that you don’t even have to have memory of what we’re working with. Yes. Like we are just seeing what’s in your nervous system, what’s in your body that needs to be resolved and letting it resolve and complete the survival cycle. So that’s, that’s somatic experiencing yeah.

Kent Holtorf, M.D.

Little nutshell in there. So now they’re in that. What, what do you do?

Aimie Apigian, M.D.

Yeah. So what we do is that the body has a natural response, a cycle of survival. And that cycle is that we get activated. Right? We see a threat, uh, Oh my goodness. Like a car is coming towards me. It may hit me. It hasn’t hit me yet, but it’s a threat. And so we go into the sympathetic high alert and that’s where there’s the anxiety, there’s the heart beating fast. And again, like thought is really out of it. Our body goes into, what do I need to do to avoid this crash? And it’s not until afterwards that we think about, you know, like, why did I do that? Did I, did I put my foot on the brake? I don’t remember. 

Right. Because the body literally takes over. And what will happen though, is that if we say we do get hit, then our body goes into this like almost shock of, I was not able to escape all of my attempts to turn the car, to stop the car. It was few tile and I’m going to get hit. And the best thing for me to do is just to kind of go numb in order to not feel the pain of this, that right. There is the same line of going from stress to overwhelm where our body says that the best way for me to survive this is just to numb the pain and not care as much, not feel as much. And whether that’s physical or emotional pain, it’s the same response. So again, I’m, I’m using an example of a car accident, but this is the same thing.

Kent Holtorf, M.D.

Don’t think about it. Yeah,

Aimie Apigian, M.D.

Exactly. Yep. Yep. I’m not mean. Yeah. And we have all of these chemicals in our body. We have natural endorphins that get released in that moment so that it numbs pain. It numbs emotional pain. We kind of become flatline right. Where we really don’t care. Um, and it, it, it’s not that we don’t care. It’s just that our body has decided that that’s the best way to survive this situation. So that is, that is the second thing that happens in this survival cycle. What happens is that once we go into that, it’s almost like a timer. So when an animal goes into the freeze mode, right, you think of an, a possum or you think of a chicken that’s been overwhelmed. It goes into freeze mode. And it actually just like, kind of falls down. It’s not dead, but it looks dead cause it’s not moving, but it’s on a biological clock, meaning it will come out of the freeze. And that is the same thing for our bodies. It is on a biological clock. It will come out of that freeze and go right back into the same, either anxiety, fear, or anger that put it into the freeze. So it goes from the freeze right back into the sympathetic.

Kent Holtorf, M.D.

No period of on good. That’s just basically go,

Aimie Apigian, M.D.

Well, there’s this, there’s this phase of waking up. Right? And so, and so for people who, some people live chronically in the free state, that was me for, you know, a couple of decades of my life. I was chronically in the free state. And then I’d come back out, go into high anxiety, I’d get overwhelmed. And I’d kind of go back into the free state. And so there’s this period of, of our body waking up. And so we can feel like we’re coming out of a fog, we’re coming out of a days. And this is where we start to feel more. We feel more of the depression. We feel more of the anger. 

We feel more of the anxiety that has just kind of been numb than flat-lined during the freeze response. And so this is where the body then comes out of the freeze and in a normal survival cycle to complete that we then would orient. And so we would look around us and this is what you see animals do in the animal kingdom, right. They look around and they see, am I still in danger? And if they are, then you will see a deer or an Impala, you know, start and run away again. Right. Cause they’ve assessed, they’re in danger. But this, this process of coming out of the freeze coming out of overwhelm and orienting grounding would be another word for it, of coming back into your full senses. Am I safe? Or am I not? And obviously to complete the cycle, we need the body to feel and know that it is safe. If it,

Kent Holtorf, M.D.

Is there a timeframe where the cycle is in general or it can be totally variable or,

Aimie Apigian, M.D.

Yeah. And this is a really great question and it, I’m going to tell you that it depends on their baseline state of health, because if they have done work on themselves where they can come back out of this and feel like they are safe now, and they are in good health, meaning they don’t have a lot of inflammation in their body. Any medical issues are well controlled. Three days, three days has been the timeframe that people kind of just are in a state of a little brain fog. And in a days in a still in shock, after a single thing has overwhelmed them. 

What most people do is that they are in the freeze and when they come out of it, they still feel like they are in danger. They don’t have that sense of safety of security. And so rather than coming back into a place of good health, they go right back into stress and sympathetic state. And then they’re just like me, right? They’re going back and forth between stress and overwhelm stress and overwhelm. I’m going to do it all. And I’ve got a deadline and I’m going to get it all done. And I’m frantic, it’s, it’s a very high energy state and then I’m going to collapse and I’m going to be exhausted and I’m going to be irritable and I’m going to push people away. Right. And go back and forth between the two of them.

Kent Holtorf, M.D.

Wow. Yeah. You start thinking about yourself. I’m like, Hmm. Yeah,

Aimie Apigian, M.D.

Yeah. I mean, we all have these patterns to

Kent Holtorf, M.D.

A degree. Yeah. I think that’s totally true. And uh, so you, you look at those patterns and so like kind of what’s going on and what do you do about it?

Aimie Apigian, M.D.

Right. And this is where we bring in a lot of the other medical side of things. This is, this is kind of where I decided that I really needed to help and share this information because many people are doing this type of therapy and still getting stuck in their healing process. And it’s because they still have ongoing inflammation in their body. They have food sensitivities that are continuing to cause a constant level of leaky gut and leaky brain. They may have had head concussions or other things in their past history that lead to primed microglia and brain inflammation. And so they’ve got all this inflammation directly affecting their nerves and their survival system. And when we have that amount of inflammation, again, going back to this idea of stress, that is an internal stress and our nervous system is telling us, I don’t feel safe. There is look at all this inflammation. And so it’s going to get stuck in the healing process because until we can bring down the internal stress and create an environment for our nervous system for it to physiologically biologically feel no that it is safe, then that’s when we’re really going to experience major shifts in changing and rewiring.

Kent Holtorf, M.D.

Yeah. How do you get out of that? And I don’t know, I’m just thinking like asking neurologists, that’d be, how do you calm down activated microglia?

Aimie Apigian, M.D.

Yeah. This is where I bring in dr. Kharrazian and, and his work has trainings have been huge for my life and you know, the ones that I work with because I do like part of, part of my history, part of living in the fatigue. Well, not the fatigue as much, but just the freeze and overwhelm has been, I’ve had more injuries, more sports injuries. I’ve had a car accident, bad car accident where I had a head concussion and, you know, broke a bone because I was living in this kind of dazed and I wasn’t fully present. I was always thinking of a million different things. My mind was somewhere else.

Kent Holtorf, M.D.

That was just, I was going to ask, is that part of it also, or just issues I’ve never lived in the present it’s in the past and in the future. Exactly.

Aimie Apigian, M.D.

This is exactly what we’re talking about.

Kent Holtorf, M.D.

I think it also seems, and that’s part of like an addicts. So you know, this whole cycle, I imagined it dramatic cleats, uh, addicted have this, you know,

Aimie Apigian, M.D.

Absolutely. Yes. And this is where the nervous system and this regulation is the root cause of all addictions, because it’s these patterns that set them up for, uh, even responding to substances or behaviors in a way that really helps them feel better. And, and yet

Kent Holtorf, M.D.

Does that, do they, they just put him through all stuff in there just the whole time.

Aimie Apigian, M.D.

Yes. They’re dying the whole time. Yep. Yep. So the, yeah, the type of work that I do is addressing the root cause of addictions as well as stress and overwhelm, because it’s the same process that’s happening. Yeah. And then you’ve taken away the need for the addiction. Right. You’re not trying to manage it. You’re not trying to cope with it. You’ve taken away the need because you feel good already. You don’t need, you don’t feel the need to use something to feel better. You already feel better.

Kent Holtorf, M.D.

Yeah. You know, it’s that whole, I don’t want to bass one day at a time, like miserable. It’s just a matter of time, you know, that you’re

Aimie Apigian, M.D.

Exactly. Exactly. Yep. And the statistics all show that, right? Yeah.

Kent Holtorf, M.D.

Wow. Wow. So how do peptides park here? Absolutely. So when we talk

Aimie Apigian, M.D.

About these patterns and how it affects the body, and then when I’m working with someone who’s wanting to shift these patterns, I need to be addressing the chronic effects that this has had on their body. And like I said, creating the environment surrounding the nerves and each neuron cell with all of the support, the nutrients that it needs to feel safe and improve neuroplasticity and neuroplasticity is that word for it. You know, making the nervous system more, flexible, more, more able to change. And when we’re needing to rewire the nervous system, that’s what we need to do. So peptides have been a huge part of what I do. Obviously the first thing that I start with are the basic functional medicine principles, right? We need to be addressing the gut. We need to be dressing, primed, microglia. 

So all of that. But then when we can bring in peptides to help with that process, it’s just that much more powerful and enables us to accelerate the healing journey in the therapy process. So one of the, one of the peptides that I have used consistently for working with these people is the BPC one 57. And I know that many people use that as an injection, which I have done that as well. But when it comes to the trauma work, there is so much inflammation that happens in the gut and the science behind that is because of the vagus nerve and the overwhelm. And the freeze is all the Vegas nerve shutting the gut down. And so there’s so much inflammation that can happen. This is why there is more food sensitivities that happen in people who are stressed and overwhelmed. And so I use the oral BPC one 57 in order to really restore the health of the gut, the gut lining, and be able to reverse that inflammation and that damage faster. Because again, when I’m, when there’s inflammation in the gut, it’s going to be telling the vagus nerve, Hey, we are still in survival mode here. We’re not safe yet. So BPC one 57, the oral capital.

Kent Holtorf, M.D.

And there’s actually, you know, studies show that people think of oral as for gut. And it does affect the brain and gut brain access, but for systemic inflammation and systemic issues, you know, brain you’ve been joint that oral is equal potent to the amount of injectable. Exactly. And for systemic issues. So it’s not just for the gut, although it does help that, but it works systemically. Let me get, you know, samples out to people, whatever are they on my knees? Oh my gosh. For the first one. Yeah. Yeah. But I think people are kind of stuck. It makes sense. You think that systemic injections better. Although I find sometimes people think it feel better with injection. Sometimes they feel, yeah.

Aimie Apigian, M.D.

Yup. Yup. But addressing the gut inflammation is crucial for, for this, for this work. And then along those lines, any the other peptides that really help with not only inflammation, but especially neuroinflammation are going to be really helpful. So for that, the thymus in beta four has been another useful tool for me. This is one that actually works on the neurons and restores them to health after like a brain injury. And so it really is able to help a neuron get back to health after it’s had a shock. And usually that’s, you know, been in the form of a physical shock. But even I have found that when there is an emotional shock, when we’re dealing with inflammation in a neuron that famous in beta four can help the inflammation in general, but because it is a potent anti-inflammatory peptide, but then specifically helping again to create that environment around a neuron and bringing it back to health after it’s had an insult. So along those lines,

Kent Holtorf, M.D.

And I’ll just comment on that. Yeah. TB for some good studies on micro grill activation, basically suppressing those and kind of that brain on fire. And especially with so many conditions, even depression, traumatic brain line, it’s huge. And we’re finding also starting to use more, um, KPV or after you’ve used that yet, but it’s a Malana Corton. Um, so we use implanted fans, but the problem is you get, you know, tanning, which could be good, but if you’re older, you get dark spots and all that. Um, and then KPV is even more potent than the alphabet similarly hormone, but great for mass cell activation, uh, microglia. So we’re, we’re really liking that one.

Aimie Apigian, M.D.

Yeah. Yes. Yeah. And that was actually going to be the next one that I brought up was the KPV or the Malana tan. I have worked more with the Malana tan too than the Malana tan one. And what I have found really helpful with that again is just the neuroprotective and anti-inflammatory benefits. The other thing that I do, like with the Malana tan two over Malana tan, one is much is more of its metabolic support as well, because for many people who experienced the overwhelm energy is a big problem. And so when I can help their mitochondria, when I can improve their energy, they feel like they have more resources and I’ve increased their capacity to handle stress. And so I’ve, I’ve moved that line of, you know, stress to overwhelm by improving their mitochondria, improving their metabolism and giving them a little bit more extra energy. So along that, you know, just I’ll just mention some other things I definitely use, you know, in a D and a lot of the other, uh, all the supportive ways that I can optimize NAD and its integration into mitochondria. Cause that’s huge for neuron health and for energy. So those aren’t peptides, but I’m definitely using those along with the picture.

Kent Holtorf, M.D.

I think we want to talk about, uh, everything and it’s like, you know, I don’t know if you can just five amino, one MQ, um, which it’s actually not a bad time, but it increases the NAD inside the cell, or Mazzi use that. I use the Nazi is also, you know, people lose weight cause it’s basically showing the mitochondria the energy, but you look at all these neurodegenerative diseases, you know, they’re all low mitochondria and longevity. If you fix the mitochondria, you’re making people younger. Exactly. And cells that don’t have enough energy. Basically they even don’t have energy to die until you have all these old dysfunctional cells that are functioning, oppose turn into cancer, all those things. So yeah, dysfunctional cells with not enough energy, even you get low thyroid does the cells can’t bring fibroids in the cell, which makes less energy. So I think it’s a vicious cycle. Yeah.

Aimie Apigian, M.D.

Yeah. And then for those who have dipped over into chronic fatigue, which is a very, very strong association with overwhelm and freeze response, or if they’ve got Lyme or, you know, any of the chronic viral type of stuff, then I’m pulling out the thymus and alpha one for them again, more just to reduce the amount of internal stress that the nervous system will be exposed to because more of that internal stress and inflammation is going to keep the nervous system in survival mode.

Kent Holtorf, M.D.

Yeah. And it, and it also, yeah, I think, you know, goes along with, you know, mental health and stress and physical health. I mean, it’s so connected.

Aimie Apigian, M.D.

It is, it’s all connected. And so the more that I can improve their physical health, obviously their body is going to be in a better place. But again, like my, my big picture is always what can I do to optimize the nervous system to have it rewire faster? And so the other peptide that for me, has been really helpful for that is actually di Hexa because what I’m using the di Hexa cream for. And I usually, you know, have them put it on their neck is that it is even more potent than the brain derived neurotrophic factor. And so when I’m looking at enhancing the neuroplasticity of the nervous system for this type of work with the nervous system, then yeah. I’m pulling out something like the Hexa that’s usually used for more of a, you know, Alzheimer’s neurodegenerative Parkinson’s, but, but I’m, I’m needing to, you know, maximize optimize the health of nervous system. So I’m pulling it out in order to specifically get those effects, uh, that are even more potent than the brain derived neurotrophic factor.

Kent Holtorf, M.D.

Yeah. And, and, you know, it’s in a lot of clinical trials for Alzheimer’s and people, it gets kind of stuck in a little, you know, segment and, but yeah, so it’s an angiotensin for, um, uh, you kind of altered some for better absorption, but yeah.

Aimie Apigian, M.D.

Great. At crossing the blood-brain barrier, it’s in so many ways. I love it. Yeah.

Kent Holtorf, M.D.

There’s a lot of these in clinical trials and hopefully the FDA isn’t take all these peptides and also hormones and thyroid away, you know, it’s like crazy. The people are going to be suffered, but again, that’s a whole nother, a whole nother thing, but, um, yeah.

Aimie Apigian, M.D.

Yeah. And the other thing that I love about the dialects is that, you know, it actually increases the, the branching and the growth of new neurons that, you know, their Dendright, uh, tentacles, if you want to call it that. Yeah, exactly. And so, as I am working in trying to create new pathways in a person’s nervous system that, you know, well yes, show up in how they think differently. But again, for me, it’s, it’s not as much the thoughts, it’s the actual nervous system when I can shift that the thoughts will come with it. And so when I can find and use a peptide light by Hexa, that actually helps me, uh, you know, use, um, help their nervous system create more and different pathways. Yes. Like that is absolutely one of the ones that I’m going to be using. Yeah.

Kent Holtorf, M.D.

And it’s actually, you look at the amount of connections, cries of intelligence. So you can argue, you’re making the people smarter, you know? And, um, and essentially what, the five minute one MQ Q we’ve had some interesting results. What I didn’t expect was some people with like, Oh, CV by polar, within days gone. Yeah. And, um, and then we found, if you push it a little too hard, it kinda stops working. And then if you add something like PQQ or Mito cue to, uh, basically bring that, that oxidation back into the Antiox inside the mitochondria, it starts working again.

Aimie Apigian, M.D.

Yeah. I’m definitely using the PQQ ubiquinol higher doses of that than normal. I’m also working with actual toxins and detoxification because as we do different forms of trauma therapy actually talks, sins are released from the tissues into the bloodstream. We need to bind those and pull those out. It doesn’t happen at, at all the points in the trauma therapy, but at certain points, there are, there are big shifts that happen. And with those shifts, there are toxins that get released. And so we need to be able to bind those. And then, yeah, so it’s just this whole combined approach that I get to use in order to, it’s just trauma therapy and it’s not just functional medicine. It’s not just this, you know, cutting edge peptides and whatnot. Like it’s all of it combined that, that we get to use in order to, to really make some big shifts happening

Kent Holtorf, M.D.

To discharge, you know, mercury, whatever it is or the cell, they need energy. Exactly. They say, take, get rid of it and it poisons the mitochondria. So again, like you’re saying, get the energy, now it better bind to it, or it’s just going to go back in. Yeah,

Aimie Apigian, M.D.

Yeah. Yeah. So, I mean, this is, this is my, this is my work. Now this is my, this is my approach. No, I, yeah. I’ve worked with some, what people would consider a hard, uh, topic, uh, hard work, you know, trauma and attachment and, and stress and overwhelm. And yet, you know, like I get really excited because I know that

Kent Holtorf, M.D.

See the look on your face were most doctors like, Oh no, you know, they’re running for the Hills.

Aimie Apigian, M.D.

There’s so much that we can do. And in a relatively short amount of time, when we’re able to combine the body-based trauma therapies, the functional medicine approaches, and then this cutting edge biohacking, you know, all of that. And you combine those three. I mean, this is powerful stuff.

Kent Holtorf, M.D.

I, I love your passion. I’m just looking at your body language and your smile, how you know, and that’s a big statement. Hey, and not that very little time we can get it. And the confidence, because, you know, you talked to, uh, I don’t want to pay a therapist to put all of their fists out of business, but, um, it’s neat. It’s neat stuff. But I think it’s pretty cool stuff. Then a little different manner that I’ve found out through myself, but patients that, that, you know, it’s the, it’s like the economy to do, but it’s the nervous system Snoop, you know, it’s, it’s incredible the power of how that is the marker for health. And it is with so many things, whether it be depression, all simers, cardiovascular disease, all those things. I, I love it. Um, where are you located by the way

Aimie Apigian, M.D.

I am located in Southern California in the moment. So Temecula area. Yeah.

Kent Holtorf, M.D.

There you go. Yeah. Whatever the, uh, Republic of Gilbert, whatever, but, um, uh, Dawson. So in addition to peptides, what other therapies do you, so you mentioned a lot of them, anything else that you didn’t mention?

Aimie Apigian, M.D.

I mean, there’s a lot that I do that comes under functional medicine approaches. And so, you know, along with that, I’m also looking at methylation. I’m looking at biochemical imbalances, I’m looking at functional deficiencies of key nutrients, especially things like zinc and B6 are key nutrients for the nervous system. If those are functionally low, then the nervous system is going to be more reactive. Magnesium is a huge one. And for most people who are in chronic stress and overwhelm, all of them are very low in magnesium. I’m looking at their, you know, their detox system, their glutathione, what other glutathione levels, what are their vitamin C levels? So when I say functional medicine approach, you know, like it really is a wide range of things that come under that, but it really is all affecting the nervous system. 

Like we said, right? Like you can’t separate this system from that system, the mind from the body, it’s all one system. And so approaching all of that, this has been the key for me, you know, like the body-based trauma therapies, all of the functional medicine approaches and then, you know, biohacking and, and these cutting edge approaches with NAD and peptides. And, you know, some of the IV fluids that I’m doing, I will do some even micro dosing of ketamine for people. I tend not to do the IVs as much. I do more of the micro dosing sublingual, uh, for, for these trauma therapies. But again, like if I were to just do microdosing ketamine and the somatic based trauma therapies, it wouldn’t, it wouldn’t work. Like it wouldn’t be as, as powerful as when we combine everything and we’ve got the mitochondria just like so efficient, right? Like running on, you know, the, the most clean fuel efficiency ever and making all the energy in the ATP. And we’ve got the toxins cleared. Like the ketamine by itself is not going to be enough. The trauma therapy by itself is not enough.

Kent Holtorf, M.D.

There’s all these ketamine clinics and that’s what they do

Aimie Apigian, M.D.

Exactly. And they don’t have the foundation built up to really support the body’s integration of ketamine.

Kent Holtorf, M.D.

Yeah. It’s part of that whole thing. And I ozone-

Aimie Apigian, M.D.

Exactly. Exactly. So, yeah, I’ve, I’ve built like this neuro optimization program where I’m like, no, if you really want the best results, this is the approach. This is everything that we’re doing. This is how we’re stacking it. This is our schedule that we’re following because otherwise it’s, you know, for not very intentional and strategic, it’s more just disorganized and you’re throwing everything at it. And some things are sticking. Some things are not, and you’re wasting time, you’re wasting money. And so it’s like, no, we can be very intentional and strategic in what we do when we do and how we do it to get some amazing results in relatively short amount of time.

Kent Holtorf, M.D.

Yeah. I love how you say that. And, uh, and I think it’s kind of goes against the way medicine is really going very much. So heart mentalization, and that’s the problem. And you can say to people, I tried that, I tried that I tried that I tried that, and yeah, if you didn’t eat one separately, all of a sudden you do it Together, which, which goes to the art, but also you gotta be adopted. Right. All these things, right? Yeah. So, uh, yeah,

Aimie Apigian, M.D.

They do it all together and in the right order and with the right dosages. Yep.

Kent Holtorf, M.D.

Yeah. And it it’s complex. And I, I was just worried you made it sound so simple. There’s a lot going on.

Aimie Apigian, M.D.

There’s a lot going on. I mean, the simple, the simple thing is, Hey, we just rewire your nervous system.

Kent Holtorf, M.D.

Yeah. But yeah, there is certain things that are much bigger bang for your buck.

Aimie Apigian, M.D.

Exactly. Yep. Yep. And there’s a way that we can optimize your nervous system in order to have it rewire faster than if we weren’t doing all of these things.

Kent Holtorf, M.D.

Yeah. And it’ll just, uh, do you find exosomes and or utilized, uh, uh, what the disarray cell proteins, how are we going to do the new terminal, let’s say now, and, um, cell signaling cells or STEM cells, you find those helpful too

Aimie Apigian, M.D.

Towards the later stages. Yes. Not in the initial phases, like their body just does not have the amount of health and flexibility to use that well. And so that’s what I’m bringing in towards the end where we’re in a great state of health and now we’re really going for optimization.

Kent Holtorf, M.D.

Yeah. Because I think that they have too much inflammation. It just exactly.

Aimie Apigian, M.D.

Exactly. Yep. And as long as we’re still in the middle of the somatic, the body-based trauma therapies, there’s going to be more stuff coming up. There’s going to be pockets of inflammation that I, that I like to say, you know, pockets of inflammation that get released and discharged. And so that’s not the right time for exosomes and STEM cells. It’s not, not yet. Not yet.

Kent Holtorf, M.D.

Yeah. Awesome. Yeah, no, I agree. We do a whole thing beforehand and just probably they tend to work so much better, but again, another tool. Exactly. Uh, wow. It’s I love everything you say. It’s, it’s, it’s been, I’m like, I didn’t know this person, you know, down the road, it’s been kind of thinking the same way I have, you know, and kind of learning or separately. We kind of figure it out. Very similar things. I think, I think that’s awesome. And it’s just really neat to see these patients that oftentimes aren’t, you’ll be fine. They’re very reluctant to get treatment to start. And it’s like, I’ve offered like, you know, veterans like with Postmates has come in, I’ll feed you for free, you know, and they don’t come in. Right. And it’s like,

Aimie Apigian, M.D.

As part of their, part of their core beliefs from these patterns of, I’m not worth it, that, you know, they’re, they’re in their freeze and they’ve given up, they don’t care. So they don’t have the energy to put towards something that’s not just basic survival.

Kent Holtorf, M.D.

Why would you come in? Uh, right. But, uh, yeah,

Aimie Apigian, M.D.

They’re in their freeze, they’re in their freeze still, you have

Kent Holtorf, M.D.

This and [inaudible] thinking, uh, and I think it’s, it’s done you very well and able to put all these things together and kind of understand, Hey, this makes sense to go with this and telling you, just doing great work for some of the patients and changing lives. Um,

Aimie Apigian, M.D.

Well, that’s, that’s the hope, right? That’s, that’s my that’s my mission is be able to save people the time from learning from my lessons so that they, they don’t have to go through what I went through. They can have a much, much faster course in journey to healing.

Kent Holtorf, M.D.

That’s awesome. That’s awesome. Uh, I love this and I think you’re just doing great stuff here, you know, just talk about it ahead of the curve. So, um, that’s awesome. And pleasure to have you on, and thank you for taking the time out, uh, to explain this very complex, uh, conditions to make it actually understandable. Uh, so I, I think that’s great. You have a gift, so, uh, keep doing what you’re doing and thank you. Thank you. Great. All right. Bye-bye