Not Fixed, Still here

Toren Ylfa

There's a particular kind of exhaustion that sleep doesn't fix. A particular kind of struggle that therapy helps but doesn't solve. A particular kind of life that doesn't follow the recovery arc. Not Fixed, Still Here is a podcast about mental health—all of it grounded in science, shaped by lived experience, and honest about the gaps in between. Hosted by someone who has navigated depression, emotional and physical abuse, and over two decades of asking challenging questions about the mind, this show brings together psychology, neuroscience, and the therapeutic frameworks that actually helped—CBT, DBT, EFT, and NLP—not to tell you what to do, but to help you understand what's happening and why. Every episode moves between the research and the reality. The science is real. The uncertainty is named. And nothing gets wrapped up too cleanly. This is not a wellness show. It is not therapy. It is not a recovery story with a tidy ending. This conversation is for those who are intellectually curious, emotionally exhausted, and tired of receiving easy answers. Not Fixed, Still Here. The science of mental health, without the performance. If this show means something to you, you can support it here: Toren "TY" Ylfa If you or someone you know is struggling, support is available 24/7. Call or text 988 (Suicide and Crisis Lifeline) or text HOME to 741741 (Crisis Text Line).

Episodes

  1. 6d ago

    Do Therapeutic Models Need Improvement?

    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. Support the show

    24 min
  2. Jun 19

    Was I Always Going To Be Like This

    Send us Fan Mail 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)  Support the show

    28 min
  3. Jun 5

    CBT Origins, Evidence, and limits as NHS default for Complex Trauma

    Send us Fan Mail The origins of CBT through Aaron Beck’s challenge to psychoanalysis summarize where CBT’s evidence base is strongest and examine how CBT became a system default in the UK—sometimes mismatched to complex trauma presentations. The episode closes by distinguishing PTSD vs. complex PTSD evidence, raising concerns about “unthinking” default application, and pointing listeners toward alternative/adjunct approaches and the next episode’s focus on biology/genetics/epigenetics/neuroplasticity. Show Notes:  Primary Sources—CBT Origins & History Beck, J. & Fleming, S.—Aaron (Tim) Beck MD—British Journal of Psychiatry (2022) Beck, J. & Fleming, S. — A Brief History of Aaron T. Beck MD and CBT — Clinical Psychology in Europe (2021) American Journal of Psychotherapy — Aaron Beck obituary (2021) StatPearls / NIH — Cognitive Behavior Therapy — NCBI Bookshelf (updated 2023) Beck Institute — History of CBT — beckinstitute.org (2023) NHS Access & Waiting Time Data NHS England — Mental Health Access and Waiting Time Standards (2024) Nuffield Trust — NHS Talking Therapies (IAPT) Programme Statistics CQC—State of Care 2024/25: Mental Health Access (2025) Royal College of Psychiatrists — NHS Therapy Waiting Times (December 2024) Money and Mental Health — Improving Wait Times for Mental Health Services (2025) House of Commons Library — Mental Health Statistics: prevalence, services and funding (2024) CBT Effectiveness & Limitations — Peer-Reviewed Research BJPsych Advances — CBT for Complex PTSD (2024) Frontiers in Psychology — Psychotherapy for CPTSD: efficacy and therapeutic factors (2026) ScienceDirect — Efficacy of psychological interventions for CPTSD: meta-analysis (2025) PMC—Recognition of neurobiological insults from complex trauma and implications for psychotherapy—CNS Neuroscience & Therapeutics (2015) World Psychiatry—PTSD: evolving conceptualisation and evidence—Brewin (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). Support the show

    26 min
  4. May 22

    You Are Not as Alone as It Has Felt

    Send us Fan Mail You are not as alone as it has felt. Nearly one in three adults in England and Wales experienced some form of childhood abuse before the age of eighteen. That is 13.6 million people—according to the most recent Crime Survey for England and Wales. But statistics can count people. They cannot hold them. In this episode we look at what the data actually shows about the lifetime prevalence of childhood abuse — and more importantly, what it doesn't and can't capture about what it means to live inside those numbers as an adult. This episode covers childhood abuse, long-term mental health outcomes, and the gap between official data and lived experience. Please take care of yourself as you listen. If anything in this episode brought something up for you, support is available 24/7. Call or text 988, text HOME to 741741, or contact NAPAC at 0808 801 0331—a free support line for adult survivors of childhood abuse. Sources: Primary Data Sources  Office for National Statistics — Abuse during childhood in England and Wales: March 2024 (published November 2025)  NAPAC — Key Facts and Figures 2025 — napac.org.uk/key-facts-figures  CSA Centre — Child sexual abuse in 2023-24: Trends in official data (March 2025)  Peer-Reviewed Research  Hailes et al.—Long-term outcomes of childhood sexual abuse: an umbrella review—The Lancet Psychiatry (2019)  Cleece & Hill — Sexual abuse and post-traumatic stress disorder in childhood, adolescence and young adulthood — Journal of Family & Child Health (2025)  1958 British Birth Cohort — Child maltreatment associations with developmental trajectories and long-term outcomes — PMC (2020)  Latiff et al.—A systematic review of factors associated with disclosure of child sexual abuse—Child Abuse & Neglect (2024)  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)  NAPAC — 0808 801 0331 — Free support line for adult survivors of childhood abuse  Support the show

    25 min

About

There's a particular kind of exhaustion that sleep doesn't fix. A particular kind of struggle that therapy helps but doesn't solve. A particular kind of life that doesn't follow the recovery arc. Not Fixed, Still Here is a podcast about mental health—all of it grounded in science, shaped by lived experience, and honest about the gaps in between. Hosted by someone who has navigated depression, emotional and physical abuse, and over two decades of asking challenging questions about the mind, this show brings together psychology, neuroscience, and the therapeutic frameworks that actually helped—CBT, DBT, EFT, and NLP—not to tell you what to do, but to help you understand what's happening and why. Every episode moves between the research and the reality. The science is real. The uncertainty is named. And nothing gets wrapped up too cleanly. This is not a wellness show. It is not therapy. It is not a recovery story with a tidy ending. This conversation is for those who are intellectually curious, emotionally exhausted, and tired of receiving easy answers. Not Fixed, Still Here. The science of mental health, without the performance. If this show means something to you, you can support it here: Toren "TY" Ylfa If you or someone you know is struggling, support is available 24/7. Call or text 988 (Suicide and Crisis Lifeline) or text HOME to 741741 (Crisis Text Line).