CHAPTER 1 Stress: How Do I Dodge the Bullets? ROBERT IS FROM THE school of old. He was brought up in an era when there were three choices in life for young men: be a doctor, a lawyer, or an engineer. He studied law knowing it would be a stable job with good security. Long, hard hours of study, bar exam, 70-hour workweeks, lots of coffee, and dealing with difficult people were all bumps on his road to success. He fought and worked his way up the ladder and is now a junior partner in a pretty good firm. The days are still long and the stress is ridiculous. He's definitely got less hair. His wife stopped working after their second child was born, so he now shoulders the entire financial burden for his family. He lives in a pretty nice house in a good neighborhood. They have a pool and a Jacuzzi he hasn't been in since last year. They own a time-share condo that they stress about getting to. Health insurance prices go up each year, and his youngest kid has asthma and some crazy food allergies--all of which cost money and time and create more challenges around the house. Even with a part-time nanny, there seems to be no sleep to be had, and their last vacation to Maui was more trouble than it was worth. He came back exhausted and dejected. Robert's life is filled with stress. Although he has a roof over his head, cars, and plenty of food, deep down, he's terrified. He knows he can't keep up at this pace. He feels like he's going to fall on his face one day, but he can't. After all, they all depend on him. He drinks coffee, goes to the gym, takes some multivitamins, and gets an occasional massage, but all the while his mind is filled with the pressures of keeping it all going. A good lawyer needs to drive a Lexus. Good parents send their kids to private school. Gymnastics and piano lessons are a must. The other parents are shipping their kids off to some fancy summer camp. Of course, we're in . . . The joy is gone. The stress has tipped the scale, and he's constantly trying to keep his chin up. His dad taught him that "real men" never give up; they fight the good fight for their family and never show any weakness. He watches the morning news while eating his cereal with the kids. He feels like an absentee dad who didn't really see them grow up, and he mourns this fact. Robert feels the weakness is gaining momentum, and he is terrified that he's going to lose the battle. After all, with all the stuff he's constantly throwing money at, they barely have any savings, and if he stopped working, they'd be in real trouble within a few months. His life insurance would pay out a decent amount if he keeled over, and a couple of times already, he's thought about it, and this scared the hell out of him. Robert is stuck. His adrenals are running on empty, and there's no end in sight. He can't see the way out, and each day, a silent desperation builds in the shadows of his psyche--a plight for the very survival of his family. Robert keeps fighting, but his doctor has warned that his blood pressure is getting too high. The stakes are high, and so are his numbers. What's a man to do? THE PROBLEM In a way, we all share Robert's problem. Our bodies developed and evolved over millions of years in response to some predictable stressors in our environment. "Fight or flight" is a beautiful system that helped us stay alive in a dangerous world filled with predators and scarcity. It evolved to help us get out of life-threatening situations by optimizing our metabolism to ramp up into crisis mode. When we're in danger, our cortisol and/or adrenaline levels surge to help divert bloodflow to the big muscles that will help us fight an opponent or flee from a predator. These are stress hormones that have top-down control over several systems in our bodies, and slight fluctuations in their levels move dials all over the place. They work in conjunction with an elegant switching mechanism in our nervous system. Our sympathetic nervous system drives the fight-or-flight reactions and quickly helps triage energy to where we need it in times of crisis. The opposite side of this switch is the parasympathetic nervous system, which can be considered the "rest and digest" mode where the body is free to heal, break down foods, and carry out detoxification and excretion. In times of danger, the body is designed to elegantly pull bloodflow from the internal organs, immune system, and parts of the brain that are associated with high cognition and drive that blood into the quadriceps so we can run like hell if we need to. It's great stuff when the shit hits the fan, but let's peel back Robert's life and see why this is bad news for a modern lawyer. Robert's stress is not from an acute incident. Sure, occasionally the car in the next lane swerves over and gets his heart rate (and middle finger) up, but that's not what's killing him. It is the chronic stress. A wild impala in Africa doesn't think about the "what if" scenarios of a lion charging. He eats, cruises around, has plenty of sex, and if a threat shows up, he runs for it. If he survives, he shakes it out and goes back to his business. Not us. We keep replaying the event in our minds, bind it to emotions, and visualize it running in different ways; we don't drop it. The impala has moved on, but we're in therapy still talking about it or, worse, still bottling it up. We don't really get into "rest and digest" mode enough to balance these systems out, so we stay wound up. Chronic stress is a killer. Robert has mini "life or death" moments every time a client threatens to cancel or a judge throws out a case. His wife came home with a fancy purse the other day, and it turned his stomach. "How much did that cost?" These modern stressors are basically death by a thousand cuts. Our abstract concept of money or currency is tied to our very survival and triggers the same circuitry. It messes with us and stresses us out. Money is tight, and deep down that means something that our bodies understand viscerally. Low levels of cortisol release over a sustained period of time have terrible consequences for the body. You can say that Robert lives in sympathetic overdrive and has forgotten how to switch back over and chill out. With the body constantly cutting bloodflow to vital systems, here's some of the predictable fallout. Restricting Energy to the Immune System A body that's under constant stress is like a country at war, and all the money, troops, and resources are being sent to the front lines (stressful fight-or-flight pathways). Who's left to police the streets? How do you deal with local gangs and terror cells? You can't. They sneak in, take hold, and then manifest as disease. By the time you call back troops from the front lines, the damage is done and you need to spend much more energy to fix it. The problem is not one of poor design. The human immune system is amazing. It is an elaborate universe that helps us recognize objects that don't belong in our bodies and get rid of them. When things are running smoothly, it is a marvel to witness the precision and efficiency of our immune system. But most people in the modern world are suffering from the consequences of compromised immunity. The Centers for Disease Control and Prevention (CDC) attributes stress as the cause of 90 percent of chronic disease. This is huge. Robert is doomed to get some nasty chronic disease once his system gets weak enough. It is just a matter of time. The problem is Robert's life. Every day, Robert unwittingly does things that draw resources away from his immune system and make it more difficult for his body to maintain balance. After some time, things will break and he will get sick. Cutting Energy to the Digestive System and Internal Organs When the body gets a signal telling it that a lion is coming, it draws blood from the viscera (internal organs) and drives it to the muscles that can hopefully help us survive the "attack." When this happens, the organs take a hit. Bloodflow is diminished to the organs as it is shunted to the big "get me the hell out of here" muscles. This cuts the energy and nutrients delivered to the vital organs. Think of it like a wartime economy. There's no money left for school books, street repair, or food stamps. When the digestive tract gets energy pulled from it regularly, we start to see issues with poor absorption, nutrient deficiencies, constipation or loose stools, indigestion, bloating, fatigue, and eventually leaky gut "syndrome." (I'll explain this later in the book.) "Rest and digest" is where we heal, but what happens when we don't allow ourselves to go there? Look around you. There's a trillion-dollar healthcare industry that makes money off of chronic diseases that stem from poor lifestyle and uncontrolled stress. Causing a Blood Sugar Roller Coaster When cortisol levels go up, all sorts of things happen. As mentioned earlier, bloodflow is directed to the "get me the hell out of here" muscles, but there's also a huge impact on blood sugar. Cortisol is like a credit card. In a crisis situation, the body needs energy immediately, so cortisol is like swiping a card to get instant gratification. It helps the body to draw energy from our glycogen reserves in the liver for our immediate needs, but that has some serious consequences. As blood sugar initially surges, the pancreas senses this and releases insulin to grab this sugar and shuttle it into the cells. This is all good, except when things start to fall off the tracks. After years of being on this cortisol energy roller coaster, the insulin spike often overshoots the sugar (energy) release, which then triggers us to get hungry and crave more sugar or carbs in order to balance it out. This can manifest in moodiness, irritability, headaches, and general fatigue; it often leaves us reaching for some coffee to bail us out of an energy lull. Maybe that muffin will help . . . We'll discuss the role of adrenaline in this craziness later in the sleep chapter. Most people have so many ups and downs with this that they feel like they're spent by midday Tuesday and are already dreaming of the weekend. Wreaking Havoc on the Endocrine System I've had dozens of elite athletes come to my clinic and secretly admit that they can't get erections anymore. Cortisol is often the reason why. These athletes burn out their adrenals with chronic elevated stress, and it eventually draws on their testosterone, estrogen, DHEA, and several other hormonal pathways. Robbing Peter to pay Paul seems to be the way of our modern era, and it is surely reflected in our bodies. Today, guys like our friend Robert borrow energy from tomorrow to get through today, but they don't look at the interest rate on that kind of deal. It sucks. Maybe you can bang through your thirties, but then you hit a wall and your body goes on strike. Once our hormones are off, we gain weight, drag around with fatigue, and take a hit in the bedroom . . . sorry, sorry, give me a minute . . . Of course, there are drugs we can take for all of these issues, but the root is often bad energy economics stemming from our adrenal burn rate. The drugs often have side effects, and the underlying problem tends to persist. Taking a Hit to the Brain Possibly the worst on the list of things that happen when we're chronically stressed is the cutting off of bloodflow to the prefrontal cortex. This is the part of our brains that separates us from the monkeys. It helps us carry out abstract thinking, problem solving, higher cognition, and higher moral reasoning. It's the part of the brain that helps with the negation of impulses. This area is called the third eye in the ancient traditions and should be cultivated and cherished. The problem is that the body's switching system knows that this part of the brain is not needed to scramble up a tree as a rhino is charging, so it diverts blood and energy to the hindbrain, which helps with instant reflexive behavior. Again, the body's impulse is "get me out of here or tear through that guy who's trying to take my stuff." On the off chance that you encounter a lion in Chicago, that's pretty handy. It also helps you to dive to a curb when a taxi doesn't see you crossing, but chronic misallocation of energy to the fight-or-flight brain keeps us reactive, distrustful, less empathic, and unable to make long- term, thoughtful decisions. Higher moral reasoning is what really made us what we are. Religion, ethics, honor, and self-awareness all come from this good gray matter, and our inability to use it is a tragedy. Most people live in "survival mode" and can relate. It is also a reason why so many people do things that harm them despite knowing better. We know that smoking isn't good for us, but many still do it. We understand that the pie is fattening, yet we eat it anyway. We tell ourselves that our exes are trouble, yet we find ourselves calling them again. Without good access to the prefrontal cortex, we're not using the part of our brains that empowers us to suppress impulses that harm our bodies. Living in chronic stress keeps us locked out of this area of our brains and drives us to be more impulsive and unaware. PERSONAL JOURNEYS When I came back from the Himalayas, I decided to take on the health-care crisis with my exuberant energy and charged sense of mission. I thought that I could fix a broken system from within, so I started a medical group and quickly grew it to three offices. We were featured in journals for our innovations in complementary medicine and were getting cool accolades, but I knew it was bullshit. Essentially, my training was in the prevention and prediction of disease, and here I was in a business model that required me to wait for someone to break and come in with a diagnosable illness. I kept trying to find work-arounds within this messy system and constantly dealt with insurance companies holding our money. There was an immense amount of stress, and it really put my meditation skills to the test. Excerpted from The Urban Monk: Eastern Wisdom and Modern Hacks That Will Help You Find Peace, Happiness, and Success in Today's World by Pedram Shojai All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
