The Stress Solution

  DR RANGAN CHATTERJEE

  THE STRESS SOLUTION

  THE 4 STEPS TO RESET YOUR

  BODY, MIND, RELATIONSHIPS & PURPOSE

  PHOTOGRAPHY BY SUSAN BELL

  CONTENTS

  Introduction

  How to Use This Book

  1/PURPOSE Chapter 1/ The 3 Habits of Calm

  Chapter 2/ Schedule Your Time

  Chapter 3/ How to LIVE More

  2/RELATIONSHIPS Chapter 4/ Human Touch

  Chapter 5/ Get Intimate

  Chapter 6/ Nurture Your Friendships

  3/BODY Chapter 7/ Eat Yourself Happy

  Chapter 8/ Make Exercise Work For You

  Chapter 9/ Reset Your Rhythm

  4/MIND Chapter 10/ Technology Overload

  Chapter 11/ Bathe Yourself in Nature

  Chapter 12/ Take Time to Breathe

  Conclusion

  References

  Acknowledgements

  Follow Penguin

  ABOUT THE AUTHOR

  Dr Rangan Chatterjee is a pioneer in the emerging field of progressive medicine, a leading voice in the lifestyle medicine movement and is changing the way that we look at illness. He is known for finding the root cause of people’s problems by taking a broad approach to health, which was highlighted in his groundbreaking BBC TV show, Doctor in the House, and in his internationally bestselling first book, The 4 Pillar Plan. He is the resident doctor on BBC Breakfast, a regular commentator on BBC Radio and hosts his own chart-topping podcast, Feel Better, Live More. He writes for the Huffington Post and has a monthly column on lifestyle medicine in Top Santé. He regularly lectures on his subject at events around the world.

  drchatterjee.com

  Facebook: DrChatterjee

  Instagram: @DrChatterjee

  Twitter: @drchatterjeeuk

  Podcast: Feel Better, Live More

  For Vidhaata, thanks for

  taking this journey with me.

  INTRODUCTION

  Let me introduce you to the Cupboard of No Return. It lives on my kitchen wall. Open the door and you’ll see three deep shelves, each crammed top to bottom with the shrapnel of everyday family life. Looking at it right now, I can see a golf ball, two hammers, stacks of unopened envelopes, a passport, an academic paper about mitochondria that should have gone into my previous book but didn’t because it was stuffed in here, a broken screwdriver, two taxi receipts, a lightbulb that may or may not be functional, plastic pieces from a board game, a child’s glove and an electric toothbrush charger. The chaos in that cupboard is the cumulative result of dozens of isolated stressful moments in the daily life of me and my young family – from when my daughter lost her glove, to when a picture fell down and I was too busy to put the hammer back in the shed, to when I was running late for work and didn’t have time to put the mitochondria paper in its appropriate folder.

  Here’s why the Cupboard of No Return is such a problem. It isn’t just the result of stress, it also has the power to generate stress. Pretty much everything in there has the potential to sprout fresh moments of anxiety and frustration – when we want to play a board game and can’t find the pieces; when we’re rushing to get out and my daughter has only one glove; when the electric toothbrush has run out of charge and we can’t find the charger; when we’re rushing for the airport and we’re down one passport. Even looking at the cupboard is the cause of stress. I can feel it glowering at us as we eat at the kitchen counter, its presence a constant reminder of all the things we haven’t done. Even though I may not always feel conscious of it, it’s broadcasting information to my brain. It’s suggesting, in a surprisingly powerful way, that my life is out of control and that there are problems in my environment that I’m just not on top of.

  This is just how the stresses in our everyday lives work. The very existence of stress in our lives, minds and bodies has the power to generate more stress. The more that piles up, the less we’re able to cope and the nearer we move to that threshold at which we simply stop managing our lives successfully. That’s when we become overly reactive, emotional, weary and, eventually, sick. People who are stressed are more likely to fall out with others, binge on bad food and alcohol and fill up cupboards with problems that will inevitably tumble out on top of them at the worst possible moment.

  THE CONSEQUENCES OF STRESS

  Stress can have devastating long-term consequences for health. Too much of it contributes to the development of obesity, type 2 diabetes, high blood pressure, cardiovascular disease, strokes and Alzheimer’s disease. Stress is also a key player in insomnia, burn-out and auto-immune disease, as well as many mental health disorders such as anxiety and depression.

  Despite these risks, many of us are blasé about stress. We think we can get away with burning the candle at both ends for ever. The reality is very different. Every day I see patients who are literally stressing themselves to an early grave. I know a local accountant who is go-go-go the entire time. He never switches off, and his wife is worried. But because he has no serious symptoms at the moment, he won’t listen to either of us. He assumes nothing’s going wrong and that the stress isn’t harming him. But it’s probably damaging his body so much that, within a few years, I suspect he’ll be hit with a serious health crisis.

  Make no mistake, we are living in the middle of a stress epidemic. In fact, the World Health Organization calls stress ‘the health epidemic of the twenty-first century’. Up to 80 per cent of all GP consultations are thought to be somehow related to stress. In this book I’m going to give you a series of practical solutions to help you de-stress your life. Most of them are simple and some take less than fifteen minutes a day. I’ve seen these tools change the lives of thousands of my patients. I know they’ll do the same for you.

  MICRO STRESS DOSES (MSDs)

  We’ll never completely rid ourselves of stress. It’s unavoidable, especially in this day and age.

  We’re living in an era of information overload and work overload and sugar, alcohol and sitting-on-our-backsides-all-day overload. There seems to be more and more pressure on us as individuals and less and less support. Think about something as simple as booking a holiday. Twenty years ago a travel agent would have arranged it on our behalf and spared us all the hassle. Today, many of us choose to do it all ourselves, and this is the way so many things are going. We’re bleeping our own shopping through at the supermarket, having to work out how to fix our own computers by digging around on baffling online forums and poring through endless FAQ lists. Particularly with the recent tech explosion, we have more jobs to do, which is creating more stress in our lives. I call such individual portions of stress Micro Stress Doses, or MSDs. Whether they come from the tech in your life or they’re just the standard stresses that come with being a husband, a wife, a parent, a boss or an employee, there’s not a day that goes by without you experiencing plenty of them.

  Take a typical hour in the life of Alexandra, a working mum. She’s had a late night and her smartphone wakes her up at 6.45 a.m. (MSD1). She flips it on and checks her Facebook feed, where she sees that a work colleague is watching the dawn on a stunning Greek island (MSD2). She flicks to a news site and sees some horrible photos taken in the wake of a mains gas explosion (MSD3) and a headline about a hate crime thousands of miles away in Canada (MSD4). She gets a text message from her phone provider telling her that her bill is ready to view (MSD5). Her husband tuts at the pinging of her phone (MSD6). She realizes she has a heavy stomach (MSD7) and a blurry head (MSD8) after last’s night treat of a pizza and an extra-large glass of wine which she had allowed herself after her stress-filled day. She notices there are paw prints on the duvet as Muffles has been sleeping on the bed again (MSD9). She goes to rouse her son, who yell
s at her (MSD10). Feeling groggy and irritable, she yells back (MSD11). She goes to the kitchen, sees through the window that it’s raining (MSD12), registers how dirty the windows are (MSD13), remembers she has to track down a plumber to check out the weird dripping noise that’s coming from the hot-water tank (MSD14), has another quick look at her phone (MSD15, 16, 17, 18) as the kettle boils, sees the chocolate biscuits that are left over from last night and thinks, ‘Sod it, I’m eating one’ (MSD19). She realizes her son has still not got out of bed (MSD20) and, now feeling really frustrated, barks up at him to get bloody moving (MSD21).

  It seems I’m going to have to stop Alexandra’s typical hour after about eleven minutes. And if I were to list every MSD she suffers over an entire day, it would probably take up more space than I have in this book. So you get my point – MSDs are constantly flying at us from all directions, even when it seems that nothing especially stressful is happening to us. While none of us can avoid MSDs completely, this book is going to show you how to deal with their effects more successfully and, ultimately, how to orientate your life in such a way that you’ll experience far fewer of them.

  EVERYTHING IS INFORMATION

  Taking a deep dive into stress is going to mean introducing you to a new way of thinking about life and health. During every moment of your life there’s a constant interplay of information between body, brain and environment. Your brain is always monitoring what’s going on with you, checking everything from your breath, to your hormone levels, to what’s happening in your gut, to the things that are happening to you in the outside world. It’s treating all this activity as information that’s telling it what kind of state you’re in. In a similar way, your gut is taking information from the food you eat, seeing if you’re in a place of feast or a place of famine. Your immune system is taking information from what’s happening to you physically and emotionally.

  Humans exist within an ecosystem of information. All those sources of information talk to each other and ultimately produce just one simple question: am I safe or am I under threat? One of the big problems with the way we treat stress right now is that we often try to tackle it from a single direction. Attacking psychological stress from overwork by practising meditation or by booking and going on a break, for example, might have only a limited effect if the lifestyle choices we’re making in the kitchen, or the fried-chicken shop, are generating constant stress signals in our body through our gut. In this book, I am going to tackle psychological stress, emotional stress, dietary stress, physical stress, technological stress, life stress and much, much more. My goal in The Stress Solution is to impact the entire ecosystem, from every direction, so that the information you are receiving is that you are safe, and not under threat.

  STRESS STATE VERSUS THRIVE STATE

  When your ecosystem of information decides that you’re in danger, it switches you out of your thrive state and puts you into a stress state. When you go into a stress state, two separate biological systems are activated. The first one is called the autonomic nervous system, which controls all the automatic processes in the body, the ones we don’t have to think about, like breathing and digestion. This system has two branches, the sympathetic and the parasympathetic. When the body receives information that we’re in danger, the sympathetic branch releases the hormones adrenaline and noradrenaline. This sends signals to the rest of the body to actively change its functioning, for example to increase the heart rate so that more blood and oxygen are pushed out into our muscles. This is a stress state. Only when these processes go into retreat does our default parasympathetic branch – or thrive state – come back in control.

  The second biological system that is activated when you are in a stress state is what we call the HPA (hypothalamic–pituitary–adrenal) axis. We can think of the HPA axis as our stress broadcast service. Stress, whether it’s physical or emotional, is detected by a part of the brain called the hypothalamus. When it detects stress the hypothalamus releases a hormone that sends a stress signal to another part of the brain – the pituitary gland – which in turn releases a hormone to send the signal all the way down to your adrenal glands, which sit on top of your kidneys. Your adrenal glands then release a hormone called cortisol.

  Cortisol, along with the hormones adrenaline and noradrenaline, are your body’s primary stress response hormones. They put you into a ‘fight or flight’ state so that you’re primed to deal with danger.

  THE UPSIDES OF STRESS

  But the stress state isn’t all bad. Far from it. Your fight-or-flight response has been developed over something like 3 million years in order to protect you. Back in our evolutionary pasts we had all sorts of threats to deal with, not least the fearsome big cat, the dinofelis, which evolved to feed primarily on humans, its jaw and teeth perfectly designed for cracking adult skulls. When we were running from a dinofelis we needed to become a peak version of ourselves.

  To achieve this, our stress hormones would kick into action a series of processes in the body designed to give us our best chance of survival. Our pupils would become dilated and sugars would be released into our blood so that we could run faster. At the same time, muscle and liver cells within our body would become resistant to the hormone insulin, so that more sugar would remain in our bloodstream, rather than being diverted to our muscles for storage, and thus be available for the most important organ of all, our brain. Our heart would start to beat faster and our blood pressure would rise to ensure that we could move blood quickly and efficiently around the body. Additionally, our concentration would become heightened and our brains hyper-vigilant to any possible threat. Our immune system messengers, or cytokines, would become ramped up and start sending stress signals all over our body, and our blood platelets would become activated, to prevent clotting from any injuries that might be coming our way. At the same time, our libido would plummet and our digestion would be switched off. In that moment, we didn’t need to be working on digesting breakfast or, for that matter, procreating – the priority was survival. Anything deemed non-essential would be turned down or off.

  And these changes would not just help us escape; if we were to get injured by the dinofelis, or had tripped and fallen during the chase, they would have been life-saving. Let’s say we sustained a cut: the immune system, whose activity would have already been ramped up, would be primed and ready to help us fight infection. If we had a bleeding wound, the increased blood pressure would ensure that our brain’s blood supply was prioritized over the rest of the body’s and we’d be less likely to die from a haemorrhage, as our blood was more prone to clotting.

  These effects are the phenomenal creations of evolution. But they’ve been designed to work for us only over short periods of time, as we were dealing with an immediate threat, whether it was from a dinofelis or an aggressive human being. We’ve evolved to live most of the time in the thrive state, punctuated by brief moments of stress. The big problem in modern society is that we’re surrounded by stress triggers we haven’t evolved to cope with. These continually activate the stress state, meaning we spend more time in a stress state than in a thrive state. This can have serious consequences for our health.

  HEALTHY STRESS RESPONSES AND THEIR DANGEROUS LONG-TERM EFFECTS

  Healthy short-term stress response Long-term harmful effect

  Raised blood pressure in the short term helps transport more blood to the brain Chronic high blood pressure increases the risk of many diseases, such as heart disease and stroke

  Increased blood clotting will help save your life if you have a bleeding wound, as the bleeding will stop more quickly Long-term tendency for the blood to clot will increase the risk of having a stroke, heart attack or DVT (deep vein thrombosis)

  Increased insulin resistance in the short term means that your body won’t store any sugar in your liver and muscle cells. It will result in more sugar staying in your bloodstream, which means that more will be available for the brain Long-term insulin resistance contributes to t
he development of type 2 diabetes, obesity, high blood pressure and the production of harmful types of cholesterol, like VLDL

  The body’s resources are directed at making the stress hormone cortisol to help deal with the immediate threat, at the expense of the production of sex steroid hormones, such as oestrogen and testosterone Long-term diversion of resources to make cortisol will lead to hormonal imbalances and contribute to a wide variety of hormonal issues such as lack of libido and menopausal symptoms

  The body’s resources are directed away from digestion, as this is a non-essential function for survival at that moment If attention is diverted away from digestion for too long, digestive complaints will result, such as constipation, bloating, indigestion and IBS

  Small amounts of cortisol improve our brain function, which allows it to function better in a short, stressful situation, e.g. being attacked by an animal, or even to perform well in an exam Prolonged release of cortisol starts to kill nerve cells in the hippocampus (the brain’s memory centre) and may increase the likelihood of developing Alzheimer’s

  The emotional brain being on high alert to look out for threats is a very good thing if you are in danger If this becomes long term, it will make you more prone to anxiety, as you start to worry about everything and see danger when no danger is present

  Short-term inflammation is the result of your immune system firing up to help you deal with the threat and prepares you to recover quickly in case you have a wound that becomes infected Inflammation that becomes chronic and unresolved increases your risk of most modern chronic diseases, including type 2 diabetes, heart disease, obesity and many cases of depression