The Stress Solution Page 2

  SICKNESS BEHAVIOUR

  Over the past few years it has become clear that chronic inflammation can be the underlying cause behind many cases of depression. Much like other stress responses, inflammation can be life-saving in the short term – for example, to help an infected wound heal – but it can start to become toxic when it is not switched off. If the body is receiving regular information that it perceives as stressful and dangerous, the inflammation becomes chronic, ongoing and unresolved, and the body starts to think it is under attack. It’s long been known that one of the clever ways that inflammation fights off bugs is by making us feel tired and reducing our appetite. Back when we were evolving, weariness and nausea would have made us retreat to the back of the cave, in the dark, away from danger, encouraging us to rest until we had recuperated.

  It’s now theorized that many cases of depression are in fact activations of similar protective mechanisms. Some of the hallmark symptoms of depression include low mood, indifference and anhedonia (an inability to experience pleasure). In my surgery, these are some of the most common complaints. Take forty-eight-year-old Emily, who used to love walking her dogs, was extremely vivacious and self-assured. Recently, she has been coming into my surgery complaining of feeling down on herself, of lacking self-confidence, motivation and energy, having no desire to go out with her dogs, and that she no longer enjoys seeing her friends. These are the same symptoms we might experience when we’re suffering from inflammation. The body reacts as if it is being attacked by a virus or chased by a dinofelis when, in fact, it is under attack from the modern world. The inflammation seems to be having a psychological effect, pushing us to the back of the cave – or under the duvet with the curtains drawn.

  YOUR EMOTIONAL BRAIN

  Such cases of depression will likely be exacerbated by specific changes in the brain. We have two large neurological systems which, very loosely, we can talk about as the rational brain (which makes logical decisions) and the emotional brain (which processes our feelings and fears). You can think of these systems as being in competition with each other, each one constantly vying for the top spot. Normally, when we’re in a thrive state, our logical brain is in control and we can make sensible decisions. But when we’re stressed our logical brain steps aside and the emotional brain takes centre stage.

  This is entirely the correct response when we’re in dangerous territory. It means that the brain is now hyper-vigilant for threats, which complements the physical fight-or-flight response that primes the body to react. But once the stressor has gone, the logical brain should take back control. The problem is that the brain is ‘plastic’ (that is, it changes its form over time), so the more frequently you feel stressed, the more powerful your emotional brain will become. The more Micro Stress Doses (MSDs) you take on, the more your rational brain will be deskilled, while your emotional brain will grow ever stronger.

  The amygdala is a key component of that emotional brain and consists of two small, almond-shaped areas. They grow when we experience repeated MSDs over an extended period of time. The amygdala is an alarm system for trouble. The more it swells, the more powerful it becomes and the more sensitive it is to detecting warning signs in its environment. If your emotional brain has grown too powerful, you’ll start to sense danger even when there’s no danger present. The smell of a summer barbecue is misinterpreted as a house fire. A rushed email from your boss is interpreted as a prelude to sacking. An innocent glance from a friend seems sarcastic and hostile, full of hidden meaning. Your emotional brain is reigning supreme.

  THE FEED-FORWARD CYCLE

  The barrage of MSDs that modern life throws at us means that all these exquisitely balanced biological and neurological systems become disrupted. Your brain changes itself and becomes more aware of threats generally, increasing your susceptibility to them. As well as this, your stress broadcast service starts to misfire, sending alarm signals when it should be sending happy signals. Like my Cupboard of No Return, this is a feed-forward cycle. The stress you’re experiencing makes you more sensitive to threat as your body and brain prime themselves against what they’ve decided is a dangerous environment. The more stress you experience, the more sensitive to new stresses you become. Your dominant emotional brain may make you come across as paranoid and defensive. You’re also likely to make bad food choices, have less sleep and drink more alcohol. The physical stress state will begin to damage your body, as it tires of always running in fifth gear, and you may become unwell.

  MACRO STRESS DOSES

  While this book is primarily about dealing with Micro Stress Doses, I absolutely recognize that some people come into my surgery who’ve had significant Macro Stress Doses in their life – and experiences they’ve had in the past are impacting their behaviour, their psyche, their personality and their health. Over the last few years there’s been some fascinating research carried out on what scientists call Adverse Childhood Experiences (ACEs). It’s been found that people who have had these ACEs are much more likely to have various unwelcome conditions, including auto-immune disease and heart trouble. But people also suffer from Macro Stress Doses in adulthood. Some lose children, or are the victims of violent crime, or have had bad experiences while on active service in the armed forces, or some other form of adverse experience that has left a permanent mark on their wellbeing. If you’re one of these men or women, I believe this book can be even more helpful to you. There’s a strong likelihood that you’re living your life much closer to your stress threshold than most, which means it takes fewer daily MSDs to cause you problems.

  My wife, Vidh, has experienced the lasting effects of a Macro Stress Dose. When I was away for work, she used to struggle to sleep. Even though we live on a very busy street, with lots of people around, for some reason she’d become extremely scared and anxious. She’d take the kids into her room, repeatedly make sure all the doors and windows were locked and jam a chair against the bedroom door. Then she’d be up for much of the night, hyper-alert for any unusual noises. Vidh was raised in Kenya. During the coup in the early 1980s, when she was a young child, people were marauding the villages, attacking and killing people and ransacking houses. On one occasion, when intruders came to her family’s door Vidh’s mum put her and her brother in a kitchen cupboard and told them to be silent. Her father used to barricade the doors every evening with large sofas and heavy furniture. She doesn’t consciously remember this happening, but when the story was told at a family dinner one night everyone became extremely emotional. Vidh was in tears. Once she recognized that her behaviour now was rooted in an experience that had been stamped into her subconscious, she spent time talking to a post-traumatic stress disorder (PTSD) specialist and is no longer so anxious when I am away from home. In addition, since her Macro Stress Dose is now being addressed, she is much less susceptible to all the MSDs that used to ‘stress her out’ because she is now living life much further away from her own, personal stress threshold.

  COMFORT INSTINCTS

  Of course, stress, whether it comes in micro or macro form, is nothing new. And humans are a unique animal in that, as well as our evolved biological systems, we also rely on culture to help us and shape us. Humans have been coming up with cultural treatments for stress for thousands of years, and I think it’s extremely useful to look at the solutions they’ve come up with down the centuries with an open mind. You don’t have to be a religious or spiritual person to understand the comfort that, say, prayer or practising gratitude or meditation has been for people for generation after generation. Science is just catching up with some of these and is ambivalent or even openly sceptical about others. The good news is I’m not a scientist, I’m a GP, and it’s my job to understand all the latest research but also to take into account what’s worked for my patients over the seventeen years I’ve been treating them.

  HOW TO USE THIS BOOK

  The Stress Solution is broken up into four pillars: Purpose, Relationships, Body and Mind. Each one represents a stress super
highway that, if you’ve bought this book, you probably need to get under control. In the first pillar, I introduce a big idea that is often not spoken about in the context of our health – meaning and purpose. The second pillar looks at our relationships and how the modern world is affecting them and putting them under strain. The third pillar deals with stress as it manifests in the body, in poor diet, in taking the wrong kind of exercise and keeping unhelpful daily routines. And the fourth pillar looks at our minds – how twenty-first-century living is tormenting our minds and giving us no respite, with a devastating impact on our mental health.

  Importantly, each stress superhighway works both ways. A lack of meaning in our lives stresses us out, but too much stress makes it harder to find meaning. A lack of nurturing relationships causes stress, but stress itself can damage relationships. Abusing our bodies with poor lifestyle choices is a significant stressor, yet stress makes it harder for us to make those beneficial lifestyle choices in the first place. And not prioritizing the health of our minds will absolutely raise our stress levels, and vice versa. Just like the Cupboard of No Return, it’s not only a result of stress, it is a source of stress as well.

  In The Stress Solution I am going to give you practical solutions that you will be able to apply in your life immediately. Each pillar contains a wide selection of solutions that will help change the information that’s being delivered to your brain and body. I’d like you to start slowly, picking one or two of the easier interventions from each of the pillars, before slowly building up. It is not about perfection in one particular pillar – you are aiming for balance across all four.

  You absolutely do not need to do every recommendation. You can personalize this to what you deem most relevant in your life at this particular time. However, the more you do, the easier it becomes to do the rest. It is a feed-forward cycle, just like stress. If you are not sure where to start, pick the one thing that you feel you can do immediately and try it for the next seven days. Bit by bit, little by little, you will start to take control of all the stress in your life. You will learn how to change each stress superhighway from being a Friday-evening-rush-hour commute into a relaxing Sunday-morning drive.

  The first pillar, for me, is the most crucial. I believe that the major elements missing from the lives of most people are meaning and purpose. In order to tackle this, you’ll need to have periods of calm space to stop and think and then pursue one or more new activities that you are passionate about. Filling your life with meaning and purpose is the single most important thing you can do to live the life you’ve always dreamed of.

  PURPOSE

  Make Daily Affirmations (see here)

  Reframe Your Day (see here)

  Practise the Three P’s of Gratitude (see here)

  Make a Schedule (see here, here, here)

  Zone In Each Morning: With the Three M’s (see here)

  Apply the L.I.V.E. Framework (see here)

  RELATIONSHIPS

  Keep a Touch Diary (see here)

  Do the Seeing Eye to Eye Exercise (see here)

  Implement the 3D Greeting (see here)

  Make a Plan for Intimacy (see here)

  Become a Regular (see here)

  Diarize Time with Your Friends (see here)

  BODY

  Eat the Alphabet (see here)

  Your Daily Exercise Prescription (see here)

  Burn the Stress Away (see here)

  Eat Your Food within Twelve Hours (see here)

  Reduce Liquid Stress (see here)

  Treat Yourself to Sleep (see here)

  MIND

  Take a Digital Holiday (see here)

  Mute Your Digital World (see here)

  De-clutter Your Life (see here)

  Enjoy a Daily Dose of Nature (see here)

  Meditate for at Least Five Minutes Daily (see here)

  Have a Regular Breathing Practice (see here)

  When we consider stress, we don’t usually think of meaning and purpose. But living a life that’s devoid of these qualities is inherently stressful. I’d even go as far as to say that the single best way of living a calmer, happier life is to do it with a strong sense of purpose. But what do I mean by ‘purpose’? One way of thinking about it is as living your life on purpose.

  People with a strong sense of purpose enjoy significantly better health compared to those who don’t, including less likelihood of developing heart disease, strokes and depression. Research also shows that they sleep better and live longer. Perhaps more crucially though, people with a sense of purpose live happier lives.

  As a GP, I’m seeing more and more patients making good progress but then hitting a plateau. Often, when I start delving into the state of their wider lives, I find that they’re not their own masters. They have no control. Things are just happening to them. The roles they’ve taken on in life are in charge of them, rather than the other way around. They think their job or the fact they’re raising children is who they are. When I ask them about their life’s purpose, they tell me, ‘I’m a mother’; ‘I’m a father’; ‘I’m an IT worker’ or ‘I’m a teaching assistant.’ But none of that tells me who they really are.

  This is a crucial question that every one of us needs to ask. Are we just trying to be what other people – parents, spouses, bosses – want us to be? Or are we living our lives authentically? Do we even know who we are well enough to answer that question? If not, we need to ask ourselves, ‘Why do I deal with stressful events the way that I do? Is it really me acting this way, or am I mirroring my father, my colleagues or maybe a friend I look up to? Which of these behaviours do I want to change?’ These are not easy issues to tackle and you can spend your whole life trying to get to the bottom of them. But that’s OK because, cliché as it is, it also happens to be true that life is a journey. Discovering ourselves is a huge part of that journey.

  YOUR RAISON D’ÊTRE

  A good place to begin is to ask what we want for ourselves. The French call this your raison d’être, or ‘reason for being’. Ask yourself, why do you bother to get up in the mornings? Is it because you’ve got a list of things to do, or do you purposefully want to get up because you’re keen to achieve certain things? So often, the poor lifestyle choices people make, such as bad dietary choices or drinking too much alcohol, have their deepest origins in them not being in touch with their true purpose. If you work in a job you hate with colleagues you don’t like and a commute that drains and enrages you, is it any wonder that, as soon as you’re back home on Friday, you open that bottle of red or peel the wrapper of that deliciously tempting chocolate bar?

  I could talk to you about alcohol and sugar being bad for you, and it might make a difference for a week or even a month or two. But if drinking too much alcohol or eating unhealthily are compensation for the lack of meaning and purpose in your life, you’re always going to struggle. When I hit a roadblock with my patients, this is often the underlying issue. They don’t have a reason to get out of bed in the morning.

  But here’s the problem. In order to find out who we are and what our purpose is, and then begin to change our lives, we need time. And time is precisely the thing that the modern world is stealing from us. This was really brought home to me about five years ago as I was driving through the Dordogne region of France one Sunday on the way back from a friend’s wedding. I noticed that all the little villages I was going through were like ghost towns. The shops were locked, the shutters closed; there was hardly anybody on the streets. French people, I was thrilled to discover, still protect their Sundays. They’re meaning days, days reserved for them to interact with others, eat long meals, play in the garden and pursue pastimes and hobbies that bring them joy. Sadly, this long tradition is now beginning to erode, not least in the more urban parts of the country. If you ask me, this is a tragedy.

  Thirty years ago, we had proper Sundays. We couldn’t check our work emails on a Sunday. We couldn’t pop to the supermarket. We couldn’t jump on to some online retail site and
buy things. The only programmes we could watch on TV were snooker games, Formula One rallies or black-and-white films, or so I remember. If we hadn’t bought bread on Saturday, we weren’t getting any until Monday. And do you know what? We coped. We managed. Now, whether it’s Sundays or the continual erosion of our evenings, we’re all having an essential resource stolen from us: time. There are many invisible costs to this, and one of the least understood is the fact that it robs us of the chance to really think about ourselves and our purpose in the world. We all need to feel there’s a point to our existence beyond picking up a pay cheque. If we don’t, we’re automatically living our lives perilously close to our stress threshold.

  In this first pillar I’m going to give you a selection of strategies that will help get you to a place, in your head and in your wider life, in which you can tackle meaning. Firstly, we’re going to look at ways you can start seeing the life you have in a different, more positive way. This will help you achieve a mindset that’s strong and calm enough for you to begin to make changes. Secondly, I’m going to help you eke out some more time in your busy day to really think. Then, I’m going to give you a brand-new framework so you can start the process of finding your reason to get up in the morning and your true purpose. Once you find true meaning, you will be well on your way to becoming the best, most authentic version of yourself.

  And if you are one of the lucky ones and feel that you’re already living your purpose or that you are well on your way to doing so, the principles I outline in this pillar will still be beneficial. They will help you to understand yourself better and to refine your journey.