The Stress Solution Page 8

  But this is not how we live today. Modern parents typically juggle intense work pressures with looking after kids and find themselves with less and less time even to talk to their friends, let alone gather with them every day to unwind, laugh and de-stress. Our elderly folk end up in care homes, staring out of windows for hours at a time, or at daytime television. A rising number of us are suffering from loneliness, and it’s not just the elderly. A recent study by the Mental Health Foundation found that eighteen- to thirty-four-year-olds were more likely to feel lonely than those over fifty-five. Scientists have long known how toxic social isolation can be. As far back as 1979 it was found that people with the fewest social ties were three times more likely to die prematurely than those with the most. Being lonely means you’re 30 per cent more likely to have a stroke or a heart attack. In fact, high social stress is an even bigger risk factor for dying from a chronic disease than physical inactivity, alcohol intake and smoking – put together.

  While it’s obvious how loneliness can make us feel unwell mentally, it’s less clear how it can have such an impact on our physical health. But the fact is that loneliness, like so much else that affects our wellbeing, is information. Because we’ve evolved to live as a single cell in the larger organism of a mutually supportive human tribe, when we feel isolated the brain reacts as if something’s wrong. It thinks we’re in danger. Back when we were hunter-gatherers, being isolated from the tribe would have been a death sentence. Loneliness is telling the brain: ‘I don’t have my tribe around me. I’m not safe. I might not be able to feed myself. I no longer have access to the tribe’s places of shelter. If I come under attack or injure myself, I’m in mortal trouble.’

  When the brain and body feel like they’re in a place of danger, there is only a limited menu of options of how to prime the body to deal with it, and one of the favourite go-tos is inflammation (more on this in ‘De-stress Your Diet’ here). George Slavich, a researcher at the University of California, Los Angeles, found that rejection and isolation switches your genes into a more inflammatory state. Over the long term, this makes your immune system weaker and predisposes you to a variety of life-threatening conditions, including type 2 diabetes, depression and obesity.

  PUBS AND CHURCHES

  There are a whole variety of reasons behind the current epidemic of loneliness, and many of them have to do with major changes in how we work and play as a nation. Up until very recent times pub life was stitched into the fabric of the existence of millions of Britons. Yes, people went there to drink alcohol, but for most pub-goers that wasn’t the pub’s only purpose. It was a place to get together, to share stories and experiences and to discuss any issues that were worrying you. It was the twentieth-century equivalent of the tribe’s campfire. The local church would have fulfilled the same role. But the first two decades of this millennium have seen huge declines in the numbers of pubs and churches in the UK. I believe these changes have been an enormous source of national stress, but nobody seems to be talking about it.

  Although we certainly don’t have the same café culture as France or Italy, I have noticed that people are now starting to get at least some of what they’ve been missing from pubs and churches over cups of tea and coffee. A few years ago, I got into the habit of stopping at a local café on the way to my surgery at 6 a.m. and ordering a black Americano. Morning after morning, I’d sit with my drink and savour it. Soon I began to recognize all the regular faces. We’d chat about what we’d been up to, discuss our plans for the day and talk about what was going on at home. On one occasion, my boiler had broken down and, instead of jumping on the internet and trying to find a plumber, I asked at the café. That got me thinking that this was like a local community. We evolved in groups in which we protected one another, pooled resources and worked together. This was exactly what was happening there. I was getting the same kind of value and interaction that people used to get from tribes, pubs and churches.

  BECOME A REGULAR

  Whether it’s going to your local café at the same time every day for a coffee, or going to a club, church or recreation centre, regular visits somewhere and a happy, open demeanour should lead you to becoming connected to a new group of people. Some examples include:

  A weekly yoga or Pilates class

  Participate (or even volunteer) in a weekly Parkrun

  Join a local sports club – table tennis, snooker, cricket, badminton or a martial art

  Join a local walking club

  Volunteer to help a local group, such as the Cubs or the Guides

  Have Sunday lunches with your neighbours

  Join a local book club

  Get involved with the rapidly expanding cycling community

  Take a regular class or workshop in a passion you wish to pursue, such as painting, sculpting, writing or learning a new language

  FAKE FRIENDS, FAKE COMMUNITIES

  Of course, one way we’re plugging the gaping hole that’s been left by the decline of our community institutions is by making connections on social media. But Facebook friends are not always ‘real’ friends. Likes and comments are no substitute for hugs and conversation. Even the way we interact online is different. One poll of 2,000 people found that roughly 25 per cent of them admitted making personal remarks to others online they’d never say if they were standing in front of them in real life. The revolutionary psychologist Professor Robin Dunbar, who specializes in research into our tribal, evolutionary history, has said that ‘People are more prone to saying something on social media that they later regret, because in these digital environments, we don’t receive the immediate checks and balances that we get during normal face-to-face interactions.’ When we’re on the other end of these negative comments, our bodies react as if we’re under attack. These are responses that have been hard-wired into our DNA over millions of years, switching on when we feel socially isolated and rejected.

  Another problem with online communities is that they change the way we get our sense of self-esteem. Everyone’s feelings of worth are tied, in part, to their sense of status. We all desire status, and Professor Mitch Prinstein from the University of North Carolina has written about the two very different forms it comes in: popularity and likeability. Facebook or Instagram ‘likes’ focus us on popularity, which encourages narcissistic, me-focused behaviour. This is a stress on the body, quite literally. If you feel disappointed when a post you make doesn’t gain any traction, that’s a form of rejection, and it will impact you on a genetic level. It’s information, to your brain and your body, that you’re not bonding with your ‘tribe’, which will flip you into a stress state.

  While social media can be wonderful if you use it to connect with people who share your interests and learn from those you admire, it’s important to be aware of the dangerous lure of popularity. Instead, try to prioritize likeability, which is the healthier form of status and is associated with much better life outcomes. It’s other-focused, not me-focused, and makes us concentrate not on how much we’re impressing our peers but on how likeable they find us.

  Personally, I don’t really call someone a friend until I’ve met them. A recent study estimates that it takes about fifty hours of time spent with someone to make a ‘casual friend’, ninety hours for them to move up to the status of ‘friend’ and two hundred hours before you can consider someone a ‘close friend’. This makes a lot of sense to me. Many of my closest friends are from my university days, when you get to spend hours and hours together. The fact is, people you’re interacting with online can only ever be peripheral to your life. You can’t truly know someone unless you’ve breathed the same air as them.

  MAKE MOAI MATES

  Thousands of miles away, in Okinawa, Japan, you can find the people who live longest in the world. The Okinawans have a concept of moai, groups of five friends who have committed to each other for life. Not only is this a wonderful idea, it’s also telling us something valuable about friendship. Feeling connected is not about the number of f
riends you have but about the quality of those friendships. If something really exciting is happening in my life, there’re only a few people I want to jump on the phone to share it with. It’s the same when something bad happens that I want to talk about. These are my moai mates.

  But with our busy lifestyles it’s often hard to keep such friendships nourished. Not only are we busier than ever but perhaps we feel we don’t need to catch up with our mates so much. After all, we ‘know’ what they are up to – we’ve seen their holiday snaps, photos of their kids, where they ate last weekend on our social media feeds. I find it remarkable that on your birthday you can receive between fifty and two hundred messages wishing you ‘Happy Birthday’. Of course, it is great to receive these messages, but is it really the same as one of your close friends remembering your birthday and actually making a call?

  Loneliness is on the rise these days. In fact, it is such a problem that the UK government has recently appointed a Minister for Loneliness. Although it can affect everyone, it does seem to be an issue that is disproportionately affecting men. Men are four times more likely than women to commit suicide and, on average, currently eighty-four men a month are committing suicide in the UK. While there are many factors that contribute to this, it is clear that the lack of a close group of friends is a significant contributor. In fact, the rate of male suicide has been linked to a steep drop-off in friendships after the age of thirty. Two and a half million men in the UK are reported to have no friends at all with whom they could discuss a serious topic such as worries about work, health, family or money. Women tend to find it more socially acceptable to spend time together – meeting up with a ‘girlfriend’ to go for a drink, a trip to the shops or a weekly fitness class, for example. Many men don’t feel as if they can do that.

  With pubs and other places for regular meet-ups gradually disappearing and the change in societal roles, many men feel a sense of isolation. In my practice, when I see men like this, we discuss ways in which they might be able to spend some time with people who share a similar outlook. Sports clubs can be great for those that way inclined, but see also the suggestions here. There will almost always be an option for everyone.

  DIARIZE TIME WITH YOUR FRIENDS

  Make sure that you are regularly diarizing time to meet up with your friends, in person. The frequency will depend on many things including workload, family and distance. For my university friends and I, who all live hundreds of miles away from each other, twice a year for a few days is what we can realistically manage. If you live near to your friends, perhaps every two weeks or once a month will work fine.

  Meeting up with your friends is not a luxury, it is an absolute necessity for good health. Why not pick up the phone right now and call your friends to arrange a get-together – what are you waiting for?

  THE CONNECTION PRESCRIPTION

  THERE IS NO MAGIC NUMBER. Don’t feel you need to have five moai mates. You may have one. However many you have, try to have one interaction every week with someone that goes to the heart. If you don’t feel that you have even one, try some of the strategies in the box here to start meeting some people who share your interests.

  PLANNING MAKES MATES. At the start of the year, think about your moai mates. Who are they? Have you got face-to-face meet-ups penned into your diary? My closest friends live hundreds of miles away from me, but I try to arrange to meet them at least twice a year. If your friends live locally, can you meet them once a week?

  CONFESS YOUR STRESS. I have a friend who was raised a Catholic. Although he’s no longer religious, he remembers how powerful the experience of confession was and how elevated and relieved he felt when he left the church having told an anonymous priest about the chocolate biscuits he’d stolen from the cupboard. I believe that Catholics have developed a powerful comfort instinct (see here) in confession, and it’s one that we can replicate in our moai interactions. We could begin by being unafraid to confess our stress. We shouldn’t be ashamed of the fact that we’re struggling. We shouldn’t feel we need to keep a stiff upper lip at all times. Stress doesn’t mean you’re a failure, it means you’re human.

  HAVE RISKY, MASKLESS CONVERSATIONS. I love what Gandhi said: ‘True happiness is when what you think, what you say and what you do are the same thing.’ This is what I strive for, although I’m certainly not there yet. We spend most of our lives trying to project an image to others. Whether we’re at the school gate or at work or having dinner with our parents-in-law, it’s very rare that we can let that mask down. Moai mates are ones with whom you can let your guard down, be authentic and take risks in what you say and do, secure in the knowledge that they get you and will always have your back.

  ‘True happiness is when what you think, what you say and what you do are the same thing’ – Gandhi

  WRITE LETTERS. I find that communications online are usually transactional rather than meaningful. We exchange information, but it’s rarely an exchange that nourishes us. My parents were born and raised in India and I still have vivid memories as a child of blue airmail envelopes arriving in the post. Mum would be so excited. With trembling fingers, she’d open the letter, stop everything and spend five minutes reading it from beginning to end. Her parents would have written the letter three weeks previously. Back then, international phone calls were extremely expensive and not that reliable. For my mother to phone her parents, she’d have to call a local operator, who’d then try to put her through to a local phone box, and even then the chances of getting hold of her parents were very slim. So these airmail letters had real value. The whole letter told a story: you could get a sense of the smell of India in the house; you got something from the ink that was used, and the handwriting, some of which was squeezed in at the tops and the sides just so it could all fit on the page. There’s something so precious and intimate about letter-writing. It takes thought and care and, when your handwritten letter arrives at its destination, it’ll be a precious moment for the receiver.

  MOVE ON WITH THANKS. Don’t be afraid to move on from friends who no longer nourish you, who don’t allow you to be yourself, who don’t want to hear your innermost thoughts or support you in your most vulnerable moments. This sounds harsh, but it’s crucially important. You don’t need to do it with animosity or regret. You can be grateful for the time you’ve spent with them and the purpose they served at the time. Don’t feel guilty about it. Life moves on. People change. Your drinking buddies from college may not be the people you choose to spend time with today. That’s OK.

  We feel stress in the body. When we’re having a bad day and those Micro Stress Doses (MSDs) are flying at us, we experience them as physical sensations: the tightening in the shoulder; the lurch in the stomach; the dryness in the mouth; the restless motion in the leg. These are the immediate bodily reactions to stress. But what’s not so intuitively obvious is that the body can also be a cause of stress. Just as your brain constantly monitors your environment for information, assessing whether you’re in a threatening place or not, it also monitors your body. If the signals sent from the body are bad, we become stressed. This pillar’s going to tell you how you can change the information that your body is emitting. By making a few simple decisions about how you eat, move and organize your day, you can start living much more of your life in a healthy, happy thrive state.

  Chapter 7

  EAT YOURSELF HAPPY

  Over the past few years I’ve been through a personal revolution in my understanding of how important the things we choose to eat are to our psychological wellbeing. This crystallized for me back in 2015 when I read an editorial in one of the most prestigious medical journals in the world, The Lancet. The editorial claimed that ‘nutrition may be as important to mental health as it is to cardiology, endocrinology and gastroenterology’. This was a simply amazing claim. Could it really be true that our food choices affect the functioning of our minds to the same extent that they affect the health of our hearts and stomachs?

  It just so happened tha
t, at the same time, I was treating a patient in my surgery who’d been suffering with an especially tricky set of mental health issues. There was no mystery as to the initial cause of forty-eight-year-old Biba’s problems: she’d been in a horribly traumatic motorway accident in her early twenties and had experienced bouts of extreme anxiety and panic attacks ever since. She felt stressed from the moment she woke up until the minute she went to sleep. She’d seen countless doctors and had tried a whole range of antidepressants, none of which really helped her. She’d also been referred to counsellors, but she found the impact of talking about the crash too painful and kept disengaging.

  I quickly realized that Biba had developed a number of coping mechanisms that centred on her food choices. She’d buy meal deals from a high-street shop and would eat a lot of highly processed food throughout the day: sugary cereals, chewy lollies, biscuits and sausage rolls. ‘Yes, there are serious emotional issues that we need to tackle,’ I told her. ‘There’s no question about that. But you’ve already tried going down that route and without much success. I think we should change tactics and take a look at your diet.’ She was a bit resistant at first, and I completely understood why. Her problem was psychological. How on earth could the living nightmare she’d witnessed on that motorway be counteracted by a piece of steamed haddock?