Cable television shows feed nonstop cycles of adrenaline-pumping headlines. I wake up in the morning wondering what disaster has occurred overnight at home or abroad. My stomach tightens when I read of the daily, relentless dismantling of our government and the relinquishing of our country's leadership on the world stage. I worry about the dangerous erosion of hard-fought rights and, frequently, I realize that my breath has become shallow, accompanied by a constant sense of unease.
These are "fight or flight" sympathetic nervous system responses to fear and dread, and they are merging into one long and dangerous period of chronic stress. They have become increasingly common over the last eight months, during which our bodies have endured daily, breathless sprints that have morphed into a marathon with no end in sight. This chronic, intense level of stress is unsustainable and represents a significant threat to our emotional and physical health.
Chronic stress occurs when people feel they have little or no control over issues of importance to them. Unlike acute stress, which releases bursts of corticosteroids (particularly cortisol), and which our bodies are designed to accommodate for short periods of time, chronic stress results in the constant and harmful release of these hormones. When corticosteroids are released over a prolonged period, they can cause inflammation, high blood pressure (and subsequently heart disease), damage to muscle tissue, suppression of the immune system and impairment of mental health.
The American Psychological Association states that chronic stress kills through increased rates of suicide, violence, heart attack, stroke and possibly cancer. And stress is no stranger to those of us who lived through the AIDS epidemic of the 1980s and 1990s. Until the release of protease inhibitors, I experienced an unyielding course of life-threatening opportunistic infections and the loss of countless friends. For years, I lived in a constant state of anxiety, hoping to survive until the next drug trial or the approval of a new medication. Unlike any period in the last two decades, recent events are fueling a similar sense of struggle, powerlessness and survival across the social spectrum.
It is incumbent on us to engage in activism and resistance, but these actions alone are insufficient to protect our health. We must take personal steps to protect our T cells, our emotional lives and our health in general. Here are some steps:
1. Take Breaks From Social Media
Technology is impacting our cognition, emotions and even the structure of our brains as never before. It is no secret that sites such as Facebook are designed with features to keep us engaged, scrolling down the feed or frequently checking in to see how many "likes" we received on a post. Like crack cocaine, we get a burst of dopamine every time we do so, creating a (short-lived) rush of good feelings that sets up a cycle of wanting more. This soon drives us back to the site to check what's new. Such constant monitoring of social media keeps a smoldering level of excitement and anticipation alive. Unfortunately, this too releases the stress hormone cortisol. Numerous studies indicate that increased use of social media actually impairs memory, creative thinking and even empathy. One study found that people interrupted by technology scored 20% lower on standard cognition tests. The culprit is multitasking, which humans don't do nearly as well as they think they do. While it's unrealistic to completely go off the grid (at least for me), longer stretches of days or weeks away provide a social media detox that is beneficial for your health. If you decide to take a break, determine in advance how long you will be away, and when you go back online, turn off notifications and give yourself time limits on using the app. Finally, you may find it beneficial to delete the app altogether.
2. Practice 4:7:8 Breathing
When stressed, we tend to revert to more shallow breathing or even hold our breath. This can increase anxiety and contribute to panic attacks. Andrew Weill, M.D., a practitioner of mind-body medicine, describes a simple and effective breathing technique that he describes as a natural tranquilizer. Begin by sitting up straight and placing the tip of your tongue on the gums just behind your upper front teeth. Breath in through your nose for a count of four, hold your breath for a count of seven and exhale through your mouth for a count of eight. The length of the breaths don't matter as much as the ratio of the counts does. Begin doing this with four breaths at a time, and expand up to eight breaths with practice, twice a day. This exercise, also useful to induce sleep, becomes more powerful with repetition.
3. Keep Moving
Too busy or stressed to exercise? Think again. Physical exercise counteracts stress hormones like cortisol by causing the release of natural painkillers called endorphins, or what the Mayo Clinic calls "feel-good neurotransmitters". Whether a vigorous aerobic workout or a gentle session of yoga, exercise plays a vital role in stress reduction. The relationship between physical exercise and improvement in mood, cognition and even the ability of our brain to adapt to new circumstances around us has been documented in numerous studies. Research shows that even as little as fifteen minutes of exercise per day can have a beneficial effect on our mood and thereby our emotional resilience, although more exercise can improve our mood to a greater degree. For example, one study of heart patients showed that greater degrees of exercise were correlated with significantly fewer symptoms of anxiety and depression.
4. Practice Mindfulness
Mindfulness, the practice of simply living in the present, aims not to calm the mind but simply to observe thoughts and feelings as they occur. A simple set of skills, such as gently observing your thoughts and reactions, avoiding judgments and gently bringing your attention back to the present moment can reduce stress levels and improve the coping capacity of a broad range of individuals. Mindfulness can be incorporated into such activities as mindful walking, which can have an upward spiral effect on mood and negate some of the physical and emotional effects of chronic stress. It can also be practiced while driving, cooking or just relaxing. Such endorphins also play a role in elevating our mood, improving sleep and even reducing clinical symptoms of anxiety and depression. Ongoing mindfulness can actually change the structure of one's brain, creating more empathy, improved serenity and increased awareness.
5. Increase Social Connections
We are a society experiencing what the National Science Foundation, in their General Social Survey, has called an "epidemic of loneliness." The survey revealed that the number of Americans reporting having no close friends has tripled since 1985, with one-quarter of survey respondents citing "zero" close friends. The relationship between intimate emotional support and improved mental well-being has long been established, but newer research indicates that broader social networks have a similar effect. Such groups of friends and peers provide social support, social influence, opportunities for social engagement and meaningful roles, all of which reduce the harmful effects of chronic stress.
There are many other important strategies that increase resilience in challenging times, including adequate sleep, healthy eating, connecting with nature, recreation and a state of mind that fuels opportunities for gratitude and optimism. For those of us mindful of our immune system, and indeed for everyone else, taking an active role in in reducing chronic stress will not only improve the quality of our life, but may lengthen that life, as well.