Toxic Stress Author Video

I'm Lawson Wilson I'm the author of toxic stress I'm a psychiatrist by profession um and I have spent my career um both teaching and studying uh mindbody questions I've um been training uh resident Physicians to become both uh primary care physicians and psychiatrists and spent my um research career trying to think about how things like depression turn into heart disease and how stress leads to various kinds of illnesses and so um writing this book um has been a a passion of mine for probably the last 10 years I started working on it about six years ago because I think that stress is one of the most fascinating m you know it's a bit like um the the climate there's a good joke about an old fish uh swimming in water um and he passes to uh young fish swimming the other way and he asks these young fish how's the water and after the old fish swims by the younger fish says to the U the other one what's water and the point of the joke is that stress is so pervasive and so all around us that we have a hard time even noticing it um unless it's really extreme and we have a hard time measuring it it's a little bit like climate change that way or any any other really complex um fact about our environment and so um working as a physician in um primary care settings as well as even in psychiatric settings it's very common for people to talk about stress and then forget about it in the clinical encounter in other words it's something that we intuitively know but doctors are not very good at measuring it not very good at treating it and so it's really not a very common part of anybody's treatment plan for common chronic illnesses that are stress related and made so much worse by uh toxic stress toxic stress really begins with the Dilemma we all have of trying to understand how stress in our daily lives turns into illness that can either slow us down or even kill us early and that involves learning how to differentiate between good tolerable and toxic stress in other words stress even though most of us think of it as bad is actually inevitable um unavoidable and quite good for us in um many ways in small doses so you know Evolution has um given us this stress response system which is a enormously complex system of systems all of which um self-regulate and it happens automatically you know even in little babies this stress response system is working at the time of birth and as we um grow it becomes even more elaborate and more complicated with the central nervous system being the the commander you can think of it a bit like an orchestra and the conductor of the orchestra is the central nervous system but imagine trying to coordinate all the functions of the heart and the lungs and the gut and the immune system and the skin and the muscles and the nerves it's enormously complex and yet we don't think twice about it it happens automatically every day until it gets out of whack disregulated doesn't work very well and that's what we call initially distress or discomfort and eventually if we don't um get it in line again and get it re-regulated we end up developing illnesses that may take on a life life of their own and you know in extreme cases something as stressful as severe depression will cut 10 or 15 years off of your lifespan compared to your sibling who doesn't struggle with depression and so it's a very costly uh process over the over the lifespan and yet in the course of a single week or a few months we may not even be aware of this quidding away way at our stress response system when it's so one of the interesting things about my job is that I have spent a lot of time working in Primary Care settings as a psychiatrist and when I go to my professional meetings I am surrounded by people who are convinced that stress is a major factor in the development of most chronic conditions like high blood pressure death diabetes or obesity or heart disease but when I come back to working in Primary Care settings most of my primary care colleagues don't spend any of their time um measuring stress or treating it because the guidelines for treating diabetes or heart disease hardly mention uh stress as a contributing factor to the onset or the progression of any of these common conditions and I got wondering wh why is this happening um how could we be ignoring something that's so important and why is this happening all over the world and in very high-powered medical centers as well as rural sort of underresourced medical settings and one of the answers is that the stress response system is a very complicated system of course and it's very hard to measure and stress Neuroscience has only been around for about 50 years that may seem like a long time to some of you but cognitive Neuroscience you know the study of intelligence has been around for a hundred years and yet we only just 20 or 30 years ago developed a comprehensive way of assessing various kinds of intelligence stress Neuroscience still hasn't come up with a comprehensive way of assessing the sort of total stress profile that any body has experienced either currently or preferably across the lifespan we're still trying to figure out how can we measure the kinds of stresses that people are struggling with right now or in the last few months and if you think about it what really matters is not just what you're what storm you're navigating right now but how many storms in your life have you navigated and if you grown up in a stormy environment a stormy family stormy internal um physiology all of that will accelerate aging um contribute to the development of these stress related diseases and sometimes uh shorten your life by 10 or 20 years so I wrote this book primarily to Foster conversations between people who have stress related condition conditions and the people who take care of them and this includes the family members of people who have these common chronic conditions and are wondering what can I do about them and you know one of the few things we can do about complicated illnesses like heart disease and diabetes and obesity is adjust the amount and the kinds of stress that we're exposed to and increase our resilience our ability to with understand life's um burdens and challenges and so I'm hoping that the people who read this book will be people who are living with uh chronic illnesses that are uh well known to be stress related or people who are living with people who have these illnesses um and the clinicians that take care of them you know a lot of these conversations get initiated by patients who are asking the people who take care of them to attend to things like how's why is my blood pressure out of control now why do I have to be on three medicines isn't there anything else I can do that's not pharmacologic and I think modern medicine needs to get smarter about the non-pharmacologic ways of managing common chronic illnesses and for many people that's things like better sleep um more frequent meditation exercise of various sorts therapy counseling ways of resolving conflicts with bosses or family members or friends so there are lots of ways of re-regulating a disregulated stress response system none of them is a quick fix and so um there there are several sections in this book about the treatment of of stress related disorders that mostly involves retraining a badly disregulated stress response system well I think um one possibility there it'll be fun to find out one possibility is that most of the stress that we're exposed to is either good or tolerable and it's good in the sense that it helps tune up our stress response system that's a kind of complicated systems issue but there's a section in the book that talks about how the kinds of challenges that we do in our daily lives for which we have sufficient resources are good for us you know games are a stressor they're a fun stressor eating food is a little stressful but it's so satisfying um exercise sex um there are lots of good kinds of stressors that help tune us up and as long as we get the proper relaxation afterwards sleep at night sitting on the couch joking around with friends you know jokes and uh laughing is a form of stress that after which we all feel a little calmer and a little better and so I think it may be surprising for some people to learn that most of the stress we're exposed to is good for us it it helps tune up and keep our stress response systems sort of in Peak tone athletes and actors and performers are especially Adept at it one of the chapters in this book is called um Symphony and 10 flat by Usain Bolt you know one of for a while he was the fastest man on earth and this is a detailed look a kind of Fantastic look at what's going on inside his body during his last professional Sprint and it's a way of understanding the magnificence of the way uh the stress response system Rises to in this case an invited challenge one of the good stressors running uh a Sprint um in this man's glorious career and it's an example of the good kind of stress you know doing the LA y or just driving your kids to school is a tolerable kind of stress things for which we have um plenty of resources and we reel it off almost without thinking the stressors that make us sick and kill us are the the unrelenting ones that we perceive as um demanding us beyond our resources to match them and these are um harassing bosses uh abusive parents poverty crime multiple chronic illnesses a number of adverse childhood events like being abandoned or separ uh parental separations the list is long and it's the cumulative burden of those kinds of stressors that move us from tolerable stress into that toxic stress Zone that then sets up the development of diseases because we're we're trying to operate on a stress with a stress response system that has no can no longer self-regulate it can't tune itself up and so our immune systems start to stutter our cardiovascular systems might not be able to get uh oxygen to all the organs that it needs in certain times the coronary arteries spasm or clamp down or Harden and and so profusion um is less than optimal and then it becomes a kind of vicious cycle one illness leads to another to another there's a syndrome called metabolic syndrome that involves having at least three of five possible risk factors and it's the kind of platform for people who make up a large proportion of primary care visits these are people who are a little bit overweight have a little bit of high cholesterol or high lipids their blood pressure is creeping up their blood sugar is creeping up and it's sort of a catastrophe waiting to happen and if we wait until the heart attack or the insulin coma um then they're already in a in that disease Zone and it's much harder to go backwards the message in this book is that we need to focus on early detection and earlier prevention that's a much easier task than trying to cure somebody of their diabetes or their heart disease so there are a lot of books uh about stress out there um I think this is the only book that really challenges us to translate what we can do about stress into the uh the clinical setting in other words um because I spent most of my career trying to bring Psychiatry into either internal medicine or Family Medicine settings um it's very clear to me that we need to do better in Primary Care settings at initially recognizing people who are on this pathway towards stress related illnesses and then bringing the resources to these patients and their clinics in Primary Care settings that can actually influence that course and change it and that's a big systems issue and so part of what fascinates me about this is that there's a there's a problem on the individual level or the the doctor patient level but then there's also this Health Care Systems level and then there's this much larger Public Health Dimension that we need to recognize that you know about one in five of us is exposed to toxic stress at sometime in our lifetimes in a way that can uh dramatically increase our risk for either developing or exacerbating uh some common chronic condition that's a pretty sizable public health problem and it's really worth um major resources being thrown at um the people who have already just in childhood um been exposed to you know four or more adverse childhood experiences these people have a very high risk of developing physical illnesses and uh mental illnesses that are going to dramatically um shorten their lives or make their lives a whole lot rougher and that to me is a very Worthy Public Health Target for funds research and um Innovations in healthcare delivery so I think that one of the um difficult to grasp facts about modern public health is that over the last 30 or so years there's been a remarkable rise in the pre prevalence rates the the frequency with which people are developing common chronic illnesses that have one key factor in common I'm thinking about diabetes you know the remarkable rise in diabetes rates the remarkable rise in obesity and these really contribute to rises in the incidence of heart disease and hypertension at the same time um rates for depression have gone up rates for suicide have gone up in ways that nobody has a good explanation for rates for um attention deficit disorder along with this uh there's another puzzling rise in autoimmune disorders particularly among women we don't really know what all these disorders have in common but one of the things that is that we do know is that all of these have a particular sens ity to toxic stress we know that toxic stress increases the likelihood for either the onset of these illnesses or the accelerates the rate of developing complications and in some cases increases the rates of um of early death and this is true for most psychiatric illnesses as well and so it seems to me that uh the the sooner we can understand how Str has this pernicious effect on such a wide range of illnesses um the more likely we are to come up with efficient interventions that can um change the course of these illnesses early on in cost-effective ways and these are not going to be simple interventions we already know among the ones that work that it takes probably six or nine months of almost daily practice to shift somebody out of the course of pre-diabetes for example or to resolve somebody's com U combined depression and heart disease in a way that actually reduces the risk of their progressing and so there are some very promising uh treatment programs that share in common this practice of um daily um minding of U stress levels diet exercise sleep um in the context of Fairly intensive uh social support through support groups that are focused on managing the illness of interest you heart disease or diabetes or depression anxiety so um I think what we're learning is that our Health Care Systems will need to invest in these kinds of treatment programs um fairly intensively uh in order to be able to both reduce the uh the suffering and also reduce the costs of ignoring the effects of toxic stress on these people who are at high risk like these people who have metabolic syndrome well I think the one of the takeaway points here is that we can understand uh good tolerable and toxic stress we can learn to understand the fascinating Mysteries of the stress response system and we can certainly do better at measuring uh toxic stress in a timely fashion that then um will help us translate that into treatment plans that really reduce the impact of toxic stress on the course of common chronic illnesses because you can't live without it um you know it is uh essential to survival um Evolution has been totally focused on developing A system that is as resilient as possible um and as resourceful as possible within certain limits and the sooner we know uh our own particular stress response systems because my system is just different than yours in so many ways the sooner I know sort of where my breaking point is and where I'm uh particularly resilient you know that's how people like usin bolt get to be such so good at sprinters they have a um particular gift but then they also build that uh gift that particular aspect of their stress response systems for you know excessively good performance in the rest rest of us in our daily lives we just need to be know we need to be much smarter I think about where our vulnerabilities are and where our particular strengths are and learn how to manage them well hard to do that if you don't have a good measurement of it my dream is that we would all get some kind of stress profile the day we graduate from high school um a little bit like wouldn't it be also wonderful if we had a good cognitive profile and we knew really how we learn and how we think and what kinds of intelligences we particularly have that would reduce so much frustration I think um for people who are confused about what they can and can't do and the same is true of a good stress profile well I I think toxic stress has always been relevant um in this book I try to highlight um particularly modern forms of toxic stress uh technology has sort of robbed us from sleeping with with the sun um and so we are exposing ourselves to all kinds of stimulation that leads to Chronic insomnia in a large proportion of the population and that's a form of apparently mild toxic stress but when you think about the cative burden of cheating on sleep for decades um it adds up and um we we pay for it sooner or later and so um you know technology is uh forcing this issue uh covid certainly forced the issue on all of us um our growing awareness about child abuse and childhood trauma is forcing this issue on us um it's all long overdue uh but we now have the U ability I think to measure the stress response system in a way that we never could in daily life um using wearable devices and um very fancy software that can analyze enormous amounts of data even for a single person if you get a large enough sample over weeks and then months and sometimes years that's a tough data analytic task the more we can do that and do it well the better we're going to be at figuring out whose stress response systems are in that toxic stress Zone and how uh we can efficiently uh retrain them in ways that will promote good health instead of early death

Channel: Cambridge University Press

Views: 48

Keywords: Stress, Psychology, Medicine, Toxic Stress, Illness, Chronic Illness, Mental Health, Health

Id: JVEy05ox0Vc

Length: 25min 40sec (1540 seconds)

Published: Tue Apr 16 2024