We've called today's event the stress paradox. And if you're joining us, I'm going to go out on a limb and guess that you are no stranger to the idea of stress, the experience of it, the torture of being stressed. Honestly, even just the word makes my heartbeat a little bit faster, my shoulders tense up. Stress is a seemingly inevitable part of so many of our lives, especially if you are living a busy, fast-paced life, as I imagine many of you are. Uh, but we might be approaching it all wrong if we are just looking to sweepingly eliminate it. Maybe there are some good things stress can offer us. Maybe there is a way to use it to propel us forward, not drag us down. And that's what our guest today is here to talk to us about. April is stress awareness month. So, in anticipation, we are thrilled to be joined by a woman who understands stress perhaps better than anyone. She is a Harvard physician and best-selling author of The Five Resets: Rewire Your Brain and Body for Less Stress and More Resilience. Please give a warm welcome to Dr. Adidi Nurarb. It's such a pleasure to join you, Whitney, and the entire TED community. Hi, Adidi. Thank you so much for for being with us, and we have tons of questions for you. Um, but before we really launch into that, um, you are a physician. Uh, would love to understand more about your background here. Um, there's a a world of areas you could specialize in. Why did you specifically choose to focus on stress? So, that's like the million-dollar question. Before I became a doctor with an expertise on stress, I was a stress patient looking for answers. I was a medical resident working 80 hours a week in the hospital seeing death and dying on a daily basis. As part of my training, it was a really rigorous and robust program. And one particular month, I was in the cardiac ICU taking care of all of my patients hearts, not really thinking about my own. And after a particularly brutal call, I did 30 hours in the hospital, as is typically done when you are a medical resident. And I developed a stampede of wild horses across my chest. That's how it felt. Knocked the wind out of me immediately. I sat down. The nurse I was working with gave me some orange juice and it went away. The sensation evaporated within seconds. And we both laughed it up. And then I kept working. That sensation never again happened in the hospital. But night after night for weeks, Whitney, I I experienced that stampede of wild horses. And then I was very nervous. And so I went to go see my doctor like a good patient should. And my doctor did the million-dollar workup, tested my blood, heart, doing an EKG, a heart ultrasound, echo cardiogram. Everything checked out fine. And my doctor with a big reassuring smile said, "Hey, everything's great. It's just stress. Try to relax." We've all been there. Medical training is tough. So, I went home and I did what you're supposed to do when you hear your doctor say, "Just relax." I watched movies. I had a spa day, retail therapy, spent time with friends, went out to dinners. Nothing really seemed to help. And only when I put my scientist hat on, because as a medical trainee, I had access to lots of studies and data, I put on my scientist hat and figured out what is stress, how does it affect my brain and my body? Because honestly, Whitney, my first reaction when my doctor said it's stress, I thought stress doesn't happen to people like me. I'm resilient. I was living the resilience myth. We can talk a little bit about that because in my medical training, I was taught that pressure makes diamonds and I was a diamond in the making. And then my diamond cracked. And so I read everything under the sun at that time and have continued to stay up to date on all the literature to figure out how stress affects the brain and the body. I found my way out of stress, my own stress struggle. And when I found my way out is when I vowed to become the doctor I needed during that difficult time. So that when a patient would come to me and say, "I'm stressed." And I would do the medical workup, my response wouldn't be, "Ah, it's just stress. Go home and try to relax." So my work really focuses on bridging that gap and closing that gap so I don't have to say to patients just relax. I can offer them something tangible. And so that's the genesis of my work, my origin, my villain origin story, so so to speak of how I became a doctor with an expertise in stress with my background as a stress patient. Well, I'm sure there are echoes of a lot of things that definitely for me for for a lot of us of things we might have personally experienced. And I I feel like stress is this word that that has almost become like a throwaway phrase culturally where people are saying all the time I'm stressed and and maybe not really understanding what the meaning is behind that. So if if we could just start with the basics of setting the scene, how do you define stress? What is what is stress? I think stress has really been vilified and when you look at it scientifically, not all stress is created equal. when you use the word I'm so stressed or it's been a stressful week or a stressful year or in many cases the stressful 5 years right for most of us that type of stress that you're describing scientifically is known as maladaptive stress that's the kind of stress that is dysfunctional unproductive and it really gets in the way of your everyday functioning what causes all of the mental and physical health manifestations that you and I and all of us are aware of you know things like insomnia anxiety depression the list goes on and on and we can talk about that in this conversation, the manifestations of stress. But there is another kind of stress, healthy stress. In scientific terms, this is known as adaptive stress. This kind of stress is productive and motivating and it moves your life forward. In fact, everything good in your life was created because of a little bit of healthy stress. And the goal of life is not to live a life with zero stress. It's actually biologically impossible to do that because, you know, examples of healthy stress include things like getting a promotion, falling in love, getting a new job or buying a new home. Maybe it's rooting for your favorite sports team or planning your next vacation. These sorts of events move your life forward. And the goal is not a life with zero stress. It is quite literally biologically impossible to do that. It's to live a life with healthy, manageable stress that can serve you rather than harm you. And you talked about some of the signs for you, the the wild horses across your chest. What are some of the physical and mental signs that we should be on the lookout for when we are beginning to experience stress? You know, stress is truly the multi-hyphenate performer. There are people who have no mental health manifestations of stress and only physical health manifestations of stress. And stress can really impact everything all the way from your head down to your toes. It can, you know, some common manifestations, physical manifestations of stress can include worsening headaches, neck pain, shoulder pain, back pain, abdominal pain or discomfort, dizziness, nausea, weakness, fatigue, and then mental health manifestations, insomnia, anxiety, depression, or irritability when you have emotional reactivity and you're quick to anger. All of these symptoms could be signs of unhealthy maladaptive stress. But like me, the first thing you want to do is see your doctor. Make sure that there isn't a underlying medical condition that is causing these symptoms. And then once you are given the diagnosis of stress, then you can start using some of the strategies that we're going to talk about today. It's important to note that stress is actually in medical terms a diagnosis of exclusion. So just like I shared my own personal story of my doctor doing the full workup in that way your doctor will also do that full workup. And Whitney I want to share a really interesting quite startling statistic with you. In the US 60 to 80% of all visits of all primary care doctor's visits have a stress related component. And yet only 3% of doctors counel for stress. So stress is truly the exam the the truly the elephant in the exam room. And so a lot of our conversation today will be unpacking a lot of that, you know, because 60 80% of patients have an underlying stressor that is causing them to come to the doctor and they get the clean bill of health like I did. And yet there's like a gap between okay, now what? What can we do from here? And I love the point that you made about maladaptive and adaptive stress, good stress and bad stress. So when you're feeling these things that you've just outlined, how do you know whether it is the good or the bad stress? If if it if not looking at your life experiences, how do you know from what you're feeling that it's good or bad stress? So the first step, you know, you have to really understand there's this fantastic concept called canary in the coal mine. And it is a historical concept. I am not a historian, but it really is appropriate for what happens to your brain and body when you're experiencing that maladaptive stress. So, what is the canary in the coal mine? Historically, coal miners would go down into the mines and they would bring a caged bird with them, a canary, and the air would get bad and they'd be toiling, you know, 12, 16 hour days. When the air got bad, the canary would stop singing. And that was sort of the first tell or the first sign of like, wait a second, we need to come out of the mines. We're not doing well. Why? Because human beings, we are notorious for pushing past our limits and our boundaries. And so, my canary, the one you we all have a canary within us. My canary was singing a song when I experienced the palpitations, that stampede of wild horses. Uh we all have that canary within us. And that was certainly not the first time that I experienced something that was likely initially a hum or a whisper and then when I wasn't really paying attention to my canary because I was like, I'm a diamond in the making. That's when it really started to belt a tune. In the same way you everyone, we all have a canary song and it's about paying attention. So think about, you know, the first step is building awareness. What is that canary singing to you? Is it one of the the list of the common u mental health manifestations of maladaptive stress? Is it a physical uh health manifestation of maladaptive stress? There is some sort of metric that you could use a symptom of like wait a second I think this could be stress related. And so your lived experience is really the best metric of knowing. And then the second step of course is to quantify that. So, you know, you go to a physician, you get the workup, and if the doctor says, "Oh, it's it's likely to be just stress," what we call stress related condition. What you can do is quantify it. And so, to manage it, you have to measure it. And what I like to do is really think about stress. I would love for one day the medical system to really embrace stress the way we do with blood pressure, where it's a quantified number that we continue to track and monitor and then adjust treatment accordingly. Um, I have a free tool on my website where I ask five questions and then you get a personalized stress score and you can use that every four weeks, every eight weeks to really track how you are doing with your stress and then you see, you know, is my stress getting better using some of these interventions or is it getting worse? And so there are kind of five key questions and we can go through those if you want. Yeah, this is all great and I'm I'm so excited to hear more strategies around how we could tackle stress and and you you wrote a book uh called the five resets. Could you tell us a little bit about about the idea behind the book? Why did you write it? I wrote the book because it was the book that I wish I had had when I was a stressed patient so that I wouldn't have to hear it's just stress try to relax. And it was the antidote to just relax. And it has, you know, for me at least, this particular book, it's 25 years in the making, and it is a step-by-step roadmap to get you out of survival mode and back to thriving. The three key tenants of the book, first, everything is scienceback because that is a non-negotiable for me as a physician. The second is that all of the strategies I offer and ever, whether it be in my talks, you and I talking together today, in my interviews, and in the book, are all costfree. because as a physician who has taken care of countless patients with varying resources, making sure that everything was cost-free and sciencebacked is really important to me. And then the third is that I really try to aim for every strategy and technique offered in the book to be time efficient because we do not have a lot of time. And you managing your stress and trying to rewire your brain for less stress should not cause more stress. And so the five resets, it's my prescriptive model and it's a proxy for my clinical decision- making and the way I have approached patients all of these years. I no longer see patients, but in the past when I was when I had a busy clinical practice, that is this is the approach that I used. And so it's five key mindset shifts and 15 strategies. And the first reset is get clear on what matters most. The second is to sync your brain to your body. The third is to find your quiet in a noisy world. The fourth is come up for air. And the fifth is bring your best self forward. And each reset has about two to three scienceback strategies that you can try today. That's the other thing you know when you are dealing with stress. It is so difficult to get out of your own way. And we can talk about why that happens. It's a biological thing. It's your amygdala, which is your stress center that is focused on your survival, your immediate needs and self-preservation. And so thinking about the future, making a plan, creating some sort of strategy to get out of stress, it's by design almost impossible. And so this particular book helps you kind of take that process because stress and trying to overcome stress. It's not about knowledge or information or a gap in this. We all know what we need to do to feel better. It's about a gap in action. And this particular book helps to close that gap. H and so and thank you for sort of outlining what the five resets are. So is the is the thinking that taken together in that order one two three four five just straight through is a tool for managing stress or do you think that there are certain situations where you might use reset number three and certain where you might use reset number two. How do you approach that? I leave it up to the reader. You know, this book is now available in 35 countries and 15 languages. And so I get messages every day on how people are using the five resets. And it's like my greatest joy to see how people are bringing this information and knowledge into their everyday lives. There are two kind of key metrics and assessment. So the first is to do a personalized stress score and the second is your lifestyle inventory. Then you get some data of where you are and then you can say you know I want to focus I want to go from you know step one all the way through or this is the main area I want to focus on whether it's sleep or socialization or media use or your diet or movement and you kind of choose one and you go from there. It's really it's a case by case basis. The key is that you need to feel a sense of agency like I can do this and I want to do it. And so whatever kind of sparks that flame within you to feel like you can make change happen is what I really encourage because I deeply believe with me that we all have the power to make meaningful change happen. And my job by the way you know I get a lot of messages from readers saying you changed my life and I always say like no I didn't. You changed your life. I was simply a mirror and like the cheerleader for you to be on your journey. Well I want to get to these strategies and sort of dive into them a little bit more. Before we do that, there's just one other thing I'd love for you to help us understand a little more clearly, which is connected to the subtitle for the book, Rewire Your Brain and Body for Less Stress and More Resilience. And resilience is a word I think we hear a lot in this sort of culture of hustle culture or grinding. And when you think about resilience as it relates to stress, what how do you look at that specifically? This is a juicy question. So I would say first off that there is a you know let me define what resilience is. True resilience the scientific definition of resilience is your innate biological abil ability to adapt recover and grow in the face of life's challenges. What's interesting about resilience is that there can be no true resilience without a little bit of healthy stress because you need a little bit of healthy adapted stress for resilience to show itself. You can think of that relationship between healthy stress and resilience by thinking about when you were a child and you learned how to swim. So your instructor, your swim instructor who encouraged you was healthy stress and your resilience, your innate ability kept your head above water while your arms were flailing and with time and practice, you were able to glide through the water with ease. Similarly with some of these techniques that we're going to talk about, it's a way to build your true resilience. You know, I really struggled initially when I was thinking about what can the subtitle be. Using that word resilience was a weighty decision for me because I'm sure all of you listening probably feel the same way. But when I hear the word resilience now in this year, like in this moment in time, I cringe. I have a visceral response because I'm like, uh, don't tell me to be more resilient. And so I really struggled with that. And the reason is because, you know, that's true def the true definition of resilience. True resilience is it honors your boundaries. It really understands your human limitations for rest and recovery and celebrates your ability to say no. However, over the past several years, Whitney, we've really seen a change in what that word resilience means. And we have really, you know, it's now everywhere. Toxic resilience. It's like that definition of resilience has become dark and sinister. It's pushing past your boundaries or, you know, productivity at all costs. It's a mind over matter mindset. It's when your demanding boss says like, "Ah, you can take on another project. Look at you. You're resilient." Or, you know, when a parent, you're a parent, I'm a parent. when people are like, "Oh, just, you know, work like you don't have kids and parent like you don't have a job." I mean, we hear these sorts of messages all day long. And so, I I hope that our conversation today and a lot of my work focuses on reframing what resilience is, moving away from toxic resilience back to true resilience. And that's really when I finally agreed, I said, "You know what? I'm going to put that word in there and I'll write all about toxic resilience." Hopefully we can then come back to what that word truly means in the here and now. So it sounds like resilience is a precursor to burnout. It is resilience. What's interesting about resilience and the relationship between resilience is and burnout is that resilience it's protective against burnout but it is not preventative against burnout because there is something called the resilience myth which is that resilient people don't get burned out and when I share some of the data so you know 70% of people have at least one feature of stress and burnout and this is a global snapshot and over the past few years about 74 84% of people across industry, these are industry-wide statistics say the last few years have been the most difficult of their professional careers. And when you look at a room of 30 people, that's like saying 21 people are struggling with stress and burnout. And so I shared some of that, you know, data to say that resilience, the true scientific definition, it's your innate biological ability. So we all have it and yet it's that we are seeing these high rates of burnout because resilience while it's protective it's not enough to prevent burnout and that resilience myth is also something that I am hoping that we can dismantle here today and really remove that onus of responsibility of building resilience and creating resilience away from individuals. Yes, we are going to talk about many ways that we can build build individual resilience, but we also have to move that notice of responsibility away from individuals and back to the systems that are meant to support us because people are resilient. It's the systems that burn us out. Well, I want us to dive into this more as the conversation goes on, but I know people are so eager to hear some of of these strategies, which you've begun to give us a little taste of with um your five resets. So, when you think about stress, what are some of the the go-to techniques or or practices for managing stress that that you use on a daily basis or that you recommend for others to use? So, you know, I had that acutely debilitating experience of stress when I was a medical trainee that stampede of wild horses and I have never had an acutely debilitating experience of stress like that intensity again. However, I have had lots of experiences of stress over the years, acute and chronic and everything in between because, you know, life happens. And so, I have very much walk the talk. So, all of these techniques that I share in my work, in my book, in my talks, I use them every single day. Like truly every single day. One that we can start with is the one that I learned and is stop, breathe, and be. I learned this from a class that I took called mindfulness for healthcare providers. I was a stressed out medical resident and a lovely um colleague of mine, Dr. Michael Bame at the University of Pennsylvania taught us this technique. I have used it to this day and I did it in fact right before we joined our call. Stop, breathe, be. It's a 3 second brain reset and we can all do it together. What you want to do is whatever you're doing right now, just stop, breathe, and be. Ground yourself in the present moment. Stop, breathe, be when you practice it over and over again throughout the day and ideally use it at transition points of the day. So when you're clicking join Zoom, when you're moving in and out of room, say a boardroom or a meeting room, when you're running to go pick up your kids or rushing off to an activity, it's a great strategy to use. I personally learned it when I was a medical resident and I would knock on the exam room door right before entering the room. It was my doororknob moment. And as I would turn the doororknob to enter the exam room, I would say to myself, "Stop, breathe, be." And what that did over time is that it connected me to my mind body connection. So it made me aware of my mind body connection. And the, you know, we can talk a little bit about what the mind body connection is, but the reason stop breathe B works so well as like the gateway to learning about how to manage your stress and rewire your brain is because it taps into your mind body connection. It helps to influence it for better. And what it does is it gets you out of that what if thinking which is, you know, anxiety is a future focused emotion. It's really m very much about what if. So what if what if I fail? What if this doesn't go well? What if what if what if what if? It gets you out of what if thinking and back to what is in the here and the now. And that shift is really important. So try stop, breathe, be do it at several points in the day and try it for the next several months. You will see a marked difference in your stress over time. And the goal is really to move away from that maladaptive stress back to adaptive levels so it can serve you rather than harm you. I I love stop, breathe, be. And in fact, I've been like practicing it right now as you're saying it. And one question I have is around what you're thinking. So you say stop and at that moment what what where should your mind be? What where should you be focused? Well, you can be focused on anything because you know we we're thinking about a million things all the time, right? So stop. You just stop and you tell yourself, you know, when I first started stop, breathe be, I would say that to myself under my breath in a in a very busy clinic and people might have thought I was nuts, but I did it anyway under my breath and I would just say stop, breathe, and be. And then that's, you know, that breathe part is really important. And the reason that breath is so important to recalibrate your stress response. And we can go as deep and scientific as you want, it's that your breath is the only physiological um process that is under voluntary control and involuntary control. So your heartbeat doesn't do that. Your digestion, your brain waves, you know, those are involuntary like things are just kind of happening. But your breath is the only thing that is under voluntary and involuntary control. which means that you and I are hanging out, we're chatting and our bre, you know, we're just breathing. But then when you say take a deep breath in and out, you are actually influencing your breath. So that's it's a really powerful tool. That's why the breath is so important when you're managing stress. And the reason the breath is so important is because it's truly a toggle like on and off switch because when you're feeling anxious, you have shallow breathing. So you have thoracic breathing. You're breathing from your chest. It's rapid and it's shallow thoracic breathing. But im and that's it kind of triggers it's um the sympathetic nervous system which is your fight or flight response and we can go all down that route if you want and that is what triggers you know the cortisol and the amydala and it's the cave person mode. It's like survival, self-preservation, and when you feel that sense of acute stress, that's what's happening. But if you practice stop, breathe, be and various breathing techniques, I have like four or five breathing techniques in the five resets and we can do a a bunch of them today. What happens is you instead of that sympathetic shallow thoracic breathing, you move into your diaphragm, what we call abdominal breathing, it's called diaphragmatic breathing. And immediately what that does is when you take those deep breaths, you trigger your brain. It's actually a center in your brain that triggers from the sympathetic nervous system to the parasympathetic nervous system. And so the sympathetic system is fight orflight and the parasympathetic system is rest and digest. And so your breath can actually act like a light switch between on and off of those two systems. So it's a fascinating interplay between your mind and your body. you're we often call it the mind body breath connection for that reason. I love that and you know I feel like there's so many moments where when I'm stressed I actually can catch myself holding my breath right and I imagine that that is a big part of what what influences this breath exercise and helping your to relieve stress. Absolutely. I mean there's kind of like three key elements when you're thinking about how to tap into your mind body connection. There is your breath, there is your posture and there is your feet. And so you can kind of bring all of those in. So I practice stop breathe be at many points during the day. Ideally, it's a great thing to do at a transition point when you're entering something that's going to be, you know, potentially stressful moment. So I do it all the time in the morning when you're rushing to drop off kids at the bus stop or you're running to a meeting. It's like that, you know, doororknob moment where did I remember everything? Everyone's lunch is back. Do I have my laptop? Do I have everything that I need? And then you head out the door. That stop breathe be moment is really important. But you can practice tapping into your mind body connection in other ways. There's a fantastic technique that I talk about in the five resets called sticky feet. And so this is really helpful if you have a job where you're on the go. You know, you are a crier. You work in lots of different areas. And so maybe stop breathe B is a technique that you want to use. But sticky feet is also something that you could try. Your feet have a 100 bones and 30 muscles in them. And so there's a lot of grounding power and surface area there for you to really tap into. And so sticky feet is this idea of making your feet, it's a Taichi principle. In fact, you make your feet like sticky webs and you put your mind where your feet are. And so you can do that at any point. I use that typically when I'm doing the dishes. I really try to focus on sticky feet. And so you're trying to bring in three elements when you're thinking about the mind body connection. Your breath, your posture, and your feet. And so then you've given us a feet one, a breath one. What would be a strategy that's connected to posture? Posture is you know again just being aware. So one thing that I love a great strategy to use particularly for people who I have so many people who say like I can't meditate there's no way you know and that's great like you don't have to that's some that's not for everyone and so what you can do is consider movement meditation. So what does that mean? And it simply means that you're walking being aware of your posture through space. And so articulating your feet on the floor as you're walking and kind of just carrying yourself you know just being aware of the carriage of your person of your body as you move. And you can do that for several minutes. And movement meditation again it's bringing a sense of intentionality to your day-to-day life so that your thoughts instead of being out there thinking about the future which we all do. I mean, we are all guilty of this, including me. I mean, I know all of the science and yet, you know, I'm a mere mortal, right? Like, try to make it through this era of life that is very challenging for all of us for lots of different reasons. And so, a movement meditation of just walking through, you know, try for five minutes a day or even two minutes. If you can try, just walk, think about your feet on the floor, think about your posture as you're holding yourself up. And it could be also helpful because it again brings you out of you know all three principles help you by getting out of that whatif thinking thinking about the future and those anxious thoughts back to what is and being very present and grounded in the here and the now. Over time I will say all of these strategies seem so simple. You know you think like well how is this really going to help me? But in fact, everything that you do, like all of these strategies, you start bringing them into your life a little bit, you know, over time, they actively change your brain. And they change your brain because of a process called neuroplasticity. I will try not to use these big scientific words because I know like people's eyes glaze over when I say neuroplasticity. You're like, "Oh my god, it's too long of a word." Neuroplasticity simply means that your brain is a muscle just like your biceps. And so the same way that you would train your bicep, right? Like if you wanted to have bigger biceps, you would lift weights. And so in the same way, you want to train your brain. And so neuroplasticity, we used to think, old thinking was that your brain, like the brain you got at birth is the brain you got for life, you know, real grab bag. Now we know that your brain actively changes and evolves and grows based on external stimuli. And that is a wonderful thing because I've had patients who've been 85 years old and learned new things because of the process of neuroplasticity. And with in the same way that you can, you know, you can actually change. Some people will say, you know, I'm just a stressed out person. I have the stress response. It's who I am and I'm not going to change. I would I would refute that and say in fact your brain is always evolving and changing and growing based on neuroplasticity. So you can change certain neural circuits and strengthen certain neural circuits and then weaken neur certain neural circuits. And it's simply about the doing. The more you do, you know, when you do better, you feel better. And that's really what neuroplasticity is. It's like that your brain is a is a muscle just like your biceps, you know, um in the same way that you would train biceps, you can do the same for your brain. And some of these techniques, stop, breathe, be sticky feet, movement, meditation. I mean, there's so many that we could talk about actively change your brain for less stress and more resilience. Well, we are getting lots of questions from our audience. Adidi, in fact, lots of folks sent questions in in advance. Um, and I want to encourage everyone watching, if you have questions for Adidi, drop them in the chat, we'll try and get to as many as we can. Um, but there are a couple of questions connected to what you're talking about right now, this idea of neuroplasticity and our brains constantly growing and evolving. Uh, Ken asks, uh, how does stress affect us differently as we age? and are there different ways to handle it that are effective um as as our stress levels and the way we manage stress changes? Great question, Ken. Okay, so let's start a little bit. Let's backtrack a little bit. When you are just, you know, normal functioning and living your day-to-day, your brain is governed by an area called the preffrontal cortex. So, if you put your hand right here on your forehead, it's the area right behind your forehead. And that prefrontal cortex governs things like memory, planning, organization, strategic thinking, complex problem solving. In layman's terms, it's adultting, right? In the truest form. Oh, I will also add that your prefrontal cortex doesn't fully form until you're 25 years old. And so up until 25, that prefrontal cortex is still being, you know, it's plastic. It's still changing. There's an element of neuroplasticity that continues all the way through all the way through our life. Now that's the prefrontal cortex. Now when you are under a period of stress, your brain is governed by another region called your amygdala. And your amygdala is a small almond shaped structure deep in your brain that is truly cave person mode. In fact, we in science call your amygdala reptile brain because while other parts of your brain have evolved and changed through millennia, that reptilian brain is the same as it was when we were all caves people. And what does the amygdala do? It is focused on survival and self-preservation. It is where the fight orflight response originates. And so your brain is expertly designed, Ken, to handle short bursts of stress. In fact, in fact, like your amydala and our your brain and your body and all of us, our brains are expertly designed for that. However, you know, cuz back when we were all caves people, you would see a tiger in the forest and you would either fight the tiger or you would flee. You would run away. That's where the fight orflight response comes from. And there are certain biochemical things that happen when you are engaged in the fight orflight response. Your pupils dilate. The blood shunts away from your vital organs to your muscles. you start breathing quicker because you're trying to get oxygen to your lungs to then send it to your heart and get, you know, fresh oxygenated blood all over to your muscles. And so there's certain biochem bio, there's a certain biochemical cascade that happens. And then what happens is in an ideal world, right, evolutionarily, you have that fight orflight response, the acute threat goes away, that tiger dissipates, and you come back to baseline. The challenge is Ken over the past several years and the modern-day stressors that we have these tigers are these metaphorical tigers are everywhere and it's not like they're going away. So financial struggles, we have relationship issues there because we have a little device that we can check of things happening in the world, all the headlines coming in, climate disasters, humanitarian crisis. And so you feel that sensation of the tiger all the time and that amygdala just stays on in the background at a low hump. And so you're not coming back to that state, the steady state or the baseline. And so over the past several years particularly, it's been very challenging. And this is why, you know, stress is very much at the forefront. Stress, burnout, mental health. These, if there's one silver lining over the past several years, is that now people are talking about it much more. We have so much more work to do to really dismantle the stigma and shame around these terms, but there's been a lot of progress made. Why? Because we are all feeling this. I mean, stress isn't the exception anymore. It's the rule, the data that I shared. And so, that's how your brain works when you're thinking about stress and resilience and you know, now to answer your question, it really depends. You know the way when you are a child and the way you experience stress because your prefrontal cortex is still taking shape you have certain response you know like when you think of I don't know if you have young children yourself but you have certainly been around young children we all have and you see their stress response right tantrums and anger and really like a full expression and as you get older you are socialized to change that stress response um in the same way so you you know that internal biochemical ical cascade is the same. It's the external manifestation how you present. And so unfortunately so many of us regardless of age, gender, where you live, what job you have, we are seeing some real there's a sense of universality when it comes to stress, burnout, and mental health issues right now. precisely because we are not, you know, your brain, the human brain is expertly designed to handle short bursts of stress, but we are not meant for this chronic ongoing onslaught that we've been experiencing for the past several years. Well, to that point, uh Joanna has a question about the types of symptoms that manifest themselves when people push too far while being stressed. What are some of the long-term consequences of living with constant stress? Oh, what a beautiful question, Joanna. It really depends on a casebyase basis. So think about, you know, you might have a particular canary that you have been noticing in yourself or maybe a loved one. Um, for me that canary in the coal mine was the palpitations, the stampede of wild horses across my chest that took that really, you know, got my attention. But now because I have have a handle on my stress because I actually walk the talk and practice the five resets and have for over 25 years now my tell or my canary is when I am irritable and my husband will often say like it's time to really double down on those five resets when he sees me like you know being snappy or snippy um because that's that's my tell and really the signs and symptoms are very individualized and that is what makes stress so difficult to identify in yourself and others. There is also a new kind of burnout. So what happens with burnout and the connection to this maladaptive stress Joanna is that when this stress when that amydala response is on, you know, in the background at a low hum, it can increase your risk of maladaptive stress, right? And the greater you have maladaptive stress unchecked, that's what leads to burnout. And so when you're thinking about how to manage your maladaptive stress and burnout and the connection, that's what the connection is. And now what we're seeing is that stress, you know, it presents in so many different ways. I shared some mental health manifestations, physical health manifestations. There is also, you know, very commonly something called the gut brain connection, which we can dive into. If people have questions, feel free to ask. Just like I shared that there's a mindbody connection, there's also a gut brain connection. And so a lot of people have gut symptoms and it's you know your your gut is truly your second brain. There's an entity in your gut called the microbiome which is an ecosystem of healthy bacteria in your gut. We all have it and it serves many roles besides digestion. And in your microbiome there's a particular entity called the psychobiome which is a group of you know trillions of bacteria whose sole purpose by the way is mood regulation managing your stress resilience etc. So there's also disorders of the gut brain connection. And the other thing Joanna to remember is that yes, there are so many ways that stress presents itself making it difficult to identify in ourselves and others. In the same way, burnout, modern day burnout is something that we're seeing more and more in one and again showing atypical features. So for example, this one particular study found that 60% of the people with burnout had an inability to disconnect from work as their main feature. So think about what burnout, you know, when you think about someone who's classically burnt out. What are you thinking? You're thinking about someone who's apathetic, not really engaged, you know, unmotivated. But now you might think, I don't have burnout. I'm chronically engaged in my work. I can't shut off. In fact, that could be the new kind of modern day burnout. And so the first step is always if you're thinking could I be stressed? Chances are you know I hate to say it but chances are yes. I mean me knowing all of the science I have had moments particularly this past year where I felt a sense of burnout and stress simply because it is no longer the exception. It is the rule. So 70% of people you know in on this call today are experiencing a lot of these things. The key here I just want to say Joanna and everyone if you are feeling this way the first thing to know is that you are not alone and it is not your fault. Um Whitney described this thing called the stress paradox and I used to see this every day in my clinic in Boston. I would see this every single day where patients would sit in the packed waiting room shouldertosh shoulder coming in to see me for stress but no one was talking to the other person right because we have all of these preconceived notions of what stress is and who gets stressed etc and then they would come into my office the door would close and then they would burst into tears and it just goes to show you that we what is the stress paradox it's that we are all struggling collectively and yet isolated in that togetherness of the experience of stress which is a real shame. So if anything, I hope this conversation today helps elucidate the fact that we are all feeling stressed and that it is okay and it is simply a a symptom of what's happening and most empoweringly is that you can find a way out of that stress struggle using some simple techniques that are costfree and time efficient. Well, you touched on something just now D that um we're seeing a lot uh in questions from from members. Uh, Michael asks specifically in 2025, they note that they feel like every facet of life is under stress when everything seems to be burning and there's nowhere to escape. How how do you navigate that? Uh, so to your point about collective stress, how can we tackle collective stress? Oh, I love that question, Michael. Um, I feel that very much. Um, you know, as someone who's an academic, I also am very interested in pop culture. I feel like that's one of the ways that I can really stay attuned to what's happening and what people are talking about and thinking about. There is a phrase I would love to share with you which when I first heard it it like took you know it knocked my socks off and really like gasped horizonlessness. It is a phrase coined by a journalist and I was doing an interview for a publication and the journalist asked me like you know tell me a little bit about horizonlessness. You know, human beings, we are meaning seeeking, purpose-driven creatures. And when we have something that we can look forward to, then you know, you have like a sense of purpose. And we can talk about the difference between hedonic well-being and udeimmonic well-being. Again, very long fancy words, but it's, you know, there's two different kinds of well-being. And when you're thinking about this idea of like the future and excitement and you're looking forward to it, think back, you know, when you back in like 2015, you probably had lots of things that you were looking forward to. But now at this stage, like most of us have that feeling of horizonlessness, which is like this blank meh, bleak feeling when you're thinking about the future. And that of course is very detrimental to our mental health because you want that forward motion. I will share something that I hope can you know one of the ways that I like to think about is when you're going through a difficult experience like stress and you're experiencing that stress paradox that we just spoke about Michael you and everyone else including me and Whitney and all of us t talking today I you know um the first thing to do is to normalize and validate this difficult experience because that automatically makes you feel better and so I want to share a kind of idea with you um that your brain is like a dam and all of us the human brain brain is like a dam. So, think back to 2020. We don't have to talk about it. It was the pandemic. We all had individual and collective stressors. And so, what happens when you're feeling a sense of acute threat or stress, and likely we're feeling that again now. What happens is you shore up your internal reserves. You keep it together at all costs. And that's what I would see a lot of times. My patients would come in, p patients with cancer, they would be referred to me to help manage their stress. And they would say, "Yeah, I have a cancer diagnosis." They'd be doing chemotherapy, radiation, and they were stoic, you know, like completely fine. They'd be like, "I'm great. I'm fine, doc." They would come see me regularly. I'm doing great. They would get the clean bill of health from their um oncologist. Congratulations. Your cancer is, you know, clear. You're see you in six months. The next day, they'd be in my office weeping. And it was because they were experiencing, you know, that that experience of the damn breaking. And so when you are feeling a sense of stress, acute stress like all of us are perhaps now more than ever. We felt that in 2020, but certainly many of us are feeling that particularly now. You shore up your internal reserves. You keep it together at all costs. And then when you feel psychologically safe and that acute threat has passed, that is when the dam breaks and your true emotions can emerge. And I just want to share that with you because if you are feeling any of these things like horizonlessness and like wait a second societyy's telling me that we should be feeling great like we're post pandemic everything's great everything's open and yet you don't feel like that and so when there's a disconnect between your lived experience and what the world is sending you in terms of messaging that can feel really challenging and so I hope today that we can normalize and validate this difficult experience because we are all feeling it together. And to that point, I I feel like so many of the strategies that you've offered have been focused around this idea of like things that you can do for for yourself to think about how you're experiencing stress internally, but to your point that there are so many of us who might be experiencing stress around the same types of things. What role does does support from others in your in your life, your friends, your family play in stress management? It plays a huge role. Whitney, I love this question. Loneliness, you know, let's talk about like why is it important to feel a sense of connection? Because I think many of us with that sense of horizonless and our you know like knowing that the brain is a dam very much you know you might feel isolated and alone and so when you are feeling a sense of stress also because of the shame and stigma and taboo around feeling stressed because we shared you know the resilience myth which is like I'm not I'm not stressed I'm resilient like people who are resilient don't get stressed we know that's a myth now right and so what can you do collectively lean in and check in on your people and lean into your community. I want to share some data on loneliness and why community is so important. We are seeing rampant rampant rises like all over the world really there's a global epidemic of loneliness. 330 million people go two weeks before speaking to anyone. And this is a global statistic. We know that loneliness, when you don't feel a sense of connection and community, loneliness is the equivalent medically, physiologically, it's the equivalent of smoking 15 cigarettes a day. Isn't that wild? Meaning that it increases your risk of cardiovascular disease, strokes, heart disease, and also it shortens your lifespan, particularly if you are elderly or if you're in an aging population. I mean, we're all aging, right? Like who's who are we kidding? But particularly in the elderly, it is a predictor of longevity. And so really combating loneliness is so important. When you're thinking about how to build community, when you're feeling stressed, when you're burnt out, the last thing you want to do is engage in like deep conversation. You know, like you're like, "Just leave me alone. I just want to Netflix and chill or whatever, whatever it is that you want to do to just decompress and tune out." But in fact, there is really compelling research to suggest something different. When you are feeling a sense of stress or if you are lonely and you're trying to figure out how do I build community and it feels so overwhelming to engage in deep conversation instead focus on weak ties. So let me explain. There was a beautiful study done comparing how community is formed or like the sensation of belonging with strong ties and weak ties. Strong ties is what you and I can already think about. So family, friends, colleagues, like people that you feel a real sense of connection with, strong ties. And um this study looked at like the way that influences our well-being. And yes, strong ties really does it works, you know, but again, we don't necessarily have the energy for strong ties when you're feeling so stressed and burnt out and truly depleted. But weak ties is like saying good morning to your barista at the coffee shop when you're getting your groceries packed. saying, "Hey," chatting with a grocery clerk, when you're picking up the mail, saying hello to your postman, when you're taking a walk in your neighborhood and you see your neighbor walking their dog, saying good morning. These short kind of exchanges that you can have throughout the day can have a profound effect on your sense of connection, community, and wellbeing. So all to say that really it can have a profound effect and lean into those weak ties. It sounds like there's just so much that we can personally just gain from relationship with the people around us, the people that we're coming into contact with. And are there systemic things that you think organizations, governments, people can can that we should encourage the the spaces that we inhabit to to make more stress free to help us manage stress in a better way. Absolutely. So, you know, I think of kind of five key strategies when you think about like the checklist because many of us work in leadership roles, right? Like together here we are in a leadership capacity in various ways. And so think about there's kind of like I think of it as five key elements of a checklist for resilient leadership and to how to like engage and really lean into a sense of true resilience. The first is that you want to normalize the experience of stress and burnout because I just shared you know that 70% of people are struggling. So your charges your employees and your in your family in your community 70% of people are really struggling. So overcommunicating about mental health is really the way forward. Another thing that you could do is if you are in a leadership position, normalize not being engaged, you know, normalize only working during working hours. So offduty expectations, minimize those off, you know, off-hour phone calls, meetings, emails, etc. Next, cultivate a sense of psychological safety and connection in your workplaces, in your groups of, you know, social groups, etc. Next, if you are a leader and in a working environment, two things that you could add is create some sort of peer support group and have a formal counseling program. The key to both is that they are well advertised, free, and confidential. And finally, really think about compassion and empathy. You know, compassion and empathy sound like soft metrics, but they have been shown to increase and influence the bottom line because engaged employees when they feel a sense of connection and value, they are 20% more profitable than their counterparts. The other thing I will say about compassion, and that's kind of like a blueprint for resilient leadership. Another thing I will say about compassion, particularly self-compassion, it is so important. Again, sounds like this woowoo concept, but self-compassion, being gentle with yourself as you're engaging in this world today, particularly now more than ever, perhaps self-compassion is so important. And self-compassion changes the brain. It dials down the value of your amygdala. And it is perhaps more important now than ever to really lean into that sense of self-compassion. As we're winding down here, I think there's one thing that we haven't uh touched upon that I know is on the minds of a lot of folks uh including it sort of has to deal with the way we're experiencing this, which is just thinking about technology um and the wayation um social media and and it's just sort of everpresent in our lives and surely uh is a is a stressor uh for folks uh in ways that we wouldn't have seen you know a decade ago, two decades ago. So how do you when you think about technology and our relationship with it, how do you think we can have a healthy relationship that supports uh a healthy level of stress in our life? Ooh, this is a great question and it's something that we can all universally agree on. So my take on this is that every relationship in your life has a set of boundaries, right? Like so we have boundaries when it comes to a relationship. we have with our partners, our colleagues, our children, everyone, our friends. And yet, we have zero boundaries and likely very poorest boundaries when it comes to the relationship you have with your devices. So, this little device right here and creating digital boundaries is incredibly important. Now I mentioned that one of the reasons for that sense of heightened stress right now is because you have you know the world at your fingertips. Your amydala because it is your reptilian brain doesn't know the difference between something happening 3,000 5,000 10,000 miles away and something happening in your backyard. It feels that sense of threat, danger, survival, self-preservation and it activates your stress response. Particularly when it comes to graphic images and videos. There's been a lot of data that shows that when you are engaging in this sort of content and we all are because you know we are all engaged and plugged in and we want to be informed citizens right it actually can increase your firsthand personal risk of PTSD believe it or not without being engaged you know while while things are happening very far. I work in medicine and I also work in journalism. This is not about censorship. I have always you know before I became a doctor I wanted to be a journalist and I believe so much more than ever that we must be informed citizens there is so much happening in the world but not at the expense of your mental health so there has to be some sort of boundary that you draw and the science shows that it's not about abstinating you know this is not about becoming a digital monk and abstaining from tech technology and saying like forget it I'm throwing out all technology and I'm going to renounce technology that in fact the science shows that it doesn't have as much of an effect on your health and well-being. What truly makes a difference like moves the needle when you're talking about stress, burnout, mental health with technology and creating digital boundaries is decreasing your reliance on your devices. And so, how can you create digital boundaries to protect your mental health while still being an informed citizen? There's several ways that you can do that. The first really quickly is grayscaling your phone. And let me show you what that looks like. In fact, let's do it together. And so what this looks like is this. Can you guys see this? How it's colored and it suddenly becomes black and white. Boom. Yep. Grayscale is a really powerful tool. And you can, you know, we can share some resources after this call about what grayscale, you know, how to actually set your phone to grayscale. I typically set my phone to grayscale during periods of focus during the day and particularly at night to to avoid a concept called revenge bedtime procrastination. We can talk about that in a second. What grayscale does is it makes scrolling less enticing and for lack of a better word less addictive for your brain less stimulating and so you're more likely to decrease your engagement and go to bed early for example and so it has been shown demonstrated effects on screen time and decreasing screen time. The other thing that you can do is take keep your phone off your nightstand and that will help in engaging in scrolling and you know checking your email and headlines first thing in the morning because none of this stuff you know there's no such thing as mindless scrolling. You think you're doing nothing. You're just doing this. What is that really doing? It actually is doing a lot. It's a it's triggering it's priming your brain for more stress. It's triggering a biochemical cascade. There is no such thing as mindless scrolling. And so really thinking about that is fantastic. and really important. Um, and so grayscale and creating what what I like to call a geographical boundary. Let me just quickly touch on revenge bedtime procrastination. What that does, you know, when you have a really busy day and at night it's like 8:30 at night, you're going to tell yourself, I have to go to bed early. And then you start scrolling and before you know it, it's 1:00 a.m. or midnight. You're like, how did I get here? And that happens night after night. Revenge bedtime procrastination is simply a sociological phenomenon where you're not giving yourself enough me time during the day short breaks and then what's happening is that at night that's when you're kind of like a rebellious teenager or rather your brain and your body are you know rebellious teenager saying like I'm going to stay up and not go to bed and so when you switch your phone to grayscale it will help overcome the sensation of revenge bedtime procrastination. Well, that feels like one of the most meaningful tips of all and and that's saying a lot because you've offered us so many great tips um during this conversation. Thank you so much for that. Adian, before uh we let you go, what's next for you? Uh what where can we find you? I am all over social media. Ironically, a lot of the way I get my work and messaging out is through sharing on social media because that is where people are. I also am launching a new Substack in the next couple of weeks. So, you can find me there. And what's next for me? I have several media projects that are coming up and book two is going to be in the next I would say year or so. All under wraps for now, but I'm very excited. But you can find me on my website. You can do the free stress quiz if you're interested. It is drant.com. Five questions and it will help you quantify your stress so that you can rewire it for the future. [Music]