the dangers of stress, a talk with aditi nerurkar [video]
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To be human today is to be stressed out. Come on, you're stressed out, I'm stressed out, we're all stressed out, which is why I'm so excited to be talking to Dr. Aditi Narukar today about stress. This is like the stress doctor, okay? She's a Harvard physician.

a nationally recognized stress expert. She's a lecturer at Harvard Medical School in the Division of Global Health and Social Medicine. Her work has been featured everywhere. We're talking about Wall Street Journal, Washington Post, Oprah Magazine, Architectural Digest, Elle Magazine. Like, she's a rock star, okay? She's also the author of The Five Resets, Rewire Your Brain and Body for Less Stress and More Resilience. I think what's really special about

about her is that she is very aware of modern stressors. She's very aware of the way that modern technology meets our biological caveman brains to create a high-stress world today. Her focus is truly helping people and making people less stressed. Not, well,

if you start a successful startup and you make billions of dollars, then you won't be stressed because you'll be on a yacht. I think that her approach is incredibly reasonable, incredibly doable. And I feel like she speaks to me in a way that I can understand so that, you know, I can apply the things that she discusses into my life so that I can slay harder. Because isn't that what it's all about?

Just finding ways to slay a little bit harder. That's what it's all about. Without further ado, let me present to you Dr. Aditi Narukar. Here she is. This episode is brought to you by Walmart. Walmart has unexpected styles and trends that match your dorm aesthetic at prices you'll love. They've got everything for your space, like bedding, throw pillows, storage, rugs, lamps, mirrors, you name it.

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Try opening moves on the new Bumble. Download Bumble now. This episode is brought to you by Squarespace. You know, I've been getting pretty good at spotting sites made with Squarespace. They just feel nice. That's because Squarespace is jam-packed with features that can help you easily make stunning websites like their Blueprint AI. It makes designing super easy and actually fun.

And with Fluid Engine, you can customize every detail with a simple drag and drop interface. Plus, you can accept payments any way you like, and their SEO tools help people find you online. Head to squarespace.com slash Emma for a free trial and use code Emma to save 10% on your first purchase. Well, let's start out with what made you want to get into healthcare and stress as a topic

Are you a stressed out person? Is that what drew you to this? Or through your studies, did you realize, oh God, this is a huge issue? You know, I became an expert and a doctor with an expertise in stress because I was a stress patient looking for answers. I was a medical resident. I was in my second year of medical training working 80 hours a week, seeing death and dying on a daily basis.

And I had a very sort of light bulb moment. I was in the cardiac ICU rounding on my patients. I had just worked a 30-hour shift. And I was seeing a patient. And then I had palpitations in my chest. It felt like a stampede of wild horses in the middle of a workday. So I sat down. My nurse, who I'd been working with for a long time, came over and gave me some orange juice. And we laughed it off because it lasted a few seconds and it went away. She noticed right away that something was wrong.

And that is when she was like, oh, it's probably nothing. You probably just have a little, you know, low blood sugar. And I said, yeah, I didn't sleep well last night. None of us, right? You're working 80 hours a week. It's a 30-hour shift. Yep. So then that was sort of my awakening. I went home and every night –

for two to three weeks straight. It would never happen during the day. And as I was going to bed, I would get this stampede of wild horses across my chest. And it was terrifying, Emma, because I've never experienced anything like that, nor now. It's been 25 years and that was like my only experience of that debilitating stress.

And I went to see a doctor because what are you going to do if you're feeling this way? And the doctor did the million dollar workup, did my blood tests and heart ultrasound and EKG and everything and told me, you're fine. Everything's good. It's just stress. Don't worry. Big smile. Yeah. Just try to relax. We've all been there in medical training. And so I was like, OK, what does it mean to relax? Just try to relax. So I did.

Did what everyone does. Like, what do you do when someone says, just try to relax? I watched movies. Yep. Spent time with my friends. I went shopping. I had a spa day. Hung out with my family. Went to good dinners. Nothing helped. It kept happening over and over. And that's when I kind of put my scientist hat on.

I said, hang on, stress. My first reaction was actually stress doesn't happen to people like me. You know, we can talk about that. Like this idea of like stress. Yeah. It's like, I'm resilient. I'm not getting stressed. Yeah. Like I'm a doctor in training and I had been taught at a very young age that

It was like my, I don't know, second month of medical school. And I was sitting in an auditorium. To this day, I'll never forget it. And the person who said it, he was a professor. He sat us all down and he said, you are going through something that very few people in the world have ever experienced. You're going to be a physician. And in that process, just remember, pressure makes diamonds.

So when you're going through a process working 80 hours a week and you're like pressure makes diamonds, I'm a diamond in the making. Yep. So then my diamond cracked. Yep. And then I had to address it. And so that's sort of my origin story, my villain origin story of how I became a doctor with an expertise in stress because I was looking for answers, didn't find them. Just try to relax wasn't enough. Yeah. Because what does that even mean? It didn't really help.

And then when I put my scientist hat on, I started doing all of the research of what is stress? How does it impact your brain and your body? And how can you get out of that mode? I got I found my way out of the dark tunnel of stress. Well, I feel like the first step to understanding something is actually knowing what it is. And I feel like everybody throws the word stress around constantly. I mean, what an overused word. You know, we're always talking like, oh, I'm stressed. I'm like, oh, she's stressed. That's why she's doing that. But

And people get angry at me at times because I love defining things in the most simple terms, but it's so helpful. What is stress in its simple terms? I love this question. And you're right. We say, we're always like, oh, I'm so stressed. Oh, you're so stressed. This week is going to be so stressful. What does that mean? There are actually two kinds of stress and not all stress is created equal. So there's...

healthy stress, good stress in scientific terms. I won't get too scientific, but it's called adaptive stress. Adaptive stress is things like rooting for your favorite sports team, getting a promotion, getting a new job, your hosting gig at the Met Ball. Healthy, positive stress. It moves your life forward. Maybe buying a house or graduating from school or getting a new dog or a pet or having a new baby. All of these things are versions of

positive, healthy stress. It is biologically impossible to live a life with zero stress. And that is not the goal. The goal is to live a life with healthy, manageable stress. Now, when the other kind of stress is unhealthy stress in scientific terms, it's maladaptive stress. Maladaptive stress is what you and I, when we hear the word stress or in pop culture, that is maladaptive stress. It's dysfunctional, unproductive, and harmful to your brain and your body.

So all of the ways that we can feel stress, there's mental manifestations, there's physical manifestations. And the goal is to really transform that unhealthy stress, bring it back to balance, to healthy, manageable stress so it can move your life forward and it can serve you rather than harm you. So those are really the key differences. Why on like an evolutionary level, why do humans get stressed?

We developed the ability to get stressed because it is a protective mechanism. It's a way for us to feel safe. When we were all cave people living together in tribes, we would go out foraging for food, let's say, and you see a tiger in the forest.

Your fight or flight response is activated. That is your stress response. It's governed by a piece of your brain. It's called the amygdala. It's a small almond-shaped structure deep in your brain. And the amygdala is what drives your stress response forward. When you see a tiger in a forest, you can either fight or you can flee. That's why we call it the fight or flight response. Your heart starts racing so that it pumps oxygen out.

and blood throughout your muscles. Your lungs breathe quickly. You start having rapid, shallow breathing. That's what anxious breathing is. It's stressful breathing. To get more oxygen, your blood is shunted away from vital organs and to muscles so you can either fight or flee. Your pupils dilate. So it's a real biological response that's happening in the body when you have the fight or flight response.

And it is a way to keep you safe. Now, after those times when people were cave dwellers, there would be a moment of respite. The tiger, you would either flee or fight, and then you would bring yourself back to equilibrium. The challenge with modern-day stress is that amygdala is always in the background. Your fight-or-flight response is always in the background because all of these tigers, we're not fighting tigers in the forest. All of our tigers now are metaphorical tigers that never seem to go away. Relationship problems, financial troubles.

health issues, climate anxiety, so many things that just are on always in the background. And therefore you're

Your amygdala is always on in the background. And so it's a part of our mechanism. So when you are feeling that chronic sense of stress, it's not you. It's your biology. In fact, your brain and your body are expertly designed to handle short bursts of acute stress. It's when it becomes chronic that it becomes a problem. And that's when burnout can set in and all of the health problems. So a little bit of healthy stress is okay.

It keeps you safe, protected. That amygdala, it is about survival and self-preservation. That is the only role of the amygdala. Do you think cave people had that sort of maladaptive stress, like that non-helpful stress? Or do you think...

That's new. I am not an evolutionary biologist. But what is interesting is if you think about the onslaughts, it's kind of the same rationale as when people say young people, they can't really handle stress like the old people used to. Right. You hear that all the time. You guys aren't as hardy or as resilient as we used to be. And I always argue to say that the onslaughts that young people are facing with technology, with

with financial struggles or all of these things. It's ongoing. It's different than the onslaughts that the older generation was facing. In the same way, evolutionarily speaking, of course, there was fear of famine or home issues with cave dwellers, but it likely wasn't something that was 24-7. Again, I'm not an evolutionary biologist, but it just seems to me that now the modern day stressors are overshadowed

ongoing, continuous, and they never seem to go away. The other thing to kind of think about is I use this analogy in my book, The Five Resets, about this night watchman. When you think about yourself, so the amygdala is always an overdrive when you're feeling stressed. And evolutionarily speaking, when the tribe would sleep,

there was a night watchman who would scan for danger so the tribe could rest. Now we are all our own night watchmen. Yeah. Because we are all feeling a sense of hypervigilance and a heightened sense of fear and we're

nervous about our own survival and self-preservation. And so we scroll. And so how do we do that? We scroll on social media or we scroll reading headlines or news and all of these ways. So in many ways, we are creating our own stress because we are just feeling that sense of constant danger. And we're looking around and scanning the environment at

all times. Back during cave dweller days, there might have been one person who was assigned and designated for that. Now, the way our modern world is working, it's just really different. And we're all doing that.

all the time. Hence that amygdala always on in the background. That's probably why it's so addicting to read the news, to, you know, scroll on social media and find all the stuff that makes us feel bad is because we're programmed to find that to protect ourselves. Now it's everywhere and it's so readily available. And what's funny about it is that technically it's

we can survive without it. Before, we needed to look out. We needed to protect ourselves from these bad things, from bad news. Whereas now, it's like, technically, we don't have to look at all that. But it's a moral dilemma that I don't want to get into. But it's like, that's very fascinating. It's like, we're bearing the weight of the entire world's

stress on our own back all the time. All day, every day. I hear a lot like, well, it's our responsibility as human beings to be aware of what's going on. And that's a huge ask of humanity. Can we handle that? It's a beautiful question.

You know, I would say that it's really important to be an informed citizen. Agreed. I work in journalism. My two loves are medicine and journalism. And I deeply believe that it's our responsibility to know what is happening in the world and to be informed as citizens so that we can act in positive, productive ways, whether it means donating, whether it means calling out certain causes and amplifying things. So this is not about censorship.

We want to make sure that people are engaged. And, you know, unfortunately, you can't do that at all times 24-7. You cannot do that at the expense of your mental health. And so it's about preserving and protecting your mental health so that you can be the amplifier and the engaged, informed citizen that you want to be about causes that you believe in. And so there's like a balance there.

It's about striking a balance and knowing when is your stress something that you can harness for good versus it becoming, you know, like Spider-Man, it's a blessing or a curse. Same kind of thing. It's like when is your stress something that can be used for good versus

to improve humanity versus something that is going to be a curse on yourself, right? I mean, this is not about anyone bigger than you. It's like, when is your stress going to get so out of hand with you engaging in news? Because studies show that when you are engaged with graphic content, whether it be podcasts,

or if you're reading lots of things, there's lots of humanitarian crises in the world. And as you are engaging and consuming that information, you yourself, without actually having been in that conflict area, you are thousands of miles away, you can be impacted firsthand and develop signs of PTSD, which was a shocking finding in the research done by a researcher here in California, in fact. And she found, her group found, Dr. Silver, who

Roxanne Silver, she found that people who consumed graphic images and content of things happening thousands of miles away increased their personal risk of PTSD and their risk of health conditions years later. So when you are consuming the news or headlines or social media or all of these things, first it's important to recognize that it's not your fault. It's your primal urge to scroll when you feel stressed, that amygdala is fired, you're scanning for danger, you are your own night watchman. And

clickbait works on the biology of stress, right? You start feeling stressed, you feel hypervigilant, so then you scroll some more. And then that increases, it's a feedback loop. And then it increases your sense of hypervigilant, so you keep scrolling and scrolling and scrolling. So you find yourself coming down this rabbit hole. But what's fascinating is that this scrolling is not benign. It's not like, oh, I can just shut it off. It's hard to shut off. But this idea that you cannot, it has to be

all or nothing, right? You can still be an informed citizen, consume the news, do it in a way that feels responsible and good for you. Do it in a way that makes you take action on issues that matter without compromising your mental health. And that is the fine line. It's hard because it's a slippery slope. And as you consume, you want to consume more and more and more. And so you can do various things to reset your stress. The key is to create digital boundaries.

Because we have boundaries in every relationship in our life. We have boundaries with ourselves, with our partners, our children, our coworkers, our family members. Why don't we have a boundary when it comes to the relationship that we have with our devices? It's almost like that boundary is like a boundary with yourself. And I think that's the hardest boundary. Like boundaries that you create with yourself.

They're so hard to uphold because you are the checks and balances. I know I have moments where I feel like I have two sides of my brain fighting each other. I have this, it is like a devil and an angel. You know, I've always felt like I have that in a way. And that's a hard thing to manage. But it is worth it. It's so worth it. To sort of further demonstrate why it's so worth it, explain to me how stress impacts you.

a human's well-being? I mean, how does stress's presence in someone's body impact their well-being on a day-to-day? The thing with stress that is so difficult is, first, let me just paint the picture of the data. 70% of people across industry, regardless of industry, regardless of what job that you have,

70% of people, regardless of industry, have at least one feature of stress or burnout right now. That's like saying in a room of 30 people, 21 people are struggling with stress and or burnout. So if you are feeling any of these things, you are not the exception. You are the rule.

How does stress manifest? It is such a personal thing. People have mental manifestations of stress and physical manifestations of stress. So certain mental manifestations of stress could be anxiety, depression, insomnia, hypervigilance, irritability, quick to anger. On the other side of the spectrum, lethargy, fatigue, not motivated, unproductive, or bored. There's

So many flavors of stress. Flavors. Physical symptoms. Some people have no mental manifestations and get physical manifestations of symptoms. I'm sure you have friends or family members who say, oh, I don't know, my back just feels weird. Or you get neck pain or shoulder pain or abdominal pain, dizziness, nausea, tingling, numbness, headaches. There are so many kinds of physical manifestations of stress.

The key is first, of course, if you are feeling any of these things, to go see your doctor because that's always important. As a doctor, I always have to say that. Of course. To get the full workup like I did when I was having the palpitations. I went to a doctor and I said, the stampede of wild horses, is it something to be worried about? Is it my heart or is it something, you know, what is it?

So once your doctor does the whole workup of whatever symptom you have, then they tell you it's probably just stress. Everything checks out okay. It's stress.

Stress in medical terms is a diagnosis of exclusion, meaning we have ruled out everything else and then we say it's probably your stress. One statistic, which is really the genesis of why I decided to do the work that I do, is because one study back in the 1980s found that 60 to 80 percent of all primary care visits with doctors had a stress-related component. That means that someone has abdominal pain or headaches or something and they go to see their doctor, they do the full workup and they're like,

It's nothing. It's just stress. So that happens, you know, 60 to 80% of times. It's not to say stress causes these symptoms, but stress makes things worse. And yet only 3% of doctors counsel their patients for stress. A lot of that is because doctors were

For them to really do their job well, a doctor has to work 27 hours a day. Who has 27 hours a day, right, to do that? And so there's lots of... It's not an individual failing of physicians. It's the system that's really broken. It's also not the individual failing of people to say, I don't know what's going on. Is this stress? Is it not? It's really hard to pin down. It's like this multi-hyphenate performer. You can't pin stress down. And stress, typically, with most people, it presents a certain way. So

I call it the canary in the coal mine. That's an analogy I like to use. It's this idea of historically, coal miners would go out down into the mines and they would take a canary, a bird, down with them. When the air got bad,

the bird would stop singing and the canary would stop singing. And so they would look around and say, okay, time to go up. Why didn't they recognize that in themselves? They couldn't recognize that the air was bad because humans historically, we are just bad historians. We can't tell when something is happening. So the canary stopping to sing was the first tell. So often...

You will notice that there is certain things happen to you when you are feeling stressed before it becomes a major issue. For me, it's irritability for people, no sleep disturbances. You kind of nodded when I said anxiety. Some people feel anxious. So there's like this tell your own canary of, wait, something's up. Something's not right. But often, because we're bad historians, we're like, it's fine. Just keep going. No problem. Just keep going. And then you get into trouble. Well, it's also like when you're not dying, right?

It's like, you know what I mean? Some of you are like, well, I'm not dying. Yeah, I'm just going to live with this. Yeah. And I think we sort of gaslight ourselves into believing that we're fine or like everybody's dealing with this. So it's like, I'm not going to make a fuss about it. And I also think a lot of people, again, you know, you made a really interesting point about out of 30 people, 21 are stressed. You know, being stressed is the rule. So again,

We've sort of normalized being stressed out. And it's almost like if you're not stressed out, well, are you working hard enough? Are you even getting your job? Well, you're lazy. If you're not stressed out, you're lazy. We kind of live in that sort of time, which is horrific. It's a manifestation of hustle culture. It's this idea of toxic resilience. So when I was seeing my doctor and that doctor said to me,

you're probably stressed. My first reaction, like I said to you, was stressed. Russell's not one of the people like me. Like I'm resilient because I had bought into the resilience myth, which is that resilient people can't get burned out and can't get stressed. We know based on data now that is absolutely false, categorically untrue. Resilience is protective, but it's not enough to prevent burnout or stress, especially now, right? 21 people out of 30 are facing some form of stress or burnout. Yeah. It's this idea of hustle culture. Yeah.

When you hear the word resilience now, Emma, you and I and everyone else, we bristle. We're like, ugh, that word. Like it just has a bad connotation. Yeah. Whereas true, because we've kind of made it into toxic resilience. Yep. You know, in 2018, 2019, you heard the word resilience.

And it was a positive word because it was true resilience. In scientific terms, resilience is your ability to adapt, recover, and grow in the face of life's challenges. Without a little bit of healthy stress, there can be no resilience. You need a little bit of stress for resilience to show itself. Now, over the past four to five years, that has morphed and it's no longer true resilience. When you hear the word resilience, it is toxic resilience.

It's a manifestation of hustle culture and corporations. How much messaging did we get in our workplaces? Just power through. You can take on this deadline. You're resilient over the past several years, right? We've all lived through individual and collective trauma and stress through global events that have occurred over the past four to five years. And so now that word has taken on a sinister and dark meaning because it is no longer this positive, uplifting thing. And so when you say that, you know, it's about...

People just feel like, oh, this is what's going to happen. Like I'm stressed. I'm burnt out. We can't let, we cannot let this way of being, which is feeling a sense of maladaptive stress and it being dysfunctional and

It can't be a badge of honor anymore. We have to change the script and debunk this idea of toxic resilience and really stand in our true resilience, which, by the way, true resilience honors your human limitations. It honors your boundaries, your human boundaries to say no. It celebrates saying no. And it leans into this idea of self-compassion. And we need a lot of grace and self-compassion now more than ever. This episode is brought to you by Squarespace.

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It should be that the more privileged you are in your life, you know, the more comfortable that your life is, the less stress that you are. But it seems humans are they want to find stress. They like they it's like almost like we're hungry for it. And so even when somebody this isn't across the board, but it's like I've just noticed a lot of unnecessary stress in the lives of people who really they shouldn't be stressed at all.

On paper. So there are two kinds of happiness. And this gets to that idea. So I would say that, you know, because I have worked in clinical medicine and I've seen so many patients from so many walks of life,

Stress is really the great equalizer that no matter how much money you have or what job you have or whether you have a roof over your head or not or whether you have food in your fridge or pantry or not, stress is really the great equalizer and it's part of the human condition. So, yes, I think that stress across the board, people feel a lot of stress.

What you're speaking about is, you know, so someone has this beautiful home and many cars and all of these degrees and can buy anything. And yet how can they feel a sense of stress, right? It's this idea of hedonic happiness and the different kinds of happiness. So it's about humans being meaning-seeking, purpose-driven creatures. And when you chase hedonic happiness, and it's something that is really perpetuated in our society, especially in the modern age, but always, right?

You chase, you know, the fancy restaurants and trips and yachts and private planes and beautiful homes and nice bags and all of these things, right?

These are all manifestations of hedonic happiness. And there is something in your brain called the hedonic treadmill, which is that we all have a set point of hedonic happiness. So you can, this is why lottery winners, they win the lottery and you think, okay, they're not going to have any stress and they're going to be happy forever. And then you kind of get back to your baseline level. Yes. And it's, and you know, you buy this, I don't know, maybe you run into a ton of money and buy a $20 million home and you think that's it.

I'm going to solve all of my problems. And you end up not solving all of your problems and you end up feeling stressed because we have a hedonic treadmill. That's not to say that if you don't have the means, we know that people who don't have financial means and who are impoverished do have more stress just because you are working on, you're focusing on survival and self-preservation, right? But it's this hedonic treadmill that we hit a set point. So what is the antidote to that?

It's about another kind of happiness. So it's eudaimonic happiness. And eudaimonic happiness is about contentment, meaning, purpose. So for you, Emma, you know, you're engaged in all of these pursuits and that brings you deep meaning, fulfillment and joy. A different kind of happiness than if you were hanging out with your friends and taking a fabulous trip to, I don't know, Italy. Yeah.

Wonderful, magical, but a different kind of happiness. And so it's about a marriage of the two and really focusing. We focus so much on hedonic happiness, right? That's what you were describing, that lifestyle. And it's about, yes, of course we want hedonic happiness, but we also want to manage our stress by creating some eudaimonic happiness. And the fascinating thing about these two different kinds of happiness is that our bodies know the difference.

difference. There has been science done which our cells show these different kinds of happiness affect our cells in a different way. Decreased inflammation, all of these fascinating things. And your body knows the difference between these two kinds of happiness. Maybe it's because when you're only focused on hedonic happiness, then it

It's so short lived that you're always looking for another hit of it. That's right. And trying to get another hit of it is stressful because it's like you start to become numb to things like going to your favorite restaurant doesn't mean anything anymore. Like it's almost too easy to only find your happiness there when it's available and there's no reason to not go in that easy direction. You can then.

the more challenging direction, which then, yeah, leads you back to your baseline because of lack of discipline, I guess, in a way, right? Like maybe that's what I'm, that's maybe that's what it,

It is in that scenario. Like why that happens? I don't know about lack of discipline because then you're putting the onus on yourself and that might not feel, you know, you're not giving yourself enough grace because when you are feeling a sense of stress, you are living in the here and now and you're focused on survival and self-preservation. When you are feeling in that resilient state or the normal state, many people can't even remember what they were like in their normal state right now.

That area of the brain, the prefrontal cortex, which is an area right behind your forehead, that is that area of the brain that governs all of these things. But if you are living in amygdala stress mode, it's hard to get out of your own way. It's hard to get out of that immediate fight or flight mechanism, survival, self-preservation, protection, and to start thinking about a different way, which is led by the prefrontal cortex. So in many ways, if you start kind of... And the other thing that happens with stress is that you start your inner critic.

starts to hold a megaphone and say, you're not good enough. You'll never achieve this. Why even try? Stop right now. All of those harmful messages you tell yourself. So if you are feeling that sense of stress or burnout, as we know, most people are, 70% of people feel that way, saying to yourself that you need more discipline. You need to do better. You need to change your ways. Find your happiness in the

And a fulfilling. Yeah. Yeah. That's true. Instead, instead, just give yourself lots of grace, have a lens of self-compassion and start small. You don't have to think about eudaimonic happiness, like what makes me happy and what fulfills me and what's my purpose. Right.

Get out of your head and into your body. Go for a five-minute walk every single day. Commit to that. Commit to some digital boundaries. Commit to protecting your sleep like the vital resource it is. Fill your tank. So many of us are running on fumes. And it's hard to think about these big,

grandiose things like purpose and meaning when you're just trying to get through the day. You can't. You can't. You biologically can't, in fact. No, you definitely can't. It's a different part of your brain. You can't be even remotely philosophical when you're in a state of burnout or when you're in a state of stress because that takes this almost impossible nowadays sort of balance in your brain to be able to focus on that level. Like it's just...

And I think it's a shame because I think...

So many people want to tap into that side of themselves and they can't because we're all so stressed out. You know, it's interesting because in 2024, you might think, oh, I got through this like horrible thing. I should be feeling amazing. Most people are feeling worse now than they did in 2020. Oh, for sure. And it's the delayed stress reaction. And everyone is wondering why. Why do I feel worse now? I should be celebrating, right? And that is because that is not how your brain works. Your brain is built like a dam.

And so during difficult moments like what we've all lived through, we shore up our internal reserves and we keep it together at all costs. Think about your life, Emma. Periods of time that have been really difficult periods of time. Chances are many of us, you keep it together. Of course, there are people who break down and you have moments, but you keep it together. Yeah. You...

shore up your internal reserves. And then once the acute crisis passes, I've seen this with my cancer patients over and over. They come to see me on the day of diagnosis. They go through their treatment. They don't shed a tear. When they get that clean bill of health, their oncologist says, congrats, your cancer is cured. They're in my office the next day weeping. It's the same thing that would happen to me. I would see patients and I was seeing so many patients in the clinic, never had palpitations. Totally fine. At night,

going to bed, finally relaxed. That's when the palpitations came. And so now all of us collectively are

have come out of a really difficult time. We are finally feeling psychologically safe. Our defenses are down now. They weren't down in 2020, right? We were very keyed up. We're all feeling more relaxed and calm. We're not feeling a sense of imminent threat or danger. Our true emotions are emerging and it's a deluge. And so that is why our dams collectively, individually have broken. Wow. And it's all coming out now.

I mean, my anxiety has been so bad over the last year and it feels like it's all coming out now. Like this is so resonating with me and it does feel like almost, it feels like a direct response to that. Like I can feel that connection. I feel those strings there. And so it's so interesting. And I feel like we all, we really all kind of just let it pass. And then now we're like, oh, we're all back to normal now. And I think a lot of people feel really off.

Because you didn't process. And really freaked out. Because we haven't processed what we've gone through. Your brain and body are not designed to sustain this level, the cyclical level of trauma, onslaught, grief. I mean, it's just going on and on and on. And there is no respite. Your brain and your body can handle short bursts of stress as long as your brain and body come back into equilibrium. But we've had no equilibrium.

We've had no recovery time. And like a muscle, your brain is a muscle. So with your biceps, you go to the gym and you work out. Then you give yourself a rest day with arms, right? I mean, you might do legs or whatever it is. You give yourself that rest day. Your muscle recovers. Then you go back to the gym the next day or, you know, two days later. And then you can work out a little bit more. But if you were lifting heavy weights and doing, I don't know,

dumbbell presses every single day for four years straight, how would your biceps be reacting? Your brain needs a rest. Your brain is a muscle just like your bicep. And

And so you need a little bit of rest and recovery to regroup. And then you can come back stronger, right? Something called post-traumatic growth. There's lots of things that can happen. But if you never have that moment of pause or respite, it all has to come out somewhere. So I think a lot of people right now are very confused because like you, Emma, people are feeling anxiety, depression, insomnia, and they're wondering why. Because their messaging that we have been told in our society is everything's great now.

Back to normal. Yeah. Yeah. Oh, we had we lost a lot of headway. So let's make up for it. Let's work harder. Let's do more. Let's do this. Let's do that. And you're like, wait a second. We didn't even take a beat.

Your brain and body certainly didn't. And so that is why you are feeling all of these things now. It's important to know that this is a normal biological process. There's nothing wrong with you if you're feeling worse now than you were in 2020. There's everything right with you. Your brain and body are acting exactly as they should. The only way around is through. You mentioned earlier how when you were going through your moment of stress and you were having the stampede at night in the heart.

on the chest and you tried all these things to make the stress go away and it didn't. Why did those things not work? You know, like how do you actually target stress and get rid of it? Because you can't just, you know, go have a spa day. Like that's a bandaid. You have to find the root cause and change it. Like change something about your life. Is that the only cure? I mean, what is the ultimate cure for stress?

So, you know, I am with you all the way in terms of getting to the root cause and trying to change it. But unfortunately for most of us, we can't change it. These are systemic forces at play. And so whether it be financial constraints or parenting constraints or, you know, responsibilities and roles in our lives, we can't just say, hey, I'm going to check out, see you later. I'm going to Bali for six months. I'm going to go on a surf trip or live in Paris for three months. Everyone in L.A. has no problem doing that.

I'm doing that. I mean, sign me up for that lifetime. I know. It's great. It's amazing. Yeah. But the reality is that 99.99% of people can't go to Bali for six months and go on a surf trip. So what is the solution there? The first is to give yourself a lot of compassion and understand that if you're feeling like this and, you know, you

You have to parent yourself. That's the first sort of approach. So I'm a mom and I have lots of rules about bedtime and screen time and all of these things. You did too as a child. We know how that works in society. We set limits and boundaries for our children. They have a certain bedtime. They have a certain time to go outside and play and move their bodies. You have certain nutritional guidelines.

Screen time. Why don't we do that for ourselves? Why don't we learn to parent ourselves? It is challenging, but it can be done. So that's the first reframe. It doesn't have to be about morality or right from wrong. It can simply be, I'm going to learn to parent myself better. So knowing what your boundaries are and when you've exceeded them, rather than being like the coal miner and just

powering through, understanding like, hey, wait a second, my canary stopped singing. I need to, you know, I need to get out of this mind. The air is bad. So understanding what that is, it's not about a large systemic change. I would love a large systemic change. But when are we, I think we got to wait a long time for that to happen, right? It has to happen in the moment, in today. And it's about building some of ways to manage your stress and reset your stress using your brain and your body and the biology of stress.

right in the messy middle of your overscheduled life. So one very clear example.

Aiming for a 10 o'clock bedtime. Embrace your inner grandmother or grandfather and go to bed at 10. In fact, I feel like grandparents stay up much later than young people these days. Because they love Jimmy Kimmel. They have to stay up for Jimmy Kimmel and Jimmy Fallon. They're living their best life. Like my parents or grandparents and they're living their best life. So instead, okay, maybe we use another analogy instead of grandparents. Inner baby, maybe. Like inner baby. Inner baby. Because babies love going to bed at like 9.

No, they don't though. They don't sleep either. Do humans ever go to bed at a reasonable hour? Maybe never. So we should be the first generation that is doing this. Yes. And really engaging and practicing self-care. We use the word self-care and self-love a lot, right? We throw that word around. Yeah. But instead, understanding that there are certain biological mechanisms that your brain and body need for rest and recovery and prioritizing rest and recovery, not as a nice to have, not something that will happen when, you know,

When my children grow up, when I have less work, when this happens and that happens. No, rest and recovery have to happen right here, right now, today. And so really protecting that. So making sure that you are going to bed at a decent hour. 10 p.m. is based on data is shown to be most protective.

Hours between 10 and midnight are the most restorative for sleep. So creating some digital boundaries. Getting your phone off your nightstand. All of these things have downstream effects because if you're not scrolling, if your phone isn't on your nightstand, you're not scrolling at night, you're going to bed at 10. That is a direct competitor with our sleep, our screen time. Mm-hmm.

In many ways, biologically, because that blue light from your screen is keeping you awake at night. It's activating the awake mechanism in your brain. And also psychologically because you're consuming lots of difficult things and then continuing to scroll because your stress response is high. Also, when you keep your phone off your nightstand in the morning, 50% of people first thing on waking, whether they've had a restful night or not, will scroll their phones. It is just amazing.

Yeah. I think that's underreported. I think it's probably higher than more, probably 60. Definitely higher than that. You know, 70, 80%, right? Instead, when you keep it off your nightstand, you create a geographical boundary, which means that you wake up, you let your eyes adjust to the light, you maybe take in a deep breath or two. We're not talking about, you know, spending an hour before checking your phone, a few minutes. Right.

That short stopgap can change the tenor of your entire day. Moving your body a little. We know that when you sit for long periods of time, there's this saying, right? Sitting is the new smoking. And when you sit for long periods of time and you feel that sense of anxiety or depression and you really just feel so heavy in your body, five minutes of a walk. Commit to it every day. It's easy. You can do it.

Lace up your sneakers. That's the hardest part, right? Then try for 10 minutes the next day and then 20 minutes. You have to find a way to avoid the all or nothing fallacy and saying, well, if the system isn't going to get fixed, why even bother? Instead, when you do these small resets, we're talking five minutes, it can help your biology of stress for your brain and body. And science shows that even 10 seconds of a break during the day can have an impact on your brain. Totally. Totally.

And there was this beautiful study done with two groups of people, and they looked at brain scans. It was done by Microsoft. And one group took no breaks, just worked straight through the day, Zoom meetings and lots of various things that we all have to manage throughout the day. The other group took short 10-minute breaks throughout the day, I think anywhere from four to five.

The number doesn't really matter, right? And at the end of the day, they found that the group that took breaks, cumulatively, they looked at brain scans and found that that group that took breaks had less stress throughout the day. At the end of the day, better cognition, attention, focus, and all of these things to preserve

preserve the prefrontal cortex. The other thing that I would suggest is while we are trying to work on the broader system and how do you manage your stress in the day to day, it's to really think about what you are doing during the day. So for example, multitasking. Multitasking, we all do it all day long. And we think like, oh, this is something good for our productivity. Multitasking is a scientific misnomer. There is no such thing.

When you are multitasking, what your brain is doing is task switching. You're doing two separate tasks in rapid succession. Even though 100% of us, Emma, think that we are excellent multitaskers, you might think you are. Of course. I used to think that I was. The truth is only 2% of human brains can effectively multitask.

And so if you are a true multitasker, likely you are part of that 98% who is task switching. So there is no such thing as multitasking. It's a myth. Instead, the antidote to multitasking, and the thing with multitasking is it weakens your prefrontal cortex. It decreases productivity, decreases concentration, memory, and ironically, decreases productivity. Totally.

Totally. So the antidote to multitasking is monotasking. And what monotasking means is when it, let's say you have an hour to finish four tasks and

What is multitasking? You have everything going all at once, right? Instead, monotasking is kind of like having a dinner party. And if you're cooking four dishes, it's focusing on one thing. Do a time block of 10 or 15 minutes. Focus on the one task. Then take a break. Build that science into your life. Take a five-minute break. Take a 10-second break if you can. Then focus on the second task.

10 or 15 minutes, then take another break. And by the end of the hour, you've finished all four tasks. You have monotasked. And you have preserved your prefrontal cortex, which is all about solving complex problems. And there are so many complex problems in the world. We cannot afford to multitask. So aim to monotask instead.

This episode is brought to you by BetterHelp. One skill everyone can benefit from is learning how to take time for themselves. I have been implementing a lot of self-care rituals recently because I was not taking nearly enough time for myself and it was negatively impacting my brain.

One thing that I've done is not allowed myself to doom scroll on social media in my time spent alone. I find that that just ruins the recharging benefits of being alone. I've been making more time to read books, do art and exercise because I find that all of those things make my alone time even more effective in terms of recharging. Whatever your schedule looks like, it's important to do stuff for you, especially when life gets hectic. That's when you need self-care the most.

If you're struggling with that, I recommend therapy. A lot of times we have a vague idea about what will make us feel better in our lives, but it can be really hard to make a plan and set it into motion ourselves when we don't even know where to start.

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H-E-L-P dot com slash anything. This episode is brought to you by PNC Bank. Unlike this podcast, some things in life should be boring, like banking, because boring is pragmatic and responsible, level-headed and wise. All the things that you want your bank to be. You don't want your bank to be cool or sexy. Sexy is for red carpets, not banks.

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how much stress I experience from picking out an outfit every day. Like I, and I look amazing. Thank you. See, no, but this is an example of me being like, I'm done. Like I need to snap into a uniform. Like I think I might do that because I, I calculated how many hours I spend picking out an outfit every day. I also weighed the pros and cons. Like, does this make me happy? Like,

Because I do enjoy fashion. Like, I love fashion. But on a day-to-day basis, constantly making these choices, I was like, this kind of has a net negative impact on my life. And I was like, I do love it, but I don't think it's working for me. And then I'm in this phase right now where I'm sort of stepping back and looking at all the things that I do and sort of analyzing what

Are they working for me? Because I don't think we do that enough. And I think there's a lot of hidden stressors that we don't think about that accumulate. I think what you're really bringing forward is this idea that we all have a limited amount of bandwidth. Yes. And it's not this thing that just grows on trees where, oh, bandwidth, you want more bandwidth. And that's the problem with toxic resilience, right? It's like, you can do more. Just do more. Just...

Expand your bandwidth. Work harder. Yeah. As if we can. As if you can't. It's biologically impossible. We all have a set amount of bandwidth. It might be different for different people based on your personal experience, your circumstances, your resources. There's so many factors that go into bandwidth, right? Like what is bandwidth? Mm-hmm.

How is it that, but to really understand that we all have a finite amount. So when you are spending 20 minutes every day picking out your outfit, there's lots of people, by the way, I think Steve Jobs, you mentioned Apple. I think he was one of them. Einstein may have been another. Full uniform. Right? Like Einstein had white shirts and gray pants and Steve Jobs had black,

turtleneck and jeans? Yes. Just an entire wardrobe. And then it was like one less decision to make because ultimately what happens is when you are, you have to take into account decision fatigue.

Because if you are constantly making many decisions all day, every day, it's a way to streamline. So I think for you, when you're saying, you know, you love fashion, of course, when you're going to the med ball, of course, you're going to be thinking about fashion. Yes. And planning your outfits or you have a big event. But in the day to day, you're like, does it make sense? Yes.

What I would actually say to you is hearing you say that you're thinking about this, you're thinking about the different areas of your life, that to me tells me that you are not feeling a sense of acute stress, that you are very much living in that thriving mode in the prefrontal cortex because you are forward thinking, strategizing, planning. So congratulations for that. Thanks.

Thank you. See, because I don't actually think I'm very stressed right now. I think you've really stepped into that idea of, you know, meaning, purpose, mission. And then you have all of these ideas of to be able to do all of those things out there. What do I need to do in my day to day to streamline? Yes. But to get there, it's taken you years. Oh, it's been the most turbulent journey. There is a sense of relief, though, when you do figure out, OK, what am I trying to do?

you know, where can I provide value to the world in some way? It doesn't need to be huge. It can be for five people. It doesn't matter. But you know, what is that? But see, that's what's so hard about the period before you discover maybe what your purpose is. You spread yourself so thin because you're just throwing everything at the wall, like what's going to stick. It's interesting because that's making me realize how not having a clear goal in life

can cause a lot of stress. Like in moments of my life where I've been aimless, that's when I've been the most stressed. That's when I've been the most overwhelmed because I don't know where to direct my energy. I feel all like sprawled out all over the place. And, um, I mean, have you noticed that having a distinct goal or it doesn't even need to be big. It can be

like I'm I want to like have a let's say you're pregnant like I want to have a healthy pregnancy you know what I mean like that and that is a big goal but you know what I'm saying it's not tangible and concrete like do you think that helps of course it helps it's the first step

I call it the most goal. It's having a most goal. It's your North Star. It's your why. Why do you want to have less stress so I can achieve X, Y, and Z? Your most goal. M-O-S-T, it's an acronym. So it stands for, is it motivating? Is the goal motivating? Is it objective? Like you said, is it something small or is it like, I just want to have, I want to make a big impact on humanity? That's not a most goal.

that's like so vague and nebulous. But I want to have enough energy by this summer so I can play...

baseball with my grandson. Yes. That is a most goal or most M-O-S-T. M stands for motivating. O is for objective. S is for small. And T is for timely. Can you achieve these things in the next three months? It takes eight weeks to build a habit. Understanding that your brain and your body, when you're having a new habit and you fall off, getting back on, falling off, getting back on, that is part of habit formation. It doesn't mean that you'd failed. It just means

That's how your brain is learning and growing and changing. And so when you have a most goal and have a why, then everything becomes more clear, right? Because then you have an aim. Okay, so for you, if your most goal, you know, if we want to use the analogy of the example of you don't want to pick out your clothes anymore. Why? Because then you don't, you want to be on time. You want less stress. Why? Because ultimately you're trying to achieve something very concrete.

In the next three months. Yeah. For your work, whatever it may be. You want to have that bandwidth because we all have a limited amount of bandwidth. Instead of dispersing it on these day-to-day actions that cause you a lot of stress, you want to hone it and focus on what matters most. And so it's less about what's the matter with me. When you're feeling a sense of stress, how often do we say because of that inner critic, what's the matter with me? Why do I feel so bad?

What is the matter with me? Instead, we need to reframe and it's not about what's the matter with me. It's what matters to me most. And really move things forward using that lens. What is your advice for figuring out what

your goal is. Because I really do think that that is so helpful. There's just something about having that goal that it makes everything else so much easier to analyze in a way. Like you're able to properly, rationally make decisions about your day-to-day life when you have that goal. But I wonder if there is any advice you give to somebody who's like, you know, I'm so stressed out

probably partially as a result of not knowing what I'm aiming for. Like, what would your advice be to a person like that? So it depends. So, you know, for someone who's saying, I'm so stressed out, I hate my job. I want a new job. So in three months, that goal could be, I want to get a new job. But to actually get there and get that new job requires a couple of things. So that's your most goal. It's motivating. It's objective. It's small and it's timely. So let's say in three months, I want a new job.

If you say that to yourself, then what has to happen? You create a backwards plan. So you end up with having a new job, but there are, I don't

I don't know, 10 or 15 steps prior to getting there, which include protecting your mental health, managing your stress, filling up your tank and having enough bandwidth to then go search for a job, right? If you're miserable at your current job, you're running on fumes, you're coming home, you're exhausted every night, you're watching Netflix, you're maybe drinking wine and self-medicating with the

you know, three or four drinks and you're up till one or two in the morning doom scrolling. Go to bed, wake up, feel terrible, go to work, you're dissatisfied with work. So if you are in that hamster wheel, you need to figure out a way to break the cycle on a daily basis so that maybe you start going to bed early. Maybe you don't doom scroll. Maybe you create a digital boundary so you're not doom scrolling. So then you start getting, you know, you start rewiring your brain through these things.

And then your stress starts decreasing. Your stress starts decreasing. You get out of amygdala mode and fight or flight mode. You start having your prefrontal cortex take over again. When your prefrontal cortex takes over, it's about forward thinking, strategy, memory, planning, organization. Then you might start your job search. You have a little bit more energy.

Right. You start cleaning up your resume, putting out feelers. So all of these things take time. And so you need to make sure that you are well enough mentally and physically to then engage in that. And then the other thing I will say is when you are doing anything new,

Understand that anything new is a stressor on your brain. Change, even positive change, is a stress to your brain. That is why when you're starting, you know, it's a new year and you have like 20 things for your New Year's resolutions, by February you've given them all up because it's just too difficult to sustain. It's not you, it's your biology. So aim to do two things at a time. I call it the resilience rule of two. And do those two things and then build on that. So for eight weeks, do these two new habits of change.

Going to bed early every night, keeping your phone off your nightstand. Then, you know, after that, those eight weeks, that habit has become part of your wiring. Then start doing a daily walk if you can and start doing something, you know, stop multitasking. Then once that has happened, then you add two new things. So by the end of that three months, you have brought all of these things in. You've protected your brain, moved out of amygdala mode, which is about survival and self-preservation, like instantaneously.

in the here and now. So you can't look for a job three months from now if you're just thinking about the now. So it's about shifting your perspective and getting out of one mode to the other. So that's just one very concrete example that I think many people can relate to because there is such a sense of feeling dissatisfied with your work, right? People are not happy in their work. They want to get out of their job. They don't know how because they don't have the bandwidth.

right now. So if you can create, it's not about creating bandwidth, exactly like you said, Emma, it's about redirecting and harnessing that bandwidth away from all of those things that are depleting you and redirecting it back to yourself so that you can start thriving rather than just surviving. This all really leads to the five resets. Give me the summary of what that, what do I need to know?

So, you know, when I was seeing patients in my clinic in Boston, what I found fascinating is that we all, as a doctor, pattern recognition is what I do, is what all doctors do, which is why I can see 100 people with a

abdominal pain, belly pain. And I can tell you the difference if this person has pancreatitis or this person has gastritis or ulcers or stress or whatever. We ask a lot of questions and then we can tease out what's happening. And I started to see a pattern with stress, one-on-one with my patients with a large group. Because stress is not this mythical, magical creature. There are actually tangible ways that we can measure our stress, understand our stress, and ultimately overcome our stress.

And so the five resets are five small but mighty mindset shifts.

along with 15 scientific strategies that get you out of everything that we've been talking about, that amygdala fight or flight mode, back into your prefrontal cortex. And it's a way to reframe your stress and burnout and transform your relationship with stress and burnout for good. These are not hacks. Your brain body is too smart for hacks. I really don't like that word very much at all. I think it's about doing small things every day. What was really important for me with the five resets is that everything is free,

Because I have been a doctor with seeing thousands of patients with all different resources, having something free, we can't all spend an hour, you know, in some fancy spa or doing some therapy. Red light therapy.

Therapy. Yeah, whatever it may be, because not everyone has access to that. So having everything be free in the book, and it's always my approach. Everything I suggest is always free. So that was really important to me. Having a low time cost as well. So it's not just about financial costs, but time. Because like I said, right, we talked about what are the things people are really stressed out about? People are stressed out about their jobs, not having the financial means, parenting. People don't have a lot of time. Everyone's juggling everything.

Life, you know, time is our greatest currency. So making sure everything was short on time. So five minutes, 10 minutes here and there, small tweaks and practical. It's got to feel like you can build it into your life today. Yeah. One of the best feelings that I have is when I give talks or when I'm talking to a patient, when someone says that that whatever...

little nugget I gave them. They're going to start doing it today and then they'll send me a DM like a week later or a month later saying, it totally worked. It totally worked. It's like amazing. So for me, what's the meta of all of this is that I wrote a book on stress and burnout

When you are writing a book on stress and burnout and sharing it with the world, you experience a lot of stress and burnout yourself. I know. It's so true. That's so true. And I doubled down on those five resets, man. I was like. You tested those. I've tested them for 25 years. But now it was like during that phase, I can't imagine. It.

was like, for me, it was a game changer to use all of those resets. And I've always used, I walk the talk and I do all of those resets anyway, but I doubled down. So I protected my sleep. I created, you know, redrew those digital boundaries because even though you know all of the science about stress and burnout, it's so easy to slip up because we are mere mortals, all of us after all.

And so for me, what has been the most gratifying about this journey of writing The Five Resets is I am used to seeing patients one-on-one and then giving me the feedback. Like they'll always say, Dr. Nurkart, you cured me of my stress. You helped me. You cured me. And I always say, I didn't cure you.

You cured you. Yes. All I did was hold up a mirror and show you and you did it yourself because it's really important for me to, for people to feel a sense of empowerment that like, I can do this. I can do this myself. Yep. I think just being able to share the human story and,

my story with others, but also other people's stories. I think my greatest hope for the five resets is this idea of bibliotherapy, which is this idea that a book can help you heal. It feels therapeutic. It creates a community. So when you are facing stress and burnout, you don't feel alone. Understanding that this is this great

paradox of stress that we are all facing this 21 out of 30 people and yet we feel completely isolated in our togetherness. Instead, I hope that the five resets and

you know, our conversation and all of my work really, really makes people feel like they are seen, heard, understood, and loved and understand that if you're feeling this way, just to normalize and validate this difficult experience of being alive in 2024. Yep. Yep. Amen. Amen to that. I can't wait for everyone to read it. Like everyone's going to love it.

it thank you you're the best you're the best no you are such a bright light for I think of all the ways that you could spend your time speaking of time and bandwidth

There are so many ways that you could spend your time. And I really, I've been a fan of this podcast and of you. Thank you. And the way you conduct yourself in this world. And of all of the things that you could do, you are so interested in bettering yourself, bettering the people around you, your community, making people think about things in a different way. And it is such a beautiful legacy. Oh, yeah.

Thank you so much. Oh, my God. Now we have to – oh, you're going to make me cry after this. But thank you. Thank you. And this is like all we can do, you know? It's like what's the point if we're not helping other people? That's like what it has to be that, if nothing else. Well, thank you again for coming on. Thank you for having me. You're the sweetest ever. Oh, my God. I learned so much. Right back at you. This episode is brought to you by Hydro Flask.

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