stress Archives - Randi Hutter Epstein M.D. M.P.H.

Many who knew Bruce S. McEwen, Ph.D., either at The Rockefeller University where he ran a laboratory or as a guest at one of his homes in New Jersey or Maine, said the same thing: For a high-powered New York City-based scientist, McEwen was unusually serene.

But McEwen was deep in stress for more than 50 years.

He conducted pioneering work on stress in the brain in the 1960s and trained a generation of the leaders in the field. I had the privilege of speaking with him a few months ago while exploring the truth behind the old adage about stress hindering fertility.

We had a few fruitful conversations–not limited to fertility. We chatted stress and its broader impact on health. We talked even talked about the good stress.

Last week, I was devastated to hear that he died after complications from a stroke. McEwen was 81. One of his articles was published on the day he died: January 2, 2020.

In the New York Times obituary that I wrote and that came out today, I touched on his discoveries. His initial study showed that corticosterone, a stress hormone, latched onto the hippocampus, the brain center for learning and memory. This research paved the way for others to show that unrelenting stress causes a spike in stress hormones (cortisol along with other chemical mediators) that shrinks parts of the hippocampus (and swells the amygdala, known for vigilance against a threat).

What drew me to McEwen was, of course, his fascinating research but also that he practiced what he preached. If you were lucky enough to catch a few minutes with him, somehow his approach to life wafted through the room or phone lines, as the case may be. You felt a little more, well, calmer. Perhaps it was his Midwestern mild manner (he grew up in Michigan) compared to my New Yorker neuroses.

Since immersing myself in his research over the past weeks, going over our conversations and listening to his many talks on YouTube, I’ve been reciting a few of his lessons, like mantras. They remind me that a few minutes a day to unwind, to take deep breaths, or to meditate has both immediate and long-term health implications.

Reducing stress is good for your brain, right down to the genetic switches.
Fleeting stress is a good thing: the kind that energizes you for, say, a talk or test.
Stress is not something that happens to you, but the way you respond.

That last one is a tricky one because, in the thick of freaking out about some frustrating incident or a screw-up at work, it’s easy to believe that our racing heart, our shallow breath, our nail-biting infuriation is the right way, or the only way, to behave. It’s not me. It’s everything done to me. But it’s at those moments, when you realize that the day may be going off course (it may be something you did wrong that needs to be fixed; or something someone did wrong to you), but you can still control your physical responses. You cannot deep breathe away a mishap but you can control the way you allow your thoughts to dwell.

McEwen leaves a massive legacy in neuroscience: he ushered in a new way of thinking about stress. And yet, according to his wide network of friends, students, and colleagues, he also leaves behind another important lesson:

McEwen was kind, supportive, and engaged in life inside and outside his lab. He played tennis, drew, painted, and enjoyed a good glass of red wine with family and friends. He was a dog-person (which ranks high in my books). Students remember his Schnauzer wandering the Rockefeller and sometimes in the faculty club.

Does niceness and companionship help people cope with stress? I would say so. And, in turn, it just may foster better focus and learning. To be sure, avoiding bad stress and engaging in good stress is not a guarantee against every chronic ailment, but it will certainly make the journey more pleasant.McEwen, Bruce S. and Huda Akil, “Revisiting the Stress Concept: Implications for Stress Disorders,” The Journal of Neuroscience, January 2, 2020 40:1 12-21

Here’s a link to his thoughts about good, tolerable and toxic stress.

REFERENCE: McEwen, Bruce S. and Huda Akil, “Revisiting the Stress Concept: Implications for Stress Disorders,” The Journal of Neuroscience, January 2, 2020 40:1 12-21

Having spent most of my career on college campuses (I’ve basically never left since I got my undergraduate degree in 1984), I’ve had the opportunity to meet amazing students. Their list of achievements never ceases to astonish me. But at the same time, their remarkable successes concern me. I worry that in their race to collect awards to bloat their already swollen resumes, they lose sight of the point of it all. What will happen when everything they do isn’t graded? What will happen when they reach their goals but there’s not another award in sight? How will they find fulfillment?

As the Writer in Residence at Yale School of Medicine, I read a lot of essays. One of my second-year medical students penned a piece that articulates the pressures that she and her peers feel. But she also offers advice—words of wisdom that she is trying to follow and hoping others will too. I’m happy to post her essay as a guest piece on my blog:

HAMSTER WHEELS: BREAKING THE CYCLE

BY CHAARUSHI AHUJA

When we were younger, my sister wanted a hamster, but my parents were quick to deny her request. They had heard too many frustrated stories from other parents who were annoyed by the critter’s incessant spinning in place. They found the hamsters’ habit of tirelessly chasing the ladder in front of its eyes to be pointless, and so they figured, not interesting, for a pet.

Ten years out, it baffles me that the quality my parents rejected in a hamster is what we are now embracing as a society. When I look around, I see young people, like my peers and me, running on our own wheels, pursuing fleeting goals with no real end or pauses in sight.

The National College Health Assessment reported recently that 60% of current college students felt “extreme anxiety” within the last two months of the survey. Younger generations, the Gen Z-ers and millennials, consistently report the highest levels of stress compared to any other generation so far.

The number should shock me. But it doesn’t.

It’s because what my generation often takes pride in is our relentless ability to collect accomplishments. We win some and then wake up the next day to keep winning some more. We don’t take breaks; we are constantly plugged in, constantly accessible, and constantly on the go. Our drive is applaudable. It brings about innovation, inventions and positive changes in our world. But it comes at the cost of our own sanity.

When I started medical school last year, I felt immense pride for all the hard work, sweat and tears that went into getting admitted. I beamed at the white coat ceremony, excited to enter training for a profession that I had been dreaming of for years. My enthusiasm, though, was short-lived.

One week into school and I moved on from my “win” and was already thinking of goals that lay ahead. What research should I do? What was my strategy for the next time I would have to apply and get admitted? In other words, what was going to be my next set of accomplishments that would shine on my wall, lead to respect, and maybe give me the same rush of excitement that I had gotten when I got my letter of acceptance.

This story, consciously or subconsciously, applies to almost everyone I know. We are running and running, until the thrill of the chase turns to utter stress, which morphs (for three out of five) into a health hazard: extreme anxiety. The irony, for me, is that I’m training to be a healer.

So, to prevent this pervasive culture from seeping into my life, here’s my new goal: I vow to create time for “reset weekends”. Once every month or two, I disconnect from my work completely; I hop off my hamster wheel and just sit in my cage. I go and find hobbies and passions that give me as much satisfaction as the thought of winning or accomplishing does. On my last reset weekend, I played badminton with my family, checked my phone a mere 4 times that day (a decrease of about 196% ), journaled extensively for 3 hours, and read a novel that had been on my mind for months.

These weekends strengthen my drive. I retune by reflecting on my actions and why the goals I am chasing are meaningful. I pause the journey, and make sure that I am not just spinning, but rather moving forward in a meaningful and satisfying way.

Resetting doesn’t have to be entire weekends; it can be a day, or mere hours—as long as the time reprograms the pursuit and revitalizes it to be more meaningful. One of my friends resets by taking week long vacations twice a year. Although not frequent enough and too long for my taste, it works for him. He is incredibly productive, healthy, and content.

Just imagine this: what if each one of us took moments to hop off the hamster wheel to celebrate, to feast, and to appreciate how far our hard work has taken us. Then rather than downtrodden hamsters fatigued by the constant squeak, squeak, squeak, we all stepped on again, refueled, reenergized, and re-motivated.

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