Calm the Mind—Slow the Decline
Stressful events are inevitable, but staying stressed is optional.
Timothy R. Jennings
Why have we heard so much about stress, reducing stress, and stress-management techniques? Because our mental attitudes really do make a profound impact on our overall health and therefore can accelerate or slow the aging process. So what is mental stress? What are some of the common causes of it, and how can we manage it?
When we speak of mental stress we are speaking of pathological stress such as chronic worry, guilt, and relationship conflicts that keep our body’s fight-or-flight system active. But not all stress is harmful—in fact, some stress is healthy and necessary for growth. When children learn to walk they are “stressing” their developing muscles, bones, and joints. When we study any new subject we are stressing our cognitive and memory circuits, placing demands on them, and exercising them, which results in growth and development. Healthy stretching of our abilities—healthy stress—is necessary for growth and development. It is this type of stress that leads to new insights, growth, and innovation.
It has been said that necessity is the mother of invention. Finding ourselves in need and not having an easy solution available to us increases our stress at that moment. But for the mature, such stress motivates thinking and activates imagination, problem-solving circuits, and creativity, leading to new solutions that bring innovation and development and turn off the stress circuitry. This type of situational stress is not harmful because it is self-limited, is grounded in reality, and leads to objective actions that result in growth.
The mental stress that is harmful is the stress that significantly and chronically activates the brain’s alarm circuitry and sends the body into an ongoing survival state, a fight-or-flight state, often when no real, objective threat exists.
When we chronically activate the brain’s fear circuitry, the brain activates our body’s immune system. This happens because the immune system is to our body what our national guard is to our nation—its purpose is to protect us from invasion.
If while walking in a national park you confront a bear on the trail, your internal alarm will fire and immediately send a signal to your immune system to prepare for invasion. This happens because if you have to fight the bear to survive, you will certainly have bites and scratches with microscopic enemy invaders—germs—trying to get in. Thus, in fight-or-flight mode your body gears up your immune system to be prepared just in case microbial invasion occurs. Your immune system does this by releasing inflammatory factors such as cytokines (IL-1, TNF-alpha, etc.), which will defend you against microscopic invaders.
Under chronic stress the immune system stays geared up, but with no enemy invaders to attack, the inflammatory cytokines instead damage the body. Specifically, they damage insulin receptors contributing to insulin resistance. At the same time, the stress circuits of the brain are telling your body to dump more glucose into your bloodstream because you are still in fight-or-flight mode. The combined effect increases the risk of type 2 diabetes, obesity, high cholesterol, heart attacks, and strokes. All these increase inflammatory factors in the body—for example, advanced glycation end-products interfere with the body’s antioxidant enzymes and thereby accelerate aging and increase the risk of dementia.1
Any belief system that chronically activates the fear circuitry is therefore harmful and will contribute to increased risk for dementia later in life. This includes religious beliefs that cause adherents to live in chronic guilt and fear, but it also includes secular beliefs that fail to provide relief from worry and fear of future outcomes, such as chronic anxiety about situations beyond one’s direct ability to control and existential concerns such as the fear of death.
Let’s examine the three major contributors to pathological mental stress and identify simple choices a person can make to lower their stress level, calm the brain’s fear circuitry, lower the inflammatory cascade, and experience a healthier brain and body.
Chronic Worry
In my experience treating thousands of patients over more than two decades, the worry with which the vast majority of people struggle is the worry about controlling something that is not theirs to control. My patients never come in worrying about whether they will brush their teeth or go to work or prepare a meal for their children or shower or mow the lawn. The true duties and responsibilities that are theirs to fulfill seldom weigh them down with worry. Instead, they worry about those things in life over which they have no control—how life will turn out and what others will think about them: Will my children grow up to be healthy and responsible adults? Will I get that job? Will my house sell? Will my spouse leave me? Will he or she like me? Did they think I sounded stupid?
Studies confirm that pessimistic attitudes about future events cause negative physical changes in our bodies that undermine health and increase the chances of early death. Investigators found that those who had pessimistic and worrisome thoughts about the future had increased markers of inflammation in their blood (IL-6) and shorter telomeres (see chap. 4).2 Both of these factors would accelerate aging and health-related problems.
Amazingly, other research has found that people who have positive mental attitudes toward aging, who are optimistic and don’t live in fear of the future, live 7.5 years longer than those with more negative mental attitudes.3 Yes, our mindsets do make a real difference in the aging process.
People worry because they forget that their true responsibility is for the decisions they make in governance of themselves, not for how things will turn out or what others will think or feel about their decisions.
Sometimes my patients worry about making mistakes, about getting “it” wrong, and this worry frequently paralyzes them into inaction. But their real fear, most often hidden from themselves, is not of making an error but of what others will think of them when the mistake is made. The true fear is fear of rejection—either in their human relationships (worrying about what others will think, afraid of offending others or being thought poorly of if mistakes are made) or in their relationship with God (worrying about what he will think, afraid of being bad or sinful or deserving of punishment if mistakes are made). Such individuals often look to others to tell them what to do so that if something turns out wrong they won’t feel responsible—“He said to do it that way.”
I have to educate my patients that there is a huge difference between making mistakes and choosing evil. Having a check bounce because one made a math error in their check registry is quite different from purposely writing fraudulent checks. While no mature person wants to choose evil, making mistakes is actually a healthy part of learning and growth. Life is a series of problems to be solved, and there is no evil in honest grappling with life’s problems, making decisions, and then learning from one’s mistakes. In fact, it is one of the primary ways we grow and develop.
If a person cannot differentiate making mistakes from choosing evil they will often become paralyzed in life. Such individuals, rather than making a decision and sometimes getting it wrong and learning from the experience, will instead feel guilt, shame, and fear of rejection and will seek to avoid these negative emotions in the future—primarily by not making choices in which mistakes could be made. This causes stagnation in maturing and chronic anxiety and stress, which accelerate aging. In fact, this is neuroticism, which has been linked to increased risk of dementia as cited earlier.
Sometimes negative thought patterns are so deeply ingrained that professional help is needed to identify and change them. Consider the language you speak—how did you learn to speak? By hearing it from your environment. Your language is not biologically programmed into your DNA but was learned after birth. When was the last time you awoke and said, “Today, I am going to think in English” (if English is your primary language)? Never, it is always on and everything gets filtered through it. Our language is not the only thing we learned in this way. Many people have automated thought patterns that they learned from their childhood environment. They never choose to turn them on but they are always active, and all life gets filtered through them. Changing these automated thought patterns is similar to learning a new language; it takes purposeful effort and often someone outside yourself to teach you a new way of thinking (internal language or self-talk).
So how do we cope with the unknown future, the fear of how things will turn out, and the fear of what others will think of us? We do it by realizing we have control only over the choices we make in governance of ourselves and therefore focusing our energy on choosing to do what we believe is the healthiest, most reasonable, and most appropriate choice given the information we have at the time in any given situation. Then—and here are the three big keys to reducing stress—we (1) surrender outcomes to our higher power; (2) evaluate the results and learn from the experience by incorporating the new data into future decision-making; and (3) set other people free to think or feel any way they want about us, accept others’ responses as evidence of their character, and make decisions based on that evidence on how we will interact with them in the future.
Surrendering outcomes to a higher power brings peace only if the higher power is worthy of our trust. If the God concept one holds is of a deity from whom we need to be protected (perhaps by offering him sacrifices—even offering the sinless blood of his son), then it is impossible to trust the future to such a being. If we do pray to such a being asking for their will to be done, we unavoidably live in fear because our trust has been placed in a being who is untrustworthy. Integral to resolving fear about the unknown future is reevaluating the beliefs one has about God and conforming them to qualities and characteristics that are absolutely true and trustworthy.
In our human relationships we find that we can trust people who we know from experience love us more than they love themselves and who would do anything to protect us, even give their life for us if necessary. I believe this is one of the primary purposes that Jesus Christ came to accomplish—to demonstrate such love in order to win our trust.
Unresolved Guilt
Unresolved guilt triggers the activation of the brain’s fear circuitry, causing a person to stay on edge, remain hypervigilant, experience self-recriminating ruminations, and anticipate punishment or reprisal. This mental state is quite damaging and activates chronic stress pathways with subsequent activation of the immune system, increasing damaging cytokines and other oxidizing molecules and accelerating aging.
There are two types of guilt—appropriate and inappropriate. Appropriate guilt is experienced when we actually do something objectively wrong—for example, exploit another, betray a trust, and so on. Resolution of appropriate guilt occurs by learning from one’s wrong choice, experiencing a change of heart attitude so you have healthier motives (this is known as repentance), forgiving one’s self, making better choices in the future, and when possible and without causing further harm, seeking forgiveness from the one offended and restoring whatever damage one’s actions may have caused them.
Inappropriate guilt occurs from believing a lie and is resolved by an application of the truth. A simple example of false guilt is the guilt one feels after the death of a loved one, which is often accompanied by thoughts such as “It’s my fault. If I had come home earlier I could have called an ambulance. If I had booked them on a different plane they wouldn’t have been on the one that crashed. If I had called them and delayed their departure ten minutes they wouldn’t have been in that car wreck” and so on. If this type of guilt is not resolved it will activate the stress circuits, increase inflammation, and accelerate aging. But inappropriate guilt cannot be resolved by repentance and restoration because there is nothing to repent of or restore. Inappropriate guilt is resolved only by the application of the truth: “I wish I could have prevented their death, but there was nothing I could have done. Their death is not my fault.” This type of guilt is often built on the hidden lie discussed above—believing one is responsible for how things turn out.
Another subtle form of the distortion that we are responsible for how things turn out, which causes false guilt, is the lie that we are responsible for how others feel, react, or think, that we are responsible for someone else’s happiness—if they are not happy it is our fault. This is false. As stated above, we are responsible for making the healthiest choices in governance of self, not for how another person feels about those choices. A husband can buy his wife roses because he loves her, but he cannot cause her to enjoy the flowers and feel valued. If she is insecure she might instead feel doubt, and worry, “Why did he do this? Has he cheated on me and is he trying to offset his guilt with gifts?”
If you are experiencing guilt and would like to resolve it, then take the following three steps:
Ongoing Relationship Conflict
Healthy relationships promote better health and longevity, but ongoing relationship conflicts undermine health and shorten life span.
As described in chapter 3, early childhood experiences impact brain development. When those early childhood experiences are traumatic, the brain’s stress circuitry (amygdala) up-regulates and the braking mechanisms to calm the amygdala are impaired. Multiple studies have documented that healthy parent-child relationships reduce the risk of mental and physical illness and promote longer life. Children reared in homes with family conflict experience higher mental stress with higher rates of mental illness, obesity, diabetes, and inflammatory problems and die at a younger age than children raised in homes in which there is low conflict.4
Another recent study of nearly ten thousand men and women ages thirty-six to fifty-two examined how frequently they had conflict with their partners, children, friends, or neighbors and whether they worried about demands from their family. Eleven years later, 4 percent of the women and 6 percent of the men had died. Almost half the deaths were from cancer, the rest from heart disease, accidents, suicide, and liver disease from alcohol use. Those who had family conflict had 3 times higher risk of dying than those with low family conflict, and those who worried had 1.5 times higher risk of dying.5
The reason for this seems to be related to thought processes impacting the stress circuitry and either activating or calming it, with a subsequent effect on the immune response of either increasing or decreasing inflammation. This happens through multiple epigenetic pathways. Thus, healthy relationships can turn on anti-inflammatory genes and shut down inflammatory ones.
A small pilot study examined gene expression in the white blood cells of six lonely people compared to eight socially connected people and found 209 genes were expressed differently. The researchers discovered that in the lonely individuals, genes associated with inflammation were up-regulated and viral-fighting genes were down-regulated.6 This means the lonely individuals were more prone to infections and oxidative stress, with accelerated aging. Their findings were replicated in a larger study of ninety-three people.7
In a study published in JAMA Psychiatry in November 2016 researchers discovered an association between loneliness and the amount of amyloid (protein associated with increased risk for Alzheimer’s dementia) deposited in the brain of cognitively normal older adults. After controlling for age, sex, genetic vulnerability to amyloid clearance (ApoE4), socioeconomic status, depression, anxiety, and social network, it was discovered that a higher amyloid concentration was significantly associated with greater loneliness. Those with high amyloid concentrations in their brain were found to be 7.5 times more likely to be in the lonely group.8 This is likely due to the fact that loneliness increases the stress pathways, which increases inflammation and results in increased oxidative stress on the brain, contributing to more neuronal death and impaired repair mechanisms.
Healthy relationships require healthy people, so the first step to a healthy relationship is to do everything in your own power to be the healthiest person possible. Healthy people use their energies to benefit those with whom they relate, set healthy boundaries, speak honestly, allow others to wrestle with and overcome their life challenges and thus develop ever-increasing capacity and maturity, forgive those who do them wrong, and choose to extricate themselves from relationships that have proven to be toxic.
Finally, numerous scientific studies have documented the multiple health benefits from a spirituality that reduces fear and calms the stress circuitry. Documented benefits include reduced heart rate, blood pressure, and anxiety; improved depression; improved attention, concentration, and performance in school; as well as more rapid recovery from illness and less pain after surgery.9
The spiritual pursuits that consistently demonstrate health benefits are meditation with an emphasis on love, other-centeredness, compassion, and altruistic activities. Religious beliefs and practices that incite fear and anxiety are consistently demonstrated to be harmful.
The benefit of healthy spirituality occurs even when started later in life. Brain research by Dr. A. Newberg and colleagues at the University of Pennsylvania with individuals sixty-five years of age and older documented that those who meditated on a God of love for twelve minutes per day for just thirty days experienced growth in the love circuits of the brain (anterior cingulate cortex) as measured by MRI brain scans, lower heart rates and blood pressure (a measure of reduced stress), and 30 percent improvement in memory testing; meditating on angry- and wrathful-god concepts was not beneficial.10 Managing one’s stress in relationship to a loving higher power is healthy for the brain!
Integrating the loneliness research with that of meditation on a God of love, one could hypothesize that practicing altruistic love—helping others—would also be beneficial for health and perhaps slow the aging process. Amazingly, that is exactly what the research shows. Studies document that older adults who regularly volunteer in their communities (after accounting for variables such as education, baseline health, smoking, etc.) live longer; have less illness, disability, depression, and dementia; and stay out of nursing homes longer than those who did not volunteer.11
LEARNING POINTS
ACTION PLAN: THINGS TO DO