July 1, 2025 • 41 mins
In Why Zebras Don’t Get Ulcers, neurobiologist Robert Sapolsky explains why our stress response, great for escaping predators, is terrible for long-term health. This episode explores how chronic stress affects the brain, body, and everything in between.
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(00:00):
Welcome everyone to the Deep Dive.
This is the show where we we really dig through stacks of
research articles, fascinating books, all sorts of stuff to
pull out the absolute best, the most useful Nuggets of knowledge
for you. And today, oh boy, we are diving
deep into something that touchesevery single one of us.
Stress. Yeah, stress.
(00:21):
But we're not just talking about, you know, feeling a bit
frazzled after a tough day. No, not at all.
We're talking about how this this constant low level hum of
stress in modern life actually physically reshapes our biology.
Right. And how it paves the way for
some of the biggest, most debilitating diseases we face
today. It's way more insidious than you
might think. It really is.
(00:42):
Think about it for a SEC. Picture like 1900.
What were our great grandparentsworried about?
What kept them up at night? Probably things like pneumonia,
right? Or TB?
Influenza. Maybe the dangers of childbirth?
These immediate, often deadly threats.
Exactly. Acute stuff.
Now jump to today. What are our big health worries?
Heart disease, cancer, strokes, diabetes, It's a totally
(01:04):
different landscape. And Robert Sapolsky, the
brilliant author of the book we're diving into today, he puts
it so well, he says we're livinglong enough to slow fall apart
from these diseases that like slow accumulation.
It's a really stark paradox, isn't it?
We beat a lot of the quick killers.
Right, we did. But in doing so, we've kind of
opened the door for our bodies to break down in these slower,
(01:25):
more chronic ways. And that huge shift in medicine,
recognizing how deeply our biology is tangled up with our
emotions, our psychology, that'skey.
Absolutely key. Which brings us to the main
event today. Yes, we are unpacking an
absolute classic. Why Zebras Don't Don't Get
Ulcers by Robert M Sapolsky Seriously, if you haven't read
(01:45):
this book, you're in for such a treat.
He's amazing. He takes this really dense,
complex science and makes it totally engaging, funny even.
Like that super smart friend whocould explain anything and make
it fascinating. Exactly.
So our mission today is to unpack how chronic stress, the
kind zebras mostly avoid, can make a sick or, you know, make
existing conditions worse. We'll pull out some surprising
(02:08):
facts and great stories from thebook and basically give you a
shortcut to being really well informed on this vital topic.
So let's start right there with that central metaphor.
Why don't zebras get ulcers? OK, the zebra pictured on the
Savannah. A lion appears.
What happens? Panic run.
Exactly. Pure physical emergency.
(02:28):
Zebra's body, like ours instantly gears up for intense
muscle work. Energy mobilization right now.
It needs fuel like immediately glucose, fats, proteins flooding
out of storage. Right, not planning for some
building project next spring. As Sapolsky hilariously says,
it's all about the immediate strength.
They run. They escape.
(02:49):
Hopefully. Hopefully, and if they do, the
key thing is that whole physiological stress response.
It shuts off here. Crisis averted.
Back to grazing. But we don't shut it off, do we?
That's the evolutionary mismatch.
Our core stress response is still wired for that lion chase,
even. When the lion is just rush hour
traffic. Or a looming deadline.
Or worrying about bills. Or social media drama.
(03:10):
It's all psychological for us, mostly.
But the body reacts like it's physical danger.
Constantly. And that's the problem.
The response itself is brilliantfor short bursts, life saving
even, but keeping it switched onfor weeks, months, years.
That's when the damage starts. It's like that fire alarm
analogy you mentioned earlier. Yeah, the alarm designed for a
(03:31):
raging fire, but it's blaring nonstop because you burn the
toast slightly. Your body's emergency systems
are just constantly draining resources.
And for centuries, you know, doctors have this gut feeling,
this intuition that personality or outlook mattered for health.
But it's kind of fuzzy, right? Not scientific.
Exactly until the mid 20th century, when stress Physiology
(03:53):
really became a rigorous science.
It wasn't there some crazy idea about the brain making hormones?
Oh yeah, Jeffrey Harris, 1944. Yeah, totally bonkers idea.
At the time he proposed, the brain itself was a glance
releasing hormones to control the pituitary.
The master gland. The master gland and people were
like, what? The brain oozing hormones?
Yeah, ridiculous. Like it should be writing
(04:14):
sonnets, not leaking chemicals. Precisely.
It seems so beneath the brain's dignity.
And then came that intense rivalry, right?
The race to actually find these brain hormones.
Gilliam and Shaley. What a story.
Total soap opera. Not the lone scientist myth at
all. Big teams, Corporate science
(04:36):
almost. Huge teams, years of grinding
work, and they apparently hated each other.
The book says vicious attacks and bitter retaliation doesn't
sound like friendly competition.Not remotely, despite one of
them claiming it was only motivated by science.
Yeah, right. So what were they actually
doing? How do you find these tiny
amounts of? Hormones, get this, They were
collecting thousands and thousands of animal brains from
(04:59):
slaughter douses, sheep brains, pig brains.
Seriously. Seriously.
Blending them up, trying to purify these miniscule droplets,
injecting them into rats to see if the pituitary reacted.
That sounds unbelievably tediousand kind of gross.
For years. But eventually they did it.
They found the first releasing hormone proved Harris right.
And ended up sharing a Nobel Prize despite the animosity.
(05:20):
Yep, 1976 monumental work. It completely changed how we saw
the brain body connection. And it paved the way to
understand the actual hormones doing the work during stress.
Exactly the real workhorses, 2 main types.
OK, what are they? First, you've got epinephrine.
That's adrenaline and norepinephrine.
Sympathetic nervous system stuff.
Super fast seconds. That's the immediate jolt,
(05:41):
right? Sweaty palms, racing heart.
That's them then backing them up, providing a more sustained
response over minutes. Hours are the glucocorticoids.
Steroid hormones from the adrenal glands.
Sapolsky loves these guys, apparently.
He's obsessed. You'll know everything about
glucocorticoids after reading the book.
They're central. So how do these all connect?
(06:03):
The brain, the pituitary, The adrenals.
It's the HPA axis, hypothalamus,pituitary, adrenal, a cascade.
OK, break it down. A stressful thought, real or
imagined, doesn't matter, Triggers CRH release in the
hypothalamus, deep in the brain that tells the pituitary
release. ACTH.
Got it. ACTH travels through the
bloodstream to the adrenal glands sitting on top of your
(06:25):
kidneys. And the adrenals then release.
Glucocorticoids flooding your system.
It's a beautifully orchestrated rapid response system.
But you mentioned it's not always the same response, like a
stress signature. Yeah, that's really interesting.
While the sympathetic system andglucocorticoids are almost
always involved, the exact mix, the timing, the magnitude can
(06:48):
vary depending on the stressor. So public speaking stress might
look different biochemically than, say, exam stress.
Lovely. Yes, And sometimes it's even
more nuanced, like the hormone levels in the blood might be the
same, but the tissues become more or less sensitive to them.
Wow, so the cells are hearing the message differently?
Exactly. Which leads us to that core kind
(07:09):
of depressing theme of the book.What's it the short term?
Can be absolutely terrible news long term.
When that brilliant emergency system gets stuck in the on
position because of chronic psychological stress, that's
where the trouble begins. Big trouble.
Right, which takes us to the actual toll on the body,
starting with the heart, the cardiovascular system.
(07:30):
Yeah, think of your blood vessels like highways.
Chronic stress is like constantly dumping grit and
debris onto them. Leading to high blood pressure,
hypertension. Yep, and atherosclerosis, that
nasty plaque buildup inside the arteries, narrowing the lanes.
How does the stress actually do that?
It's a cascade. Chronic pressure can cause tiny
tears in the artery lining. Inflammation kicks in.
(07:51):
Immune cells rush to the site. Like little repair crews.
Kind of, yeah. But then fatty foam cells form,
starting the plaque. Plus, remember epinephrine?
Adrenaline. Yeah, the fast one.
It makes your blood thicker, stickier.
Platelets clump together more easily.
Add the extra fat and glucose mobilized by stress.
And you've got perfect conditions for plaque to form
(08:12):
and harden, clogging the highway.
Precisely. And there's amazing evidence for
this Jay Kaplan's monkey studies.
Oh yeah, tell us about those. He show that monkeys low on the
social ladder, the ones getting constantly picked on,
experiencing chronic psychological stress, they
developed way more atherosclerotic plaques.
Same diet as the dominant monkeys, but way more plaque.
(08:35):
Wow, just from social stress. Just from social stress.
But here's the kicker, if you gave those same stressed monkeys
beta blockers, drugs that block the sympathetic nervous system,
no plaques formed. It's a direct link.
Psychological stress, sympathetic activation, physical
heart disease. It's not all in your head
that's. Incredible.
So the chronic stress weakens the system.
(08:57):
Exactly. And then each new acute
stressor, a sudden scare, a burst of anger, becomes even
riskier. Because the arteries are already
compromised. Right.
That's myocardial ischemia. The heart muscle isn't getting
enough oxygen because the arteries are narrowed.
So during acute stress, instead of opening up to deliver more
blood. They might clamp down even
further. Paradoxically, yes, starving the
(09:19):
heart muscle can lead to angina or even a full heart attack.
Yikes. OK, Speaking of weird stress
reactions, Sapolsky asks that question right.
Why do we wet our pants when terrified?
Yes, he admits, science doesn't really have a solid answer.
It's counterintuitive cause normally stress makes you
conserve water. So what's his best guess?
(09:39):
Purely speculative, but maybe for humans a full bladder is
just like sloshy dead weight youdon't need when running for your
life. Whereas other animals use urine
for scent marking. Right, so maybe our ancient
brain just hits the empty bladder panic button, logic be
damned. It's a funny reminder of how
rimal some responses are. It really shows the chaos of
(10:00):
extreme stress. Which brings us to something
much less funny. Sudden cardiac death.
Yeah, terrifying Often happens during or right after intense
stress. The heart's electrical rhythm
just goes haywire. Ventricular fibrillation.
And it's more likely if the heart's already damaged by
atherosclerosis. Much more likely though, sadly,
and sometimes happen seemingly out of the blue, revealing
(10:22):
hidden damage later. OK, but then there's that really
word paradox being killed by pleasure.
How does that work? Because physiologically, extreme
joy, extreme triumph, even orgasm places similar to stands
on the heart as extreme rage or fear.
The sympathetic nervous system doesn't care if it's good or bad
stress. It just responds to intensity.
(10:42):
Massive emotional arousal, whatever the flavor, puts a huge
sudden strain on the cardiovascular system.
So that Ellie Wiesel quote fits the opposite of love is not
hate, it's indifference. Intensity is the key.
Intensity is the key. It challenges your allostatic
equilibrium. Allostatic equilibrium.
What's that exactly? It's not just staying static
(11:04):
like homeostasis, it's your body's ability to achieve
stability through change, adapting, adjusting constantly.
Like a tightrope Walker making constant small adjustment.
Perfect analogy. Not standing rigid, but
dynamically balancing. When stress overwhelms that
ability to adjust the tidal Walker falls, things breakdown.
Got it. OK, let's talk specifically
(11:24):
about women and heart disease. It's on the rise, right?
Tragically, yes, and beyond smoking and obesity, stress is a
huge factor. Studies on female monkeys
mirrored the males. Subordinate stressed females had
twice the atherosclerosis. Even on the same low fat diet.
Even on the same diet and in human women, the data
surprising. Working outside the home isn't
the risk factor per SE. So what is?
(11:45):
It's if that work is low controllike clerical work, or if you
have an unsupportive boss that classic high demand low control
stress. Responsibility without autonomy.
Exactly. And another big predictor?
Having kids back home, which points to that double burden
many women face. Managing work and the bulk of
home life. Relentless.
(12:07):
Absolutely. Then came the big estrogen
bombshell back in 2002, the Women's Health Initiative study.
Oh, I remember that huge news. Hormone replacement therapy.
It wasn't protective. After all, worse for older women
taking estrogen plus progestin, it was actually increasing the
risk of heart disease and stroke.
It completely flipped the script.
Why the contradiction? Everyone thought estrogen was
(12:29):
protective. It came down in nuance, the type
of hormones, the dose, but crucially, the timing.
Timing. How so?
Earlier lab work suggested estrogen helps prevent the
formation of plaque. Doesn't really reverse existing
plaque. And the women in the WHI study
were older. Mostly fifties, 60s.
They likely already had significant plaque buildup from
(12:49):
years of Western lifestyle, so the estrogen therapy started too
late to offer that initial protection.
So it's not that estrogen is bad, it's that starting it late
on top of existing damage might actually be harmful.
That seems to be the complex picture, a real lesson in
biological timing and research nuances.
Wow. OK, from the Hart Highways,
let's move to the body's energy economy, metabolism.
(13:12):
Right back to that lion chase. Where did the energy come from?
Not the snack you just ate. It's got to be from storage,
right? Fat, liver, muscles.
Instantly mobilized, the system is designed for that immediate
power search. And the key hormone for storing
energy is insulin. Absolutely.
So Persky calls it the optimistic hormone that plans
for your metabolic future, filling those deposit slips at
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your fat banks. It even releases before you eat
sometimes. Anticipatory.
Yeah, if you always eat at 6:00 PM, by 5.45 your pancreas is
already releasing a bit of insulin, prepping the system.
Amazing proactive balance. But stress inevitably messes
this up, too. Big time for juvenile diabetes
type 1, the autoimmune kind where the pancreas doesn't make
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enough insulin. Frequent or big stress responses
can increase the odds of gettingit, speed it up, and make
complications worse. Stress management is critical
there. And what about adult onset type
2 diabetes? Sapolsky is emphatic.
This is not normal aging. It's a disease of inactivity and
fat surplus. So what happens?
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Your fat cells get literally full.
You don't make many new ones after adolescence, they just
swell up then when insulin comesknocking with more glucose to
store. The fat cells say no vacancy.
Pretty much no room at the end. They become resistant to
Insulin's message. Insulin resistance.
I've heard that term. Right.
So the pancreas tries harder, pumping out more insulin to get
the message through, but eventually insulin producing
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cells can just get exhausted andthen type 2 starts looking like
type 1, needing external insulinand all that extra glucose and
fat circulating damages everything.
Kidneys, eyes, nerves. It's a cascade, and this often
clusters together, right? Metabolic Syndrome.
Exactly, It's not one disease, but a dangerous group hug of
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problems. High insulin, high glucose, high
blood pressure, insulin resistance, bad cholesterol,
belly fat. The Apple shape.
That's the one. Technically, nothing might be
diagnosably wrong yet, but you have a bunch of measures that
are almost abnormal. Like all the warning lights on
your car dashboard are just starting to flicker.
Our perfect analogy? Yeah, it's a huge red flight for
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future heart disease, cognitive decline, earlier death.
Even if you're technically not sick, that cluster predicts
trouble ahead. OK, metabolic mayhem.
Let's shift down to the digestive system, the gut.
Often underestimated how much energy digestion takes.
It's not passive that rhythmic muscle contraction peristalsis.
The snake dance, Spolsky calls it.
Yeah, plus the stomach turning, the chemical breakdown, the
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sphincters opening and closing. Like Panama Canal locks.
It can use 1020% of your daily energy.
So stress must impact this too. Appetite, for instance.
It seems mixed. It is confusing.
About 2/3 of people eat more when stressed hyperphagic. 1/3
eat less. Hypophagic rats show the same
split. Why the difference?
Hormones pulling in opposite directions.
(16:06):
CRHA, key stress hormone tends to suppress appetite, but
glucocorticoids. Sapolsky's favorites.
They stimulate appetite and specifically for comfort foods,
starchy, sugary, fatty things. So that's why we reach for the
Oreos, not the celery. When stressed, blame the
glycocorticoids. You absolutely can.
It's a major driver of stress induced overeating in our modern
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world. What about things like IBS?
Irritable bowel syndrome. Hugely frustrating for people.
They feel awful pain, bloating, messed up bowel habits, but
doctors often find nothing wrongon standard tests.
But Sapolsky says these are immensely sensitive to stress.
Absolutely. The brain gut connection is
incredibly powerful. And here's a weird twist with
pain. Stress can numb pain on your
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skin or muscles, right? Like an athlete playing through
injury. But paradoxically, it increases
sensitivity to visceral pain, pain from internal organs like
your intestines, which is exactly the pattern in IBS.
And IBS symptoms often get better during sleep.
Which strongly points away from a purely physical cause and
towards the role of conscious orsubconscious stress.
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The book also mentions childhoodtrauma increasing IBS risk
later. Yes, leaving an echo
vulnerability initially dismissed by some as
psychoanalytic gibberish. But animal studies clearly show
early stress physically alters the gut stress response systems
long term. It really highlights the lasting
impact of early experiences. OK, the big one.
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Ulcers. Stress causes ulcers, right?
Everyone knows that. Well, that was the dogma for
decades until Barry Marshall came along.
The guy who drank the bacteria. The very same a truly heroic,
soon to be a movie move. He swallowed Helicobacter pylori
bacteria to prove they not stress alone caused ulcers.
And he was right. Monumentally right?
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Got a Nobel Prize for it. Turns out H pylori is
responsible for like 85100% of ulcers in the West.
The bacteria weaken the stomach linings defenses against acids.
So stress plays no role. Not the primary cause, but it
can definitely worsen things if you already have the bacteria
increasing acid reducing protective factors, it
exacerbates the damage. And there's that weird timing
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thing, the ulcer paradox. Yeah, ulcers often form not
during the stress, but during the recovery period afterwards.
So lots of short intermittent stresses might be worse than one
long one. Exactly, it's when the system
tries to reset that the damage can manifest complex rebound
effects. OK, shifting scale completely
now, growth and development, howdoes stress fit in?
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Simple principle, growth is expensive energy wise, a huge
investment. And if you're running from that
lion? It's no time to get any benefit
from growth. Survival first, building
projects later. This is seen most tragically in
stress dwarfism, right? Psychosocial Dwarfism.
Absolutely devastating, caused by extreme emotional neglect or
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psychological abuse. Sapolsky gives these haunting
examples. Kids locked in closets, fed
under doors. Appearing physically stunted,
emotionally vacant. Bruised with distorted flinching
postures. Haunted Slack facial
expressions. It's a physical manifestation of
profound emotional trauma. And it's linked to growth
hormone levels. It's.
Extremely low GH. There's an incredible story in
(19:20):
the book about a child whose GH levels and growth rate tanked
when his favorite nurse went on vacation for three weeks.
With no change in his food intake.
None whatsoever. And his GH soared when she came
back. You couldn't ask for clearer
proof that it's about emotional connection, not just calories.
That's unbelievable. So love, or the lack of it, has
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direct biological effects on growth.
Profoundly so. But there's a twist with GH2.
Short term stress actually boosts GH release.
Why? It helps mobilize energy
quickly. But long term chronic stress
inhibits actual growth. It blocks the downstream
hormones, the semitomedens that do the actual building.
(20:01):
It's like GH gets the cash from the bank for construction.
But the cash gets diverted to the immediate emergency.
Exactly, leaving the long term project stalled.
And early life stress, even before birth has.
Huge effects prenatal stress or early post Natal stress like
maternal deprivation in animal studies leads to lifelong higher
glucocorticoid levels, more anxiety, changes in brain
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development. And it's not just severe trauma.
Even normal variations matter. Yeah, so Polsky notes that even
within the normal range, lower birth weights predict higher
adult glucocorticoid levels and higher risk of metabolic
syndrome later. Early life casts a very long
shadow. OK, now for something really
weird. Those cross cultural studies on
(20:42):
stressful rituals for infants. Land over and Whiting.
Yeah, fascinating and controversial.
They looked at societies with stressful rights for kids under
2, piercing temperature extremes, stuff like that.
A correlation a. Correlation.
Those societies had adults who were, on average 2.5 inches
taller. What?
How? Oh, that seems completely
(21:04):
backward. Highly debated.
Could be selective mortality only the toughest.
Maybe genetically predisposed tobe taller.
Survived. Could be other factors like
diet. Lots of confounds.
But some anthropologists think maybe certain types of early
physical stress could paradoxically stimulate growth.
It's a provocative idea. Highlights how complex and non
linear these responses can be. Definitely not a recommendation
(21:25):
for stressing out babies. Definitely not, but regardless
of that anomaly, chronic stress is bad for bones, right?
Oh yeah, Glucocorticoids wreak havoc on calcium.
They block its absorption from food, increase its excretion by
the kidneys, and speed up the breakdown of old bone.
Pushing the balance towards disintegration.
Not good for aging skeletons. Not good at all.
OK, let's move to another systemoften put on hold by stress.
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Reproduction makes perfect evolutionary sense, right?
Lion chasing you, not the time to make babies.
So the general impact is less sex drive fertility problems.
Pretty much across the board, yeah.
Irregular cycles in females, erection difficulties in males.
Reduce libido in both. The body puts reproduction on
the back burner. How does it work in males
(22:10):
hormonally? There's a pathway.
LHRH for the brain, LH from the pituitary, colitary testosterone
from the testes. Stress disrupts this so.
Stress lowers testosterone, yes.Both psychological stress like
those poor officer candidate school trainees and extreme
physical stress like an elite athletes.
And that's partly linked to endorphins, the runners high
chemicals. It seems to be endorphins
(22:32):
inhibit reproductive hormones somood boost but maybe less baby
making drive. A trade off and erection
specifically. Stress makes those harder.
Definitely. Erections need the
parasympathetic rest and digest system to get blood flow going.
Stress activates the sympatheticfight or flight system.
Direct physiological conflict. Unless you're a hyena, what's
(22:55):
that about? The Hyena Anomaly 1 of
Sapolsky's Great Zoological Detours.
Female hyenas are dominant, muscular, have masculinized
genitals. A fake scrotum and an enlarged
clitoris they use for sex and birth.
Wild. Totally wild, and they seem to
be an exception to the Stress inhibits erection rule.
A friendly word of warning before you date a hyena, as the
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book puts it. Duly noted.
OK, what about females? How does stress mess with their
cycle? Similar disruption of the
hormone cascade LHRHLH and FSH, Estrogen and progesterone stress
can lengthen cycles, stop them all together in menorrhea,
inhibit progesterone needed for pregnancy.
And increase prolactin which caninterfere with implantation.
Yes. Multiple ways stress undermines
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fertility and successful reproduction.
And during pregnancy itself. Severe stress increases the risk
of miscarriage and preterm birth, likely due to those high
glucocorticoids missing with thedelicate hormonal balance.
A very direct impact of mom's stress on the developing baby.
Absolutely. And there's that fascinating
comparison about breastfeeding. Right Weston versus Hunter
(24:01):
Gatherer. Patterns in the West.
Infrequent nursing leads to fluctuating prolactin lots of
periods over a lifetime. Hunter gatherers Frequent long
term nursing keeps prolactin high, suppressing ovulation for
years very few periods. And the book suggests this
difference might relate to higher rates of endometriosis or
certain cancers in Western women.
(24:21):
It's a provocative thought. Maybe activating that
reproductive machinery hundreds of times when it evolved for
maybe 20 has unforeseen long term costs.
Interesting and for sexuality, hormones matter, but.
For humans, Sapolsky stresses, social and interpersonal factors
are far more important. Our minds drive desire as much
or more than our hormones. OK, moving from the body up to
(24:44):
the mind itself. Memory stress messes with
memory, right? Makes it worse.
Actually, surprise. Moderate stress can enhance
memory formation. Really.
Particularly for emotionally charged events.
Arousing, exciting, momentous occasions, good or bad, those
things get etched forever in your mind.
Like your first kiss, or 911, ora car crash.
(25:05):
You remember that moment vividly, but maybe not the hours
around it. Exactly.
The book explains the differencebetween explicit memory facts
and events like knowing Paris isthe capital of France.
Declarative. Memory and implicit or
procedural memory. Skills and habits like riding a
bike without thinking about it. And patient HM was key to
understanding this. Absolutely.
(25:27):
After his hippocampus was removed for epilepsy, he
couldn't form new explicit memories, couldn't remember
meeting you minutes ago. But he could still learn new
motor skills like a puzzle, evenwhile denying he'd ever seen it
before. So these are separate systems.
And we don't really have grandmother neurons, right?
One cell for one specific face. No, that was an early,
(25:47):
charmingly simple idea. It's more like impressionism
neurons, as Sapolsky calls them.They build a picture from the
convergence of many inputs like dabs of paint.
So how does stress enhance the important memories?
Moderate stress boosts the hippocampus, which handles
explicit memory, and it's strongly activates the amygdala,
(26:08):
the. Emotion Center.
Right, which tags memories with emotional significance, making
them stick. This is crucial for
understanding PTSD, where those emotional tags are maybe too
strong, making memories intrusive and overwhelming.
But stress isn't always good forthinking, is it?
What about higher level stuff? That's the dark side.
Stress significantly disrupts executive function, strategic
(26:30):
planning, judgment, complex decision making, organizing
thoughts, the stuff your prefrontal cortex does, the
sophisticated thinking. So when you're stressed, it's
literally harder to think straight or make good choices.
Yes, your brain prioritizes immediate reaction over careful
deliberation. And the hippocampus, the memory
center, is actually vulnerable to long term stress.
Very vulnerable. Chronic stress can cause neurons
(26:53):
there to actually atrophy, shrink, lose connections.
That's scary. It is, and interestingly,
amygdala activation seems necessary for this damage to
happen, which leads to that weird finding about sex in rats.
Oh yeah. Sex raises glucocorticoids in
male rats, but it doesn't mess up their hippocampus.
Why? Because sex doesn't activate the
(27:15):
fear center, the amygdala. Context matters.
Fascinating. But here's a really disturbing
idea. During a stroke or seizure, the
body's own stress response makesthings worse.
That's the chilling implication from animal studies.
The massive glucocorticoid floodmeant to help coke seems to
exacerbate the brain damage. So removing the adrenals or
(27:35):
blocking the hormones actually reduce the damage.
In those studies, yes, it suggests our own stress response
can become part of the pathologyin a neurological crisis.
OK, let's talk sleep, or lack thereof, the dread vicious
cycle. Perfect description.
Not enough sleep as a stressor and being stressed makes it
harder to sleep. You get trapped.
We cycle through sleep stages, right?
Shallow, deep R.E.M. Yep.
(27:57):
Deep sleep or slow wave sleep isthe really restorative phase.
Yeah, brain metabolism slows waydown.
Energy is restored. Housekeeping gets done.
And R.E.M. is dream sleep. What's happening in the brain
then? The frontal cortex, your brain's
logical CEO, the superego, it's metabolism goes down.
Takes a break. It does, which disinhibits the
(28:18):
older, more emotional limbic system allows it to run wild.
And that's why dreams are so weird, illogical, emotional,
flying underwater. Exactly.
Your inner illogical, hyper emotional self gets to play
without the usual executive control.
Makes sense, and stress is a major trigger for insomnia.
Huge About 75% of chronic insomnia cases start with a
(28:39):
major stressor, and poor sleepers consistently show
higher stress hormone levels or sympathetic activity.
And it's not just less sleep, it's worse quality sleep, less
deep sleep. Right.
More fragmented, less restorative.
It really depletes you over time.
OK, finally aging. How does stress interact with
getting older? Well, some good news first.
Self reported happiness doesn't necessarily decline with age.
(29:01):
Social networks often prioritizequality over quantity.
And older people tend to think they're healthier than the
average older person. A bit optimistic, yeah.
Yes, a statistical impossibility, but a charming
one. But there's a physiological
downside, which is as we age, weget worse at turning off the
stress response. Hormones like glucocorticoids
(29:22):
stay elevated longer after a stressor, and even baseline
levels creep up. So older bodies are living in a
state of mild chronic stress activation.
Often yes, which raises concernsabout glucocorticoid
neurotoxicity. Meaning the stress hormones
themselves might damage the brain over time, especially the
hippocampus. That's the fear based on animal
studies contributing to age-related memory decline.
(29:44):
The fear of losing yourself, your memories, that's the really
scary part of aging for many. But successful aging is possible
that Harvard study identified factors.
George Veyon study Yeah, followed people for decades.
Key predictors for healthy aging, often visible by midlife
No smoking, minimal alcohol, exercise, healthy weight, stable
marriage, no depression, and crucially, a mature, resilient
(30:07):
coping style. Resilience seems key, which
brings us to how our minds filter stress.
It's not just what happens, but how we see it.
Absolutely critical. Point Sapolsky hammers this
home. The physiological response can
be modulated by psychological factors.
Same stressor, different perception, totally different
outcome. The input is the same, the
(30:27):
output changes based on our interpretation.
Exactly which leads right into the power of social support.
The evidence there is pretty solid, right?
Connected people live longer, healthier lives.
Overwhelmingly so. Spouses, close friends,
community, they buffer stress that is really soldier study is
so poignant. The parents who lost sons, only
(30:49):
the divorced or wittered ones, had increased health risks
afterward. Yes, having a partner to share
that immense burden with was protective physiologically.
And the mechanism Isolated people have higher sympathetic
activity, higher blood pressure.Consistently 2 to five times the
risk of heart disease if you're socially isolated.
Right, But there's a but. Social connection isn't always
good. Not always throwing a lonely
(31:11):
animal into a group of strangers.
Massive stress response and for humans a bad conflict ridden
marriage is linked to immune suppression in women.
Quality over quantity comfort doesn't come from just any
connection, especially not strangers.
Precisely now. Predictability and control.
These are huge psychological filters.
Predictability. First, knowing when the bad
(31:33):
thing is coming helps, even if you can't stop it.
Yes, reduces that awful anticipatory dread.
The London Blitz example, city dwellers had less stress than
suburbanites because the city raids were more predictable,
even if more frequent. They knew when to expect the
sirens. Like the dentist saying OK last
one helps you relax slightly. Right.
(31:54):
And control, or even the illusion of control, that's
incredibly powerful. The yoked rats experiment.
Tell us about that again. Classic 2 rats get the same
shocks. One has a lever and things
control the shocks even if it doesn't.
The other has no lever, no control.
Same shocks, different perception.
And dramatically different outcomes.
The rat with the illusion of control.
(32:14):
Far fewer stress hormones, far fewer ulcers.
The helpless rat. Ulceration city.
Feeling helpless is toxic. Applying that to humans, the
executive stress idea is mostly wrong.
Top dogs don't get ulcers, they give them.
Largely A myth. People at the top usually have
more control. It's middle management often
stuck with high demands but low autonomy.
(32:35):
Responsibility without control, they're at higher risk.
It all comes down to meaning, doesn't it?
How you frame the situation? Totally. 25 shocks an hour could
be good news or bad news depending on the context.
Pain can be welcomed if it meansa treatment is working.
The story you tell yourself matters.
But fake control isn't always helpful.
It can backfire. Crucial distinction.
It helps for manageable stuff, reinforcing agency.
(32:58):
Glad I did X. But for truly awful
uncontrollable events it leads to self blame which is
incredibly damaging. You shouldn't feel responsible
for the uncontrollable. Which connects to John Henry
ISM. Yeah, that belief that you can
conquer anything just by workinghard enough.
Admirable, but dangerous. When facing systemic issues like
poverty or discrimination, or just sheer bad luck leads to
(33:20):
burnout and despair. You have that strong internal
locus of control, but reality keeps blocking you.
We really do filter the world through different psychological
lenses. And those filters shape our
biology, which brings us to depression.
Major depression. Sapolsky defines it.
Not just a sadness, but that profound loss of pleasure.
Right. Anadonia can appreciate sunsets.
(33:42):
Exactly. Cognitive therapist like Aaron
Beck see it as a disorder of thought.
Depressives literally see the world through dark tinted
glasses. Remembering the funeral scene,
not the feast scene. Always half empty.
And physiologically, they often have high glucocorticoid levels,
which makes sense if you see thedepressive not as passive but as
fighting this immense internal battle.
(34:03):
A tightly coiled spool of wire, tense, straining, but all
inside. That explains the exhaustion,
the hormone levels. Right, and there are different
types. Unipolar.
Just the lows. Bipolar, the wild swings between
depression and mania. Like the woman buying 3
Cadillacs she couldn't drive. That's mania.
Extreme example, but yes. Yeah, total disinhibition and
(34:23):
the rhythm of some depressions like SAD linked to seasons.
Rhythmicity screams biology. It's not just psychological.
No. And the neurochemistry, first it
was 2 little neurotransmitter, serotonin, noremaphrin.
That's what early drugs targeted.
SSRI is boosting serotonin. Right.
But then the revisionist theory,maybe those receptors become
(34:46):
less sensitive flooded. So it's about amount and
sensitivity more complex. The cortex plays a role to that
cingulotomy procedure. Targeting the anterior singular
cortex ACC, which deals with theemotional aspect of pain, the
feelings about the pain. It's often overactive and
depressive and. Their amygdala reacts more to
sad faces, not fearful ones. Another sign of shifted
(35:06):
emotional processing. And crucially, evidence now
suggests stress and high glucocorticoids can cause
depression, not just result fromit.
To depression, that's huge. It is, Freud talked about grief
turning into depression via ambivalence and aggression
turned inward and internal battle.
And Seligman's learned helplessness.
Rats giving up after uncontrollable stress A.
(35:28):
Powerful model they learned. Nothing I do matters.
Ever. Depressed humans often over
generalize like that from 1 bad experience, feeling hopeless
about everything. And early life stress makes you
more vulnerable lifelong higher CRH levels allostatic load.
Exactly since you up at that rent of vulnerability, but the
body is built for recovery. How so?
(35:50):
Even as stress depletes something like noropine frying,
it simultaneously triggers its production.
We have built in rebound mechanisms, which is why most
people recover from acute stress.
But some don't. Why the difference?
Genetics play a role. Seems likely that Gene Z, the
serotonin transporter Gene 5 HTT1 version, combined with major
stress significantly increases depression risk.
(36:13):
And guess what regulates that gene's production?
Let me guess, glucocorticoids? Bingo.
A direct link. Stress hormones.
Gene expression vulnerability. Wow, OK, so after all this, how
do we live with stress? Sapolsky talks about us
inventing weird sources of pleasure and pain.
Yeah, Westernize humans especially compare the loudest
sound a medieval peasant might hear.
(36:34):
A cathedral organ maybe. Awe inspiring with the constant
assault of noise we experience. Or compare finding rare wild
honey back then. With the hundreds of engineer
junk foods hitting our dopamine systems way harder, way more
often than anything natural. What's the consequence of this
constant intense stimulation? We get used to it.
(36:54):
Habituation. We stop noticing the simple
quiet pleasures. Autumn leaves a kind glance, and
we need bigger, faster hits to feel anything.
Now isn't as good as it used to be.
We're always chasing. Sadly, yes.
And hostility. Remember that Redford Williams
work. Right.
Cynical hostility, not just being busy.
Type A is the real heart risk factor.
(37:15):
Huge factor linked to heart disease, stroke, higher
mortality across the. Board and dopamine.
It's not just about the pleasureof the reward.
Less about the reward itself, more about the anticipation.
Schultz's studies the dopamine spikes before the reward comes.
When you know the rules and expect it, this is going to be
great. Fueling the pursuit.
Exactly, Philip showed the bursthappened just before the action.
(37:38):
Pleasure is often more in the appetite, the chase, especially
if there's some uncertainty about getting the reward.
Like the difference between early relationship, passion,
dopamine fueled and dissipation and later comfort different
brain areas. Perfect example, edgy excitement
versus warm security. Both good but different
neurochemistry. And stress and addiction.
(37:59):
What's the link? Simple grim punchline.
Stress makes you use more and relapse more easily.
Especially unpredictable stress or being low status.
Both increase risk. Why?
Acute stress boosts dopamine itself so the drugs effect which
might be mild, normally feels cosmic under stress making you
crave it more. A biochemical trap?
(38:20):
So philosophically, we're smart enough to invent stress, foolish
enough to let it rule us. That's Sapolsky's gentle
critique. He shares that funny line about
God finding Monday suffered frombipolar disorder.
And that Monopoly sermon anecdote about the pieces just
going back in the box. So powerful, a reminder of what
truly matters, beyond the accumulation, the winning.
(38:40):
It's about the game, the connection.
Like the tickling machine, you can't tickle yourself because
there's no surprise predictability kills the
sensation. Exactly.
We need that element of the unexpected.
So, practical wisdom. The 8020 rule for stress
management. Meaning, focus on the stuff that
gives the biggest bang for your buck.
Kind of, but his main point is simpler.
Don't get crazed searching for the perfect technique.
(39:03):
Just pick something and do it. It doesn't matter what
management technique you use, just do it daily.
The commitment, the consistency,That's 80% of the battle
prioritizing it. Like the Serenity Prayer, accept
what you can't change, change what you can.
Know the difference? Yes, and that Quaker analogy.
Be grass in the wind. Be wind against the wall.
(39:24):
Cognitive flexibility. Adapt your strategy.
And finally, his really strong stance against blaming the
victim. Absolutely crucial.
He rails against the idea that incurable disease is the
patient's fault or due to a lackof love.
He calls that viewpoint negligent and cruel.
Stress can make you sick, but exaggerating that is harmful.
We can't just think ourselves well from everything.
(39:45):
Exactly, it's a nuanced balance.Stress influences biology, yes,
but you can't understand illnesswithout understanding the person
who is ill, their life, their psychology.
Reconciling biology and the mind.
Body connection. Beautifully, he ends with
Virtua's 19th century vision. Medicine is a social science and
(40:06):
politics. Nothing but medicine on a large
scale seeing the bigger picture.A vision that feels kind of lost
sometimes today. Sadly, yes.
So wrapping up this deep dive. So Polsky's book is just
incredible, a shortcut to understanding this complex
interplay of stress, biology andpsychology.
It really connects the dots between the science and our
(40:27):
everyday lives. So as we finish, here's that
final thought to Mull over straight from the book score
message. The Physiology of the system is
often no more decisive than the psychology.
We humans, especially in our privileged lives, are uniquely
be smart enough to have inventedthese stressors, and uniquely
foolish enough to have let them too often dominate our lives.
But the hope, the potential, is that we can also be uniquely
(40:48):
wise enough to banish their stressful hold.
So think about it. Control, predictability, social
support, perspective. How can you use these
psychological filters as wisdom in your life?
How can you shift from just surviving the stress to maybe
even thriving despite it? Something to reflect on.
That's all for this deep dive. We hope you feel maybe a little
(41:10):
less stressed, definitely more informed, and perhaps ready to
manage those stressors with a bit more wisdom and resilience.
Until next time.
Welcome everyone to the Deep Dive.
This is the show where we we really dig through stacks of
research articles, fascinating books, all sorts of stuff to
pull out the absolute best, the most useful Nuggets of knowledge
for you. And today, oh boy, we are diving
deep into something that touchesevery single one of us.
Stress. Yeah, stress.
(00:21):
But we're not just talking about, you know, feeling a bit
frazzled after a tough day. No, not at all.
We're talking about how this this constant low level hum of
stress in modern life actually physically reshapes our biology.
Right. And how it paves the way for
some of the biggest, most debilitating diseases we face
today. It's way more insidious than you
might think. It really is.
(00:42):
Think about it for a SEC. Picture like 1900.
What were our great grandparentsworried about?
What kept them up at night? Probably things like pneumonia,
right? Or TB?
Influenza. Maybe the dangers of childbirth?
These immediate, often deadly threats.
Exactly. Acute stuff.
Now jump to today. What are our big health worries?
Heart disease, cancer, strokes, diabetes, It's a totally
(01:04):
different landscape. And Robert Sapolsky, the
brilliant author of the book we're diving into today, he puts
it so well, he says we're livinglong enough to slow fall apart
from these diseases that like slow accumulation.
It's a really stark paradox, isn't it?
We beat a lot of the quick killers.
Right, we did. But in doing so, we've kind of
opened the door for our bodies to break down in these slower,
(01:25):
more chronic ways. And that huge shift in medicine,
recognizing how deeply our biology is tangled up with our
emotions, our psychology, that'skey.
Absolutely key. Which brings us to the main
event today. Yes, we are unpacking an
absolute classic. Why Zebras Don't Don't Get
Ulcers by Robert M Sapolsky Seriously, if you haven't read
(01:45):
this book, you're in for such a treat.
He's amazing. He takes this really dense,
complex science and makes it totally engaging, funny even.
Like that super smart friend whocould explain anything and make
it fascinating. Exactly.
So our mission today is to unpack how chronic stress, the
kind zebras mostly avoid, can make a sick or, you know, make
existing conditions worse. We'll pull out some surprising
(02:08):
facts and great stories from thebook and basically give you a
shortcut to being really well informed on this vital topic.
So let's start right there with that central metaphor.
Why don't zebras get ulcers? OK, the zebra pictured on the
Savannah. A lion appears.
What happens? Panic run.
Exactly. Pure physical emergency.
(02:28):
Zebra's body, like ours instantly gears up for intense
muscle work. Energy mobilization right now.
It needs fuel like immediately glucose, fats, proteins flooding
out of storage. Right, not planning for some
building project next spring. As Sapolsky hilariously says,
it's all about the immediate strength.
They run. They escape.
(02:49):
Hopefully. Hopefully, and if they do, the
key thing is that whole physiological stress response.
It shuts off here. Crisis averted.
Back to grazing. But we don't shut it off, do we?
That's the evolutionary mismatch.
Our core stress response is still wired for that lion chase,
even. When the lion is just rush hour
traffic. Or a looming deadline.
Or worrying about bills. Or social media drama.
(03:10):
It's all psychological for us, mostly.
But the body reacts like it's physical danger.
Constantly. And that's the problem.
The response itself is brilliantfor short bursts, life saving
even, but keeping it switched onfor weeks, months, years.
That's when the damage starts. It's like that fire alarm
analogy you mentioned earlier. Yeah, the alarm designed for a
(03:31):
raging fire, but it's blaring nonstop because you burn the
toast slightly. Your body's emergency systems
are just constantly draining resources.
And for centuries, you know, doctors have this gut feeling,
this intuition that personality or outlook mattered for health.
But it's kind of fuzzy, right? Not scientific.
Exactly until the mid 20th century, when stress Physiology
(03:53):
really became a rigorous science.
It wasn't there some crazy idea about the brain making hormones?
Oh yeah, Jeffrey Harris, 1944. Yeah, totally bonkers idea.
At the time he proposed, the brain itself was a glance
releasing hormones to control the pituitary.
The master gland. The master gland and people were
like, what? The brain oozing hormones?
Yeah, ridiculous. Like it should be writing
(04:14):
sonnets, not leaking chemicals. Precisely.
It seems so beneath the brain's dignity.
And then came that intense rivalry, right?
The race to actually find these brain hormones.
Gilliam and Shaley. What a story.
Total soap opera. Not the lone scientist myth at
all. Big teams, Corporate science
(04:36):
almost. Huge teams, years of grinding
work, and they apparently hated each other.
The book says vicious attacks and bitter retaliation doesn't
sound like friendly competition.Not remotely, despite one of
them claiming it was only motivated by science.
Yeah, right. So what were they actually
doing? How do you find these tiny
amounts of? Hormones, get this, They were
collecting thousands and thousands of animal brains from
(04:59):
slaughter douses, sheep brains, pig brains.
Seriously. Seriously.
Blending them up, trying to purify these miniscule droplets,
injecting them into rats to see if the pituitary reacted.
That sounds unbelievably tediousand kind of gross.
For years. But eventually they did it.
They found the first releasing hormone proved Harris right.
And ended up sharing a Nobel Prize despite the animosity.
(05:20):
Yep, 1976 monumental work. It completely changed how we saw
the brain body connection. And it paved the way to
understand the actual hormones doing the work during stress.
Exactly the real workhorses, 2 main types.
OK, what are they? First, you've got epinephrine.
That's adrenaline and norepinephrine.
Sympathetic nervous system stuff.
Super fast seconds. That's the immediate jolt,
(05:41):
right? Sweaty palms, racing heart.
That's them then backing them up, providing a more sustained
response over minutes. Hours are the glucocorticoids.
Steroid hormones from the adrenal glands.
Sapolsky loves these guys, apparently.
He's obsessed. You'll know everything about
glucocorticoids after reading the book.
They're central. So how do these all connect?
(06:03):
The brain, the pituitary, The adrenals.
It's the HPA axis, hypothalamus,pituitary, adrenal, a cascade.
OK, break it down. A stressful thought, real or
imagined, doesn't matter, Triggers CRH release in the
hypothalamus, deep in the brain that tells the pituitary
release. ACTH.
Got it. ACTH travels through the
bloodstream to the adrenal glands sitting on top of your
(06:25):
kidneys. And the adrenals then release.
Glucocorticoids flooding your system.
It's a beautifully orchestrated rapid response system.
But you mentioned it's not always the same response, like a
stress signature. Yeah, that's really interesting.
While the sympathetic system andglucocorticoids are almost
always involved, the exact mix, the timing, the magnitude can
(06:48):
vary depending on the stressor. So public speaking stress might
look different biochemically than, say, exam stress.
Lovely. Yes, And sometimes it's even
more nuanced, like the hormone levels in the blood might be the
same, but the tissues become more or less sensitive to them.
Wow, so the cells are hearing the message differently?
Exactly. Which leads us to that core kind
(07:09):
of depressing theme of the book.What's it the short term?
Can be absolutely terrible news long term.
When that brilliant emergency system gets stuck in the on
position because of chronic psychological stress, that's
where the trouble begins. Big trouble.
Right, which takes us to the actual toll on the body,
starting with the heart, the cardiovascular system.
(07:30):
Yeah, think of your blood vessels like highways.
Chronic stress is like constantly dumping grit and
debris onto them. Leading to high blood pressure,
hypertension. Yep, and atherosclerosis, that
nasty plaque buildup inside the arteries, narrowing the lanes.
How does the stress actually do that?
It's a cascade. Chronic pressure can cause tiny
tears in the artery lining. Inflammation kicks in.
(07:51):
Immune cells rush to the site. Like little repair crews.
Kind of, yeah. But then fatty foam cells form,
starting the plaque. Plus, remember epinephrine?
Adrenaline. Yeah, the fast one.
It makes your blood thicker, stickier.
Platelets clump together more easily.
Add the extra fat and glucose mobilized by stress.
And you've got perfect conditions for plaque to form
(08:12):
and harden, clogging the highway.
Precisely. And there's amazing evidence for
this Jay Kaplan's monkey studies.
Oh yeah, tell us about those. He show that monkeys low on the
social ladder, the ones getting constantly picked on,
experiencing chronic psychological stress, they
developed way more atherosclerotic plaques.
Same diet as the dominant monkeys, but way more plaque.
(08:35):
Wow, just from social stress. Just from social stress.
But here's the kicker, if you gave those same stressed monkeys
beta blockers, drugs that block the sympathetic nervous system,
no plaques formed. It's a direct link.
Psychological stress, sympathetic activation, physical
heart disease. It's not all in your head
that's. Incredible.
So the chronic stress weakens the system.
(08:57):
Exactly. And then each new acute
stressor, a sudden scare, a burst of anger, becomes even
riskier. Because the arteries are already
compromised. Right.
That's myocardial ischemia. The heart muscle isn't getting
enough oxygen because the arteries are narrowed.
So during acute stress, instead of opening up to deliver more
blood. They might clamp down even
further. Paradoxically, yes, starving the
(09:19):
heart muscle can lead to angina or even a full heart attack.
Yikes. OK, Speaking of weird stress
reactions, Sapolsky asks that question right.
Why do we wet our pants when terrified?
Yes, he admits, science doesn't really have a solid answer.
It's counterintuitive cause normally stress makes you
conserve water. So what's his best guess?
(09:39):
Purely speculative, but maybe for humans a full bladder is
just like sloshy dead weight youdon't need when running for your
life. Whereas other animals use urine
for scent marking. Right, so maybe our ancient
brain just hits the empty bladder panic button, logic be
damned. It's a funny reminder of how
rimal some responses are. It really shows the chaos of
(10:00):
extreme stress. Which brings us to something
much less funny. Sudden cardiac death.
Yeah, terrifying Often happens during or right after intense
stress. The heart's electrical rhythm
just goes haywire. Ventricular fibrillation.
And it's more likely if the heart's already damaged by
atherosclerosis. Much more likely though, sadly,
and sometimes happen seemingly out of the blue, revealing
(10:22):
hidden damage later. OK, but then there's that really
word paradox being killed by pleasure.
How does that work? Because physiologically, extreme
joy, extreme triumph, even orgasm places similar to stands
on the heart as extreme rage or fear.
The sympathetic nervous system doesn't care if it's good or bad
stress. It just responds to intensity.
(10:42):
Massive emotional arousal, whatever the flavor, puts a huge
sudden strain on the cardiovascular system.
So that Ellie Wiesel quote fits the opposite of love is not
hate, it's indifference. Intensity is the key.
Intensity is the key. It challenges your allostatic
equilibrium. Allostatic equilibrium.
What's that exactly? It's not just staying static
(11:04):
like homeostasis, it's your body's ability to achieve
stability through change, adapting, adjusting constantly.
Like a tightrope Walker making constant small adjustment.
Perfect analogy. Not standing rigid, but
dynamically balancing. When stress overwhelms that
ability to adjust the tidal Walker falls, things breakdown.
Got it. OK, let's talk specifically
(11:24):
about women and heart disease. It's on the rise, right?
Tragically, yes, and beyond smoking and obesity, stress is a
huge factor. Studies on female monkeys
mirrored the males. Subordinate stressed females had
twice the atherosclerosis. Even on the same low fat diet.
Even on the same diet and in human women, the data
surprising. Working outside the home isn't
the risk factor per SE. So what is?
(11:45):
It's if that work is low controllike clerical work, or if you
have an unsupportive boss that classic high demand low control
stress. Responsibility without autonomy.
Exactly. And another big predictor?
Having kids back home, which points to that double burden
many women face. Managing work and the bulk of
home life. Relentless.
(12:07):
Absolutely. Then came the big estrogen
bombshell back in 2002, the Women's Health Initiative study.
Oh, I remember that huge news. Hormone replacement therapy.
It wasn't protective. After all, worse for older women
taking estrogen plus progestin, it was actually increasing the
risk of heart disease and stroke.
It completely flipped the script.
Why the contradiction? Everyone thought estrogen was
(12:29):
protective. It came down in nuance, the type
of hormones, the dose, but crucially, the timing.
Timing. How so?
Earlier lab work suggested estrogen helps prevent the
formation of plaque. Doesn't really reverse existing
plaque. And the women in the WHI study
were older. Mostly fifties, 60s.
They likely already had significant plaque buildup from
(12:49):
years of Western lifestyle, so the estrogen therapy started too
late to offer that initial protection.
So it's not that estrogen is bad, it's that starting it late
on top of existing damage might actually be harmful.
That seems to be the complex picture, a real lesson in
biological timing and research nuances.
Wow. OK, from the Hart Highways,
let's move to the body's energy economy, metabolism.
(13:12):
Right back to that lion chase. Where did the energy come from?
Not the snack you just ate. It's got to be from storage,
right? Fat, liver, muscles.
Instantly mobilized, the system is designed for that immediate
power search. And the key hormone for storing
energy is insulin. Absolutely.
So Persky calls it the optimistic hormone that plans
for your metabolic future, filling those deposit slips at
(13:33):
your fat banks. It even releases before you eat
sometimes. Anticipatory.
Yeah, if you always eat at 6:00 PM, by 5.45 your pancreas is
already releasing a bit of insulin, prepping the system.
Amazing proactive balance. But stress inevitably messes
this up, too. Big time for juvenile diabetes
type 1, the autoimmune kind where the pancreas doesn't make
(13:55):
enough insulin. Frequent or big stress responses
can increase the odds of gettingit, speed it up, and make
complications worse. Stress management is critical
there. And what about adult onset type
2 diabetes? Sapolsky is emphatic.
This is not normal aging. It's a disease of inactivity and
fat surplus. So what happens?
(14:15):
Your fat cells get literally full.
You don't make many new ones after adolescence, they just
swell up then when insulin comesknocking with more glucose to
store. The fat cells say no vacancy.
Pretty much no room at the end. They become resistant to
Insulin's message. Insulin resistance.
I've heard that term. Right.
So the pancreas tries harder, pumping out more insulin to get
the message through, but eventually insulin producing
(14:38):
cells can just get exhausted andthen type 2 starts looking like
type 1, needing external insulinand all that extra glucose and
fat circulating damages everything.
Kidneys, eyes, nerves. It's a cascade, and this often
clusters together, right? Metabolic Syndrome.
Exactly, It's not one disease, but a dangerous group hug of
(14:59):
problems. High insulin, high glucose, high
blood pressure, insulin resistance, bad cholesterol,
belly fat. The Apple shape.
That's the one. Technically, nothing might be
diagnosably wrong yet, but you have a bunch of measures that
are almost abnormal. Like all the warning lights on
your car dashboard are just starting to flicker.
Our perfect analogy? Yeah, it's a huge red flight for
(15:21):
future heart disease, cognitive decline, earlier death.
Even if you're technically not sick, that cluster predicts
trouble ahead. OK, metabolic mayhem.
Let's shift down to the digestive system, the gut.
Often underestimated how much energy digestion takes.
It's not passive that rhythmic muscle contraction peristalsis.
The snake dance, Spolsky calls it.
Yeah, plus the stomach turning, the chemical breakdown, the
(15:44):
sphincters opening and closing. Like Panama Canal locks.
It can use 1020% of your daily energy.
So stress must impact this too. Appetite, for instance.
It seems mixed. It is confusing.
About 2/3 of people eat more when stressed hyperphagic. 1/3
eat less. Hypophagic rats show the same
split. Why the difference?
Hormones pulling in opposite directions.
(16:06):
CRHA, key stress hormone tends to suppress appetite, but
glucocorticoids. Sapolsky's favorites.
They stimulate appetite and specifically for comfort foods,
starchy, sugary, fatty things. So that's why we reach for the
Oreos, not the celery. When stressed, blame the
glycocorticoids. You absolutely can.
It's a major driver of stress induced overeating in our modern
(16:30):
world. What about things like IBS?
Irritable bowel syndrome. Hugely frustrating for people.
They feel awful pain, bloating, messed up bowel habits, but
doctors often find nothing wrongon standard tests.
But Sapolsky says these are immensely sensitive to stress.
Absolutely. The brain gut connection is
incredibly powerful. And here's a weird twist with
pain. Stress can numb pain on your
(16:51):
skin or muscles, right? Like an athlete playing through
injury. But paradoxically, it increases
sensitivity to visceral pain, pain from internal organs like
your intestines, which is exactly the pattern in IBS.
And IBS symptoms often get better during sleep.
Which strongly points away from a purely physical cause and
towards the role of conscious orsubconscious stress.
(17:12):
The book also mentions childhoodtrauma increasing IBS risk
later. Yes, leaving an echo
vulnerability initially dismissed by some as
psychoanalytic gibberish. But animal studies clearly show
early stress physically alters the gut stress response systems
long term. It really highlights the lasting
impact of early experiences. OK, the big one.
(17:33):
Ulcers. Stress causes ulcers, right?
Everyone knows that. Well, that was the dogma for
decades until Barry Marshall came along.
The guy who drank the bacteria. The very same a truly heroic,
soon to be a movie move. He swallowed Helicobacter pylori
bacteria to prove they not stress alone caused ulcers.
And he was right. Monumentally right?
(17:55):
Got a Nobel Prize for it. Turns out H pylori is
responsible for like 85100% of ulcers in the West.
The bacteria weaken the stomach linings defenses against acids.
So stress plays no role. Not the primary cause, but it
can definitely worsen things if you already have the bacteria
increasing acid reducing protective factors, it
exacerbates the damage. And there's that weird timing
(18:16):
thing, the ulcer paradox. Yeah, ulcers often form not
during the stress, but during the recovery period afterwards.
So lots of short intermittent stresses might be worse than one
long one. Exactly, it's when the system
tries to reset that the damage can manifest complex rebound
effects. OK, shifting scale completely
now, growth and development, howdoes stress fit in?
(18:37):
Simple principle, growth is expensive energy wise, a huge
investment. And if you're running from that
lion? It's no time to get any benefit
from growth. Survival first, building
projects later. This is seen most tragically in
stress dwarfism, right? Psychosocial Dwarfism.
Absolutely devastating, caused by extreme emotional neglect or
(18:58):
psychological abuse. Sapolsky gives these haunting
examples. Kids locked in closets, fed
under doors. Appearing physically stunted,
emotionally vacant. Bruised with distorted flinching
postures. Haunted Slack facial
expressions. It's a physical manifestation of
profound emotional trauma. And it's linked to growth
hormone levels. It's.
Extremely low GH. There's an incredible story in
(19:20):
the book about a child whose GH levels and growth rate tanked
when his favorite nurse went on vacation for three weeks.
With no change in his food intake.
None whatsoever. And his GH soared when she came
back. You couldn't ask for clearer
proof that it's about emotional connection, not just calories.
That's unbelievable. So love, or the lack of it, has
(19:41):
direct biological effects on growth.
Profoundly so. But there's a twist with GH2.
Short term stress actually boosts GH release.
Why? It helps mobilize energy
quickly. But long term chronic stress
inhibits actual growth. It blocks the downstream
hormones, the semitomedens that do the actual building.
(20:01):
It's like GH gets the cash from the bank for construction.
But the cash gets diverted to the immediate emergency.
Exactly, leaving the long term project stalled.
And early life stress, even before birth has.
Huge effects prenatal stress or early post Natal stress like
maternal deprivation in animal studies leads to lifelong higher
glucocorticoid levels, more anxiety, changes in brain
(20:22):
development. And it's not just severe trauma.
Even normal variations matter. Yeah, so Polsky notes that even
within the normal range, lower birth weights predict higher
adult glucocorticoid levels and higher risk of metabolic
syndrome later. Early life casts a very long
shadow. OK, now for something really
weird. Those cross cultural studies on
(20:42):
stressful rituals for infants. Land over and Whiting.
Yeah, fascinating and controversial.
They looked at societies with stressful rights for kids under
2, piercing temperature extremes, stuff like that.
A correlation a. Correlation.
Those societies had adults who were, on average 2.5 inches
taller. What?
How? Oh, that seems completely
(21:04):
backward. Highly debated.
Could be selective mortality only the toughest.
Maybe genetically predisposed tobe taller.
Survived. Could be other factors like
diet. Lots of confounds.
But some anthropologists think maybe certain types of early
physical stress could paradoxically stimulate growth.
It's a provocative idea. Highlights how complex and non
linear these responses can be. Definitely not a recommendation
(21:25):
for stressing out babies. Definitely not, but regardless
of that anomaly, chronic stress is bad for bones, right?
Oh yeah, Glucocorticoids wreak havoc on calcium.
They block its absorption from food, increase its excretion by
the kidneys, and speed up the breakdown of old bone.
Pushing the balance towards disintegration.
Not good for aging skeletons. Not good at all.
OK, let's move to another systemoften put on hold by stress.
(21:49):
Reproduction makes perfect evolutionary sense, right?
Lion chasing you, not the time to make babies.
So the general impact is less sex drive fertility problems.
Pretty much across the board, yeah.
Irregular cycles in females, erection difficulties in males.
Reduce libido in both. The body puts reproduction on
the back burner. How does it work in males
(22:10):
hormonally? There's a pathway.
LHRH for the brain, LH from the pituitary, colitary testosterone
from the testes. Stress disrupts this so.
Stress lowers testosterone, yes.Both psychological stress like
those poor officer candidate school trainees and extreme
physical stress like an elite athletes.
And that's partly linked to endorphins, the runners high
chemicals. It seems to be endorphins
(22:32):
inhibit reproductive hormones somood boost but maybe less baby
making drive. A trade off and erection
specifically. Stress makes those harder.
Definitely. Erections need the
parasympathetic rest and digest system to get blood flow going.
Stress activates the sympatheticfight or flight system.
Direct physiological conflict. Unless you're a hyena, what's
(22:55):
that about? The Hyena Anomaly 1 of
Sapolsky's Great Zoological Detours.
Female hyenas are dominant, muscular, have masculinized
genitals. A fake scrotum and an enlarged
clitoris they use for sex and birth.
Wild. Totally wild, and they seem to
be an exception to the Stress inhibits erection rule.
A friendly word of warning before you date a hyena, as the
(23:18):
book puts it. Duly noted.
OK, what about females? How does stress mess with their
cycle? Similar disruption of the
hormone cascade LHRHLH and FSH, Estrogen and progesterone stress
can lengthen cycles, stop them all together in menorrhea,
inhibit progesterone needed for pregnancy.
And increase prolactin which caninterfere with implantation.
Yes. Multiple ways stress undermines
(23:39):
fertility and successful reproduction.
And during pregnancy itself. Severe stress increases the risk
of miscarriage and preterm birth, likely due to those high
glucocorticoids missing with thedelicate hormonal balance.
A very direct impact of mom's stress on the developing baby.
Absolutely. And there's that fascinating
comparison about breastfeeding. Right Weston versus Hunter
(24:01):
Gatherer. Patterns in the West.
Infrequent nursing leads to fluctuating prolactin lots of
periods over a lifetime. Hunter gatherers Frequent long
term nursing keeps prolactin high, suppressing ovulation for
years very few periods. And the book suggests this
difference might relate to higher rates of endometriosis or
certain cancers in Western women.
(24:21):
It's a provocative thought. Maybe activating that
reproductive machinery hundreds of times when it evolved for
maybe 20 has unforeseen long term costs.
Interesting and for sexuality, hormones matter, but.
For humans, Sapolsky stresses, social and interpersonal factors
are far more important. Our minds drive desire as much
or more than our hormones. OK, moving from the body up to
(24:44):
the mind itself. Memory stress messes with
memory, right? Makes it worse.
Actually, surprise. Moderate stress can enhance
memory formation. Really.
Particularly for emotionally charged events.
Arousing, exciting, momentous occasions, good or bad, those
things get etched forever in your mind.
Like your first kiss, or 911, ora car crash.
(25:05):
You remember that moment vividly, but maybe not the hours
around it. Exactly.
The book explains the differencebetween explicit memory facts
and events like knowing Paris isthe capital of France.
Declarative. Memory and implicit or
procedural memory. Skills and habits like riding a
bike without thinking about it. And patient HM was key to
understanding this. Absolutely.
(25:27):
After his hippocampus was removed for epilepsy, he
couldn't form new explicit memories, couldn't remember
meeting you minutes ago. But he could still learn new
motor skills like a puzzle, evenwhile denying he'd ever seen it
before. So these are separate systems.
And we don't really have grandmother neurons, right?
One cell for one specific face. No, that was an early,
(25:47):
charmingly simple idea. It's more like impressionism
neurons, as Sapolsky calls them.They build a picture from the
convergence of many inputs like dabs of paint.
So how does stress enhance the important memories?
Moderate stress boosts the hippocampus, which handles
explicit memory, and it's strongly activates the amygdala,
(26:08):
the. Emotion Center.
Right, which tags memories with emotional significance, making
them stick. This is crucial for
understanding PTSD, where those emotional tags are maybe too
strong, making memories intrusive and overwhelming.
But stress isn't always good forthinking, is it?
What about higher level stuff? That's the dark side.
Stress significantly disrupts executive function, strategic
(26:30):
planning, judgment, complex decision making, organizing
thoughts, the stuff your prefrontal cortex does, the
sophisticated thinking. So when you're stressed, it's
literally harder to think straight or make good choices.
Yes, your brain prioritizes immediate reaction over careful
deliberation. And the hippocampus, the memory
center, is actually vulnerable to long term stress.
Very vulnerable. Chronic stress can cause neurons
(26:53):
there to actually atrophy, shrink, lose connections.
That's scary. It is, and interestingly,
amygdala activation seems necessary for this damage to
happen, which leads to that weird finding about sex in rats.
Oh yeah. Sex raises glucocorticoids in
male rats, but it doesn't mess up their hippocampus.
Why? Because sex doesn't activate the
(27:15):
fear center, the amygdala. Context matters.
Fascinating. But here's a really disturbing
idea. During a stroke or seizure, the
body's own stress response makesthings worse.
That's the chilling implication from animal studies.
The massive glucocorticoid floodmeant to help coke seems to
exacerbate the brain damage. So removing the adrenals or
(27:35):
blocking the hormones actually reduce the damage.
In those studies, yes, it suggests our own stress response
can become part of the pathologyin a neurological crisis.
OK, let's talk sleep, or lack thereof, the dread vicious
cycle. Perfect description.
Not enough sleep as a stressor and being stressed makes it
harder to sleep. You get trapped.
We cycle through sleep stages, right?
Shallow, deep R.E.M. Yep.
(27:57):
Deep sleep or slow wave sleep isthe really restorative phase.
Yeah, brain metabolism slows waydown.
Energy is restored. Housekeeping gets done.
And R.E.M. is dream sleep. What's happening in the brain
then? The frontal cortex, your brain's
logical CEO, the superego, it's metabolism goes down.
Takes a break. It does, which disinhibits the
(28:18):
older, more emotional limbic system allows it to run wild.
And that's why dreams are so weird, illogical, emotional,
flying underwater. Exactly.
Your inner illogical, hyper emotional self gets to play
without the usual executive control.
Makes sense, and stress is a major trigger for insomnia.
Huge About 75% of chronic insomnia cases start with a
(28:39):
major stressor, and poor sleepers consistently show
higher stress hormone levels or sympathetic activity.
And it's not just less sleep, it's worse quality sleep, less
deep sleep. Right.
More fragmented, less restorative.
It really depletes you over time.
OK, finally aging. How does stress interact with
getting older? Well, some good news first.
Self reported happiness doesn't necessarily decline with age.
(29:01):
Social networks often prioritizequality over quantity.
And older people tend to think they're healthier than the
average older person. A bit optimistic, yeah.
Yes, a statistical impossibility, but a charming
one. But there's a physiological
downside, which is as we age, weget worse at turning off the
stress response. Hormones like glucocorticoids
(29:22):
stay elevated longer after a stressor, and even baseline
levels creep up. So older bodies are living in a
state of mild chronic stress activation.
Often yes, which raises concernsabout glucocorticoid
neurotoxicity. Meaning the stress hormones
themselves might damage the brain over time, especially the
hippocampus. That's the fear based on animal
studies contributing to age-related memory decline.
(29:44):
The fear of losing yourself, your memories, that's the really
scary part of aging for many. But successful aging is possible
that Harvard study identified factors.
George Veyon study Yeah, followed people for decades.
Key predictors for healthy aging, often visible by midlife
No smoking, minimal alcohol, exercise, healthy weight, stable
marriage, no depression, and crucially, a mature, resilient
(30:07):
coping style. Resilience seems key, which
brings us to how our minds filter stress.
It's not just what happens, but how we see it.
Absolutely critical. Point Sapolsky hammers this
home. The physiological response can
be modulated by psychological factors.
Same stressor, different perception, totally different
outcome. The input is the same, the
(30:27):
output changes based on our interpretation.
Exactly which leads right into the power of social support.
The evidence there is pretty solid, right?
Connected people live longer, healthier lives.
Overwhelmingly so. Spouses, close friends,
community, they buffer stress that is really soldier study is
so poignant. The parents who lost sons, only
(30:49):
the divorced or wittered ones, had increased health risks
afterward. Yes, having a partner to share
that immense burden with was protective physiologically.
And the mechanism Isolated people have higher sympathetic
activity, higher blood pressure.Consistently 2 to five times the
risk of heart disease if you're socially isolated.
Right, But there's a but. Social connection isn't always
good. Not always throwing a lonely
(31:11):
animal into a group of strangers.
Massive stress response and for humans a bad conflict ridden
marriage is linked to immune suppression in women.
Quality over quantity comfort doesn't come from just any
connection, especially not strangers.
Precisely now. Predictability and control.
These are huge psychological filters.
Predictability. First, knowing when the bad
(31:33):
thing is coming helps, even if you can't stop it.
Yes, reduces that awful anticipatory dread.
The London Blitz example, city dwellers had less stress than
suburbanites because the city raids were more predictable,
even if more frequent. They knew when to expect the
sirens. Like the dentist saying OK last
one helps you relax slightly. Right.
(31:54):
And control, or even the illusion of control, that's
incredibly powerful. The yoked rats experiment.
Tell us about that again. Classic 2 rats get the same
shocks. One has a lever and things
control the shocks even if it doesn't.
The other has no lever, no control.
Same shocks, different perception.
And dramatically different outcomes.
The rat with the illusion of control.
(32:14):
Far fewer stress hormones, far fewer ulcers.
The helpless rat. Ulceration city.
Feeling helpless is toxic. Applying that to humans, the
executive stress idea is mostly wrong.
Top dogs don't get ulcers, they give them.
Largely A myth. People at the top usually have
more control. It's middle management often
stuck with high demands but low autonomy.
(32:35):
Responsibility without control, they're at higher risk.
It all comes down to meaning, doesn't it?
How you frame the situation? Totally. 25 shocks an hour could
be good news or bad news depending on the context.
Pain can be welcomed if it meansa treatment is working.
The story you tell yourself matters.
But fake control isn't always helpful.
It can backfire. Crucial distinction.
It helps for manageable stuff, reinforcing agency.
(32:58):
Glad I did X. But for truly awful
uncontrollable events it leads to self blame which is
incredibly damaging. You shouldn't feel responsible
for the uncontrollable. Which connects to John Henry
ISM. Yeah, that belief that you can
conquer anything just by workinghard enough.
Admirable, but dangerous. When facing systemic issues like
poverty or discrimination, or just sheer bad luck leads to
(33:20):
burnout and despair. You have that strong internal
locus of control, but reality keeps blocking you.
We really do filter the world through different psychological
lenses. And those filters shape our
biology, which brings us to depression.
Major depression. Sapolsky defines it.
Not just a sadness, but that profound loss of pleasure.
Right. Anadonia can appreciate sunsets.
(33:42):
Exactly. Cognitive therapist like Aaron
Beck see it as a disorder of thought.
Depressives literally see the world through dark tinted
glasses. Remembering the funeral scene,
not the feast scene. Always half empty.
And physiologically, they often have high glucocorticoid levels,
which makes sense if you see thedepressive not as passive but as
fighting this immense internal battle.
(34:03):
A tightly coiled spool of wire, tense, straining, but all
inside. That explains the exhaustion,
the hormone levels. Right, and there are different
types. Unipolar.
Just the lows. Bipolar, the wild swings between
depression and mania. Like the woman buying 3
Cadillacs she couldn't drive. That's mania.
Extreme example, but yes. Yeah, total disinhibition and
(34:23):
the rhythm of some depressions like SAD linked to seasons.
Rhythmicity screams biology. It's not just psychological.
No. And the neurochemistry, first it
was 2 little neurotransmitter, serotonin, noremaphrin.
That's what early drugs targeted.
SSRI is boosting serotonin. Right.
But then the revisionist theory,maybe those receptors become
(34:46):
less sensitive flooded. So it's about amount and
sensitivity more complex. The cortex plays a role to that
cingulotomy procedure. Targeting the anterior singular
cortex ACC, which deals with theemotional aspect of pain, the
feelings about the pain. It's often overactive and
depressive and. Their amygdala reacts more to
sad faces, not fearful ones. Another sign of shifted
(35:06):
emotional processing. And crucially, evidence now
suggests stress and high glucocorticoids can cause
depression, not just result fromit.
To depression, that's huge. It is, Freud talked about grief
turning into depression via ambivalence and aggression
turned inward and internal battle.
And Seligman's learned helplessness.
Rats giving up after uncontrollable stress A.
(35:28):
Powerful model they learned. Nothing I do matters.
Ever. Depressed humans often over
generalize like that from 1 bad experience, feeling hopeless
about everything. And early life stress makes you
more vulnerable lifelong higher CRH levels allostatic load.
Exactly since you up at that rent of vulnerability, but the
body is built for recovery. How so?
(35:50):
Even as stress depletes something like noropine frying,
it simultaneously triggers its production.
We have built in rebound mechanisms, which is why most
people recover from acute stress.
But some don't. Why the difference?
Genetics play a role. Seems likely that Gene Z, the
serotonin transporter Gene 5 HTT1 version, combined with major
stress significantly increases depression risk.
(36:13):
And guess what regulates that gene's production?
Let me guess, glucocorticoids? Bingo.
A direct link. Stress hormones.
Gene expression vulnerability. Wow, OK, so after all this, how
do we live with stress? Sapolsky talks about us
inventing weird sources of pleasure and pain.
Yeah, Westernize humans especially compare the loudest
sound a medieval peasant might hear.
(36:34):
A cathedral organ maybe. Awe inspiring with the constant
assault of noise we experience. Or compare finding rare wild
honey back then. With the hundreds of engineer
junk foods hitting our dopamine systems way harder, way more
often than anything natural. What's the consequence of this
constant intense stimulation? We get used to it.
(36:54):
Habituation. We stop noticing the simple
quiet pleasures. Autumn leaves a kind glance, and
we need bigger, faster hits to feel anything.
Now isn't as good as it used to be.
We're always chasing. Sadly, yes.
And hostility. Remember that Redford Williams
work. Right.
Cynical hostility, not just being busy.
Type A is the real heart risk factor.
(37:15):
Huge factor linked to heart disease, stroke, higher
mortality across the. Board and dopamine.
It's not just about the pleasureof the reward.
Less about the reward itself, more about the anticipation.
Schultz's studies the dopamine spikes before the reward comes.
When you know the rules and expect it, this is going to be
great. Fueling the pursuit.
Exactly, Philip showed the bursthappened just before the action.
(37:38):
Pleasure is often more in the appetite, the chase, especially
if there's some uncertainty about getting the reward.
Like the difference between early relationship, passion,
dopamine fueled and dissipation and later comfort different
brain areas. Perfect example, edgy excitement
versus warm security. Both good but different
neurochemistry. And stress and addiction.
(37:59):
What's the link? Simple grim punchline.
Stress makes you use more and relapse more easily.
Especially unpredictable stress or being low status.
Both increase risk. Why?
Acute stress boosts dopamine itself so the drugs effect which
might be mild, normally feels cosmic under stress making you
crave it more. A biochemical trap?
(38:20):
So philosophically, we're smart enough to invent stress, foolish
enough to let it rule us. That's Sapolsky's gentle
critique. He shares that funny line about
God finding Monday suffered frombipolar disorder.
And that Monopoly sermon anecdote about the pieces just
going back in the box. So powerful, a reminder of what
truly matters, beyond the accumulation, the winning.
(38:40):
It's about the game, the connection.
Like the tickling machine, you can't tickle yourself because
there's no surprise predictability kills the
sensation. Exactly.
We need that element of the unexpected.
So, practical wisdom. The 8020 rule for stress
management. Meaning, focus on the stuff that
gives the biggest bang for your buck.
Kind of, but his main point is simpler.
Don't get crazed searching for the perfect technique.
(39:03):
Just pick something and do it. It doesn't matter what
management technique you use, just do it daily.
The commitment, the consistency,That's 80% of the battle
prioritizing it. Like the Serenity Prayer, accept
what you can't change, change what you can.
Know the difference? Yes, and that Quaker analogy.
Be grass in the wind. Be wind against the wall.
(39:24):
Cognitive flexibility. Adapt your strategy.
And finally, his really strong stance against blaming the
victim. Absolutely crucial.
He rails against the idea that incurable disease is the
patient's fault or due to a lackof love.
He calls that viewpoint negligent and cruel.
Stress can make you sick, but exaggerating that is harmful.
We can't just think ourselves well from everything.
(39:45):
Exactly, it's a nuanced balance.Stress influences biology, yes,
but you can't understand illnesswithout understanding the person
who is ill, their life, their psychology.
Reconciling biology and the mind.
Body connection. Beautifully, he ends with
Virtua's 19th century vision. Medicine is a social science and
(40:06):
politics. Nothing but medicine on a large
scale seeing the bigger picture.A vision that feels kind of lost
sometimes today. Sadly, yes.
So wrapping up this deep dive. So Polsky's book is just
incredible, a shortcut to understanding this complex
interplay of stress, biology andpsychology.
It really connects the dots between the science and our
(40:27):
everyday lives. So as we finish, here's that
final thought to Mull over straight from the book score
message. The Physiology of the system is
often no more decisive than the psychology.
We humans, especially in our privileged lives, are uniquely
be smart enough to have inventedthese stressors, and uniquely
foolish enough to have let them too often dominate our lives.
But the hope, the potential, is that we can also be uniquely
(40:48):
wise enough to banish their stressful hold.
So think about it. Control, predictability, social
support, perspective. How can you use these
psychological filters as wisdom in your life?
How can you shift from just surviving the stress to maybe
even thriving despite it? Something to reflect on.
That's all for this deep dive. We hope you feel maybe a little
(41:10):
less stressed, definitely more informed, and perhaps ready to
manage those stressors with a bit more wisdom and resilience.
Until next time.
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