Aditi Nerurkar

I was a medical resident working 80 hours a week in the hospital, seeing death and dying on a daily basis. As part of my training, it was a really rigorous and robust program. And one particular month I was in the cardiac ICU taking care of all of my patients' hearts, not really thinking about my own.

After a particularly brutal call, I did 30 hours in the hospital, as is typically done when you are a medical resident, and I developed a stampede of wild horses across my chest, that's how it felt. It knocked the wind out of me. Immediately I sat down, the nurse I was working with gave me some orange juice, and it went away. The sensation evaporated within seconds. We both laughed it off, and then I kept working.

That sensation never again happened in the hospital. But night after night for weeks, Whitney, I experienced that stampede of wild horses. And then I was very nervous. And so I went to go see my doctor like a good patient should. And my doctor did the million dollar workup, tested my blood, heart, doing an EKG, a heart ultrasound, echocardiogram. Everything checked out fine. And my doctor with a big reassuring smile said, hey, everything's great.

It's just stress. Try to relax. We've all been there. Medical training is tough. So I went home and I did what you're supposed to do when you hear your doctor say, just relax. I watched movies. I had a spa day, retail therapy, spent time with friends, went out to dinners. Nothing really seemed to help. And only when I put my scientist hat on, because as a medical trainee, I had access to lots of studies and data.

I put on my scientist hat and figured out what is stress? How does it affect my brain and my body? Because honestly, Whitney, my first reaction when my doctor said it's stress, I thought stress doesn't happen to people like me. I'm resilient. I was living the resilience myth. We can talk a little bit about that because in my medical training I was taught that pressure makes diamonds and I was a diamond in the making. And then my diamond cracked. And so I read everything under the sun at that time and have continued to stay up to date on all the literature.

To figure out how stress affects the brain and the body. I found my way out of stress, my own stress struggle. And when I found my way out is when I vowed to become the doctor I needed during that difficult time. So that when a patient would come to me and say I'm stressed and I would do the medical workup, my response wouldn't be, ah, it's just stress. Go home and try to relax. So my work really focuses on bridging that gap and closing that gap.

So I don't have to say to patients, just relax, I can offer them something tangible. And so that's the genesis of my work, my origin, my villain origin story, so to speak, of how I became a doctor with an expertise in stress with my background as a stress patient. Well, I'm sure there are echoes of a lot of things that definitely for me, for a lot of us, of things we might have personally experienced. And I feel like stress is this word that has almost become like a throwaway phrase culturally.

When you use the word, I'm so stressed, or it's been a stressful week, or a stressful year, or in many cases, the stressful five years, right, for most of us. That type of stress that you're describing scientifically is known as maladaptive stress. That's the kind of stress that is dysfunctional, unproductive, and it really gets in the way of your everyday functioning. It's what causes all of the mental and physical health manifestations that you and I and all of us are aware of, you know.

Things like insomnia, anxiety, depression, the list goes on and on. We can talk about that in this conversation, the manifestations of stress. But there is another kind of stress, healthy stress. In scientific terms, this is known as adaptive stress. This kind of stress is productive and motivating and it moves your life forward. In fact,

Kaikki hyvää elämääsi on luotu siksi, että on vähän terveellistä stressiä. Tarkoituksena ei ole elää elämäänsä täysin terveellisellä stressillä. Se ei ole biologisesti mahdollista tehdä sitä, koska esimerkkejä terveellisellä stressillä ovat esimerkkejä kuten tuomio, rakkaus, uusi työsuunnitelma tai uusi kotipalvelu. Ehkä se on yrittäminen suositella suosituksesi suosituksesi suosituksesi suosituksesi suosituksesi suosituksesi suosituksesi suosituksesi suosituksesi suosituksesi

The goal is not a life with zero stress. It is quite literally, biologically impossible to do that. It's to live a life with healthy, manageable stress that can serve you rather than harm you. You talked about some of the signs for you, the wild horses across your chest. What are some of the physical and mental signs that we should be on the lookout for when we are beginning to experience stress? Stress is truly the multi-hyphenate performer.

There are people who have no mental health manifestations of stress and only physical health manifestations of stress. And stress can really impact everything all the way from your head down to your toes. It can, you know, some common manifestations, physical manifestations of stress can include worsening headaches, neck pain, shoulder pain, back pain, abdominal pain or discomfort, dizziness, nausea, weakness, fatigue. And then mental health manifestations, insomnia, anxiety, depression or irritability.

When you have emotional reactivity and you're quick to anger. All of these symptoms could be signs of unhealthy maladaptive stress. But like me, the first thing you want to do is see your doctor, make sure that there isn't a underlying medical condition that is causing these symptoms. And then once you are given the diagnosis of stress, then you can start using some of the strategies that we're going to talk about today.

It's important to note that stress is actually, in medical terms, a diagnosis of exclusion. So just like I shared my own personal story of my doctor doing the full workup, in that way your doctor will also do that full workup. And Whitney, I want to share a really interesting, quite startling statistic with you. In the US, 60 to 80 percent

All visits, all primary care doctor's visits have a stress-related component. And yet only 3% of doctors counsel for stress. So stress is truly the elephant in the exam room. And so a lot of our conversation today will be unpacking a lot of that. Because 60-80% of patients have an underlying stressor that is causing them to come to the doctor and they get the clean bill of health like I did.

called Canary in the Coal Mine. And it is a historical concept. I am not a historian, but it really is appropriate for what happens to your brain and body when you're experiencing that maladaptive stress. So what is the canary in the coal mine? Historically, coal miners would go down into the mines and they would bring a caged bird with them, a canary. And the air would get bad and they'd be toiling, you know, 12, 16 hour days. When the air got bad, the canary would stop singing. And that was sort of the first tell or the first sign of like, wait a second,

We need to come out of the mines. We're not doing well. Why? Because human beings, we are notorious for pushing past our limits and our boundaries. And so my canary, the one, we all have a canary within us. And my canary was singing a song when I experienced the palpitations, that stampede of wild horses. We all have that canary within us. And that was certainly not the first time that I experienced something that was likely initially a hum or a whisper. And then when I wasn't really paying attention to my canary because I was like, I'm a diamond in the making.

Se oli silloin, kun tunti alkoi kehittyä samalla tavalla. Me kaikki olemme kanarien kappaleita, ja se on käsittää kiinnostusta. Joten ajattele, että ensimmäinen asia on rakentaa tietoa. Mikä on tämän kanarien laulaminen sinulle? Onko se yksi näkökulmasta?

mental health manifestations of maladaptive stress? Is it a physical health manifestation of maladaptive stress? There is some sort of metric that you could use, a symptom of like, wait a second, I think this could be stress-related. And so your lived experience is really the best metric of knowing. And then the second step, of course, is to quantify that. So you go to a physician, you get the workup, and if the doctor says, oh, it's likely to be just stress, what we call stress-related condition,

you can do is quantify it and so to manage it you have to measure it and what i like to do is really think about stress i would love for one day the medical system to really embrace stress the way we do with blood pressure where it's a quantified number that we continue to track and monitor and then adjust treatment accordingly i have a free tool on my website where i ask five questions and then you get a personalized stress score and you can use that every four weeks every eight weeks to really track