I was recently watching an incisive, hour-long program on HBO called “One Nation Under Stress.” It is an investigative piece by head physician/journalist at CNN, Sanjay Gupta. The takeaway I perceived was that America is a nation under significant stress. If we were an individual lifeform, we would be said to be ailing, in great danger. I want to briefly take a look at some of the signs and symptoms, and take a glancing blow at some causes of stress, and highlight some of the costs. True to form, I will point out that this is based in part on cultural-political phenomena, primarily. Stress underlies it all. My ultimate point is that this is a shame, because some of the best that we humans can do is to keep our values “in front of us” and focus on what makes life worth living, and not get ulcers and become alcoholics as we focus on the ever-present hum of chronic stress that plagues most of us.
I doubt HBO would mind me sharing liberally from the promo material about the short and sweet program, which of course I recommend. Here is what it’s about:
Despite spending more on healthcare than any other country, America is experiencing decreased life expectancy. In One Nation Under Stress, neurosurgeon and investigative journalist Dr. Sanjay Gupta sets out to discover why. Driven primarily by an epidemic of self-inflicted deaths of despair — from drug overdose, chronic liver disease, and suicide – this rise in the U.S. mortality rate can be seen as a symptom of the toxic, pervasive stress in America today.
Gupta travels across the country, interviewing experts in a wide range of fields, who share their insights on why we’re experiencing so much stress, how it affects the brain, body and behavior, and the long-term consequences for the health of the nation. Along the way, he speaks candidly with Americans struggling with their own stress-related ailments and those who have lost loved ones lost to deaths of despair, particularly in communities facing economic and social instability.
So that is the rough sketch of the problem and of the angle Gupta takes. Here is a dig-down on the conversation Gupta has with renowned (and very busy!) county medical examiner, Cyril Wecht:
Gupta notes that a) liver cirrhosis, b) drug overdose (mainly opioids), and c) suicide “are called deaths of despair, and it seems to be a symptom of an underlying problem – as opposed to the problem itself.”
It is noted that Americans comprise four percent of the world’s population, but consume 80-90 percent of the world’s opioids.
“What we are looking at is an increasingly stressed society,” says forensic pathologist Cyril Wecht, who points to stressors like depersonalization, economic uncertainty, and unstable family units, all of which can be deadly when coupled with self-medication or over-medication of prescription drugs. Gupta notes, “Ultimately, these premature deaths are all a reflection of the stress, the pain that comes with that stress, and the desire to, in some ways, medicate it away, even to the point it could be dangerous and it could end your life.”
Wecht points to a society in which “the stressors become greater and greater – making a living; the ‘roboticization’ of society; families splitting up, etc.” Overprescription of opioids, and in general the idea that Americans love pills is mentioned. Astonishingly, 50 Americans a day die from mistakes or overuse of prescription drugs! Perhaps even more amazing, the United States is not experiencing positive population growth for the last three years. This hasn’t happened since like World War II or an extreme pandemic. These are difficult and dangerous times, despite the “tremendous economy” Trump touts.
Americans are under stress from the police and criminal justice system (see this link), economically (see this link), due to political polarization driven in part by social media (see this link, and this link), and the fraying or rapidly-changing social and cultural milieu (see this link).
Here is a source called “The United States of Stress 2019“. One alarming stat: 47 percent of all respondents — with women and men almost evenly matched — say that their response to stress is to take it out on themselves. We worry about the past, we worry about the future, we worry about our image, and we worry about comfort, success, dominance, and ambiguity. There is virtually no end to how much a person can worry, largely a function of how neurotic they are.
Stress has many physical and psychological costs, side-effects, and downsides. Long ago we stopped facing significant threats from being an animal on the plains of Africa, and we started making causes of stress us in our heads. If you’ve ever seen a chimpanzee or baboon colony, you know what primates are capable of. If you’ve ever learned about a suicide, a murder, mass murder, or some of the findings of social psychology research, you know what humans are capable of.
Chronic stress is damaging to the brain (see link). The neurochemicals that help us cope can exact a horrific cost, including heart attack, the nation’s #1 killer. I am pretty sure that my brain was altered by exposure to childhood stress around family dysfunction, and it’s no small matter. I’m sure I would be less neurotic if I were raised differently. Try being a foster kid, losing a parent to suicide, or being seriously bullied and see what that does to your brain.
If money were the answer, we would be all set. We are almost at zero unemployment (officially), and wages have finally, after decades of lagging, begun to tick up for the average working American (the wealthy have been doing very well financially, especially since they raked in mountains of profit since the 2008 economic meltdown (that was quite preventable). If money were the key to happiness and wellness, the wealthy would be happier and healthier. I think they might be somewhat healthier, not probably because they are brilliant at coping with stress or are living lives the rest of us should truly envy, but because the health outcomes are so poor for the poor and not too much better for the middle class. Certainly, to be black in America is to face greater poverty, chronic illness, and even premature death.
We tend to focus on illness in American medicine, and yet it is more expensive than any other advanced industrial society, and millions of Americans are underinsured or uninsured. It is very easy to see the sway that pharmaceutical companies, medical device makers, physicians, and insurance companies hold over the healthcare situation in this country. In a word, it’s dysfunctional. Special interests have their dirty fingers over everything. Every competing country does it better, for cheaper (with the exception of one of our strengths, which you can see the effect of social class on: the availability of the latest and greatest treatments and devices). Infant mortality? Nope, we suck. End of life care and healthcare dollar rationing? Nope – 50% of healthcare dollars are spent on the dying and the elderly. With baby-boomers aging and with Republicans staying up late at night trying to figure out a way to harm healthcare coverage (being preternaturally opposed to social services and entitlement programs), it’s a recipe for an even greater disaster in the future. And to some degree, we are stuck in the throes of affluenza, as evidenced by the relative wealth of the counties which have a high vaccine noncompliance rate.
VIDEO: Can You Buy Happiness? What is affluenza? This older PBS piece with psychiatrist Michael Stone hits the mark.
Society as a whole is eerily reflective of the situation on the ground in our communities. It’s not as if America as a country behaves with salubrious values, comports itself admirably, and avoids the pitfalls that rich and powerful empires before it have succumbed to. To take one look at Donald Trump and all the damage that he, his Administration, and his policies are doing to the fabric of America and its interests is to witness this phenomenon. Here is how the cultural sensation Doris “Granny D” Haddock describes this:
“Just as an unbalanced mind can accumulate stresses that can grow and take on a life of their own, so little decisions of our modern life can accumulate to the point where our society finds itself bombing other people for their oil, or supporting dictators who torture whole populations — all so that our unbalanced interests might be served.”
Well, I could go on and on. In sum, I would urge us all to calm down. We need to be both purposely mindful of the fact that often, stress is in our minds. I have thought of this before when I consider folks who, facing a major reversal of fortune, sometimes kill themselves. It is surprising, is it not? It seems like one would rather just downshift and live the life of a beach bum in Costa Rica for $15,000 a year than to die. But human beings are marvels at catastrophizing and getting worked up about stuff.
I want to see positive changes occur at the macro level in society; all liberals do. I think it’s also important that we develop good skills and proper ego strength to cope with “the slings and arrows of outrageous fortune.” But at the same time, I have to feel like we should turn off Facebook, defocus from the shoulds and the have-to’s that cage us all mentally. Solve what problems are solvable, and cope with the one’s that are not.
Irrational beliefs underlie some of our stress. It’s an interesting concept. Here is the founder of Rational Emotive Behavior Therapy describing its importance: “No matter how or when a person acquired their irrational beliefs and self-sabotaging habits, they now, in the present, choose to maintain them – and that is why they are disturbed. One’s past history and present life conditions importantly affect one; but they don’t disturb one. A person’s present philosophy is the main contributor of their current disturbance.”
Here is another tip from a prominent psychologist in the form of a quote: “Emotional intelligence encompasses such characteristics as being able to motivate oneself and persist in the face of frustrations; to control impulse and delay gratification; to regulate one’s moods and keep distress from swamping the ability to think, empathize, and hope.”
And this thought on applied psychology as well:
“There are hundreds of peer-reviewed scientific papers offering evidence that mindfulness improves mental and physical wellbeing while also enhancing creativity and decision making. In short, mindfulness is a potent antidote to anxiety, stress, depression, exhaustion, and irritability. Regular meditators are not only happier and more contented, but they are far less likely to suffer from psychological distress as well.”
Last piece of advice, and it gets at character and values and personal growth: “Be kind, for everyone you meet is fighting a hard battle.” ~ Plato
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