The Mental Health Doctor: Your Phone Screen & Sitting Is Destroying Your Brain!

1. 0:00 – 2:01

   Intro

   1. ANDr. Aditi Nerurkar0:00

      You need to hear about this. 72% of people are struggling with stress. 70% have at least one feature of burnout. And we are seeing a rise in mental health problems like we've never seen before.

   2. SBSteven Bartlett0:12

      What's happening?

   3. ANDr. Aditi Nerurkar0:13

      So as a doctor, I can tell you that-

   4. SBSteven Bartlett0:15

      Dr. Aditi Narula is a Harvard physician, nationally recognized stress expert who is- ... understanding and combating modern-day burnout.

   5. ANDr. Aditi Nerurkar0:23

      When I was a medical student working 80 hours a week, I was in my own stress struggle. And it was terrifying, but I couldn't find a doctor who could help. So I became the doctor I needed. I uncovered all of these studies and found a solution that wasn't just try to relax. We are seeing increased rates of depression, sleep disorders, fatigue, or burnout because stress is higher than ever. Studies have shown at least 60 to 80% of patient visits have a stress-related component.

   6. SBSteven Bartlett0:53

      Jesus.

   7. ANDr. Aditi Nerurkar0:54

      It's crazy. And 60% of people with burnout had an inability to disconnect from work and being addicted to work and can't shut off and checking their phone 2,600 times a day. Yes, that is a statistic. So you might be experiencing atypical burnout. Even two-thirds of parents have burnout.

   8. SBSteven Bartlett1:13

      That's crazy.

   9. ANDr. Aditi Nerurkar1:14

      And yet even though we are all collectively experiencing it, it's so isolating that now 330 million people go two weeks before speaking with anyone. So what can we do? Well, these are the five resets that are going to help you survive and thrive. The first technique is...

   10. SBSteven Bartlett1:33

       Quick one. This is really, really fascinating to me. On the backend of our YouTube channel, it says that 69.9% of you that watch this channel frequently over the lifetime of this channel haven't yet hit the subscribe button. I just wanted to ask you a favor. It helps this channel so much if you choose to just subscribe. Helps us scale the guests, helps us scale the production, and it makes the show bigger. So if I could ask you for one favor, if you've watched the show before and you've enjoyed it and you like this episode that you're currently watching, could you please hit the subscribe

2. 2:01 – 6:45

   Is The World Getting More Stressed?

   1. SBSteven Bartlett2:01

      button? Thank you so much. And I will repay that gesture by making sure that everything we do here gets better and better and better and better. That is a promise I'm willing to make you. Do we have a deal? (upbeat music) Dr. Aditi Narula, where does your story begin? And when I say that I'm talking about the story that inspired the work you do on stress, burnout. There tends to be a catalyst moment in the experts that I speak to's lives where something happened which started a chain of events, the first domino that fell, which led them to be sat here. Where does that story begin for you?

   2. ANDr. Aditi Nerurkar2:42

      My origin story as a doctor with an expertise on stress started as a stressed patient who couldn't find a doctor with an expertise in stress. And I became the doctor I needed at a time when I was in my own stress struggle.

   3. SBSteven Bartlett3:00

      What is the backdrop? What is the situation of stress, the state of stress in the world at the moment? Are we getting more stressed as a people?

   4. ANDr. Aditi Nerurkar3:08

      We are seeing unprecedented levels of stress in the world. It is affecting every single industry and no country or group, including, you know, all ages, all industries, all races. It is the great equalizer. More now than ever. So as a physician and clinician, those of us who work in the medical field, stress has always been a major problem. We see it with our patients, but now if there is one silver lining from the recent several years is that now mental health, stress, burnout, the lexicon has grown and it is something that people are talking about finally in the C-suite, in other areas, where before it was, you know, there was so much taboo. There still is, but it is finally getting the recognition it deserves. And stress right now is higher, at greater rates than ever.

   5. SBSteven Bartlett4:08

      What are the, what are those rates?

   6. ANDr. Aditi Nerurkar4:10

      So typically 70% of people have at least one feature of burnout. 72% of people are struggling with stress and approximately that same number have said that the past se- several years have been the most stressful of their entire professional careers.

   7. SBSteven Bartlett4:27

      What's happening?

   8. ANDr. Aditi Nerurkar4:29

      A couple of things are happening. So going back to my own personal stress story. Why did I have those palpitations at night as I was going to bed? I was developing something called a delayed stress reaction. And what happens is under periods of acute stress, like the recent events that we've all endured collectively as a global whole, during acute periods of stress, we shore up our internal reserves. As a human being, you often do not crack in that moment. You keep it together at all costs. I've seen this with my cancer patients. They have a cancer diagnosis and they go through the treatment, radiation, chemotherapy, all of it, and they are fine. They do not shed a tear. Then when they get that first clean bill of health from their doctors, they are in my office sobbing and everyone is confused. "Why now? What's going on now?" Same thing with all of us. You may be feeling this way. I may be too. Right now it's that feeling of like, "Okay, we've just lived through the pandemic. We should be celebrating." I'm sure you've seen every headline over the past several years, at least I did, "The roaring twenties are coming, the post-pandemic era." The Guardian had a great piece on this, and I remember seeing headline upon headline and I would just laugh because I would think, "That is not how the brain works." The reason we are all feeling very much not the roaring twenties is because our brains are built like dams. So what happens is when you are going through a period of stress, you shore up your internal reserves and you keep it together at all costs. That is just how the brain is built.... when that acute period of stress is over, so in a cancer patient, the actual cancer treatment, for me as a medical resident going through, you know, the difficult 30-hour work shift and going to bed, and for all of us collectively, going through the pandemic experience and the various things that have happened since, we keep it together. But when we have that moment of respite, when that acute stressor is over, then our psychological defenses come down and our true emotions can emerge. And it's often a deluge, and it comes out in different ways. The manifestations of stress are different, but it's this delayed stress response. We are all feeling it, which is why none of us feel like it's the Roaring 20s. We are seeing increased rates of mental health

3. 6:45 – 13:56

   What Are the Signs of Being Burnt Out?

   1. ANDr. Aditi Nerurkar6:45

      issues, anxiety, depression, sleep disorders, stress-related disorders, and a general feeling of malaise or fatigue or burnout now even more than we were back in 2020 or 2021. It's the delayed stress reaction.

   2. SBSteven Bartlett7:00

      What is stress? We should probably define that word. And I'd also like to try and define it against the word burnout. Are they different things? Are they the same thing? Do either of them exist?

   3. ANDr. Aditi Nerurkar7:10

      Great question. There is a difference between acute stress and chronic stress. Under normal circumstances, we function in resilient mode, and we are governed by the prefrontal cortex. The prefrontal cortex is the part of our brain, if you put your hand here, right behind the forehead.

   4. SBSteven Bartlett7:29

      Mm-hmm.

   5. ANDr. Aditi Nerurkar7:30

      And it is the part of your brain that is responsible for, in scientific terms, we call it general executive function, or, you know, layman's terms, adulting.

   6. SBSteven Bartlett7:39

      God, mine's huge.

   7. ANDr. Aditi Nerurkar7:41

      (laughs) Behind the skull. (laughs)

   8. SBSteven Bartlett7:44

      (laughs) Okay.

   9. ANDr. Aditi Nerurkar7:44

      Memory, planning, organization, this is what our... Strategic thinking. You're really good at these things, even.

   10. SBSteven Bartlett7:51

       Thank you. Thank you so much. (laughs)

   11. ANDr. Aditi Nerurkar7:51

       The prefrontal cortex-

   12. SBSteven Bartlett7:53

       (laughs)

   13. ANDr. Aditi Nerurkar7:53

       ... is what governs all of that. Under stress, we are governed not by the prefrontal cortex, but by the amygdala. And the amygdala is a tiny, almond-shaped structure deep in our brains. You can't touch it. It's not like the prefrontal cortex right behind here. It's like between your ears, deep down, and that is our emotional center. It's the limbic system. And we often call it the reptilian brain because that part of our brain has not evolved the way other parts of our brain have. So it's that... And the response that, that amygdala creates is the fight or flight response, that stress response in our bodies. So under acute stress, we are not governed by the prefrontal cortex up here. We are governed by our amygdala. Our brains and our bodies are expertly designed to manage acute stress. We are built for managing stress. However, nowadays... So for example, let's talk a little bit about the fight or flight response that the amygdala governs, right? Back when we were all cave people, we were in the forest, we saw a tiger, you would either flee or fight. And there's all of these bodily mechanisms that happen when you are engaged in the fight or flight response. Your heart beats faster. Your lungs start taking in more oxygen. Blood is shunted away from your vital organs and it goes to your muscles, so you can either fight or you can run. Your pupils dilate. There's so many biological, physiological mechanisms that happen with the fight or flight response. Then, when that acute threat is over, so you either have fought or you have flown away from the tiger, you have a moment to recalibrate. Modern day times, there are no acute threats anymore. The- all of our tigers are chronic, bills, financial troubles, marital conflicts or relationship problems, health issues. So there's this constant low hum of that fight or flight response in the distance, and that is the problem. So acute stress, we are good at. Our brains and bodies are great at managing. Chronic-

   14. SBSteven Bartlett9:51

       And it serves a, serves a role, right?

   15. ANDr. Aditi Nerurkar9:52

       Of course it serves a role. It's evolutionarily healthy. And we can talk about the differences between healthy stress and unhealthy stress. But when it starts becoming chronic, that is when burnout sets in. Your brain doesn't get time to rest or recharge. It's not like a tiger in the forest where you fight, flee, and then there's like a respite time. So it's just ongoing, in the, in the background at a low hum at all times.

   16. SBSteven Bartlett10:16

       What are the symptoms of burnout then? How do I know if I'm burnt out?

   17. ANDr. Aditi Nerurkar10:20

       The interesting thing about burnout is that the definition is changing. So earlier, when you think about burnout, you know what someone with burnout has, or you might, yourself might think like, "Oh, I know what burnout is. I don't have it." That's-

   18. SBSteven Bartlett10:34

       Mm-hmm.

   19. ANDr. Aditi Nerurkar10:34

       A lot of people feel this way. Classic, typical symptoms of burnout, apathy, lethargy, feeling unproductive, not very motivated. And the WHO in 2019 designated burnout as an occupational phenomenon and a clinical syndrome, which was really validating for many people who were feeling that way. This is 2019, way before the pandemic. In 2020, 2021, and 2022, what burnout is looking like has changed. So it is no longer these classic typical symptoms. Now we are seeing increasingly atypical features of burnout. In one study, 60% of people with burnout had an inability to disconnect from work as their main feature of burnout. So it's not what you think when you're thinking about the face of burnout of someone who's really not interested in work. You could be that person who is engaged in work and can't shut off and you're thinking to yourself, "This can't be burnout. I'm totally, you know, engaged in work. In fact, I can't shut off my brain." You might be experiencing atypical burnout.

   20. SBSteven Bartlett11:41

       Atypical burnout. 'Cause yeah, when I think of burnout, I think of like, ugh, like not getting out of bed and losing motivation. But you're telling me that my addiction to work might be a symptom and a sign of being burnt out.

   21. ANDr. Aditi Nerurkar11:54

       That's right.

   22. SBSteven Bartlett11:55

       So how do I know? 'Cause I'm addicted to my work. I love my work.

   23. ANDr. Aditi Nerurkar11:58

       You know when you, when it is different from your baseline. Being addicted to work, you love your work-

   24. SBSteven Bartlett12:04

       Mm-hmm.

   25. ANDr. Aditi Nerurkar12:04

       ... yes, but you also make time for sleep-

   26. SBSteven Bartlett12:08

       Yeah.

   27. ANDr. Aditi Nerurkar12:08

       ... relationships and connections with loved ones.

   28. SBSteven Bartlett12:11

       Yeah.

   29. ANDr. Aditi Nerurkar12:12

       You feel a sense of engagement in the world.

   30. SBSteven Bartlett12:14

       Mm-hmm.
4. 13:56 – 16:23

   Work Addiction & Burnout Linked

   1. ANDr. Aditi Nerurkar13:56

      deserve a rest, and to function optimally, you need to have spaciousness. You need y- you know, to function optimally, you need to have rest, and when you feel that sense of burnout, you are not thriving.

   2. SBSteven Bartlett14:12

      What if I don't feel it? What if I'm one of those people that you just ... has said that's, you know, checking my emails 15 times a night. I seem, you know, I be, seem to be successful in my work. I can't ... I'm kind of out of balance in my life. I don't really have anything else going on in my life. I'm just work, work, work, work, work, work, work. But I don't necessarily feel like there's anything wrong. So if I don't feel like there's anything wrong, if I'm successful in my work, then what is the case for making a change?

   3. ANDr. Aditi Nerurkar14:36

      So I've had lots of patients. I had a clinical practice in Boston.

   4. SBSteven Bartlett14:39

      Yeah.

   5. ANDr. Aditi Nerurkar14:39

      And what you're describing is the, you know, young entrepreneur. So many patients who are young entrepreneurs, and the question I would always ask them is, "What's your endgame? So is it a sprint or a marathon? Are you looking to do this for two years and you love it and then that's it, you're gonna cash out? Or do you want to think about what your life is gonna look like 10, 20, 30 years from now?" And so they would think about it, ponder, and then say, "Yeah, I wanna spend time. You know, I ... My endgame is that I wanna lead a great life and I wanna live until I'm 75 or until I'm 100." And so if you are on this fast track that you're describing, you know, burnout is not conducive with this idea of longevity and having that long life.

   6. SBSteven Bartlett15:23

      That's what I was thinking. I was thinking of, uh, case studies that I know of, of people that I think probably check their email 15 times a night and are like that. And tho- those that are out of balance, I think as you say, you can do that intensity, but you can't do it consistently. Like, it's possible to be that intense, but it's not sustainable, and it doesn't allow you to achieve the other things that life can offer you that will make you happy. There's no way of, of being like that and having, like, a healthy f- relationship with your family, building a family, staying in shape, and all those other things. And that, for me, is th- the really clear cost to that is s- you just play it out. Zoom out on your life. In 10 years time, something's gonna be broken.

   7. ANDr. Aditi Nerurkar16:02

      Something's gotta give. You know, we don't have ... I mean, I think that's a good segue into this idea of toxic resilience. It's like, we don't all have, human beings, we don't have an unlimited amount of bandwidth. There is a discrete amount of bandwidth that we all have, mental and physical. And so if you are not getting the proper rest that you need and you're not sleeping as much as you, you

5. 16:23 – 22:29

   Toxic Resilience

   1. ANDr. Aditi Nerurkar16:23

      know, your body and brain need, and it's not about you as in personal, "I don't need sleep. I only need four hours." I've also had many patients who've said that to me. But your brain and your body do physiologically and biologically need a certain amount of rest simply for the cellular function to continue.

   2. SBSteven Bartlett16:39

      But we've got these posters up in our kitchens, you know. Not my kitchen, uh, obviously, but some people have their po- you know, posters up in their house. You know, the "Keep calm, carry on." That's like a hallmark of s- society today is to just tough it out and carry on, and we're praised for that. We're praised for our resiliency. Resilience is a good thing, right?

   3. ANDr. Aditi Nerurkar17:00

      Beautifully said, "Keep calm and carry on." Resilience, the true scientific definition of resilience is our innate biological ability to adapt, recover, and grow in the face of life's challenges. But resilience doesn't function in a vacuum. You need stress for resilience to show itself. Without stress, there can be no resilience. So think of swimming. You ... The swim instructor is the stress saying like, "You can make it to the other side," and your resilience is what keeps your head up as you're swimming while your arms are flailing. And then with time and practice, it gets better. What you're describing, "Keep calm and carry on," is a manifestation of hustle culture, and it ... Our, our entire modern society is built on this idea of toxic resilience. And so what is toxic resilience? You have heard the word resilience over your lifetime, and you had no real, you know, no real ... It had no real charge, right? Like, you would listen to that word, and it would be like, "Okay, fine." And s- over the past several years, specifically 2020, 2021, it was used. It was like a real buzzword at the start of our quarantine, "We're resilient. We're gonna get through this." And it has been misused.And this is because of corporations and large companies said, "You can work more. You're working from home now. Take on an extra project, you're resilient. It doesn't matter that you're doing childcare and working, you're resilient." And so you- you hear these toxic messages all of the time. Resilience went from being something that's true, which is honoring your boundaries, making space and time for rest and to recharge, focusing on a sense of self-compassion, and understanding that you are a human being with limitations. That is true resilience. Toxic resilience is productivity at all costs, a mind over matter mindset, and what many of us think of as true resilience is in fact toxic resilience. We are taught from a very young age that dealing with discomfort and being okay with discomfort is what resilience is all about. And I am here to debunk that, because absolutely not. Resilience is our innate biological ability, but it also needs rest and recovery. It is not meant to be toxic.

   4. SBSteven Bartlett19:17

      But being resilient, is that a good thing in your view? Being a resilient person.

   5. ANDr. Aditi Nerurkar19:21

      Resilient... Being- being a resilient-

   6. SBSteven Bartlett19:23

      Not in the biological context. I mean the psy- just being psychologically resilient.

   7. ANDr. Aditi Nerurkar19:26

      Being resilient is an excellent thing to be. It is something that we can learn how to be better at. And yes, true resilience is wonderful. The challenge right now is that many of us hear the word resilience and we bristle at it. I do. When I hear, you know, the messaging of toxic resilience, no one calls it toxic resilience when they're giving you that messaging. They just say, "Hey, it's resilience." It's cringe worthy, right? Like, you hear it, like, "Oh, be more resilient." And so yes, true resilience is a gift. It is our innate biological ability. We all have the power and the aptitude for true resilience. But toxic resilience is what we often see and what is often promoted, and that is something that needs to stop.

   8. SBSteven Bartlett20:11

      Do you think, uh, people are getting more or less resilient with the nature of the way that the world is? I- I often have the conversation about whether, you know, the boomer generation are more or less resilient than the Gen Z or whatever's coming next. What's next? Is it, like, alpha? I think it's Generation Alpha. These new generations. A- and the argument, the stereotypical argument is that because the boomer generation were working in factories and mines and they were doing harder labor and they had less comparison 'cause they didn't have social media and they didn't see, you know, their mate down the road having a chocofrocolaty yata during their lunch break and doing-

   9. ANDr. Aditi Nerurkar20:47

      (laughs)

   10. SBSteven Bartlett20:47

       ... yoga sessions or whatever, then they are more resilient. And the Gen Zs, they've got it easy. They're all doing like, you know, breath work and yoga for six hours a day. Is- is that true?

   11. ANDr. Aditi Nerurkar21:00

       I would say no, because we know that with Gen Z and other younger populations, we're seeing a rise in mental health, burnout, stress like we've never seen before. And I don't think it's because they're "less resilient." They are managing lots and lots of onslaughts. You know, they've lived through something really awful. They've had a sense of collective trauma. Their minds are still young. They haven't had that lived experience of, you know, decades of going through stuff. So no, I don't think so. And of course, the older generation is going to say that. I remember when I was in my medical training, you know, people would say, "Ugh, 80 hours? That's all you're working? 'Cause we worked 120 hours," 'cause there was some reform in terms of like how many hours we could work as medical residents. And 80 hours felt awful to me. And so I think it's important to validate and normalize people's difficult experience. And it's not about what happened to you. You know, like, so in this example about prior generations, it's about helping people feel a sense of validation, because if you- you need to name it to tame it. And so for example, when you are going through a difficult experience, like a young person, there are- there's such a rise of anxiety, depression, stress-related conditions, sleep disorders, mental health challenges, physical health challenges in the younger population. It's not because they're not resilient. It's because they're living in a hyper-connected world and that is causing all sorts of issues down the road for them, both mental health and physical health.

6. 22:29 – 27:51

   The 5 Resets to Deal with Stress

   1. ANDr. Aditi Nerurkar22:29

      So I reject this idea that the older generation was more resilient. They had less stimulation and they had, you know, different- they had different challenges. But I think it's important to normalize and validate the difficult experience that people are having.

   2. SBSteven Bartlett22:45

      I wanna go through your book now, which is called The Five Resets, which is released January 2024, very exciting, um, which really aims to take on how we deal with stress, how we manage stress. There's sort of shades of neuroplasticity in how we can change our- our responses to stress. But I guess this first question about the canary in the coal mine, why did you write about that? What's that got to do with stress?

   3. ANDr. Aditi Nerurkar23:09

      It has everything to do with stress, because stress is something that is so individualized, and that's something that we were talking about earlier, right? Like, some people who feel a sense of stress have physical manifestations. Like, I had palpitations. You had palpitations. Someone else might have headaches, neck pain, shoulder pain, back pain, GI upset, gastrointestinal issues, dizziness, fatigue, sleep problems, irritability, anger. The list goes on and on. It's- it's, like, never-ending list. And the canary in the coal mine is my way of personally, it's my way of really explaining this idea of the physical manifestations of stress. So my canary in the coal mine was palpitations. Back-

   4. SBSteven Bartlett23:57

      What is- what is that phrase? I've never heard the phrase "the canary in the coal mine." Well, I've heard the phrase before, but I've just kind of been one of those people that pretends they know what it means.

   5. ANDr. Aditi Nerurkar24:04

      (laughs) The canary in the coal mine is a historical reference. Back when there were coal miners, they would bring a canary, a bird, down into the mines with them.... the bird would sing its canary song. When the air got bad, the workers were just working, right? Like 12-hour days and continued to work. When the air got bad, they... The canary would stop singing. They were in their mode. They didn't understand... You know, they weren't paying attention. And when the canary stopped singing, that was the first tell that the air is bad, before any physical or mental health ramifications for the workers. And so the coal miners, when they stopped hearing the canary song, they would leave the mine with the canary, and it was the first tell of something going awry. And so everyone has a canary within them that tells them... A signal, a song that is telling them that there is something happening with their stress. I didn't pay attention to it. It took, uh, the palpitations to occur every single night for two weeks before I sat up and took notice. All of the physical manifestations of stress that I've mentioned, of course you need to see a doctor, like you and I did, got the full workup and been told... Stress is often what we call a diagnosis of exclusion, meaning you rule out any organic problems, and then you say, "Okay, this is because of stress." So seeing your doctor and getting that full workup is important. I have to say that as a medical professional, because I believe in the medical system and I'm part of the medical system. And so the canary in the coal mine is this idea that we all have a song, a stress song, and our body is trying to tell us something. And understanding that canary symptom for you, you know, it takes a little time to dig through, but once you kind of figure it out, then you can use that. We all have our Achilles' heel of something that is the tell. So when... If you have a medical condition like, say, peptic ulcer disease, that's easy to understand. You know, you feel like, "Oh, I have stomach pain and so I can't eat certain foods and I need to take care of myself," and there'll be a flare and then you manage that symptom and it goes away. And, you know, you know what that tell is of peptic ulcer disease, stomach pain. But for stress, often things are happening to your body and you're not even aware of what that physical manifestation is. That's not to say that it's, you know... Your headaches are caused by stress, but they're certainly worsened by stress. So when you have a certain symptom happening to your body, understanding that, "Hey, that could be my canary song."

   6. SBSteven Bartlett26:35

      I think everybody intuitively knows what their canary is. I think everybody knows what theirs is. I've got a bunch of different ones. Um, whenever I'm stressed and you... I- I don't even know when I'm stressed, but... I don't know why, but I don't- I don't know consciously that I'm stressed, but certain things start to happen. I have this really weird one where, on my tongue, I'll get a little bit of like a... not like an ulcer. It kind of feels like I've got a spot on my tongue. I get that whenever I'm stressed. My skin gets worse, so I get, like, spots on my face when I'm stressed. Um, there's a few of them. I- I... I will get a cold pretty much exclusively when I'm stressed, which happens about one time... once every six months or so. I think generally I manage stress well, generally, but I'm not immune. I, once upon a time, thought I was immune. I thought stress and all these other things, men's health, all happened to other people.

   7. ANDr. Aditi Nerurkar27:23

      That's right.

   8. SBSteven Bartlett27:23

      Turns out it happens to me too.

   9. ANDr. Aditi Nerurkar27:25

      That's right.

   10. SBSteven Bartlett27:26

       You know? And I think I really pushed myself (laughs) for a good five, six, seven, 10 year... You know, I was a CEO of a company that had hundreds and hundreds and hundreds of employees, um, and I was 25. 23, 24, 25, 26, 27. So I pushed myself very hard and for... I think for the first couple of years, I withstood it, but then as time went on, you know, I was not able to outrun the inevitable. Um-

   11. ANDr. Aditi Nerurkar27:49

       And that's that resilience myth,

7. 27:51 – 35:10

   Understanding If You Have Stress

   1. ANDr. Aditi Nerurkar27:51

      you know, that like, "Resilient people don't get burned out. It can't be me. Of course, I... Of course, I'm not stressed." I... Someone like me couldn't even fathom being stressed and I have seen thousands of people who have said that very thing. I said the exact same thing during my stress struggle. "Stress? Doesn't happen to people like me."

   2. SBSteven Bartlett28:07

      It's a... You don't want to admit it either because there's a... there's an element of it where you go, "I don't want to be fucking weak. I don't want to be the weak person. If I'm... If I'm experiencing stress or I'm burnt out, then that makes me inadequate in some way. So I don't want to talk about that," you know? But I- I- I think I've been a v- victim of that, like that pride, that ego, especially as like a... as like a man and like a CEO and all of those things that are stereotypically, toxically associated with strength. Um, I've never wanted to admit that I was stressed, ever. I don't think I've ever actually said the word to anybody, but I've definitely been stressed. And I know because my body told me, and it tells me in a very predictable way. That canary stops singing. So I just think that's important because...

   3. ANDr. Aditi Nerurkar28:47

      It's your mind-body connection. And once you see it, you cannot unsee it. It's like gravity. It's all around you, it's working in the background all the time, and then suddenly, you start paying attention and it's like, "Oh, my God."

   4. SBSteven Bartlett28:59

      And on that point of it feeling like evidence of your inadequacy, it's actually evidence that you're a human, that you're-

   5. ANDr. Aditi Nerurkar29:04

      Abso-

   6. SBSteven Bartlett29:04

      ... perfectly normal, that you're... that you're not broken, versus this idea that it's evidence that you're broken. Um-

   7. ANDr. Aditi Nerurkar29:10

      Beautifully said.

   8. SBSteven Bartlett29:12

      Thank you.

   9. ANDr. Aditi Nerurkar29:13

      Really, just beautifully s-

   10. SBSteven Bartlett29:14

       Have you listened to this podcast before? I'm joking. (laughs)

   11. ANDr. Aditi Nerurkar29:16

       I am-

   12. SBSteven Bartlett29:17

       I'm joking.

   13. NANarrator29:17

       (laughs)

   14. ANDr. Aditi Nerurkar29:18

       For the record, testing, testing, one, two, three.

   15. SBSteven Bartlett29:21

       (laughs)

   16. ANDr. Aditi Nerurkar29:21

       I am a avid fan of this podcast and I have listened countless times. And I... This is the one podcast I regularly listen to on my morning walks. And I have shared-

   17. SBSteven Bartlett29:34

       Wow.

   18. ANDr. Aditi Nerurkar29:34

       ... on Instagram probably hundreds of lessons in my stories about what I've learned on this podcast.

   19. SBSteven Bartlett29:42

       Thank you. So st- stress on the brain. You write about that in your book as well. I know that stress causes cortisol. This is my very li- limited understanding of stress. It causes corti- cortisol. Talk me through that, and then I have this other question that I wanted to ask you about the contagion of stress. If I am stressed and Jack is over there, will Jack feel my stress?

   20. ANDr. Aditi Nerurkar30:07

       So let's talk about stress and the main highway of stress in the brain and the body. It is the HPA axis. H stands for hypothalamus, P stands for pituitary gland, A stands for the adrenal glands. The hypothalamic pituitary adrenal axis, mouthful, but the H and P part of the axis is in your brain. And the A part of the axis is above your kidneys, the adrenal glands. And that is the information highway that is responsible for our stress response. It's all of the things that we talked about, the fight or flight response. It makes our heart beat, it makes... you know, it does all sorts of stuff. The amygdala works in that HPA axis as well, and other parts of the brain, the prefrontal cortex, etc. So when you've had that experience of stress, and this, we're talking about acute stress, this is what is happening to you. Your brain and your body are syncing up and reacting. There's a cascade of hormones that happens in the body, and that is what you feel as, "Wow, I'm stressed," or like you described, this discomfort or familiar feeling of like, "Wait a second. I know what this is. It's that thing that I have when I'm under pressure or under situations that are tense." And that is the stress response, and that is essentially what is happening to our bodies when we are feeling that fight or flight syndrome. Unfortunately, what often happens with the amygdala is that while it is helping with this fight or flight syndrome and the HPA axis, it, with chronic stress, does not shut off, and that is the problem.

   21. SBSteven Bartlett31:49

       So those hormones are just flowing through that high- highway all the time?

   22. ANDr. Aditi Nerurkar31:53

       Yes. And cortisol is our stress hormone, and it's all part of that as well because cortisol surges during, you know, adrenaline, noradrenaline, all of these hormones are working through our bodies and surging through our bloodstream. Cortisol is also a stress hormone. And so when we have chronically elevated levels of cortisol, all sorts of badness can happen.

   23. SBSteven Bartlett32:15

       Is stress contagious? 'Cause I- I was on, I was on Google and I ty- typed in, "Is stress contagious?" and it says that in a workplace, stress is contagious.

   24. ANDr. Aditi Nerurkar32:23

       Stress is not contagious in the way that you think of a virus or microbes are contagious, as far as I am aware. Now, there might be emerging data to suggest otherwise, but it is not like a microbe where like it's going to spread, like the, a virus that it's gonna spread from me to you, for example. But, you know-

   25. SBSteven Bartlett32:43

       'Cause there are hormones, aren't there, that spread like pheromones? Is it pheromones?

   26. ANDr. Aditi Nerurkar32:46

       Pheromones, but that's different. That's like, you know, that's more for like, like attraction, sex, and other things like charisma, etc. What is kind of contagious, and I wanna use that word loosely, is like emotions. So yes, creating a toxic environment, right? Like we call it in pop culture like a vibe, like, "That person just didn't have a good vibe." What's really interesting, and there... it's anecdotal. There isn't a ton of research to support this, but I find this fascinating, that the heart has a electromagnetic field that extends 15 feet. That's something that one of my early mentors had told me. And so that is that vibe that you sense from people, like you feel that goodness, right? Like when you meet someone that you just really like their heart, you know? It's like heart expansiveness-

   27. SBSteven Bartlett33:40

       So we're-

   28. ANDr. Aditi Nerurkar33:40

       ... and other people.

   29. SBSteven Bartlett33:41

       We're five feet away from each other. So your heart, its electromagnetic field is overlapping with my heart's electromagnetic field right now?

   30. ANDr. Aditi Nerurkar33:52

       So they say. Now, I've heard this in lots of, you know, lots of people say this, but I have also dug deep into the science of like, "Does this even exist? Is that a... Is this even a real thing?" And I'm not sure if it's a real thing, because I haven't found like multiple scientific studies that show robust data that, yes, this is a real thing. But it is a fascinating thing to think about as a mind exercise, not so much from the scientific perspective, but like from a human lived experience perspective of, you know... And I try to think about that when I enter a room, certainly when I'm with a patient. We call it the therapeutic presence or the therapeutic encounter, and it's this idea that when you are with a patient, or right now, I'm talking to you and I am the doctor talking to you, right? Not your doctor, of course, but it's this idea that you have, that you could have a therapeutic experience. I try to engage in the therapeutic encounter at every talk anytime I'm speaking to an audience. I want people to leave feeling a sense of healing. Healing and cure are two different things, by the way. So I'm not saying like, um, you know, we're gonna talk and then it's like, "You're gonna be cured of whatever illness you have." (laughs)
8. 35:10 – 43:06

   How to Have a Therapeutic Presence

   1. ANDr. Aditi Nerurkar35:10

      behind the therapeutic encounter, and what that simply means is that doctors who have that sense of therapeutic presence, you know exactly what I mean. You might not call it that. And then you also have had lots of doctors who've had no therapeutic presence, and you know what that feels like too.

   2. SBSteven Bartlett35:27

      How does one get a therapeutic presence?

   3. ANDr. Aditi Nerurkar35:29

      It's something that needs to be cultivated. Of course, it's something that, you know, you can have, but then you cultivate it with training and practice, etc. But the therapeutic presence, that therapeutic encounter, has been shown to actually have health outcomes. So greater adherence, you know, to medication, tighter glucose control, decreased asthma flares, like real concrete health outcomes when you have a therapeutic encounter with... in that doctor-patient relationship.

   4. SBSteven Bartlett35:58

      So-

   5. ANDr. Aditi Nerurkar35:59

      So there is some magic secret sauce happening in that encounter. What is it?

   6. SBSteven Bartlett36:03

      How, how do I cultivate it? Are there any tricks? Any, any tips, tricks? Is there like a body language thing, maybe? I don't know.

   7. ANDr. Aditi Nerurkar36:10

      Yes. So as a doctor, I can tell you that-There is lots of studies, there are lots of studies which show that it's not really the amount of time you spend with someone, it's your body. And so, for example, they've been, they've done studies on doctors who stand for, let's say, seven minutes and talk to the patient, versus a doctor who sits down, makes eye contact, and is at the same level or a lower level than the patient. The patient has a perceived sense that this doctor cares more and is more engaged and has a therapeutic presence. No difference in time. I think that's the great myth that people say, you know, "Oh, I need to spend more time to create a therapeutic presence." It's not about the time spent. It's about how you are spending the time and the quality of time. So that's, like, one trick-

   8. SBSteven Bartlett36:57

      What about-

   9. ANDr. Aditi Nerurkar36:58

      ... that you could try.

   10. SBSteven Bartlett36:58

       Eye level, you mentioned eye level there.

   11. ANDr. Aditi Nerurkar37:00

       Being at the same eye level or lower because it's a power dynamic. Think about when you're seeing, if you were in the hospital and you were lying in a hospital bed and your doctor came in and you're lying there and the doctor is speaking above you. Does that feel therapeutic in any way? Not really. But if the doctor came, pulled up a chair, sat next to you, and looked at you eye level. That's why when you're talking to a child, it's better to bend down and make, you know, get on their level and talk to them.

   12. SBSteven Bartlett37:26

       And if I'm in a meeting and my chair is maybe a little bit higher and I'm speaking to a client and I want the client to do a deal with me, it's best for me to get down to their eye level?

   13. ANDr. Aditi Nerurkar37:35

       I- it depends because in that situation, you know, again, this is like what you were talking about earlier, like, there's times when you want to show a sense of, like, power and therapeutic presence is not a sense of power, right? It's a sense of equality, compassion, empathy. Are these the qualities that you're trying to create in a business interaction? I don't know, maybe-

   14. SBSteven Bartlett37:56

       Well, one of the things-

   15. ANDr. Aditi Nerurkar37:56

       ... but maybe not.

   16. SBSteven Bartlett37:56

       ... we've learned from, I don't know, I've been making content for about 10, 15 years now, for a long time, making lots of videos. One of the things we've learned is that the engagement goes significantly up if you are on the eye line of the camera.

   17. ANDr. Aditi Nerurkar38:08

       Yes.

   18. SBSteven Bartlett38:08

       So you'll notice in the Diary of a CEO, w- we don't shoot from above, we don't shoot from below. We go to great lengths to make sure that the camera is, is on eye line and we just see that the engagement numbers are higher. And actually, the more down the barrel it is, especially so if I'm looking into this camera here, the more down the barrel and the more on eye line I am, the better the engagement with the video. We've just seen that o- over thousands and thousands of videos we've made. So that's why the, the podcast is set up like this, where there's-

   19. ANDr. Aditi Nerurkar38:32

       I love it.

   20. SBSteven Bartlett38:32

       ... we're, we're on your eye line and we're on down the barrel as much as we possibly can be without you seeing too much of the back of my head there. And the same applies for this one 'cause it just makes, for some reason, the engagement with the audience is better. We see it in the numbers. It's interesting.

   21. ANDr. Aditi Nerurkar38:45

       And there's so many tricks that you could use. I mean, like, sitting down, eye level is one. Um, mirroring, also something else. This is not related to stress, but it's like mirroring. So, for example, as I'm talking to you, as you're talking, if I do this. If I do this, and then you're like, "Oh, this person is, like, totally following me."

   22. SBSteven Bartlett39:05

       Now, I think you've lost your mind. (laughs)

   23. ANDr. Aditi Nerurkar39:07

       You know? (laughs) But it's like-

   24. SBSteven Bartlett39:08

       I started flapping my arms, by the way.

   25. ANDr. Aditi Nerurkar39:08

       ... if I start doing this, you just did this, and so I did this. So there's, like, mirroring is something that you, you know, there's lots of ways to try that. But again, it has to feel-

   26. SBSteven Bartlett39:16

       Is that supported by science?

   27. ANDr. Aditi Nerurkar39:17

       Yes. It, the, the key is authenticity though, right? Like, you can do all of these things, but ultimately, authenticity and the human, the really fascinating thing about podcasting, by the way, and any sort of connection with another human being, is the voice. So we as children, as infants, we are highly attuned to voice. It's one of our first primal instincts, right? Like hearing our mother's voice or our caregiver's voice or our parent's voice. And we can, our BS meter with voice is high. So if someone isn't authentic, and that is why the audio version, like so listening to a podcast, the reason, like, you can always suss out, like, who is, uh, for example, I don't know, like, who's telling the truth and who's not. And it's not, like, something that you can explain. You just, like, you're like, "Oh, I don't really like this person," or, "I really like this person." It's because they lead with authenticity, vulnerability, all of these things that, you know, the likability factor is high. It's because our brains are primed to recognize and register the human voice in a way that's very different from the physical. So yes, we, of course, like, we see someone and you get the whole picture, yes. But when you hear them in your ear, there's, like, something that is deeply intimate about that experience and that, you know, evolutionarily, and even, like, in our own life, it's, um, very poignant.

   28. SBSteven Bartlett40:48

       And it's an intuitive thing. We don't necessarily know what it is about a voice-

   29. ANDr. Aditi Nerurkar40:51

       That's right.

   30. SBSteven Bartlett40:51

       ... that's authentic. It's just a feeling that you have.
9. 43:06 – 48:29

   Why You Should Stick to 2 Changes at a Time

   1. ANDr. Aditi Nerurkar43:06

      studies about comfort and maternal comfort and, um, self-soothing or soothing with your parent or caregiver. But most of the pheromone research that I am aware of is, um, like sexuality, attractiveness, charisma, um, but mostly due to mating behavior.

   2. SBSteven Bartlett43:22

      Um, so going back to this subject of stress. I get stressed now. I kind of understand the difference between acute stress and sort of chronic stress, which is a very bad thing. In your book, you talk about the resilience rule of two.

   3. ANDr. Aditi Nerurkar43:36

      Yes. The resilience rule of two is how our brains make change possible. So, when we are undergoing a change, even a positive change in our life, like, let's say, you know, I've had a patient who came to see me and had a binder filled of things that he was trying. And it was like the kitch- everything but the kitchen sink approach. And so he came to see me and was like, "Doc, I've been doing a great job. It's been a month, and now I'm in month two and I don't wanna do any of it. And I'm done." And he was under a lot of stress and he was trying all sorts of things. We've all been there. We've tried lots of different things. And then you just say, "Okay, I'm done. Can't do any of it." Why? Our brains, even when we're making positive changes, like let's say you recognize, like, "Yeah, I think stress is a problem in my life. I'm gonna make a change. I'm going to start eating better and I'm gonna start exercising and sleeping better, and I'm gonna spend time with friends and I'm gonna do less work, and I'm gonna do all of these things to help my life and, you know, make a big lifestyle overhaul, and I'm really stressed." It will not last because our brains have the ability to make two new changes at a time. Because even positive change, like all of these things that we're describing right now, are a stressor to your brain.

   4. SBSteven Bartlett44:53

      How do we know that? How do we know we can only make two changes at once?

   5. ANDr. Aditi Nerurkar44:56

      The basis of the rule of two is based on a seminal landmark study in the 1960s by two psychiatrists, Doctors Holmes and Rahe. They looked at 5,000 people and looked at 43 common conditions, like life events that happen in people's lives, the most common ones. Graduation, getting a new job, buying your first home, a outstanding personal achievement, getting married, having a child, getting a divorce, death of a loved one. 43 of the most common conditions. And when in every single condition, good and bad, got a score. They studied 5,000 people and found that the more life events someone accrued, and it's not about, like, age or, you know, chronology of age, it's just the more life events a person accrued, the greater their stress. The greater the likelihood also that they would develop an illness later in life. And that Holmes and Rahe study is the basis of this rule of two, because what they discovered is that positive life changes are also a stress to your brain and your body. And that is because there is a certain level of adapting. You know, there's a certain level of human adaptation that needs to happen with something positive and fantastic that happens in your life to regain the stability that you had before. Think about your own life. There are probably so many examples. I recently moved into a new home. Everyone was like, "Congratulations, this is amazing, a new home." And it was wonderful for a few months and then, like, also incredibly stressful. And then, of course, I had the delayed stress reaction three months later, right? Like, where you're running on adrenaline initially and everything is great, and then, uh, that stops and then you're, you know, having sleepless nights about all the various stressors. So the rule of two is based on this idea that positive life events, things that you think might be really helpful to you to manage your stress, if you do them all at once, chances are it's not going to stick. So instead, aim to do two new things at a time, build them into your life over time. In The Five Resets, I offer five mindset shifts, 15 science-backed strategies, and every step of the way, it's about two small changes at a time. You work with your biology of stress rather than against it and competing against it. That is how you make change possible. In clinical practice, when I was a medical resident learning how to take care of patients, my mentors would do the same thing. So this is 50 years later after that study. They taugh- taught me that when I'm seeing a patient, you know, a patient will come in with a laundry list of symptoms or they will have six, seven, eight medical conditions. You always focus on two things, because if you say to the patient, "I really think you should stop smoking. Here's some suggestions. Let's work on your weight and get your weight better. Let's work on your cholesterol. How about your blood pressure? How about minimizing chances of cancer?" Too overwhelming for the brain to sustain. Instead, let's focus on getting you to stop smoking and let's focus on lowering your cholesterol. These are two tangible things that you can work on. It takes about eight weeks to build a habit. Once you are engaged and that has become a habit for you, then you add two new things.Let eight weeks go by, then two new things. So over time, you do address that laundry list of symptoms, or in this patient's case, you know, all eight medical

10. 48:29 – 53:50

    Your Stress Score and How to Improve It

    1. ANDr. Aditi Nerurkar48:29

       diagnoses. In the other patient's case who came in with everything but the kitchen sink approach to managing his stress, we eventually did get all the way to the finish line of fixing his stress and addressing all of the issues. But it only happens two small, incremental steps at a time.

    2. SBSteven Bartlett48:45

       The five resets. The first of those resets is to get clear on what matters the most.

    3. ANDr. Aditi Nerurkar48:50

       When you are feeling a sense of stress, you are living in survival mode. You are governed by your amygdala. Its focus is self-preservation. You are literally living in the moment. Your prefrontal cortex is the area of your brain that, like we said, behind the forehead, that governs forward thinking, planning, organization. When you tell someone who is deeply stressed and in a crisis or fight-or-flight mode, "Oh, just figure it out. You know, make a plan. Figure out what's gonna help you and just do it. Mind over matter." None of that helps. It is also biologically impossible to think five, ten steps ahead when you are living in fight-or-flight mode, governed by your amygdala. The first reset, "Get clear on what matters most," offers three concrete, science-backed strategies that can help you when you are feeling a sense of stress and you're in fight-or-flight mode to help get out of your own way, create a roadmap and a plan forward. So it actively, through going the, go- by going through these strategies, you slowly get out of that amygdala mode and back to letting your prefrontal cortex take over.

    4. SBSteven Bartlett50:10

       So how do I figure out what matters to me most? Is there a system?

    5. ANDr. Aditi Nerurkar50:12

       Yes. MOST is an acronym. M-O-S-T. And the book has a whole strategy of how to figure out what matters to you most, because it's not so much, "What's the matter with me?" It's, "What matters to me most?" So when you shift that framework and stop blaming yourself and criticizing yourself of like, this, you know, "What's the matter with me? Why do I feel like this?" Instead, have an external why. We know that when you have a why, you can get through things, right? Like you have a North Star of like how do you want to get to that place. And so my job is to hold up a mirror and say, "This is your why," because you've fi- you've figured it out using the strategies. The first reset will c- get you a clear plan and roadmap to that destination.

    6. SBSteven Bartlett51:03

       So I'm gonna do the first reset. Um, so you have a stress score that you, uh, sort of initially do with your patients, right? So you figure out how stressed they are.

    7. ANDr. Aditi Nerurkar51:11

       That's right.

    8. SBSteven Bartlett51:12

       There are some questions, I think, in the book, which I'll put up on the screen for anyone that's watching the video. These are questions you ask your patient to help them figure out their stress score.

    9. ANDr. Aditi Nerurkar51:19

       Yes.

    10. SBSteven Bartlett51:20

        And then the first reset is really figuring out what matters to them, which is the acronym you're talking about, MOST, motivating, objective, small, and timely. That's like a... What am I doing with that? So I'm setting myself a, a goal.

    11. ANDr. Aditi Nerurkar51:33

        Yes.

    12. SBSteven Bartlett51:33

        Or understanding what matters, what goals matter to me. And I want those goals to be motivating, objective, which means, um, can you objectively and easily monitor this goal's progress? Small, is the goal small enough to guarantee success? And timely, is the goal time-sensitive? Can you achieve it in the next three months?

    13. ANDr. Aditi Nerurkar51:52

        I've had so many patients, when I was seeing patients in Boston, I have had so many patients who have been stressed, and they want to feel better, but they don't know why. Because they are consumed with what's mat- "What's the matter with me? What's the matter with me?" rather than "What matters most to me?" And so this is a way to reframe that internal dialogue and the conversation to what matters most to you. And so you figure out what your MOST goal is, and there are many examples throughout the book. The book is filled with patient stories, real life people who've had lots of different experiences, and they're examples of MOST goals. You know, some MOST goals have been, "I want to throw... I wanna teach my grandson how to throw a baseball." "I wanna go this summer on a hike and my knees not hurt."

    14. SBSteven Bartlett52:41

        How does that help me with my stress?

    15. ANDr. Aditi Nerurkar52:43

        Because you have something to look forward to.

    16. SBSteven Bartlett52:45

        Okay.

    17. ANDr. Aditi Nerurkar52:45

        And-

    18. SBSteven Bartlett52:45

        It takes me out of the present moment.

    19. ANDr. Aditi Nerurkar52:47

        And it also gives you something measurable. You know, when we... Stress can often feel like this vague, nebulous thing that's happening to us, right? But we need a metric to measure our progress, and the book is filled with metrics. And so the MOST goal is your first sort of like North Star of this is where you want to go. And then there are various other strategies throughout the book of like how to get there and what to measure. We do this with, I don't know, we do this with every single... We do this with blood pressure. We check to see like if you have high blood pressure. We check, like, "Oh, your blood pressure's getting better with these interventions." But we don't do anything when it comes to stress. We just say like, "Are you feeling better? Yes or no?" And stress is not a yes or no question. There are degrees and shades of stress in there. So you need a quantifiable metric to say, "Yes, my stress is getting better." Why? "Because I wanted to walk 20 blocks, and guess what? I could walk zero blocks when I started with you, but now I can walk five blocks," and that is good. So whatever that

11. 53:50 – 58:01

    How Exercise Manages to Reduce Stress

    1. ANDr. Aditi Nerurkar53:50

       goal is for you of like you're feeling a lot of stress because you've had a medical issue or, you know, whatever that MOST goal to you is, finding that goalpost to say like, "Okay, that's my destination and this is where I am today," and then finding a way to get there.

    2. SBSteven Bartlett54:04

       In, um, this, this team here, there's about 30 of us at the Diary of a CEO, and we, we have a group inside the company which is about exercise and fitness. And we do that because, uh, m- so many members of the team love to exercise. I mean, even the team here in New York City, they went out for a long run, all of them together, um, in the morning. And I think, you know, we do that because we have goals for fitness and we like exercise, whatever else. What is the evidence that shows exercise helps with stress management?What is the research?

    3. ANDr. Aditi Nerurkar54:32

       Reams of research on exercise helping with stress. And the real misconception is that you have to do a lot of exercise to manage stress, and that is unequivocally false. Even a little bit of exercise can help because it gets you out of your head and into your body. A few minutes here and there can make all the difference. Park far away when you're driving someplace and you're going to a restaurant, or you're going into a mall, a shopping center. Park far and walk if you can. Build it into your day throughout the day. Take the stairs if you can. It is just small incremental changes over the course of a day. Aim for 20-minute walk. It has lots of health benefits. It gets you out of your head and into your body. It gets you into that daily habit of movement. Initially when you are a sedentary person and lifelong non-exerciser, going into the gym to exercise is, like, a complete deterrent. I remember as a medical resident when I was going through my stress struggle, I had a state-of-the-art gym in my building. I remember being incredibly stressed and, you know, I'm a doctor, I was like, "Oh, yeah, exercise is good for me." I walked into the gym. I saw the mirrors. I saw all of the fancy equipment. The techno music blasting. I walked right out. Walked right out. I then started a walking regimen simply because it was nice out one day and I walked around the block. And then I was like, "Oh, that felt really nice." Next day, I walked around the block and then some. Did a five, ten-minute extra walk. And then the next day it was manageable. It was a low lift. It was easy for me to do. It wasn't like all this complicated equipment. So I walked a little bit more and I just gradually moved up over the course of a week or two to 20 minutes, and then I committed to a 20-minute walk. Over time, my self-efficacy, which is that ability of y- of you to know, like, "Oh, I can do this," it increased and that's what happens when you exercise and you do something like this, something small, a little bit every day. Your sense of self-efficacy increases, so you feel like, "Oh, I can do this," and your inner critic starts silencing, and then I started walking.

    4. SBSteven Bartlett56:35

       People that do that, just the walkers, you know, not the extreme exercisers, just the walkers. You're telling me there's research that shows those people h- have... are less stressed in their lives and more resilient per se?

    5. ANDr. Aditi Nerurkar56:43

       It's not so much that walkers are less stressed. It's that movement, when you go from being sedentary to moving, that the daily physical activity even at low levels can help decrease your stress. So it's not like at-

    6. SBSteven Bartlett57:00

       Why and how?

    7. ANDr. Aditi Nerurkar57:02

       So many reasons. So the first reason is because something like walking is something that's a very natural phenomenon that all of us do. We don't really feel like walking when we are feeling a sense of stress. You just want to be still. But science shows that, you know... You've heard of the expression "sitting is the new smoking." You've heard of that expression?

    8. SBSteven Bartlett57:21

       Yeah.

    9. ANDr. Aditi Nerurkar57:21

       But a s- research study found that sitting can also increase your sense of anxiety. So it's not so much that sitting is the new smoking per se, yes, but it also has a tremendous impact on your actual mental health. And that movement is a antidote to that. So it's not necessarily that you have to do excessive exercise, but even just a simple walk, getting out, low-grade exercise has been shown to help with longevity. It's been ho- it's been shown to help with so many markers of health, just a simple walk. And yes, your team, you know, people who like to run, I'm not

12. 58:01 – 1:03:34

    How Social Media Fuels Stress

    1. ANDr. Aditi Nerurkar58:01

       saying that, like, you don't ha- you ca- you can continue running, but that's someone who is, like, a avid exerciser and so they run. Some people walk. It doesn't really matter what you do, it's that you do something you enjoy a little bit every day.

    2. SBSteven Bartlett58:16

       I want to talk about social media. And in your book, you use this term "popcorn brain" which I... For a second, when I read what popcorn brain meant, started to think maybe I now have a popcorn brain. What is a popcorn brain?

    3. ANDr. Aditi Nerurkar58:31

       Many people, most people have popcorn brain. Popcorn brain is a biological phenomenon, a real biological phenomenon cor- coined by a man named Dr. Levy, a psychologist, and it is essentially your brain circuitry starting to pop based on overstimulation. So it's not like your brain is actually popping, but it's that sensation of popcorning because of spending too much time online. It is hard to disengage from what's happening online because there's a constant information stream, and it is difficult to live fully offline where life moves at a decidedly slower pace. Popcorn brain is an affliction that nearly every single person has right now. Think about what you do when you're waiting in line at the grocery store. You're not just, like, letting your brain wander, pondering things. You are on your phone. What are you doing at the bank? On your phone. At a car wash, at a traffic light. Pedestrians walking across the street, they're not looking up at the light. In fact, it's like one of the hazards, a public health hazard of, you know, pedestrians having near miss accidents because they're looking down on their phone. I see it in Boston all the time, a busy street and people are looking at their phone.

    4. SBSteven Bartlett59:43

       Most people listening now will be, like, on a tube somewhere, on a train, on a plane, looking at their phone. Well, they're listening to this, but...

    5. ANDr. Aditi Nerurkar59:50

       We rarely give our brains a moment of rest. So popcorn brain is different. A lot of people will ask me, "Is popcorn brain internet addiction?" No. Internet addiction is a real... It's called Internet Addiction Disorder. It's a DSM-IV criteria and it means... That's our diagnostic criteria in, um, medicine. And it's a real disorder, but what really defines internet addiction and popcorn brain is that internet addiction interferes with your life where you're unable to do certain things. Popcorn brain on the other hand is ubiquitous. It's everywhere. It is what defines modern life. Those two are very different things.And when we are feeling a sense of stress, we are especially prone to popcorn brain. Why? Because when we feel stress, we talked about the amygdala, right? Like, that part of our brain that is focused on survival and self-preservation. Back evolutionarily when we were all cave people, there was a night watch person, and that person would sit by the fire. The tribe would sleep and that person would scan for danger to keep the tribe safe. In modern times, we have all become that night watch person, and we scroll incessantly when we feel a sense of stress, because it is our primal urge. It is the way our amygdala feels a sense of safety, because we are scanning for danger. We are no longer in a tribe. We're not cave people anymore, so what do we do? We scroll. That is how we are scanning for danger, especially when we are feeling stressed. In recent times, there's been a lot of bad news. In fact, it feels like the onslaught of bad news, one thing after another, whether it's a climate disaster, or a conflict in a certain part of the world, or something or the other is always happening now. The information stream, it is rapid and unprecedented, and so we are constantly scrolling and scanning for danger. And it's that primal urge to scroll. So how do we... The goal is really not to limit our social media use or media use, because we know, studies have shown that it is not about abstinence, because that actually doesn't have an impact, a positive impact, on our mental health or our wellbeing. But what does have an impact on our mental health and wellbeing is w- decreasing our reliance to our phones. You know, most of us check our phones 2,600 times a day. That is a statistic. 2,617 times a day is the average number of times a person looks at their phone. Think about that, right? The other thing you wanna think about is when you're thinking about, like, "Huh. Do I ha- am I- do I have a reliance on my phone?" It's like, the goal here is to reconsider your relationship with your phone. It is not about abstinence. We're not trying to become digital monks here. It's about creating digital boundaries. In every relationship in your life, you have boundaries. You have a boundary with your partner, with your children, with your colleagues, because relationships need boundaries, right, to thrive. Why don't we have a boundary when it comes to the relationship we have with our phone? There is no boundary. It is simply porous. We check in the morning. We check at night. What's the first thing you do when you wake up before your second eye is even open? You are scrolling.

    6. SBSteven Bartlett1:03:18

       Studies show that 62% of people check their phones within 15 minutes of waking up, and about 50% check them in the middle of the night. I'm guilty of this. I, like, I'm not gonna pretend I'm some saint here. I'm that person. I'm on- on the upper end of that scale. I'm

13. 1:03:34 – 1:12:13

    The Relationship Between Food and Stress

    1. SBSteven Bartlett1:03:34

       glued to my phone. Glued to my phone. And do you know what? When I'm stressed, I'm even more glued to it.

    2. ANDr. Aditi Nerurkar1:03:40

       Yes.

    3. SBSteven Bartlett1:03:40

       That is facts. I tell you, when I'm stressed, I've got some bad habits.

    4. ANDr. Aditi Nerurkar1:03:44

       It's your primal urge to scroll. It's a feedback loop.

    5. SBSteven Bartlett1:03:47

       Diet-

    6. ANDr. Aditi Nerurkar1:03:47

       You wanna feel safe.

    7. SBSteven Bartlett1:03:48

       ... out the window. You know, all kinds of bad habits that are (imitates explosion) probation-

    8. ANDr. Aditi Nerurkar1:03:53

       And we can talk about the diet piece too.

    9. SBSteven Bartlett1:03:55

       Well, some of them we can't talk about, but we can talk about the diet piece. For some reason, if there's ever a time in my life where my diet slips, it's when work is hard or when I'm, you know, when something's difficult in my life. That's when I- s- I just can't get out of that bad diet rut for just, you know, just a moment.

    10. ANDr. Aditi Nerurkar1:04:09

        So we can do a small caveat, 'cause I think the social media piece is really interesting and what people, like, everyone loves hearing about that. The reason that you crave high... So emotional eating is what you're describing when you're saying that your diet goes out the window when you're f- feeling a sense of stress, and that is because your amygdala. When your amygdala, like I said, it's like a, I'm like a broken record when I say your amygdala is focused on survival and self-preservation. Your amygdala doesn't recognize a famine coming or bills or work stress, right? It's the reptilian part of your brain. And so it is focused on survival, and calories equal survival. So when you are stress-eating or emotional eating, your body craves high-fat, high-sugar foods. That's just biologically what your body craves. And that is why instead of berating yourself and letting that inner critic really... instead of berating yourself and letting that inner critic really take off, like when you're craving, you know, chocolate cake or... My guilty pleasure is tortilla chips. I just can't get enough when I'm under stress. What's your stress food?

    11. SBSteven Bartlett1:05:19

        None of your business.

    12. ANDr. Aditi Nerurkar1:05:19

        (laughs)

    13. SBSteven Bartlett1:05:21

        (laughs) Carrot cake.

    14. ANDr. Aditi Nerurkar1:05:23

        Oh my God, I didn't-

    15. SBSteven Bartlett1:05:24

        Listen, I can't get carrot c- so, you know, it's- carrot cake's not easy to get. You can't bake it yourself very easily. But, um, I'd say, like, just things like that, like sweet food's my, probably my, my thing when, when I'm really stressed. And it- I- sometimes I go through these periods, maybe e- once every, like, three to four m- I'm like really... I think generally if you see what I eat, I think I'm really healthy. I think I, I do what I say, but there are moments, you know?

    16. ANDr. Aditi Nerurkar1:05:47

        And it should be that way, because you're a human being and it ebbs and flows. And so you're not a robot, you're a mere mortal, as am I, and so even though I know all of the science, like, put a chocolate cake in front of me when I'm stressed and I will... Of course, it's my biology. Anyway, so tha- we can talk about social media if you wish, but that is an important caveat, 'cause I think people... Often when you're stress-eating and you're feeling a lot of stress, like you even said, right? Like, "I hate myself when I- my diet is off and it's like-"

    17. SBSteven Bartlett1:06:12

        Yeah, I be... I start beating myself up. I'm like, "Steve, listen, you got bloody podcasts. There's people that follow you that, like, you know..." And I think, like, you got, you gotta live what you say. And then I'll just go through that moment of m- it's like... It feels like most of the time I've got my hands on the steering wheel and I'm in charge, and then once in a while, I'm in the back seat and this car is on autopilot and, and we're just flying down the motorway and I'm, I'm like, "Jesus," and I'm trying to get back into the front seat and I'm struggling against, I don't know, the wind. The windows are open. Shit's flying everywhere. And then eventually I get...... a hold of the steering wheel again with one hand, and then I can kind of pull myself back onto the steering wheel. And we have another good couple of months, you know?

    18. ANDr. Aditi Nerurkar1:06:46

        That's right.

    19. SBSteven Bartlett1:06:46

        Discipline returns.

    20. ANDr. Aditi Nerurkar1:06:47

        And that ability that you have that, where you are able to get out of the back seat, get your whereabouts, and get back into the front seat and the driver's seat, that time for you is likely maybe a week-

    21. SBSteven Bartlett1:07:02

        Mm-hmm.

    22. ANDr. Aditi Nerurkar1:07:03

        ... maybe two weeks, max.

    23. SBSteven Bartlett1:07:05

        Yeah.

    24. ANDr. Aditi Nerurkar1:07:05

        And because you have all of this knowledge and you've done this before, it's a muscle, right? It, like, grows that sense of agency-

    25. SBSteven Bartlett1:07:13

        Mm-hmm.

    26. ANDr. Aditi Nerurkar1:07:13

        ... and like, "I can do this. I know how to get this back on track."

    27. SBSteven Bartlett1:07:17

        Yeah.

    28. ANDr. Aditi Nerurkar1:07:17

        For others who may not have th- the practice that you have or the knowledge, it takes a longer time. And that is what I am trying to work on, is, like, closing the gap between knowledge and action. Understanding, by the way, that your brain, it takes eight weeks to build a habit, and falling off the wagon is part of habit-building.

    29. SBSteven Bartlett1:07:37

        So how? How do we close that gap? Some- there's gonna be people listening to this now that have heard everything you've said. They want to implement better habits in their life to counteract the stress they're experiencing. They want to get away from that red velvet carrot cake whatever. Um, but they don't have that sense of agency, or they struggle to a more extreme extent.

    30. ANDr. Aditi Nerurkar1:07:53

        You don't have to have a sense of agency. In fact, my favorite patients have been the skeptical patients, and people who are like, "I don't believe any of this stuff." When you follow the five resets and the 15 science-backed strategies, your body... It's all based on the biology of stress. So when you start the process and you go through the first technique and the second technique, your brain and your body will just know what to do, because you will be doing the work. It's all about the work of doing. And when you do better, you feel better. That's the mind-body connection. Your brain and your body are constantly speaking to each other. They're inextricably linked. What's good for your body is good for your brain, and when you do better, you feel better. But it's all in the doing and getting yourself into that moment of action when you have the information, but you need to act. It's all about small, m- keeping it smaller than you think it is. So it's not about going to the gym for an hour every day when you're stressed. Forget it. Your amygdala and prefrontal cortex will be duking it out for that one. No way, you're not gonna go. It's like you're wading through molasses to put your sneakers on. But if you start small and say, "I'm gonna go for a five-minute walk today," you'll do it.
14. 1:12:13 – 1:18:16

    The Importance of Taking Breaks

    1. ANDr. Aditi Nerurkar1:12:13

       constraints with your family, obligations, all of these things, and so we can't do all of those things to suddenly scale back into that sweet spot of human productivity. So what can we do? We can honor our breaks. And there was a study by Microsoft done not too long ago which showed that even taking 10-minute breaks, like three to four 10-minute breaks throughout the day, can have a cumulative impact on your stress.... and can help with your mood, productivity, sense of engagement. So it's not like, "Oh, breaks are nice to have." They should be an essential part of your workday, because it helps manage your stress in the workday, is a way to honor your breaks, to get back into that sweet spot of human productivity so that you can have just right stress. And with that idea of just right stress, I wanna make a point that not all stress is bad. Stress isn't the enemy. Our cultural perception of it is. There is good stress and bad stress. Good stress is adaptive stress. That's the scientific term for healthy, good stress. Bad stress is maladaptive stress. That is the scientific term. Everything good in your life was created because of a little bit of stress. Like, you started this podcast, something really positive. You met your girlfriend, also something positive. You may have made a new friend as an adult, wonderful and positive. Cheering for your favorite sports team, also a positive thing. Now, when we think of the word stress in modern culture, we think about bad stress. Bad stress are all of the things that we already know, right? Like the feelings that we've talked about. But the goal of life is not to live a life without stress, because that is biologically impossible. Our brains and our bodies need stress to survive. It is to live a life with healthy, manageable stress. It's to move away from unhealthy stress back to healthy stress.

    2. SBSteven Bartlett1:14:03

       I, my calendar, and people see my calendar a lot because we have this, um, vlog channel. My calendar is full of just, like, back, to back, to back, to back meetings. I actually had a conversation with my assistant the other day. I was like, um, "When you look at my calendar, there's actually not a, a 60 second gap between meetings," which means I'm continually, like, late, because meetings always run over. And also, you have to travel between one meeting to the next, or at least you might have to load up Zoom or something, which takes, like, 30 seconds. All right, so I'm gonna be 30 seconds late, because there's not a gap. And when I was reading in your book about this Microsoft study that compared brain scans of people who were in back to back meetings with those who took short breaks, and they found that the group taking short breaks experienced significantly less stress, it made a lot of sense to me. Because when I'm back, to back, to back, to back, to back, to back, it's kind of like your kettle example. You have the... I'll put it on the screen. The, the kettle analogy of stress. I just feel like it's filling up with steam, you know? And then in the kettle analogy, when the steam comes out of the nose of the kettle, that's kind of when you, like, let some of the stress out, so taking those gaps-

    3. ANDr. Aditi Nerurkar1:15:05

       Opening the lever.

    4. SBSteven Bartlett1:15:06

       Oh, you can open the le- That also lets the stress out. Um, that's what I don't have in my day. I don't have breaks. Like, when this podcast ends, right, people will come through this door over there, one by one, and they have... And Jack's laughing 'cause he knows he's one of them. He's, he's wa- He's, he's closer, so he gets in first. I have like 17 things that I need to do for these people. I won't even be able to make it to the toilet because someone's gonna want me to review something. And that's my day, every day.

    5. ANDr. Aditi Nerurkar1:15:36

       You have to build in breaks. And even if that means that you're putting it in your calendar... Again, this study was 10 minutes. You can do as little as 10 seconds, that research has shown. Why? Because neural consolidation. Again, a very f- fancy scientific term, but it simply means that when we are on the go and moving, moving, moving, we are not always learning. And so when do you want to learn? Neural consolidation means that there's information floating in our brains. And it... Consolidation, your brain lays down, cements that information into knowledge, right? So there's information and knowledge. And neural consolidation is the process of the cementing of new information. And taking a break helps to do that.

    6. SBSteven Bartlett1:16:20

       Wait, so if I'm listening to a podcast and something profound just gets said, I should pause the podcast and just wait 10 seconds to help with the neural consolidation?

    7. ANDr. Aditi Nerurkar1:16:30

       That would be wonderful.

    8. SBSteven Bartlett1:16:31

       Hmm. Interesting. As you know, this podcast is sponsored by Whoop, and people often ask me why I chose Whoop over all of the possible wearable options. And I've tried many of them, but Whoop for me stands out for several reasons. A, because of its non-invasive design, B, because of its unique analytics, and C, a membership model that continually evolves with the product. But the biggest game changer for me, which is reason D, is Whoop's ability to foster meaningful behavior change for me. With Whoop, I've been more attuned than ever before on how my daily activities can impact my sleep and stress levels. And their features like the Whoop Coach feature, which they recently announced, and the journal and the weekly planner have been instrumental in helping me to maintain health and fitness habits that I previously struggled to achieve consistency with. If you're looking to improve your health and fitness this year, beyond January, then you've got to give Whoop a try. Go to join.whoop.com/ceo and you'll be able to get Whoop for 30 days risk-free with zero commitment, and let me know how you get on. As you guys know, I'm a big fan of Huel. I'm an investor in the company, and they sponsor this podcast. And what I've done for you, I put together what I call the Huel Steven Bundle, which is a selection of my favorite products from Huel, including the black edition salted caramel flavor, which is super high in protein and has 17 servings per container. Also comes with their ready-to-drink product, which is one of my all-time favorite products from Huel. The brand new and very exciting Huel complete nutrition bars. This is chocolate caramel. You can see from the empty box in front of me that I've eaten most of them, right? Me and my team here. If you leave these on the counter for five seconds, they'll go. I'm gonna say something I've never said. When Huel first made their bar many, many years ago, I tried it and I didn't like it, so I've never talked about it on this podcast. They've

15. 1:18:16 – 1:21:11

    Your Gut Health Impacts Your Stress

    1. SBSteven Bartlett1:18:16

       spent roughly the last two to three years making a brand new bar, which I absolutely love. If you wanna order them yourself and get started on your Huel journey, the link is in the description below. In this podcast episode, wherever you're listening to it, there'll be a Steven's bundle link and check it out. Back to the episode. On this podcast, one of the things I came to learn about was this gut-brain connection.

    2. ANDr. Aditi Nerurkar1:18:35

       Yes.

    3. SBSteven Bartlett1:18:36

       I think Tim Spector-

    4. ANDr. Aditi Nerurkar1:18:37

       We've had-

    5. SBSteven Bartlett1:18:37

       ... was one of the first people-

    6. ANDr. Aditi Nerurkar1:18:37

       Yeah.

    7. SBSteven Bartlett1:18:37

       ... who talked about that. But many other guests have, have built on that knowledge. And now, if it wasn't for this podcast, I wouldn't understand the importance of the gut. I thought the gut was just where the food goes in, chemicals attack the food, processes it, poop.... comes out the other end. What I've come to learn, which is really surprising and amazing, is that much of my mental health can be attributed to my gut. That is incredible.

    8. ANDr. Aditi Nerurkar1:19:01

       Isn't it?

    9. SBSteven Bartlett1:19:02

       Isn't it?

    10. ANDr. Aditi Nerurkar1:19:02

        It is newly emerging science. Honestly, every month, we learn more and more about the gut-brain connection, the microbiome, which is an ecosystem of healthy bacteria that govern the gut-brain connection, and what you're speaking about specifically, an even newer entity called the psychobiome, which are a dedicated group of healthy bacteria in your gut whose sole function is to manage mood and other mental health.

Episode duration: 1:57:56