Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

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Posts Tagged ‘Crossfit’

Optimization vs. Diminishing Returns

Some time ago I wrote about the Minimum Effective Dose (MED), the concept in which we seek to optimize our results with the smallest amount of whatever it is that we are using to achieve that outcome. The quest to find the MED is one that crosses quite easily between my day job (medical) and my own quest for health (CrossFit). A quick mention of Eva T in Outside magazine and the program she uses with her clients made me think a bit more on the MED. The Everyday Math column in the WSJ provided an enhanced vocabulary for the journey.

Sometimes the MED really is a “something” you take. Here one thinks of medicine or food, for example. More often is the case that we are looking at a dose of time or effort. Or perhaps both. In this case we are seeking to optimize the effort as it relates to the outcome, to make the value of outcome divided by effort as large as possible. The rate limiting factor here is the Law of Diminishing Returns, of course: at some point additional effort produces such a small incremental increase in the outcome that it becomes not worth making. This applies to everything from WODs/week (or day) to decorating a birthday cake. At a certain point you just have to feel you’ve succeeded.

How, then, to know when you have reached this optimal level? Eugenia Cheng, the mathematician who wrote the WSJ piece, offers the concept of the “minimal acceptable standard”. Once she has reached this outcome the additional effects garnered from more effort have moved beyond the point where Diminishing Returns kicks in and she simply accepts the outcome. We would call these “minimal standards” goals, but the concept is essentially the same. We want an outcome; setting a target or a goal is step one in optimization.

Cheng then goes on to refine optimization with a discussion about boundaries. One is your goal, of course. In real life others also exist, things like a 24 hour day and a 7 day week and the need to make a living. The dose you choose, both qualitatively (what it is) and quantitatively (how much you get) is unavoidably affected by boundary conditions over which you have less control.In the end no outcome worth getting happens without effort. Health, friendship, or the unraveling of a gnarly math problem–you’re going to put effort in to get your results out.

Maximizing your outcome-to-effort ratio is just another way to say you are seeking your Minimum Effective Dose, in CrossFit and elsewhere.

Mental Health is Part of Health

Some time ago I wrote about creating a way to measure health. Real health. Health that encompasses every aspect of what it means to be alive and well. As a CrossFitter I definitely included Coach Glassman’s Disease -> Health -> Wellness continuum, and I also acknowledged the critical importance of his concept of “Fitness over Time”. As a classically trained physician/scientist there is clearly a place for more traditional metrics like blood pressure, serum lipids and the like, although they may, indeed, be an variable that is ultimately tied to fitness.

Where my thoughts on defining and measuring health seem to depart from most current trends is in the recognition that mental health–emotional wellbeing—is as much a part of being healthy as any other thing we might examine.

Think about it for just a moment. Most of what we would classify as mental illness has as many outward signs that we can see as diabetes and hypertension. Which is to say, none. Yet we—all of us, not just CrossFitters—see nothing but the good in treating diseases like diabetes openly and aggressively. There is no stigma attached to seeking care for your hypertension or your elevated LDL. To the contrary, if someone who loves you discovers you quit measuring your glucose before you bolus your insulin, they are for sure gonna get in your grill.

For whatever reason, mental illnesses are looked at quite differently. No one is asking the person with chronic depression whether she is taking her life-saving medication, for example. We might notice an insulin pump on a friend or family member, but then it’s quickly forgotten. Everyone seems to be very uncomfortable around the young man who has very obvious hand tremors from the life-saving medication he takes for his Bipolar disease. We all seem to be so much more understanding when we have to wait for a response from someone suffering from Parkinson’s Disease than from the young women who has the same symptoms as a side-effect from the medicine that quiets the dangerous thoughts in her head from Schizophrenia.

It’s not even necessary to look only at these kinds of severe mental illnesses when we are examining the importance of mental or emotional wellbeing as an integral part of being healthy. What good does it do to have a 5:00 mile, a 500 lb. deadlift, and a 1:59 “Fran” if it was self-loathing that drove you in the gym to get there? You may be quite accomplished, the envy of your peers, at the peak of whatever life mountain you wished to climb, and yet you cannot feel joy. How is it possible to be healthy without joy? I look at Usain Bolt and what I see is quite possibly the healthiest man alive. My friend Tim, the writer, tells me that Justin Gatlin has nearly everything that Bolt has—youth, fitness, wealth—but the combination of failure to knock off Bolt, and the public disapproval reigned on him as boos from the Rio stands has left him emotionally broken. It’s subtle, but if you look at his face in the blocks of the 100M Final it’s there.

Our complex and conflicted attitudes and feelings about mental illness are especially evident when the topic of suicide comes up. Just typing the word makes me uncomfortable. Even how we describe suicide is fraught with hidden meaning that reflects our discomfort: someone has “committed suicide”. Right? Someone committed an act that we simply cannot fathom, one that leaves the survivors completely without any understanding whatsoever. How could someone DO that? It’s as if every suicide is the same as the suicide of the crooked prison warden in The Shawshank Redemption when he looks out the window and sees his fate arrive in the front seat of a State Trooper’s car.

In reality most of the time it’s simply not like that at all. Nothing about it is simple at all.

The outer walls at the periphery of my world have been breeched by suicide twice in the last couple of weeks. One of them actually does feel a bit like that prison warden. Frankly, I am too conflicted, too aware of the external circumstances and not enough aware of the internal life of the deceased to offer much right now. The other one, however, just stopped me in my tracks when I heard. The loss was profound.It has also introduced to me a new vocabulary that I truly believe provides a starting line from which we can change how we think about not only suicide, but all of mental illness. A friendly acquaintance lost his wife when she was killed by suicide.

We don’t need to know all of the details of the story. Suffice it to say that in the face of a child’s illness she suffered quietly. Too quietly to be noticed. Perhaps she didn’t realize how badly she was suffering, or maybe she was like so many of us and couldn’t bring herself to see her illness for the life-threatening entity that it was. No one will ever know. What is clear, though, is that this was not anything about commitment. Kidney failure may be cause of death in a diabetic, but it is diabetes that kills him. There is no difference here. The cause of death was suicide. Her disease, her depression is what killed this young woman.

Each of us has a very few moments in our lifetimes that forever change us. On the second Tuesday of July in 2006, unbeknownst to me, one of those moments was transpiring in a lonely, dark corner. Joyfully, the moment was a beginning, not an ending. Regardless, once learning of the moment I was changed forever. Now I knew. You cannot see any marks from mental illness, no swollen appendage or insulin pump. But it is there all the same, and it must be acknowledged and accorded the same degree of care as any other disease that may take our loved ones from us. Mental illnesses are real, and they can be deadly. There ought not be any conflict or discomfort in treating them.

We may stop losing so many of our loved ones when start to see emotional wellbeing as part of being healthy.

Offloading info/Work

Why do I write? Why do I sit down and use time that could otherwise be put to use in the gym, or in the office, or even just hanging with the Man Cub? As a long-standing lover of language I am always on the lookout for the best vocabulary to explain concepts I sometimes struggle with. Offloading is a term that is used in this case to describe what it is that humans do with information that they do not need to keep on hand in “useful memory” space.

This is what I do with ideas when my “wetware” memory is full.

This is hardly new. Indeed, the sturm und drang associated with the mega-trends in education, etc. associated with our massive information/recall apparatus that is the internet actually has its origin in the Greek era of Socrates and the transition from an oral tradition to one in which teachings were written. (HT to Frank Wilczek). Prominent adherents to the oral tradition such as Socrates and Simonides argued forcefully that the advent of the written transfer of information would weaken the mind and produce an inferior type of intelligence. In a fascinating and delicious ironic twist, all we know of either of these men we know because someone else wrote down what they recalled hearing.

In my day job we are still encased in a paradigm in which information is transferred from teacher to student and then tested to see if that information has been committed to memory. Imagine, with the explosion of data now available in the world of medicine we test (and test, and test…) both new doctors and established ones to see if they remember a certain percentage of facts, regardless of how often those facts come into play in the act of practicing medicine. The CrossFit analogy is to test a trainer on the precise moment that the obturator engages in the deadlift. One neither needs to know this to teach the deadlift, nor does one need to have memorized this in order to have it on hand in the gym. So, too, in medicine.

Please don’t get me wrong, I still enjoy knowing a bunch of stuff and being able to call up that stuff without needing to use my Google-Fu. The reality is that we have made a move from memory in written form to memory in digital form that is just as profound and disruptive as that from oral to written. We have only to remember where it is we have stored our memories, our books and our music and our musings.

And our passwords. We still need to remember our passwords.

Is There an Optimal Age?

Last week I got a bit sidetracked with the main focus of Sunday musings. Nuclear attacks will do that to a body. I’d run across an article on WSJ.com in which a fascinating hypothetical was proposed: If you could stop the aging process at a particular point in time, at what age would you do that? At what age do you feel that you are close enough to your physical peak that you are comfortable balancing that against your intellectual capacities and maturity? Great question, that.

My physical fitness has been slipping for at least several years. Despite this I remain generally stronger than I was at any time other than my years as a college football player. When did I peak? At what time was my overall physical fitness, when my capabilities across the 10 general characteristics of fitness at its highest level? Although I didn’t know it at the time I probably peaked somewhere in medical school. My buddies and I managed to cram in marathon hoops sessions, round robin squash fests, and an admittedly conflict of interest laden exploration of 1980′s aerobics classes (most of my friends were single) while we finished up school. I supplemented this with pretty standard issue weight training (Mrs. bingo like lifting, even back then). Make that peak age 25 or 26.

Believe it or not, from there the slow age and career inflicted decline began in earnest. Had it not been for that Men’s Journal article in December 2005 I’d likely be a typical 58 year old desk jockey, broken by my job and the various and sundry weekend warrior injuries I would have doubtless suffered. Ah, but this CrossFit thing not only saved me from that but also gave me another peak somewhere around age 48. To be truthful I’m back on the descent now, but at least summited another (slightly lower) peak before starting the slide.

How about the other half of the equation? The part where you have a certain amount of intelligence, experience, and maturity? Well, for sure I was whip smart at 26. Every doctor is simply brilliant on med school graduation day; we have no idea what we don’t know, and no idea how to actually be a doctor, but hey, we just crammed for 4 straight years and our brains are busting at the seems with, you know, smart stuff. You know where this part is going, of course. At 26 I’d yet to acquire the maturity and experience that is necessary to create what I’d like to call “actionable intellect”. Such a thing could also be called “judgment”, and in short the ingredients you add to the mix are mileage and the accumulated humility that one acquires “on the road”. Like every other 26 year old I was pretty sure I knew it all already, but we all know how much longer the story is at that point, don’t we.

So it must be age 48 then. Another physical peak achieved. lost of miles under my belt including the humility of a struggling business and the grounding effect of nearly losing a child. Must be 48, right? Well, to be quite honest, I would really love to return to age 48 in a physical sense. My 58 year old bones are more than weary, and I’ll admit right now that I’m slow-rolling writing this because I’m dreading the WOD that’s gonna happen right after I hit “comment”. A funny thing happened on the way to my “final answer” though: I realized that my non-physical growth over the last 10 years has been extraordinary.

It’s not that you have to forgo all of the wonderful things in life at your chosen “stop age”, but the proposal in the exercise is to choose an intersection where the combined peaks were some kind of best. The truth is that my non-physical fitness has continued to grow at a rate which is far, far greater than the rate at which my physical prowess has declined. I have learned, and become so much better at things like empathy, acceptance, caring and the like that there are times that I wonder how anyone ever put up with my younger version. 10 more years of loving and being loved by Mrs. bingo. Of learning how to continue to love other people in my life despite their (or my) faults.

And joy. Oh my, learning that there is joy to be had out there if you can spend just a moment and let it come to you. My little Man Cub has taught me that. At 48 I really had no idea just how much joy there could be. No, for me at least I don’t think I’ve hit that magical intersection of mental growth and physical decline at which I can say I’m at the optimal point. So it’s off to the gym for me so that I can stave off decrepitude just a little bit longer, to give myself a chance to enjoy whatever non-physical growth I have in me yet.

The Man Cub is bringing his family over to play later on and I’ve gotta be ready.

 

Tending Your Culture

“When you decline to create or to curate a culture in your spaces, you’re responsible for what spawns in the vacuum.” –Leigh Alexander

Nature abhors a vacuum. In all ways and in all places. While I have never seen this immutable law applied to group culture that only speaks to my own lack of imagination and insight, and by extension Alexander’s surfeit of both. I use “spaces” a bit differently, preferring the term as a reference to internal or personal geography (timespace, brainspace, emotionalspace). Alexander’s choice of “space” rather than “place” adds to the brilliance, the “aha”-ness of the insight in that it specifically includes the virtual as well as the physical.

Some people exert, or could exert, enormous influence over very large spaces by either actively tending to the culture or by standing aside and simply observing what fills the vacuum. The just-retired CEO of our local medical behemoth has imposed his will at a very granular level on an organization that employs 10′s of thousands. Rules and regulations abound there. The opposite was the case, at least at the outset at CrossFit, Inc. The culture arose primarily from the founder’s libertarian philosophy and worldview. Pretty freewheeling, rough and tumble, then and to some degree now.

Think for a moment about your own spaces, maybe looking initially at the ones over which you might have a bit of control or influence. Work. Home. Third space. What has your role been in the creation and ongoing curation of the culture of those spaces? It’s a rather Taoist proposition, I think: to act is precisely equal to not acting, because one or the other course must be chosen. At my day job we actually did go about the task of creating a culture (A Tribe of Adults), and we knowingly curate that space by culling the tribe of those who don’t, won’t, or can’t acculturate.

In the end this is probably just another entreaty to consciously examine your own spaces, your world, and seek to exert whatever control you can wherever you can in order to live well. Whatever “well” means to you. Again, the Tao te Ching gives us some useful vocabulary, imagery we might reference. We are all more like the pebble in the stream than the reed in the field. We may aspire to live as the reed, flexible and ever able to flow with whatever breeze may blow through. The reality is that an untended culture surrounding us flows so powerfully that it, like the water in a stream, eventually reshapes us as it inevitably sculpts the stone in the stream.

The difference, as both Lao-tse and Leigh Alexander teach us, is that you have the ability to control the flow.

On the Beach 2018

(Surely you knew this was coming) This weekend begins the Royal Hawaiian Eye Meeting, an annual gathering of eye surgeons that I have thus far managed to avoid attending every year of my career. Why, you ask? Meh. 6 time zones for 3 days of work is the best answer. If that doesn’t do it I’ll add that Mrs. bingo won’t join me for the trip, and I really dislike most travel without the company of Mrs. bingo.

As you may have heard there was a bit of excitement in Hawaii yesterday. Seems a rather fumble-fingered employee jabbed the “alert all” button when taking his turn at the helm of the Emergency Response Center and sent off a 1960′s style, death from the air is coming, curl up under your desk kids and kiss your ass goodbye nuclear attack warning. Funny (funnier?), the doof figured out what happened when he got a text on his own cellphone.

Note to Expedia: this guy needs his own “Wanna get away” commercial.

What was your reaction? Mrs. bingo is away visiting her ailing Mom so I was alone chez bingo to contemplate what I would have done (interestingly, I would have been alone in Hawaii as noted above for real). The good folks of Hawaii and their 10′s of thousands of weekend guests were handed the dubious privilege of contemplating, if for just 30 minutes or so, how they would spend the last couple of hours of their lives knowing that they were about to spend the last couple hours of their lives. Did this occur to you, too?

Yesterday also brought me a couple of articles in a similar vein. One, from the WSJ, was not quite so stark. It asked when you would take a pill that arrested the aging process. At what age would you decide that the balance of physical prowess and age-begotten wisdom was optimized? (N.B. this was going to be the main topic of “musings”…) I also stumbled across a review of a book or a movie or something in which 3 siblings are told as young children the precise date of their deaths. What followed was the decisions these young children made based on that knowledge. Gotta admit, I went right to that place when I heard about the Hawaiian modern air-raid siren.

T’was a time when this type of inquiry was a rather commonplace occurrence. You could do worse than reading Neville Shute’s novel or the Stanley Kramer movie “On the Beach” based on it to get a sense of what a nuclear fraught world felt like. Both the novel and the movie depict a world destroyed by nuclear war, and life in Australia as the end-of-life nuclear cloud approaches the continent. How and what normal people decide to do in the face of an unavoidable expiration date some weeks ahead is central to the story. Yesterday’s equivalent would have been some hours ahead it seems.

What would you have done? Would you have sought shelter, as suggested, and hoped to somehow miraculously escape incineration if you were at ground zero? (As an aside, can you even imagine the horror of taking part in the effort to get off the islands to escape the radiation? We’d learn what savages we actually are, I fear) Would you go all Sartre or Beckett and choose an earlier “departure” of your own making as did so many in “On the Beach”? If it were real, what do you think you would have done?

As it turns out this kind of hypothetical is not solely the enterprise of the nuclear age. In fact a Parisian newspaper asked essentially the same question of its readers in 1922, long before the dawn of the nuclear age. Marcel Proust, the famous philosopher, offered perhaps the most lovely response I’ve heard before or since. “I think life would suddenly seem wonderful to us if www were threatened to die as you say. Just think of how many projects, travels, love affairs, studies, it–our life–hides from us, made invisible by our laziness which, certain of a future, delays them incessantly. But let all this threaten to become impossible forever, how beautiful it would become again!”

I surely know not what came before, as surely as none of us truly knows what, if anything, comes in the end. Questions that arise from the (usually) hypothetical “what if you knew when” scenarios lack the urgency to force an honest appraisal. Again, Proust: without the cataclysm “we find ourselves back in the heart of normal life, where negligence deadens desire. And yet we shouldn’t have needed the cataclysm to love life today.” It will be interesting for me to have a chance to chat with folks I know who are in Hawaii right now (a couple are close friends), but for now it was enough for me to have undergone this thought experiment for the umpteenth time and come to the same conclusion: I would have sought my people. Some how, in some way, with my last dwindling moments I would do whatever it took to be with my people.

Greater personal meaning will come from Proust: I will seek my people every day, for it is with them where lies joy. It is for others to seek the greater societal and geopolitical meaning and impact of yesterday’s blunder.

 

We Have More In Common Than Not

Several people of whom I am very fond have recently asked me to engage in something or another about which they are very, very passionate. In truth, my interest in any of these particular things/issues/ventures begins and ends with my friendship or association with the individual. For a number of reasons I just cannot find the time-space, brain-space, or emotional-space to engage in any but the most superficial manner in that which has my colleagues/associates/friends all fired-up.

In no way does this mean that these issues, etc. are not significant or important, it means only that they are not close enough to what is central to my core for me to become involved. Not becoming involved also does not mean that I think any less, or even any differently about the individuals involved. Not at all. That is the point, and more so, that I believe may be the tonic that is necessary to treat the virulent strain of discord that seems to have consumed so much of our discourse whether it be writ large of small.

We all have more in common than not. There are more things that we each hold dearly, that we feel are existentially important, than there are things on which we disagree to a point that we cannot inhabit the same space. This is the 80/20 rule of a functioning society.

Sure, maybe it’s 70/30 or 95/5, but does that really matter? Personally I think it’s more like 95/5 or even 98/2, but that may be a reflection of my worldview or frame of reference (when asked about my Holiday season I tell folks I batted .950). The point is that our commonality is far, far greater than not. If you and I agree on 95% of the things we might encounter but disagree on 5%, is our relationship over? If I do, in fact, agree with you but decide I do not have the time (or the stomach) to join you at the same level of commitment you’ve chosen, are we not able to continue our discourse? When I choose to spend 4 hours playing with the Man Cub and his Thomas the Tank Train rather than take up the mantel of your cause/issue/enterprise I am not really saying anything about those, or you, at all.

Where once Americans separated themselves along only large, even epic fissures (Religion, wealth, race, etc.) we now seem willing to render ourselves asunder over progressively smaller, hairline fractures in a connection. This is sad, and all the more sad because it is unnecessary. Pick a number–80/20, 95/5. Whatever. The solution to many of our social disquietudes lies in choosing to begin your engagement on the side of the larger of the two numbers, that which we have in common, before giving consideration to that which we may not share.

That which we have in common is the greater.

As We Turn the Page on 2017

Chief Justice John Roberts gave a commencement speech to a group of 9th graders this year in which he wished them “bad luck”. Now, lest you think ill of the Chief Justice, that he was being churlish and mean-spirited, what he meant was that he wished that these young people would experience some degree of hardship in their youth so that they would develop tactics to persevere as adults when those same hardships inevitably arose.

“I hope you will be treated unfairly, to that you will come to know the value of justice. I hope that you will suffer betrayal, because that will teach you the importance of loyalty. I hope that you will be lonely from time to time so that you don’t take friends for granted. I wish you bad luck from time to time so that you will be conscious of the role of chance in life, and understand that your success is not completely deserved and that the failure of others is not completely deserved either.

And when you lose, as you will from time to time, I hope every now and then your opponent will gloat over your failure. It is a way for you to understand the importance of sportsmanship. I hope you’ll be ignored so that you know the importance of listening to others, and I hope you have just enough pain to learn compassion.”

My hope for each of you is encapsulated in Justice Roberts’ conclusion: I hope that you will have the ability to see the message in any of your misfortunes, and that you will express appreciation for the people who help you overcome them.

Let me leave 2017 with a final thought, inspired by Ben Reiter’s review of the movie “I, Tonya”.

“Each of us, “I, Tonya” suggests, is more than the worst thing we’ve ever done–or, in Tonya’s case, the worst thing she might have done.” In our present days of instantly available and infinitely scalable opinion, we should add that we are more than the worst thing that someone says we did.

Let us, each of us, resolve that in 2018 we will look first to that which is good about each other, and endeavor to see that each of us is more like the best thing we’ve ever done than not.

 

‘Tis the Season to Indulge

‘Tis the season, eh? Indulgence at this time of year, at least in the Judeo-Christian world, is rather obvious. I WAM my nutrition all year so that I can eat pie at Thanksgiving and cookies at Christmas. Neither of which I weigh or measure, by the way.

There’s an aspect of guilt when it comes to indulgence. It’s more than just the occasional treat. An inch of dark chocolate on your Paleo Diet doesn’t really cut it, and if you consider that an indulgence it’s probably time to loosen up a bit. I was thinking that the ultimate First World indulgence is the un-timed hot shower, but anything that occurs on a daily basis probably doesn’t count either.

Uh uh…indulgence involves a certain sense of not only excess but also a bit of “I really shouldn’t”. Jay McInerney: “I find the shadow of guilt always adds piquancy to any indulgence. It’s almost more pleasurable, feeling slightly guilty.” As a boy raised Catholic by a mother who openly admired the way her Jewish friends raised their kids (producing what I’ve come to call “double guilt”), I definitely get the “shadow of guilt” angle to indulgence, especially with ones that only occur on rare occasions.

Others, though, indulge in ways both frequent and grand. Indulgence writ large, if you will. Take, for example, Lilly Bollinger and her approach to Champagne: “I drink it when I’m happy and when I’m sad. Sometimes I drink it when I’m alone. When I have company, I consider it obligatory. I trifle with it if I’m not hungry and drink it when I am. Otherwise, I never touch it–unless I’m thirsty.” Man, THAT woman knows how to indulge. Not much guilt evident, either. I’m sure my Mom wouldn’t approve, and I’m equally sure that Lilly wouldn’t care.

In a perfect world we would all be more like Lilly Bollinger, indulging on a daily basis in something that brings us pleasure with or without a side of guilt. The world, as I’ve oft said, is messy, no matter where it is you might live. Indulgence is what you make of it, and it’s probably a good thing that we have this Holiday Season during which we give ourselves permission to indulge a bit. Life is messy and exercise is hard–you’ve earned it.

[Raises flute]

Evaluating and Treating Stress

Let’s talk about stress, shall we? It’s the Holiday Season in North America after all. Frankly, it’s been on my mind pretty much all day, every day, for a couple of years now. Probably because it appears to have taken up permanent residence in my body and soul for that same couple of years. Lots and lots of talk about stress around me, too. Everybody is talking about “having stress” in their lives, especially as the holidays roll around, so let’s talk.

First of all, as in all things it’s important that we lay some ground rules, establish some definitions so that we are sure to be talking about the same thing. Stress is what appears in your body in response to stressors; stressors are what you have in your life that produce stress, like serving dinner to family on Christmas Eve. I know, I know, it’s a pretty fine point, but bear with me because I think it will make a bit more sense in a moment.

In my day job I am constantly asked if various and sundry ailments are caused by stress. The most accurate and honest answer, from a strictly medical/scientific standpoint, is “yes”. What people are actually asking me, though, is: are the ailments that they have a direct result of the stressors in their lives? Again, perhaps a bit of a fine point, but it will matter. Everyone routinely conflates “stress” with “stressors”.

You can reduce the stress in your body; you may or may not be able to effectively reduce the stressors that cause it.

Think about that for a moment. You can do quite a few things that will reduce the ailments you may have because stress has been induced in your body. The simple science is that chronic stress throws your neuro-endocrine “fight or flight” response out of whack. Our bodies secrete cortisol when faced with acute stress. This is in turn associated with a release of adrenaline. Your pupils dilate, your BP and heart rate go up, and you shunt blood to skeletal muscle in preparation to do battle or to flee.

Chronic stress, on the other hand, causes an increase in both the basal cortisol secretion and a blunting of the normal daily secretion pattern of more in the AM and less in the PM. You have a flatter curve over the day, and the whole curve is elevated. In time you have a chronically elevated BP, and your state of chronic “readiness” begins to affect all manner of the rest of your systems. Stress then becomes a stressor itself, a repeating negative feedback loop. For example, your sleep pattern gets fried. Heck you may not sleep very much at all. That makes stress worse. That “lump in your throat” feeling when you are just pre-panic”? Yeah, that can be there all the time. It even has a name: globus.

Rather ominous word, that. Globus. Stresses me out just typing it.

Here’s the rub: if you could avoid stress—the adverse affect on your body—who wouldn’t do so? When people talk about trying to have less stress in their lives what they are actually saying is that they wish they had fewer and less powerful stressors causing that stress. Work issues, illness, family strife, money issues…life would just be better if we didn’t have them. Pretty simple. Get rid of stressors, get rid of stress. Sadly, our ability to excise stressors from our lives, or even insulate ourselves from them, is somewhere beyond inadequate and approaches impossible.

What to do then? If we cannot avoid the root causes of our stress, how can we relieve it? It turns out that both the magnitude and particular variety of stress can often be measured. Specific symptoms (sleep abnormalities, globus) will point toward equally specific interventions. There are laboratory tests that can be ordered given your particular stress (e.g. midline fat deposition); nutrition adjustments can be made in response (elevated cortisol reduces insulin sensitivity->consume carbohydrates during periods of lower daily cortisol levels).

For me the bottom line is this: we likely have little to no ability to control stressors, those exogenous factors that incite stress. Further, left to its own devices, our body will respond with stress. We can manage that stress by acknowledging it, evaluating it, and then proactively going about counteracting it. You are a Black Box experiment with an n=1.

Attack stress in exactly the way you attack fitness or nutrition. Weigh it, measure it, analyze it, and then attack it.