Life in the Fast Lane…

Life today is in the fast lane. As a society we are doing so much more than ever. Our responsibilities and day to day activities are crazy… time flies by and we barely have time to take a deep breath. Never before has there been such a thing as this. The world is getting smaller and what happens now is felt thousands of miles away in an instant. It’s like we are going faster and faster, our bodies and our minds. Buckle our seat belts for we are about to crash. Stress is all around us. We say we’re stressed out but what does that really mean? Is this anxiety? Is this normal? What’s the difference between stress and anxiety? To put it simply, stress is an outside force and anxiety is how we respond to stress. This is akin to measuring the stress weight that a bridge can carry. In fact, all organisms have stress and from an evolutionary point of view we all have developed a means of dealing with that stress.

Stress may be positive or negative, many times it’s the perspective that we look at the stressor. If the NY Mets are playing against the NY Yankees the stress factor is heightened. If the Mets win, Yankee fans feel a negative stress but the Mets fans are elated. The same stress but a different response.

Every organism has the ability to respond to the environment, it’s an innate survival instinct that has evolved over millions of years, way before humans were even alive. If stress didn’t provoke anxiety then our ancestors wouldn’t have escaped from the saber toothed tiger. Stress is mediated by an area in the brain called the amygdala, our fight or flight response. Every organism has this ability, it is one of survival. When the gun is aimed at your head, it activates the sympathetic nervous system ( via dopamine) and leads you towards survival mode. This is an appropriate response to a gun aimed at your head but in today’s world it’s over activated. We don’t need to wait for the gun, we have work stress, responsibilities, bills, relationships and so many other things both real and perceived. We are bombarded with so much information from TV, the News, the internet and even social media. What took weeks or months in the past is upon us instantly. There is sensory overload. We weren’t made to process so much all at once. Our amygdala is on overdrive. When the gun is aimed at our head it’s appropriate to activate our fight or flight for 3 minutes, but not 3 hours or 3 days or 3 weeks or even 3 months. What once protected us is now burning us out.

When the amygdala is activated, it stimulates dopamine in our subconscious, the subcortical area our brain referred to as the striatum. This is via the D2 receptors. Dopamine is a catecholamine, a stimulant that is metabolized ultimately to adrenaline. Our pupils dilate, our heart beats faster, the blood pressure increases, blood flow to our muscles increases, our mind races and we are in the fight or flight mode. Survival yes but wait, the saber toothed tiger is not attacking us and there is no gun to our head. What’s going on?

Overactivation of our fight or flight, better known as our sympathetic nervous system chronically leads to a dangerous scenario, one of burnout. For our brains ability to respond to stress is mediated by a series of chemicals called neurotransmitters and repeated stress depletes these neurotransmitters. The result is that we experience more anxiety with less and less stress. Take the old saying ‘You come home from work and you kick the dog’. What? Why? Your compensatory mechanism are depleted therefore you can’t deal with any more stress, even minor things. Your body is in overdrive, the engine is racing but you aren’t moving. If the average brain is going 30 mph in a 30 mph zone, yours is going 60…or maybe even 100 mph. You can’t turn it off. Sleep is impossible as you are overactivated. You aren’t moving, and not even thinking of your past day, but are developing anticipatory anxiety for tomorrow. Sleep is to recharge your mind, like plugging in that cellphones. Without restorative sleep it’s like that cellphone is only at 30% in the morning. Day after day without relief, chronic stress leads to more and more anxiety. If left alone, depression creeps in and before you know it you’re a mess, ready to crash.

Let’s look at it in a simplified way. Stress is an outside force and anxiety is the response to stress. This is mediated by your neurotransmitters. Repeated stress depletes those neurotransmitters and now you experience anxiety in response to much less stess. But what determines our neurotransmitter levels?

The first is genetics, we are all born with the ability to handle stress through a complex interaction from the genes we inherited from both our parents. Ask any parent, a child’s ability to handle stress is apparent from the earliest ages. Adoption studies have found that anxiety and depression are linked to the genetic parents to a high degree. Ever notice that anxiety runs in families? With maturation, the brain has what is called neuroplasticity or the ability to change and reorganize itself in response to new experiences, environments, and learning. However in today’s world, kids are given cellphones, iPads or TV and the influences of the parents is minimized. The brain becomes passive, not learning, but passively placated by senseless exposure. The ability to think and react is now limited and thus the future interactions are in a sense negated. Cognitive flexibility doesn’t develop as it should.

After genetics, the next factor influencing our neurotransmitters is the environment. This plays a crucial role in our sense of stress. Structure is stability and variability is stress. The new experiences, external stimuli, and dealing with unknown variables increases stress and thus anxiety. Man likes to have control over his environment but in today’s world that is lost. In the generations before us, roles were very defined. The woman was the housewife, taking care of the household and children while the man went to work. Cultural norms were enforced and everyone knew their roles. Families ate together, worshiped together and neighborhoods were homogenous. This is no longer the case. The family structure is lost, both parents work, the children are on their own; cellphones, computers and social media have taken their place. As structure is lost so is the security of the past. In the 1940’s Erich Fromm wrote a book titled ‘Escape from Freedom’. That sounds odd , who would want to escape from freedom? However, ‘Escape from Freedom’. That sounds odd , who would want to escape from freedom? However, freedom is decision making, variability, the ultimate stressor. Human nature is to seek out and escape from responsibilities by submitting to authoritarian systems or conforming to societal norms. Being a follower is much less stressful than being a leader. The more variability, the more the stress. And the more the stress, the more the anxiety. This leads eventually into burnout and depression. Programs have seized upon this as evidenced by the 12 step AA program for alcoholic anonymous, fundamental religions, cults or even the strict structure of the military. There is comfort in being told how to think, how to dress, how to act, how to make your bed, etc. When that structure is lost, disaster will occur. Leaders are the ones who are capable of making decisions, dealing with variability and living their convictions with less anxiety.

The last variability determining our neurotransmitter status is hormones; more so in women than men. We see premenstrual mood disorders, postpartum depression and the melancholy of menopause . In response to the same stimuli, the response is much different. Men also experience this hormonal influence but in a more subtle way. A man’s role hasn’t changed much over the years as man’s responsibility was always to leave for work and provide for his family. It’s the woman who has been subjected to the most intense change. She is now expected to not only have a career but to still be the one responsible for the home, child rearing and all the challenges associated with it. With giving birth many women feel torn; they are either abandoning their previous lives as professionals in becoming a stay at home mom or they are abandoning their children in pursuit of their own career. Many women find it hard enough balancing & managing their own careers after getting married , however after having a child, the multitasking now involves career, spouse, baby and herself. This severe variability often leads to severe anxiety and depression, referred to as postpartum depression. However, in some cases it should be diagnosed as ‘postpartum ADHD’ (I’ve coined this term). As her multiplicity of tasks increases, her ability to compensate decreases.

Be careful when referring to dopamine as the pleasure hormone. It all depends on where the dopamine is in the brain. Believe it or not, dopamine in the subcortical region(subconscious) called the striatum , is involved with our ‘fight or flight’ reflex. Here dopamine stimulates the D2 receptors. When a gun is aimed at your head, the amygdala senses danger and activates dopamine. The dopamine reinforces behaviors associated with emotional stimuli . The sympathetic nervous system is activated via dopamine as dopamine is metabolized into norepinephrine then epinephrine (pure adrenaline). The heart beats faster, you begin to sweat , the pupils dilate, cortisol is released, blood pressure increases as blood flow is diverted to the muscles and the mind starts to race. If the brain goes too fast and for too long, the abnormal dopamine signaling can lead to mania or even hallucinations. Dopamine release in the striatum can be protective but also problematic. Antipsychotic medications block D2. Traditional antidepressants such as SSRI’s activate D2. Beware when one of your clients is on an SSRI antidepressant. Antidepressants can cause increased anxiety, insomnia, agitation, mind racing and mania. But worse of all is the emergence of suicidal ideation especially in children and adolescents. Many feel that this group of younger patients should almost never be treated with antidepressants as the emergence of depression before 25 years old may be secondary to bipolar depression. In bipolar, antidepressants via serotonin (5HT2A receptors) can fuel dopamine release leading to mania, hallucinations or suicidal thoughts. Depressed individuals don’t want to jump off the bridge when the mind is going to slow, only when it is going too fast. Physicians are supposed to screen for bipolar tendencies prior to treating with antidepressants but they almost NEVER do, not even psychiatrists who should know better (see FDA health advisory March 22,2004).

In the cortex , our conscious & intellectual area of the brain, this is very different. Here dopamine signals the D1 receptors involved with executive function, attention (dysregulation seen with ADHD) , working memory and cognitive flexibility. Thus cortical dopamine is very positive. Leaders tend to have a strong dopamine response in the prefrontal cortex as it drives those qualities as discussed above. In essence, optimal brain function involves modulating D2 activity in the striatum to regulate our subconscious reactions, while maximizing D1 activity in the cortex to enhance our conscious thinking.

While the Declaration of Independence asserts that all men are created equal, our neurotransmitters tell a different story. Genetic predispositions can influence our brain chemistry, and without effective coping mechanisms, we may struggle with anxiety, depression or mood instability. Beyond traditional medical treatments, natural approaches can also support neurotransmitter balance. A diet rich in whole foods, fruits, vegetables, lean proteins and whole grains provides the building blocks for dopamine production. Tyrosine, an amino acid found in protein rich foods like lean meats, fish, seafood, dairy products, nuts, seeds, legumes, and whole grains is converted into dopamine in the brain. Fatty fish like salmon, sardines and mackerel are particularly beneficial due to their high content of omega-3 fatty acids, especially EPA, which has anti-inflammatory properties and supports brain health. Other brain-boosting foods include leafy greens like spinach and kale, berries rich in antioxidants, and fermented foods like kimchi and sauerkraut which contain probiotics that support gut-brain health. Regular exercise, mindfulness practices and spiritual activities can also help regulate dopamine levels and reduce impulsivity. Additionally, limiting exposure to overstimulating factors like social media, sugary foods, and stress can help maintain a healthy dopamine balance.

The cortical dopamine is involved with executive function, decision-making, motivation and cognitive processing. Again nutrition is extremely important as is regular exercise. Obesity, insulin resistance, and the proinflammatory state all negatively impact dopamine. Fragmented or nonrestorative sleep greatly impacts dopamine and impairs the way we deal with stress. Social connections are extremely important. Humans survived due to social connections, not physical attributes. Socialization is crucial in our development as a species and maintaining social connections supports the dopamine release in the cortex. In addition, engaging in cognitive training programs or activities that challenge the brain and promote positive flexibility, such as creative pursuits, reading and learning new knowledge that challenge the brain are crucial for cortical neurons as is challenging oneself with new activities or hobbies. Incorporating these cognitive training programs and activities into your daily routine and can help improve cognitive flexibility and build new neural connections. Brain Derived Neurotrophic Factor (BDNF) is referred to as the fertilizer of the brain. BDNF sustains the viability of the neurons, is neuroprotective, increases dendritic arborization(or branches) and increases the number of synapses(connections between neurons), whereas the BDNF gene is suppressed by stress and depression via cortisol. Decreased BDNF levels lead to neuronal atrophy and death, a pro inflammatory state in the brain. Activities mentioned above that are positive are associated with increased BDNF, this is especially true for exercise. BDNF is essential for cognitive function, mood regulation, as well as having neuroprotective effects against a range of neurological disorders such as Alzheimer’s and Parkinson’s disease. Exercise, the Mediterranean diet , adequate sleep hygiene, adequate cognitive stimulation and low stress levels all improve BDNF. Meditation, mindfulness and yoga all support BDNF production.

Behavioral interventions as mentioned above have a much more sustained and holistic effect on BDNF, much more than the effects of medications, although drugs, such as antidepressants & lithium, I have been shown to be beneficial in certain individuals. However, these medication’s are not without side effects which can limit their effectiveness. There are no known side effects associated with good nutrition, exercise, mindfulness, meditation or spirituality. These interventions have the most impactful and long lasting benefits.

As we navigate the complexities of modern life, it's clear that our brains are wired to respond to stress in ways that can both protect and harm us. By understanding the intricate balance between stress, anxiety and dopamine, we can take steps to reclaim control over our minds and bodies. By prioritizing nutrition, exercise, mindfulness, and social connections we can build resilience and promote cognitive flexibility. As we strive to find balance in our increasingly fast-paced world, let's not forget the importance of self-care, compassion, and seeking social support when needed. This is best achieved through a holistic, natural and individualized approach. By doing so, we can mitigate the negative effects of stress and cultivate a more harmonious relationship between our brains and bodies; ultimately leading to a more fulfilling and balanced life. We can take control of our lives by shifting gears. Let’s slow down and breathe; prioritize our wellbeing and avoid burnout by finding a sustainable pace. We must drive our lives with focus and intention, not speeding through on autopilot. For each of us is in the driver’s seat; navigate ‘Life in the Fast Lane’ with purpose, precision and a healthy dose of self care and love.