The Mental Health Doctor “Sitting Is Increasing Your Anxiety!”, Your Phone Is Destroying Your Brain, You May Have ‘Popcorn Brain’!

In this in-depth discussion, Dr. Aditi Nerurkar, a Harvard physician and stress expert, challenges the misconceptions surrounding stress, burnout, and resilience. She emphasizes that while stress has skyrocketed, with 72% of people struggling and 70% exhibiting burnout symptoms, the key lies in understanding and managing our stress response. Dr. Nerurkar dispels the myth of multitasking and advocates for 'monotasking' as a means to protect our prefrontal cortex and enhance productivity. She also highlights the significance of the gut-brain connection, noting that our gut houses more serotonin receptors than our brain, which can affect our mood and mental health. Dr. Nerurkar introduces practical strategies like diaphragmatic breathing and expressive writing to help mitigate stress and calls for digital boundaries to counteract the 'popcorn brain' effect of constant media consumption. Lastly, she proposes "living a lifetime in a day" to find balance and fulfillment by incorporating elements of play, work, solitude, vacation, community, and reflection into our daily lives.

• A significant portion of the population is experiencing stress and burnout.
• Stress is contributing to a variety of mental health issues.
• Burnout often includes an inability to disconnect from work.
• Atypical burnout is becoming more common, affecting even those who are highly engaged in their work.

"72% of people are struggling with stress. 70% have at least one feature of burnout."

This quote emphasizes the high prevalence of stress and burnout in the population, suggesting a widespread issue.

"60% of people with burnout had an inability to disconnect from work."

This quote identifies a specific symptom of burnout, highlighting the difficulty that individuals have in separating themselves from their work responsibilities.

• Dr. Aditi Naruka transformed her personal struggle with stress into a professional mission to help others.
• She became a stress expert to provide the assistance she once needed herself.
• Dr. Naruka's approach to combating stress and burnout is informed by her own experiences and extensive research.

"I became the doctor I needed at a time when I was in my own stress struggle."

Dr. Naruka's personal experience with stress during her medical training motivated her to specialize in stress management, making her both a physician and a patient in this field.

• Stress levels are at unprecedented levels worldwide, affecting all demographics.
• The recent years have brought increased attention to mental health and stress-related issues.
• Stress is now being discussed more openly in various sectors, including corporate environments.

"We are seeing unprecedented levels of stress in the world."

This quote indicates a global increase in stress, suggesting that it is a pervasive issue crossing all boundaries.

• Acute stress is a short-term response to immediate threats, while chronic stress is persistent and long-term.
• The prefrontal cortex manages executive functions, but under stress, the amygdala takes over, triggering the fight or flight response.
• Chronic stress leads to burnout because the brain does not get time to rest and recover.

"Under acute stress, we are not governed by the prefrontal cortex. We are governed by our amygdala."

This quote explains the shift in brain function during stress, from rational thought to emotional response, which is crucial for understanding the physiological basis of stress and burnout.

• Burnout symptoms are evolving, and many people may not recognize that they are experiencing it.
• Atypical burnout can manifest as an excessive engagement in work, contrary to the classic symptoms of apathy and lethargy.
• Recognizing the changing face of burnout is important for addressing it effectively.

"60% of people with burnout had an inability to disconnect from work as their main feature of burnout."

This quote highlights a key symptom of modern burnout, where individuals are excessively connected to their work, often to their detriment.

• Atypical burnout is significant because it can hinder one's ability to thrive and function optimally.
• Rest and recovery are essential for the brain and body to function at their best.
• Success in work does not preclude the negative effects of burnout on other aspects of life.

"Your brain and your body deserve a rest."

This quote underscores the necessity of rest for maintaining mental and physical health, which is often overlooked in cases of atypical burnout.

• Toxic resilience is a societal issue where people are encouraged to push through stress without adequate recovery.
• True resilience involves the ability to adapt and recover, but it requires stress for its expression.
• There is a need to distinguish between beneficial resilience and harmful, toxic resilience.

"Resilience is our innate biological ability, but it also needs rest and recovery. It is not meant to be toxic."

This quote clarifies the concept of resilience, stressing that it is not about enduring stress without limits but rather includes necessary periods of rest and recovery.

• There is debate over whether older or younger generations are more resilient.
• Mental health issues are rising among younger generations, not due to a lack of resilience but because of different challenges they face.
• Validating and normalizing the experiences of each generation is important for understanding and addressing stress and burnout.

"I reject this idea that the older generation was more resilient. They had less stimulation, and they had different challenges."

Dr. Naruka rejects the notion that previous generations were inherently more resilient, suggesting that each generation faces its unique set of stressors.

• The "canary in the coal mine" metaphor is used to describe early warning signs of stress.
• Physical symptoms can be indicators of stress, and recognizing them is crucial for managing stress effectively.
• Understanding one's personal "canary" can help identify stress before it becomes overwhelming.

"The canary in the coal mine is my way of explaining this idea of the physical manifestations of stress."

Dr. Naruka uses this metaphor to illustrate how individual symptoms can alert a person to the presence of stress, much like the canary warned miners of dangerous gases.

• Recognizing and admitting to stress and burnout is challenging, especially due to societal expectations of strength.
• It is important to acknowledge that experiencing stress is a normal part of being human and not a sign of weakness.
• Identifying personal signs of stress can lead to better management and prevention of burnout.

"Stress doesn't happen to people like me."

This quote reflects the common denial of stress, which can prevent individuals from seeking help or making necessary changes to manage their stress levels.

• The HPA axis stands for Hypothalamic-Pituitary-Adrenal axis, a central stress response system in the body.
• The hypothalamus and pituitary gland (H and P) are located in the brain, while the adrenal glands (A) are located above the kidneys.
• This axis is responsible for the fight or flight response, which includes an increase in heart rate and other physiological reactions.
• Acute stress triggers a cascade of hormones that create the familiar feeling of stress.
• Chronic stress can lead to the amygdala not shutting off, causing continuous stress hormone release, including cortisol.

"It is the HPA axis. H stands for hypothalamus. P stands for pituitary gland. A stands for the adrenal glands."

This quote explains the components of the HPA axis, which is fundamental to understanding how stress affects the body.

"And cortisol is our stress hormone, and it's all part of that as well, because cortisol surges during adrenaline, noradrenaline, all of these hormones are working through our bodies and surging through our bloodstream."

Dr. Aditi Naruka clarifies that cortisol is a key hormone in the stress response, working alongside adrenaline and noradrenaline.

• Stress is not contagious like a virus or microbe.
• Emotions can be perceived as contagious, creating a toxic environment or a 'vibe.'
• Anecdotal evidence suggests that the heart’s electromagnetic field could contribute to the feeling of a 'vibe,' but scientific validation is lacking.
• The therapeutic encounter in medicine can create a sense of healing without necessarily curing the patient.
• Cultivating a therapeutic presence can improve health outcomes like medication adherence and control of chronic conditions.

"Stress is not contagious in the way that you think of a virus or microbes are contagious, as far as I am aware."

Dr. Aditi Naruka addresses the misconception that stress is spread like an infectious disease.

"What is kind of contagious, and I want to use that word loosely, is like emotion."

Here, Dr. Aditi Naruka suggests that while stress isn't contagious like a virus, emotions can spread and influence the mood of a space or group.

• Therapeutic presence is a cultivated skill that positively impacts health outcomes.
• Body language, such as sitting at eye level with a patient, can enhance the therapeutic presence.
• Power dynamics play a role in whether one should position themselves at or below eye level.
• Authenticity and vulnerability in voice and communication are crucial for establishing a genuine connection and trust.

"The therapeutic presence that therapeutic encounter has been shown to actually have health outcomes."

This quote emphasizes the practical health benefits of a doctor's therapeutic presence, beyond just patient comfort.

"It's not really the amount of time you spend with someone, it's your body."

Dr. Aditi Naruka points out that the quality of interaction, rather than the duration, contributes to the therapeutic presence.

• The brain can effectively manage two changes at a time, even if they are positive.
• The Resilience Rule of Two is based on a study that found accumulating life events, both positive and negative, increase stress.
• Positive changes are also stressors as they require adaptation.
• Incremental changes are more sustainable than a complete overhaul at once.

"The basis of the rule of two is based on a seminal landmark study in the 1960s by two psychiatrists, Drs. Holmes and Rehy."

Dr. Aditi Naruka explains the historical study that forms the basis of the Resilience Rule of Two, which informs her approach to managing stress and change.

"Our brains have the ability to make two new changes at a time."

Here, Dr. Aditi Naruka simplifies the concept of the Resilience Rule of Two, which is crucial for understanding how to effectively implement lifestyle changes.

• Identifying what matters most can provide a roadmap out of stress.
• The acronym MOST (Motivating Objective Small Timely) helps to set clear and achievable goals.
• Having a forward-looking goal can shift focus from immediate stress to future aspirations.
• The MOST system is designed to reframe internal dialogue from self-criticism to constructive planning.

"It's not so much what's the matter with me, it's what matters to me most."

Dr. Aditi Naruka introduces the concept of focusing on what is important to the individual to combat stress.

"You need a quantifiable metric to say, yes, my stress is getting better."

This quote underscores the necessity of having measurable goals to track progress in stress management.

• Regular exercise, even in small amounts, can reduce stress.
• Movement helps shift focus from mental stress to physical activity.
• Incremental integration of exercise into daily routines can increase self-efficacy and reduce stress.
• The benefits of exercise are not limited to intense workouts; even walking has significant positive effects.

"Even a little bit of exercise can help because it gets you out of your head and into your body."

Dr. Aditi Naruka highlights the mental health benefits of exercise, regardless of the intensity or duration.

"Sitting can also increase your sense of anxiety."

Here, Dr. Aditi Naruka discusses the negative impact of a sedentary lifestyle on mental health, advocating for regular movement as a remedy.

• Popcorn brain is a term for the overstimulation of the brain due to excessive online activity.
• Constant engagement with digital content can make it challenging to disconnect and enjoy slower-paced, offline activities.
• This phenomenon is common in modern society due to the ubiquity of smartphones and digital media.

"Popcorn brain is an affliction that nearly every single person has right now."

Dr. Aditi Naruka describes the widespread issue of popcorn brain, caused by the pervasive use of digital technology.

"Because of spending too much time online, it is hard to disengage from what's happening online because there's a constant information stream."

This quote explains the cause of popcorn brain, highlighting the challenge of balancing online engagement with the need for mental downtime.

• Pedestrian accidents are occurring due to phone usage while walking.
• People are often distracted by their phones in busy streets.

"It's, like, one of the hazards, a public health hazard, of pedestrians having near miss accidents because they're looking down on your phone."

This quote highlights the risk associated with pedestrians using phones and not paying attention to their surroundings, leading to potential accidents.

• Popcorn brain is different from internet addiction.
• Internet addiction is a DSM-IV recognized disorder that significantly interferes with life.
• Popcorn brain is a ubiquitous condition that characterizes modern life.
• Stress makes individuals prone to popcorn brain due to the amygdala's response to danger.

"Popcorn brain, on the other hand, is ubiquitous. It's everywhere. It is what defines modern life."

Popcorn brain is defined as a widespread phenomenon in modern life, distinct from internet addiction, which is clinically recognized and has a severe impact on daily functioning.

• The amygdala is focused on survival and self-preservation.
• Modern humans have become like the night watch person in ancient tribes, constantly scanning for danger.
• Bad news and rapid information streams trigger our primal urge to scroll for safety.

"We scroll incessantly when we feel a sense of stress because it is our primal urge."

The urge to scroll through information, particularly when stressed, is likened to an evolutionary behavior where one scans the environment for threats, a task historically assigned to a designated individual in a tribe.

• Decreasing reliance on phones is more beneficial than abstaining from social media.
• The average person checks their phone 2,617 times a day.
• Creating digital boundaries is essential, similar to boundaries in personal relationships.

"The goal is really not to limit our social media use or media use... But what does have an impact on our mental health and well-being is decreasing our reliance to our phones."

The focus should be on reducing reliance on phones rather than completely abstaining from social media or media use, as the latter does not significantly improve mental health or well-being.

• Stress triggers cravings for high-fat, high-sugar foods due to the amygdala's focus on survival.
• Emotional eating is a response to stress where the body seeks calories for survival.

"So when you are stress eating or emotional eating, your body craves high fat, high sugar foods."

During periods of stress, the body biologically craves foods with high fat and sugar content as a survival mechanism, driven by the amygdala's focus on preserving life.

• Gaining control over stress-related behaviors is a muscle that grows with practice.
• It takes eight weeks to build a habit, and falling off the wagon is part of the process.
• Starting small with actions like a five-minute walk can help build positive habits.

"It takes eight weeks to build a habit, and falling off the wagon is part of habit building."

Building habits is a time-consuming process that includes occasional setbacks, and it is important to recognize that it typically takes two months for a new habit to become ingrained.

• Human productivity follows a bell-shaped curve with a sweet spot between too little and too much stress.
• Taking breaks is essential for managing stress and maintaining productivity.
• The Microsoft study showed that short breaks can significantly reduce stress.

"There is a sweet spot of human productivity right in the middle of that bell-shaped curve, and that is the Goldilocks principle, the just right part of stress and human productivity."

The optimal level of productivity is achieved when stress levels are neither too high nor too low, referred to as the Goldilocks principle. This balance is crucial for maintaining effective work output and managing stress.

• Taking breaks aids in neural consolidation, which cements new information into knowledge.
• Even a ten-second pause can help with neural consolidation and learning retention.

"Neural consolidation means that there's information floating in our brains, and consolidation, your brain lays down, cements the information into knowledge."

Neural consolidation is the process by which the brain solidifies new information into long-term knowledge, and taking short breaks can facilitate this process.

• The gut is connected to mental health through the microbiome and psychobiome.
• Serotonin receptors are more prevalent in the gut than the brain.
• The health of the gut can impact mood and stress levels.

"Trillions of healthy bacteria and microbes living in your gut... they have many different roles besides digestion."

The gut houses trillions of microbes that play a role beyond digestion, including the regulation of mood and mental health, highlighting the significant gut-brain connection.

• Constant phone use, especially at night, can increase stress.
• Lack of movement, poor sleep, and social isolation contribute to stress levels.
• Erratic meal times and processed food intake can worsen stress.

"30 day plan to maximize anxiety and stress. No movement whatsoever."

A hypothetical plan to increase stress and anxiety is detailed, emphasizing behaviors such as excessive phone use, lack of physical activity, poor sleep, and unhealthy eating habits.

• Multitasking is a myth; only 2% of people can effectively multitask.
• Task switching is detrimental to the prefrontal cortex and complex problem-solving.
• Monotasking and time blocking, such as the Pomodoro technique, are more effective.

"98%, 100% of people think they are excellent multitaskers. But in fact, the science shows that only 2% of human brains can effectively multitask."

The belief in multitasking is widespread, but scientific evidence suggests that only a tiny fraction of people can genuinely multitask, with most people engaging in task switching, which is less efficient.

• Monotasking involves completing tasks one at a time, protecting and strengthening the prefrontal cortex.
• Multitasking can lead to decreased self-efficacy and increased stress due to the inability to complete tasks effectively.
• The sense of accomplishment from completing tasks through monotasking reduces stress and enhances a sense of agency.

"hour and a half, you have completed all of your tasks, but you have been monotasking, not task switching. So you're protecting your prefrontal cortex, strengthening your prefrontal cortex, and not decreasing or making it difficult with attention, memory, concentration, et cetera, that multitasking."

This quote emphasizes the benefits of monotasking, which protects cognitive functions like attention, memory, and concentration by avoiding task switching.

"Multitasking makes you more stressed? Yes, because it decreases your sense of self efficacy, because most people aren't good at multitasking."

Multitasking is linked to stress because it can make people feel less capable, as they often struggle to perform multiple tasks simultaneously with proficiency.

• Diaphragmatic breathing (belly breathing) is a natural breathing technique that can be relearned in adulthood.
• Breathing is unique as it is under both voluntary and involuntary control, which can be leveraged to mitigate stress.
• The "stop, breathe, and be" technique is a quick method to transition from the sympathetic to the parasympathetic nervous system, reducing stress and promoting presence.

"Two first, diaphragmatic breathing. It's how we all breathe as babies, and somewhere in our adulthood or young adulthood, we lose our ability to innately do diaphragmatic breathing."

Diaphragmatic breathing is a foundational breathing technique that can be relearned to reduce stress and promote relaxation.

"The reason that breathing is truly a game changer when it comes to your stress response is because the breath is the only physiological mechanism in our body that is under voluntary and involuntary control."

Breathing's unique ability to be controlled consciously allows individuals to directly influence their stress response and nervous system.

"Stop, breathe, and be. It's a way to tap into your mind body connection, and it can be really helpful."

The "stop, breathe, and be" technique is a simple and effective way to engage the mind-body connection and alleviate stress.

• Expressive writing involves writing about traumatic or stressful events for a set time over consecutive days.
• This technique can help with mood, sleep, anxiety, and even academic performance.
• Therapeutic writing allows for cognitive reframing, emotional processing, and developing self-compassion.

"A wonderful researcher, psychologist named James Pennebaker from the University of Vanderbilt, developed a technique called expressive writing, also known as therapeutic writing."

James Pennebaker's research supports the effectiveness of expressive writing in addressing various psychological and physical health outcomes.

"You are moving away from amygdala to prefrontal cortex because you're thinking, strategizing, organizing your ideas. You're expressing yourself."

Therapeutic writing transitions the brain's activity from the emotional amygdala to the more rational prefrontal cortex, aiding in emotional processing and problem-solving.

• Overconsumption of graphic content can lead to increased risk of PTSD and other mental health issues.
• Setting boundaries and limits on media consumption is crucial for maintaining mental health.
• Being an informed citizen is important, but it should not come at the cost of one's mental well-being.

"Your risk of PTSD increases when you consume graphic images, even if the thing that you're consuming is happening thousands of miles away."

Exposure to graphic content can have profound psychological impacts, regardless of physical proximity to the event, increasing the risk of PTSD.

"It is not about censorship, because the news and journalism, and I am speaking from the perspective of being a journalist or correspondent. It's vital."

While staying informed is important, it is equally important to manage media consumption to protect mental health.

• "Live a lifetime in a day" is a concept that involves incorporating six elements of a meaningful life into each day.
• The elements include childhood (play and wonder), work, solitude, vacation (joyful activities), family (community), and retirement (reflection).
• This approach combats hustle culture and promotes a sense of fulfillment and purpose daily.

"The six elements of live a lifetime in a day are childhood... Work... Solitude... Vacation... Family... And finally, retirement."

Incorporating these six elements into daily life can lead to a sense of fulfillment and counteract the negative effects of a constantly busy lifestyle.

• Despite being hyperconnected through technology, many people experience profound loneliness.
• Loneliness has significant health consequences, comparable to smoking and increasing the risk of various diseases.
• Building a sense of community and connection is an essential antidote to stress and loneliness.

"Loneliness is something that is a real concern because we know that when we are not spending time with people and we feel a sense of loneliness... it actually has a health outcome."

Loneliness is not just an emotional issue but also a health risk, emphasizing the need for meaningful social connections.

"330,000,000 people globally go two weeks before speaking with anyone."

This staggering statistic highlights the global scale of loneliness, underscoring the importance of fostering community and connection.

• People's internal feelings often do not match their external appearance of confidence or composure.
• Recognizing this discrepancy can lead to greater empathy and understanding in interactions with others.

"One idea that I used to think was true is that people's internal experience and external presentation match up."

Understanding that external appearances can be deceiving encourages a more empathetic approach to others, acknowledging that many people may struggle internally despite a composed exterior.