Combatting stress, the global epidemic of the 21st Century.

Dr. Amit Sood was born and raised in Bhopal, India. He is a Professor of Medicine at the Mayo Clinic, and he is committed to decreasing suffering and increasing happiness. Dr. Sood is the author of The Mayo Clinic Handbook for Happiness and The Mayo Clinic Guide to Stress-Free Living.

The Mayo Clinic’s structured Stress Management and Resilience Training (SMART) helps patients to build the best brain possible.

Dr. Sood, stress is one of the most pronounced words in the world today. How come? Is the concept of stress abused in today’s medicine?

Currently, three out of four people in the world have excessive stress, hence its common usage. This is because of a number of factors that all converge to excessive load on our brain, and the limited capacity of our brain to lift that load.

How would you define stress, is it a serious medical condition in itself or because someone is stressed that he or she becomes ill?

 Stress is struggle with what is, what was or what might be. Stress predisposes to the worsening of almost every medical condition known to mankind.

When did you decide to dedicate your skills to this medical specialty at the Mayo Clinic?

When I first came to USA I was expecting people here would be much happier compared to what I saw overseas.  I was surprised to see a disconnect between emotional and material wellbeing, and also its downstream impact on every aspect of society. My curiosity to understand this disconnect and my desire to find solutions brought me to this field.

You were born and studied in India. Is stress similar for every person in the world?

Stress is the same for a US person and a person from India. A brain that has the ability to imagine, has preferences, loves control and has to take care of children is bound to experience stress. This is true for every part of the world. While the stressors might be different – food insecurity versus emotional insecurity or lack of purpose or guilt – the feeling of stress is the same.

Did you combine Western medicine with Indian medicine and philosophy?

Not really. My focus is understanding the human condition from a scientific perspective. So I look at psychology, philosophy, neuroscience, evolutionary biology, anthropology, decision making, behavioural economics, medical science, and many other fields. I try to understand the truth, and at a deeper level the truth is the same – for an Indian farmer or an American hedge fund manager.

What are the major causes of stress?

The three external factors are: demand resource imbalance, lack of control and lack of meaning. These are multiplied by our brain, which was designed for survival and safety, not for peace and happiness.

What are the consequences of stress?

Stress predisposes to the worsening of almost every medical condition known to mankind. It clogs arteries, hollows the brain, inflames our body, suppresses immunity, takes away sleep, destroys relationships and increases our biological age by 10-14 years.

Is there good stress and bad stress? Is a certain level of stress a normal thing in the human condition?

Stress is like salt in our soup. We need some salt, no salt is bland and tasteless, excessive salt takes over the soup. We need some stress to make life happen and keep it interesting, but not so much that it becomes overwhelming.

At what point do you discover if you are borderline or broke the boundaries and went too far?

When stress starts affecting your physical health, quality of life, work performance or relationships, then it has gone too far.

Dr Amit Sood explaining his book to the Dalai Lama.

How do you treat stress at the Mayo Clinic?

We have a structured program variously called stress management and resilience training (SMART) program or Mayo Clinic Resilience. The program has three components – Awareness, Attention and Attitude. Awareness helps you understand the neural vulnerabilities that multiply our stress. Attention helps you develop deep sustained intentional attention. Attitude helps you cultivate thinking aligned with your core values. The program is more fully described in the two Mayo Clinic books on Stress (Mayo Clinic Guide to Stress Free Living and Mayo Clinic Handbook for Happiness).Besides this Mayo Clinic has several other programs that are based in Psychology.

What are the remedies you suggest?

You can decrease stress by either decreasing the load or increasing capacity to lift the load.

They say that in your practice you also included religion. How come?

That’s not correct. Our program is secular and anchored in neuroscience.

Is there a danger of abuse of tranquillisers or anti-depressants? How do you handle or prescribe the use of medicine to treat stress?

I use the driving metaphor. If the car sways from the road you want to bring it back, if it is in the ditch you need more aggressive manoeuvres. For people with more severe conditions, there is a place for medications.

Is it possible to eliminate stress in a normal life?

Just as the World Health Organization (WHO) definition of health is an unachievable ideal, a stress-free life is an unachievable ideal. We cannot eliminate stress, but we can decrease it and help ourselves so it doesn’t become suffering. As such, the problem in the world isn’t too little stress, it is too much stress.

Is it true that we spend 50% of our time with a wandering mind? Is this good or bad?

It is true. 50% or more. Good or bad, it depends on what we are thinking about. If our wanderings are creative and productive, they can be good. If they are negative ruminations they are often a good waste of time.

What are the results of the stress management programme that you have put in place at the Mayo Clinic?

The program has been around for about 8 years. We have conducted 20 clinical trials so far that show consistent efficacy for decreasing stress and anxiety, and increasing resilience, quality of life, happiness and health care behaviours.

Treating stress is a branch of medicine. Is it making progress in the cure of it?

Stress cannot be cured and need not be cured. We want to know how to handle it and how to find or make meaning out of it.

 Do you believe that what you do at Mayo is more advanced than anywhere else in the world? How many people do you treat?

We wish we completely knew what is happening everywhere else. We strive to integrate the most cutting edge research in our model. We do not know of any other program that has integrated the neuroscience research that we do. We reach about 40,000-50,000 people every year.

Rich countries like Western Europe and America seem to have more stress. Is it a case of the more you know the more stress you have?

It isn’t that simple. America has 45 million people who are poor. Every person has a unique blend of stressors they are dealing with. The progress of medicine and the advanced societies release or increase stress. Here also balance is important. Living in a society rife with infections, malnutrition and poverty is stressful. Living in a society that struggles with loneliness and lack of meaning is also stressful. We need to advance while maintaining connection with our roots and humility, and strive for contentment.

Can one die of stress? How many people die because of stress?

Yes, one can die of stress. I don’t have the precise statistics. Currently stress is considered the third most significant risk factor for heart disease.

Should how to take care of it be taught in schools if it is an inevitable part of the modern condition?

Absolutely. We must raise children who are emotionally intelligent. Making even a slight change at a young age can have phenomenal impact long term.

Is stress a global illness?

Yes, WHO calls it the global epidemic of the 21st century.

Is freedom a cause or a release of stress?

The opposite of freedom, slavery, is definitely stressful. Excessive freedom that doesn’t bound you to any rules can lead to poor judgments and lack of self-regulation, which will lead to stress. Perhaps a balance of feeling free but morally bound to values might be an optimal state.

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12th February, 2017