Rangan believes our collective modern lifestyles are driving a lot of our ill health. He says we don't give enough air time to what is arguably the biggest driver of chronic health problems: stress. We got him on the phone to delve a little further into his ideas around stress and the power of community, friendship and purpose discussed in his new book The Stress Solution. Here's a few fascinating insights from his 18 years as a GP...
On the stress of modern life
We are seeing more stress related illness than ever before, even compared to five years ago, it’s gone up severely. To put this into perspective, the World Health Organisation calls stress the health epidemic of the 21st century - a pretty alarming statement. Studies have shown that around 80% of what a GP sees on any given day is in some way related to stress - that’s a remarkable statistic. Examples include anxiety, low mood, fatigue, insomnia, poor memory, poor concentration, low libido, gut problems (such as IBS), obesity and high blood pressure. We think of all of these things as quite unrelated and separate conditions but actually they’re not, at their root cause they have stress as a key driver.
Studies have shown that around 80% of what a GP sees on any given day is in some way related to stress - that’s a remarkable statistic.
The stress response evolved in a very different era, to keep us safe if we were being attacked by another animal for example. It works beautifully well and we’re well adapted to a short-term increase in our stress level. But the problem in life today is that our stress response is not being activated to wild animals attacking us, it’s being activated through our daily lives – by emails, social media, competing demands, to-do lists that are never done, two parents working and one of them trying to finish early to get the kids to take them to an after school club and looking after elderly parents at the same time. These responses that are helpful in the short-term but they become harmful in the long-term.
We engage in unhealthy lifestyle choices because of underlying stress in life. Let’s take sugar, in January a lot of people try to reduce how much sugar they consume, and I understand the rationale behind it, but the reality is if you are using sugar as a way to soothe and cope with the stress in your life, willpower will only take you so far - maybe a week or two - but you’ll flip back because you haven’t dealt with the underlying driver. It’s the same with alcohol – people doing dry January and then going right back to old patterns in February. Unless you look at why you’re consuming so much alcohol, the underlying drivers of that behaviour, attempts to change are destined to be short lived. People drink more alcohol than they may want to, because the alcohol is helping them de-stress. By lowering stress levels - which is not as hard as we think it is - many just choose to drink less because they don’t need to de-stress as much.
In modern life our stress response is not being activated by wild animals attacking us, it’s being activated through our daily lives – by emails, social media...
I want to give people simple tools that they can apply in their everyday life. All of them are free and I know they work because I’ve been seeing patients for nearly 18 years. Whether they’re 20-year-old students or 45-year-old parents who are trying to juggle kids, work and everything else, these are the sorts of things I use, particularly with mental health problems.
WATCH: Rangan's 5 tips to destress for #GramFam
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Another coping mechanism is staying up late and binging on Netflix or box sets. This affects your sleep and lack of sleep is one of the biggest stressors. With lack of sleep your decision making ability, concentration, mood, ability to solve problems and ability to make healthy lifestyle choices all drop. You feel hungrier and will never feel full because the hormones have changed in your body. One of the best stress relieving mechanisms we’ve got is good sleep – we’ve got infinite distractions but we really need to make it a priority.
For many of us now our amygdala is on high alert day-in-day-out because our bodies perceive our lives to be unsafe.
Anxiety is very prevalent these days, it’s one of the most common mental health issues that we see. The stress response makes one part of your emotional brain, the amygdala, hyper-alert so you are hyper vigilant to threats around you. That’s a very good thing if you are on a dark street and someone is trying to attack you, you want your amygdala to be on high alert to help keep you safe. But for many of us now our amygdala is on high alert day-in-day-out because our bodies perceive our lives to be unsafe. In sleep deprived people their amygdalas can be up to 60% more reactive than when they have slept properly. Simply put, not sleeping enough will make your anxiety worse. Sleep is one of the best ways to reduce how severe your symptoms are.
Loneliness is reaching epidemic proportions in the UK. What a lot of people don’t realise is that loneliness causes physical changes in our body. Recent studies have suggested that being lonely may be as harmful for your health as smoking 15 cigarettes a day. Why is that? If you think on an evolutionary level, two million years ago if you weren’t part of your tribe and your community you were vulnerable to attack, so your body would prepare itself. Your stress response would be ramped-up and your immune system would go into high alert. These days we don’t have lions attacking us but many of us are feeling so lonely that our bodies are reacting in the same way. Seeing your friends in person is not a luxury for good health, it’s an absolute necessity. For many of my patients, all I need to do is help them prioritise their friendships.
Seeing your friends in person is not a luxury for good health, it’s an absolute necessity. For many of my patients, all I need to do is help them prioritise their friendships.
Recently I saw a 37-year-old chap who was self-employed, working hard, making decent money, working late into the evenings and managing emails every weekend. He was worried he might have depression, feeling quite low, struggling to concentrate. I checked him out, asked him questions, we did blood tests and everything came back normal. He lived in a village where he grew up so he had lots of his friends around him. But he never saw them. I told him for the next six weeks, once a week, to see at least one of his friends in person, and when with them, put phones away so they are really present for that interaction. He was skeptical, but he went away and six weeks later he came back and said he felt like a different person; “I feel happy, my mood is better, my self esteem is better, I’m performing and concentrating much better at work”. He said a couple of times he played five-a-side football but mostly, on a Sunday morning he went down to the local cafe with a friend and they just talked. That’s all he did. To put this in perspective, this chap didn’t have a mental health problem, what he had was a deficiency of friendship in his life and when we corrected that, very quickly we saw positive change.
The #BestManProject celebrates the power of male friendship.
I see this over and over again. After the age of 30 a lack of strong male friendships is closely associated with the risk of suicide. For those people who don’t have friends, I really encourage them to become a regular at places like local sports clubs, the gym, five-a-side teams or a local park-run. Even if you don’t want to run, I have patients who go and volunteer at the park run and their mental health has improved because they feel part of a community. Community is missing for many of us in the modern world. I highlight those things that people can do very quickly, mostly things that already existed in society around 20 years ago that have been slowly eroded away. It’s a reminder, we don’t give friendship the same importance as food for our health.
For those people who don’t have friends, I really encourage them to become a regular at places like local sports clubs, the gym, five-a-side teams or a local park-run.
A guy around 50 years old came to see me because he felt a bit indifferent about everything, things felt like a struggle and he was concerned he might have depression. He didn’t enjoy his job, his marriage was so-so but they didn’t do anything fun as they prioritised the kids. He said he didn’t have time for hobbies but I found out that as a kid he loved train sets and he had one in the attic that he hadn’t touched for years. I told him to get it down and start playing with it - unusual advice from a GP - but it worked. He came into see me a few months later and he told me he felt like a different person, he loved the train set, he was now closer with his wife, he was getting more enjoyment out of his job and he just felt really good about himself. This is another example of someone who had a form of mental health issue that didn’t require prescription treatment, he had a passion deficiency in his life. When he started to get a bit of passion back - things he did unashamedly for himself - everything else started to improve, his relationship, his job, his mood. So many people these days are busy doing what they need to do they forget about doing what they love to do.
When he started to get a bit of passion back - things he did unashamedly for himself - everything else started to improve.
On men seeking help
It’s well recognised that men don’t seek medical help early enough as often as women do. And it seems to be more socially acceptable for women to get together to hang out with their mates whereas men feel like they need a reason to get together. It’s fair to say there seems to be a difference between the sexes in how we approach various things. Men have been taught that it’s weak to ask for help and that they should just plough on.
So many people these days are busy doing what they need to do they forget about doing what they love to do.
On how society sees mental health
Long term I would love us not to be talking about mental and physical health as two separate things, the mind and body are connected, I wasn’t taught that at medical school but I've learnt it through 18 years of seeing patients. We know food affects our physical health, but food plays a huge role in your mental health too. Physical activity, we associate that with looking good and being buff, but physical activity is one of the best things you can do for your mental health. Before we can start talking about them as one thing, we need to get mental health up to parity with physical health, but you'll find the same things help both areas.