Today's Reading

INTRODUCTION
Jennifer

You are under a great deal of stress. I know this, not because I have the gift of telepathy or prophetical insight—that I know of, anyway—but because you're reading my intro, and people who are carefree, who ride their unicorns from Los Angeles to Fiji every other Wednesday just because they can don't read intros for books like this. Something has happened to you or someone you love and you are overwhelmed by emotions: anxiety, grief, indecision, uncertainty, anger, helplessness, hopelessness. Whatever your unique circumstances, one thing is sure: you are drowning and in need of a lifeline. If you've read the preface, you know that I've needed one before, too.

So what's going on in your life? What are you feeling? Why do you feel this way? Asking why is my favorite thing to do. So naturally, when patients come into my office in a life crisis (possibly similar to the one you're experiencing now), I want to know all of the physical and emotional symptoms they're experiencing so we can address the crisis wisely and comprehensively. When a patient comes into my office with a symptom, before rushing to alleviate it, I always ask myself why the symptom is there. One of my pet peeves is hearing about people who go to a doctor, complain about a symptom, and are immediately handed a prescription without any discussion. For example, someone will go in to discuss problems focusing his or her attention and leave with a prescription for a stimulant medication for ADHD after ten minutes. Many of these people invariably end up in my office, having tried numerous medications for poor focus, to no avail. Why? Well, the doctor never asked that question. There are many reasons someone may have poor focus; ADHD is just one of them. In my office, I treat poor focus as a symptom rather than a diagnosis. Anxiety is one of the more common causes I see, and I've diagnosed more than my fair share of thyroid disorders, hormone abnormalities, and substance use disorders. A stimulant won't treat any of those issues.

So the first thing I always do is ask why. Then I start every treatment plan with an explanation of what I think is going on so my patients and I are on the same page. So, why are you stressed to the point of crisis?

Stress is apparently expected, as humans come prewired to manage it straight out of the womb. We have an intricate stress-response system built into our brains and organs, and at the time of birth, our stress-response system expects to respond to stress the way our lungs expect to respond to air. We are hardwired for it.

Well, kind of. We are hardwired for survival, like when early humans had to escape wolves and bears while gathering berries. The "fight-or-flight" response is meant to save our lives in acute emergencies. But there is a limit to how much stress the system can handle.

So what happens when stress is chronic? When multiple stressors pile up at once? When multiple chronic stressors pile up? This is where it gets interesting (or infuriating, depending on whether I'm wearing my scientist hat or my human hat). Our brains release a cascade of chemicals, which in turn cause various organs to release more chemicals, resulting in a wide range of physiological changes that can leave us exhausted, unproductive, fat, sick, impotent, and perusing a book on life crisis'.' In other words, you can't sleep, can't have sex, can't accomplish what you want and need to do, and now you have a muffin top or a panda belly, or maybe an extra jowl.

Awesome.

When you are in the throes of a life crisis, its helpful to understand all the strange changes going on in your body, so I'll start us off in "The Science of Stress" chapter with an explanation of how the human stress-response system is wired. I'll explain why you may be staring at the ceiling at three o'clock in the morning, why you've had a cold for four months straight, why you're suddenly allergic to everything, why you can't zip up your jeans, why you started clenching your jaw, and why you feel you're crawling out of your skin.

Kjell and I will then tag-team throughout the book, first introducing you to a five-step model that will help you work through any life crisis.* Then we're going to apply the steps to real life crises—losses such as divorce, financial ruin, and betrayal, and medical illnesses such as cancer, chronic back pain, and depression. We'll apply the steps to family crises such as addiction, raising a child with special needs, and having a partner or parent with a chronic illness. We'll address traumatic experiences such as bullying, growing up with an alcoholic parent, abuse, and a mass shooting. We will even address spiritual and existential crises such as the heartbreak surrounding suicide or losing one's sense of purpose or meaning in life.

*Confession #1: I haven't fully thought through the one-offs, like Armageddon, hostile extraterrestrial invasion, or Facebook crashing, so if you're buying the book for one of those, you'll have to send in comments we can incorporate into the second edition.
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