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One Nation Under Stress (2019) is a documentary hosted by Dr. Sanjay Gupta that examines the growing pressures facing Americans today. The film explores how issues such as work, health, and lifestyle affect well-being, while also highlighting research, expert insights, and personal stories. With a thoughtful and informative approach, this documentary sheds light on the challenges of modern life and the importance of resilience and balance.
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One Nation Under Stress, One Nation Under Stress 2019, One Nation Under Stress movie, One Nation Under Stress full movie, One Nation Under Stress film, One Nation Under Stress trailer, Sanjay Gupta documentary, HBO documentary 2019, health and lifestyle documentary, American society challenges, stress in modern life, resilience documentary, thoughtful social documentary, One Nation Under Stress cast, One Nation Under Stress scenes, meaningful health documentary, informative social issues film, well being documentary 2019, life balance documentary
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00:05:00There's probably nobody better in the country that has seen the ups and downs of American culture from a medical perspective than Dr. Cyril Wecht.
00:05:10He's the guy that most of us turn to when we have questions about pathology, but he's also the guy that can help really solve a mystery.
00:05:18Hello, good doctor.
00:05:48I cannot tell you how sad it is.
00:05:50I cannot tell you how sad it is, but to whom do I submit my application to become the medical director of CNN?
00:05:54You know, I have no sense wasting any fucking time, right?
00:05:57I appreciate the pragmatism there.
00:05:59I appreciate the pragmatism there. The morning did not last that long.
00:06:02No, thank you for your time. You've taught me a lot. Not only did you teach me forensics, but I think you taught me a way of thinking about things, you know, a methodical way of thinking about things.
00:06:15That's very gracious of you.
00:06:17There's a few things I want to ask you in that regard. Liver cirrhosis, drug overdose, mainly opioids, and suicide. They are called deaths of despair. And it seems to be the symptom of an underlying problem as opposed to the problem itself. What is your sentiment in that regard?
00:06:36I think what we're looking at is an increasingly stressed society. I think a society in which the pressures become greater and greater and in all respects, making a living, depersonalization of society, the roboticization of society, families breaking up, splitting off.
00:06:57These are all things that I think play a role in leading to this stressful society that we have. And then you have changes on the medical side. The idea that people should not have to suffer. We're going to take care of it. And it's very easy. You're going to write the prescription.
00:07:18It seems to be that we are self-medicating. We are 4.7% of the world's population. We take 80 to 90% of the world's Oxycontin and Hydrocodone.
00:07:27It's incredible.
00:07:28I'm pretty sure we don't have 80 to 90% of the world's pain.
00:07:30How about when I'm looking at a 62-year-old woman lying on the table and, you know, she's perfectly healthy looking. And I'm thinking, my God, this could be, you know, somebody's mother. This could be somebody's grandmother.
00:07:44And most Americans, I think, do not yet understand. It's proportionately white between 35 to 55.
00:07:53I mean, do you think there should be this idea of stress being an actual diagnosis? Because it seems like this very nebulous term.
00:08:00You have A is the immediate cause of death. And then you have another box of contributing causes. That is certainly where stress should be listed.
00:08:14And you look at the main stress hormones that we secrete, and it's the same exact chemicals in a lizard, in a fish, in a bird. This is like ancient, ancient biology.
00:08:25For 99% of beasts out there, what stress is about is three minutes of some screaming crisis where somebody's very intent on eating you or you're very intent on eating somebody.
00:08:36And everything that your body does at that time makes perfect sense. You increase your heart rate, your blood pressure, your breathing rate. You turn off everything that's not essential.
00:08:46You shut down growth and tissue repair, lions chasing you. You're running for your life. And one of the things you're doing is all sorts of metabolic stuff to hand energy to your thigh muscles.
00:08:58Oh, my God. You think about only three months until taxes are due, and you divert energy to your thigh muscles? It makes no sense whatsoever. And that's where you pay the price.
00:09:15Hello. How are you? How are you doing? Good. Nice to see you. Come on in. Thank you. Come on up. Appreciate it. Thank you. Shoes okay? Yeah.
00:09:23Dr. Robert Sapolsky is sort of this Indiana Jones-like character. Goes off and lives with baboons for 20 years in Africa. And then he comes out and he writes this book, Why Zebras Don't Get Ulcers.
00:09:41If you're a zebra and a lion's chasing you, you want stress in order to get away. But once you get away, then the stress levels return to normal.
00:09:53Stress is not the enemy here. It's the constant, never-ending, toxic stress. That's the stress that'll kill you.
00:10:04I always wonder how, like, just when you're not talking about stress, if you, in fact, were experiencing stress.
00:10:12Unbelievable amounts. Yeah.
00:10:14I've had a transition in recent years. I closed my lab about four years ago.
00:10:20So rather than, like, the usual escape of becoming a dean or a chair of something or other,
00:10:25I've just been hiding out here, writing.
00:10:27I think what we know by now from baboon world is what makes psychological stress really corrosive.
00:10:40Lack of control. Lack of predictability. Lack of social support.
00:10:44If you're chronically stressed, you've chronically increased your blood pressure.
00:10:50You're going to get more fluid turbulence with the lumens, your blood vessels.
00:10:54They hit the walls. They pound the walls.
00:10:57They cause microscopic little bits of scarring, tearing, and you get inflammation there.
00:11:01And you get plaques, and you got the whole cascade there.
00:11:04Some of this may sound more basic for you, but I'm wondering, when you think about what's happening in the United States now,
00:11:21these spikes in different causes of death among the white working class,
00:11:25liver cirrhosis, opioid overdose, and suicide,
00:11:30do you think stress is the root problem here?
00:11:34Oh, absolutely.
00:11:35Our lives are more psychologically corroded by stress.
00:11:40Stress, am I valued?
00:11:41Stress, do I have a meaningful place?
00:11:44And the community, stress, is there even a community I can ever rely upon?
00:11:50Stress, why am I here?
00:11:53I've often wondered what our great-great-grandkids would say about the lives that we led.
00:12:10They'd probably say that we lived in a world that was changing faster than ever before.
00:12:15I think in many ways we'd say that the wealth of the nation was pretty good.
00:12:24When it comes to health, it actually becomes a much harder thing to describe.
00:12:29You'd look at things like obesity rates, you'd look at cancer rates, you'd look at heart disease.
00:12:32That there'd be this underlying current that'd be much harder to define, which is this real state of stress.
00:12:42Everybody wants a pill.
00:12:43Sometimes we just don't have a pill to make you better.
00:12:46We demand more drugs.
00:12:49We take more drugs than any other country in the world.
00:12:53There's no question those drugs can save lives.
00:12:56But nearly 50 Americans die every day from prescription painkillers.
00:13:07What does stress look like?
00:13:12Stress is ugly.
00:13:15Stress is something that can cause issues in every area of your life.
00:13:22Close your eyes.
00:13:25Here we go.
00:13:27In Victoria, Texas, I met Angela.
00:13:31She's a mother, she's a wife, she's a nurse,
00:13:34and she's being prescribed a huge cocktail of meds for her stress.
00:13:39Here, let me grab his clothes.
00:13:40I lost my second child, and I was full term.
00:13:46And that's when I really started to look for ways to cope with what I was going through.
00:13:55I took pain medication, hydrocaratone, and I took the Xanax for the anxiety.
00:14:17She'd be acting different.
00:14:20It got worse after we lost a child.
00:14:25And it's just steadily gotten worse since then.
00:14:29It's come to where I take way more than I'm supposed to.
00:14:35And even the other night, I was sitting there thinking maybe I should just take all of these
00:14:42things and just go to sleep.
00:14:51It's hard to hear and to think about how many Americans have been led down this path of drug dependence.
00:14:58I know many people who've been helped by antidepressants and other medications.
00:15:03But then ultimately, at the end of the day, these premature deaths,
00:15:06they are all a reflection of the stress, the pain that comes with that stress,
00:15:11and the desire to, in some ways, medicate it away,
00:15:16even to the point where it could be dangerous and it could end your life.
00:15:19Whites are reporting poorer and poorer health, more and more pain,
00:15:31more and more social isolation, more depression.
00:15:35Along with this increase in mortality from drugs, alcohol, suicide,
00:15:40there's just a lot more morbidity, pain, social isolation.
00:15:43Anne came up with the term deaths of despair, but it's really taken off.
00:15:47Anne Case and Angus Deaton, husband and wife, economists out of Princeton,
00:15:53did this breakout study on mortality.
00:15:58Enough people have died of deaths of despair to make it of the same order of magnitude
00:16:03as all the people have died of AIDS in the U.S. since the beginning of the AIDS crisis.
00:16:09Those mortality changes were large enough to cause life expectancy to fall,
00:16:14first for whites and then for the entire population,
00:16:18and that's a really unusual event.
00:16:20These were the children of the people who won the World War.
00:16:25They were supposed to inherit the Earth.
00:16:27That's a shocking statistic.
00:16:29So they were promised the Earth, but they did not inherit it.
00:16:32In every state but two, cirrhosis and alcoholic liver disease went up.
00:16:37And in every state, drug poisonings went up.
00:16:39In every state between 1999 and 2015, suicide rates went up for people aged 25 to 64.
00:16:47If you treat people in a really shabby way for long enough, bad things happen to them.
00:16:55That happened to African Americans forever,
00:16:59and it started to happen to whites with a high school degree or less,
00:17:03starting probably in the mid-70s.
00:17:05And now bad things are happening to both those groups.
00:17:11I started this journey just outside of Pittsburgh with Cyril Wecht.
00:17:16Right there, right there, is where my mother and father had the mom and pop grocery store.
00:17:22Right there.
00:17:23Were those better times?
00:17:25It depends on what you mean by better.
00:17:28If you want to see how economic decline can impact your health,
00:17:32just go visit the Rust Belt.
00:17:33We were producing more steel than the rest of the world combined.
00:17:4024 hours a day, 7 days a week,
00:17:44that smoke went up into the air along the Monongahela River and the Mon Valley.
00:17:50This valley is the epicenter of the greatest industrial collapse in the entire developed world in the 80s.
00:18:141983 is when economic Armageddon hit.
00:18:17Now, you wonder why somebody wants to commit suicide.
00:18:24You let them go live a certain way for 30 years,
00:18:27and then you pull the rug out from underneath them.
00:18:34Today, it looks like it's still happening.
00:18:36Everyone says the economy is improving, but plants are closing, jobs are being outsourced,
00:18:42and there are so many people still left behind.
00:18:45So, I worked midnight shift, got done on Monday morning, Sunday into Monday,
00:18:51and phone calls, text, everything started coming.
00:18:55One of the guys at the plant called and said,
00:18:57there's a big meeting at 10 o'clock, the bigwigs are in,
00:19:00and he said, I'm sorry.
00:19:07It's closing.
00:19:14My dad worked there.
00:19:15My sister-in-law worked there.
00:19:17My brother worked there.
00:19:20It was the best job of your life,
00:19:22and then you're told one afternoon the plant is just shutting down.
00:19:25Yes, they completely went about this in a very wrong manner.
00:19:30If you're going to tell a whole facility, 220 people,
00:19:33that this place is closing down,
00:19:35bring them all in at once.
00:19:37Don't let them find out because they're badging in,
00:19:40and their badge is not working.
00:19:42You know, 26 plus years in one place,
00:19:46they talked down to you like you were nobody.
00:19:50And not only do you feel helpless, do you feel rage.
00:19:55We had something here. We had something great here.
00:20:02We had, this plant was awesome.
00:20:05I have a wife and five kids at home,
00:20:07and my thoughts are, what am I going to provide for them?
00:20:12This country was built on the back of the middle class.
00:20:16Is that American dream still alive?
00:20:20Uh, I don't know.
00:20:27I hired on there expecting to be there another 30 years.
00:20:30I'm a dedicated worker. A lot of us are.
00:20:32You know, this part of the country, that's what we do.
00:20:33We go to work.
00:20:35My first reaction was anger.
00:20:37We were lied to straight to our faces.
00:20:39We were told we were taking our plant down for maintenance shutdowns,
00:20:41and then whenever we're going to fire this place up again.
00:20:45It's kind of a kick in the teeth.
00:20:47You know, they can say all the I'm sorries in the world.
00:20:50It doesn't help any.
00:20:53We're just workers.
00:20:54I have thought about this issue a lot.
00:21:07I grew up with this issue.
00:21:09My parents are immigrants to this country,
00:21:11and we lived in a very small town in Michigan when I was a kid.
00:21:17This Indian family grew up with the white working class.
00:21:20Parents working for the odd industry for 35 years plus
00:21:26saw an incredible downturn
00:21:28and saw lots and lots of people
00:21:31who they worked with for decades suddenly lose their jobs.
00:21:35You had the two baseball fields, so they're gone.
00:21:38We used to play football right there.
00:21:40Yeah.
00:21:40I can tell you that tree wasn't there.
00:21:42The swimming pool that we had.
00:21:44I love that swimming pool.
00:21:45I think there may have been summers where we didn't pay at all.
00:21:47Exactly.
00:21:47We were sneaking in all the time.
00:21:50Everything else has changed.
00:21:52It's good to be back.
00:21:54Glad to have you back.
00:21:58We lived in this really homogenous town.
00:22:02There was nobody else who really looked like me.
00:22:07And then on top of that, you know,
00:22:08when I was a kid, the Iran hostage crisis was happening.
00:22:11And all of a sudden, anybody of a certain skin color
00:22:16was a target of xenophobia.
00:22:19So it was pretty brutal, I think, for a while for me.
00:22:23So when Sanjay started kindergarten, went to school, just crossed the street.
00:22:30So one day he comes home and he's very quiet.
00:22:33So he said, Mom, can I change my name?
00:22:36I said, sure, we'll change your name.
00:22:38What do you want to be?
00:22:39I want to be Steve.
00:22:40That time, $6 million man show was his favorite show.
00:22:44Oh, okay.
00:22:45The Steve Austin show.
00:22:46Yeah.
00:22:47You know?
00:22:48Then I asked Sanjay, I said, so how many Steves are in your class?
00:22:51And he counted five Steves already in his class.
00:22:54And I said, Sanjay, one of that Steve is going to do very good.
00:22:59But then if there are five, six of them,
00:23:01people will have a hard time finding which Steve did good.
00:23:04But the day Sanjay will do good, there will be only one Sanjay.
00:23:08You know, I was supposed to go with him to school and change his name next day.
00:23:11He came before I even got up.
00:23:13He said, Mom, you're not coming to school.
00:23:16I said, why not?
00:23:16He says, I don't want to be Steve.
00:23:18I want to be Sanjay.
00:23:20See, now that's something that I never would have known as a child or even her.
00:23:25Wow.
00:23:26I mean, we're the only Indian family, I think.
00:23:29Around, right?
00:23:30What about you guys now, though?
00:23:32I've been with the Michigan prison system for over 28 years.
00:23:36And throughout time, because of economics, budget cuts,
00:23:41a lot of people I know are under a lot of stress
00:23:45because things aren't as stable or secure as things used to be.
00:23:49And things can change real quick.
00:23:51You can be doing everything right, but they can...
00:23:54Ford visa, a lot of layoffs.
00:23:56Yeah, I was hired in 1967 as the first female engineer with Ford Motor Company.
00:24:03And after close to almost 34 years, no notice, nothing.
00:24:08They said, this is, today's your last day.
00:24:11Saw a lot of people, they had tears in their eyes as they were walking out.
00:24:14I've been handed that layoff slip a couple times.
00:24:18When you're not in control, and it's stressful.
00:24:24Yeah, so here, everybody stand right here.
00:24:27I just assumed that I'm like one of the most stressed guys with my work as a surgeon and as a journalist.
00:24:35And then I look at my best friend from childhood and probably has a lot more stress in his life than I do.
00:24:40Because I'll tell you what I do have, I have some control.
00:24:47With Frankie, I realize because he doesn't have control, because he doesn't have the certainty,
00:24:51that, that's a huge stressor.
00:24:54How does your job or your status really impact your health?
00:25:07There was this famous study out of England called the Whitehall Study,
00:25:11and it was one of the first to really try and dig into this.
00:25:14At the time that I got going with the Whitehall Study,
00:25:20everybody knew that stress was what caused heart disease,
00:25:25and everybody knew that high-status people had more stress.
00:25:30When we looked at civil sermons, what we found was the lower the status,
00:25:36the shorter your life expectancy.
00:25:37Low control at work increases risk of heart disease,
00:25:43of mental illness, of musculoskeletal disorders.
00:25:47And so close is the link between social circumstances and health,
00:25:52that health gives us a measure of how well we're doing as a society.
00:26:07Hey, good morning.
00:26:08How are you?
00:26:09Good, good, how are you?
00:26:10Good to see you.
00:26:10Good to see you too.
00:26:11I appreciate you making some time.
00:26:13You really do dedicate so much of your life and so much of your time,
00:26:17which is part of what I wanted to talk to you about today.
00:26:21Charles and I have known each other for years.
00:26:23We train together as doctors,
00:26:25and I think we share a lot of the same objectives in life.
00:26:28I don't quite know how to present what I'm seeing, what I'm learning here.
00:26:33I'll be honest with you.
00:26:34On one hand, we're seeing these white working class statistics
00:26:38start to flatten in terms of life expectancy or even come down.
00:26:42On the other hand, you are seeing a little bit of an uptick
00:26:44in life expectancy among African Americans.
00:26:48It's still worse for African Americans,
00:26:50but you're starting to see the lines come a little bit closer together.
00:26:55I don't even know what to make of that.
00:26:57For African Americans, it's been a chronic state of stress.
00:27:02For certain white populations, it's a new issue.
00:27:08And possibly that's what's causing that decline for them.
00:27:12The white working class have not seen that systematic type of oppression.
00:27:18If you look at the whole country,
00:27:22African American life expectancy is still three and a half years less than whites.
00:27:28Which is why Charles spends his evenings treating people
00:27:31who would otherwise have no access to health care
00:27:33in this clinic that he set up outside the hospital.
00:27:36Just have a seat right in here, and I'll be right in with you, okay?
00:27:42You can compare these zip codes to zip codes that are north of Atlanta,
00:27:46and there's a 12-year life expectancy difference.
00:27:50It's like 15 bucks for 20 pills or something like that.
00:27:53But I just don't know if I can afford it right now.
00:27:56Having to make a choice between medication and food
00:27:58or medication and gas is a very stressful situation.
00:28:03You know, looking at other countries that I've traveled to,
00:28:07even though they're poor, there's still hope.
00:28:10I think in many places in the U.S., you're poor,
00:28:13and many people have no hope.
00:28:15Since we've lost a job,
00:28:27we've gone through a lot of our severance money.
00:28:30We're dipping into savings.
00:28:34And the lack of control in this has been hard.
00:28:45There's always stress in the house.
00:28:53There's stress looking for a job.
00:28:55I can get out here and calm down.
00:29:04I've probably stocked my house
00:29:05with 75% of our mate this year by hunting.
00:29:10Venison, rabbit, porcupine, squirrels.
00:29:13My wife, it depends on me.
00:29:17I've got to make sure I have a way.
00:29:26It just seemed like we didn't matter.
00:29:29We didn't.
00:29:29We don't.
00:29:31If we mattered, it wouldn't have been like this.
00:29:35There's so much that's going on in the world today,
00:29:37and, you know, when you think about
00:29:38manufacturing jobs as a whole,
00:29:41leaving,
00:29:41why do you think that's happening?
00:29:45Greed.
00:29:46Greed.
00:29:47I don't think we have compassion anymore
00:29:50for the little guy.
00:29:52I think we've lost it
00:29:53because we're a number.
00:29:55My parents both worked in the automotive industry
00:29:56for 35 years,
00:29:58and when they got laid off,
00:30:00I remember we didn't talk about it, really,
00:30:03in the household
00:30:03because there was not much to really say.
00:30:06if I talk to the guys at work
00:30:08that I, like, catch up with or see,
00:30:12they don't want to talk about it.
00:30:13It hurts.
00:30:17I know it's painful to talk about,
00:30:19but if you don't talk about it,
00:30:22that hurt
00:30:22can turn to despair
00:30:25or even worse.
00:30:28Stock market's up.
00:30:30If you pick up the paper,
00:30:31and then you hear the economy is
00:30:32doing really, really well.
00:30:34It doesn't seem like it
00:30:35when there are so many struggling.
00:30:37I mean, you know, Nick, myself, my husband.
00:30:40Companies are doing great profit-wise.
00:30:43We're not seeing it.
00:30:44You're so used to
00:30:46being able to pay bills
00:30:47and not have to worry about
00:30:48and then all of a sudden
00:30:50when it's taken away from you,
00:30:52it's hard.
00:30:54I think with my brother,
00:30:56he lost his job.
00:30:57Unfortunately,
00:30:58he just bought a brand-new house,
00:31:00a brand-new truck,
00:31:01and two little ones.
00:31:03You know,
00:31:03I think he kind of thought that,
00:31:05you know,
00:31:05he had that security
00:31:06that was going to stay.
00:31:08You don't realize
00:31:09how frail life is
00:31:10until something,
00:31:12unfortunately, drastic
00:31:13or terrible happens.
00:31:16My mom had called me
00:31:18and said straight out,
00:31:19she said,
00:31:19your brother's missing.
00:31:21And I said,
00:31:22what do you mean he's missing?
00:31:24You know,
00:31:24in my mind,
00:31:25how can he be missing?
00:31:27It wasn't even 10 minutes later
00:31:28that she called.
00:31:31She said,
00:31:32he's gone.
00:31:34I said,
00:31:35what do you mean he's gone?
00:31:36He can't be.
00:31:37She said that,
00:31:38that he'd shot himself.
00:31:43He's an amazing person.
00:32:02In the United States,
00:32:09more people die by suicide
00:32:11with a handgun
00:32:12than die by homicide
00:32:14with a handgun.
00:32:15It's gone up 30%
00:32:16over the last 17 years.
00:32:19Sadly,
00:32:19there are lots of reasons
00:32:21someone dies by suicide,
00:32:22but for too many people,
00:32:24I think it really does come back
00:32:26to this idea
00:32:26of expectations.
00:32:28The belief
00:32:30that if you just work hard enough
00:32:31in this country,
00:32:32you can have a decent standard of living.
00:32:35Those dashed expectations
00:32:37end up being the unique
00:32:39and really toxic factor here.
00:32:41The headline is
00:32:57that stress kills.
00:32:59I think this is very important.
00:33:00Stress is everywhere.
00:33:01We're drinking more.
00:33:02We were smoking more
00:33:03before we had social interventions
00:33:05that like a higher taxation.
00:33:08We have a massive obesity epidemic.
00:33:10economic and economic stress.
00:33:12So we have the stage
00:33:13for uncontrollable chronic stress.
00:33:17The person is laying
00:33:19in the scanner
00:33:19and there are stressful images
00:33:22coming at them.
00:33:29And you can see that image
00:33:31for five seconds.
00:33:32You're going to say,
00:33:33no big deal.
00:33:33These things keep coming at you.
00:33:36And you see their stress ratings
00:33:38going up.
00:33:38Your response may be
00:33:41very different than mine.
00:33:42So it's very individualized.
00:33:43And that's another piece
00:33:44that we really study.
00:33:46We also got data
00:33:48from these subjects
00:33:49about cumulative adversity
00:33:51and trauma exposure.
00:33:53And we showed
00:33:55using brain imaging,
00:33:57the amount of stress
00:33:58they've had in their lives
00:33:59directly correlates
00:34:01with the volume
00:34:02in certain specific regions
00:34:03of the brain.
00:34:04As a neurosurgeon,
00:34:06I'm kind of amazed
00:34:07to hear that chronic stress
00:34:09can actually reduce
00:34:11the size
00:34:12of certain parts
00:34:13of the brain.
00:34:14I mean,
00:34:14I thought only neurosurgeons
00:34:15could do that.
00:34:19Your metric is
00:34:20when you start
00:34:21to feel out of control.
00:34:22Yeah.
00:34:23That is a good time
00:34:24to basically say,
00:34:25look,
00:34:26the stress is now,
00:34:27it's reached that tipping point.
00:34:29But, you know,
00:34:30even something like that is...
00:34:32Amy Arnsten spent
00:34:33the last three decades
00:34:34doing pioneering work
00:34:35on stress in the brain.
00:34:37So even as a teenager,
00:34:40I wanted to understand
00:34:41how stress affects the brain.
00:34:44Because there were several years
00:34:46where we lost
00:34:47so many loved ones.
00:34:49And I watched how
00:34:50we'd go from being
00:34:52very thoughtful,
00:34:53rational,
00:34:54to suddenly being
00:34:55in a swirl of confusion.
00:34:57and I wondered
00:34:58what's happening
00:34:59in our brains
00:35:00that can do something
00:35:02that powerful.
00:35:04So this is
00:35:05the prefrontal cortex.
00:35:07This is the part
00:35:08of the brain
00:35:09that subserves
00:35:10our highest order
00:35:12cognitive abilities
00:35:13so we can inhibit
00:35:14inappropriate thoughts,
00:35:16inappropriate actions,
00:35:18inappropriate emotions
00:35:20like cravings.
00:35:21But this part of the brain
00:35:23is incredibly vulnerable
00:35:25to stress.
00:35:26and even a mild stressor
00:35:29makes these circuits
00:35:30disconnect.
00:35:32And we often can feel
00:35:33confused,
00:35:35our mind blank,
00:35:36unable to concentrate,
00:35:38unable to make
00:35:39thoughtful decisions.
00:35:42With chronic stress,
00:35:43the synapses
00:35:44where cells talk
00:35:45to each other
00:35:46atrophy.
00:35:47They're called dendrites
00:35:48because they look like
00:35:49trees with little twigs.
00:35:52And they speak to each other
00:35:53through those twigs.
00:35:55and so their connections
00:35:57out to other cells
00:35:58wither away
00:35:59and that part of the brain
00:36:01loses its function.
00:36:03At the same time,
00:36:05stress actually strengthens
00:36:07these primitive circuits
00:36:08that actually make us
00:36:10very emotional
00:36:11and very much strengthen
00:36:13habits like cravings.
00:36:15I think this is the critical point.
00:36:19When you are exposed
00:36:20to chronic stress,
00:36:21you get these changes
00:36:22in your brain
00:36:23that make it increasingly
00:36:25difficult to actually deal
00:36:26with more stress.
00:36:28So how do you fix that?
00:36:29in and out.
00:36:37Just observing that in-breath
00:36:39and the out-breath.
00:36:48Noticing the sensations.
00:36:49One crucial thing
00:36:54that's helped me
00:36:54with my own stress
00:36:55and I certainly teach others
00:36:57is taking a hold
00:36:58of your mind.
00:37:00So we have early data now
00:37:02that is starting to show
00:37:03that with, say,
00:37:05certain types
00:37:06of behavioral skills training,
00:37:08whether it's mindfulness,
00:37:09short-term meditation,
00:37:11for example,
00:37:12exercise,
00:37:13there are branches
00:37:14that are regrowing.
00:37:16The brain is plastic
00:37:19and with treatment,
00:37:22some of it can come back.
00:37:29After seeing this,
00:37:31I couldn't help
00:37:33but think of Angela
00:37:34back in Texas.
00:37:46If I knew
00:37:46I was going to be here
00:37:47right now,
00:37:48I wouldn't have ever
00:37:49started taking medication.
00:37:52And I don't wish
00:37:52this on anybody.
00:37:58And I don't deserve
00:38:01to live like this.
00:38:02My kids don't deserve it.
00:38:03My husband doesn't.
00:38:08I, uh,
00:38:09I'm not going anywhere.
00:38:11I don't know.
00:38:13We said our vows.
00:38:14We made our commitments.
00:38:14and I'm here
00:38:16for the long haul.
00:38:18There's only one way
00:38:19to go from here
00:38:20and that would be up.
00:38:23I want to learn
00:38:24how to cope
00:38:26other than
00:38:27self-medicating.
00:38:28That's something
00:38:29that I haven't learned before.
00:38:36I'm sorry.
00:38:44please don't hate me.
00:38:50I hope for any start.
00:38:56Hi.
00:38:56Hi, how are you going?
00:38:57Good.
00:38:58I'm Angela Glass.
00:38:59As a doctor,
00:39:07I'm pretty used to knowing
00:39:09what the prognosis is
00:39:10for my patients.
00:39:11And as I sit here
00:39:12and watch Angela,
00:39:13I don't know
00:39:14how she's going to do.
00:39:18And I don't know
00:39:19what the prognosis is
00:39:20for this epidemic
00:39:21of self-destructive behavior.
00:39:29White nationalists rally.
00:39:30Nuclear conflict.
00:39:32It's a very unsettling feeling.
00:39:36The veterans
00:39:36have done
00:39:37suicide
00:39:38more than in combat.
00:39:39What happens
00:39:41when you live
00:39:42in a society
00:39:42that continuously
00:39:44stresses
00:39:45300 million people?
00:39:47A ban on
00:39:47Muslim immigrants.
00:39:49Protests are spreading.
00:39:50Children may remain
00:39:51in holding facilities
00:39:52for some time.
00:40:02Rhesus monkeys
00:40:02are so social,
00:40:04they provide a good model
00:40:05for understanding
00:40:05how social factors
00:40:06can affect
00:40:07physiological functioning.
00:40:08And in particular,
00:40:09stress.
00:40:15We are fundamentally
00:40:16social animals,
00:40:18just like our
00:40:19primate relatives.
00:40:20Our social relationships
00:40:22impact our stress
00:40:23and well-being.
00:40:27One of the things
00:40:28we're interested in
00:40:29is the idea
00:40:30of certainty
00:40:30of status.
00:40:32You know,
00:40:33in humans,
00:40:34we have
00:40:34socioeconomic status.
00:40:37Well, in monkeys,
00:40:38they have
00:40:38a high or low rank
00:40:40and it's kind of similar.
00:40:43The idea is you can have
00:40:44high or low position
00:40:45and that does govern,
00:40:47you know,
00:40:47access to resources.
00:40:49But in health outcomes,
00:40:51the uncertainty
00:40:52might actually play
00:40:53a stronger role.
00:40:54So animals that are
00:40:57on the really low
00:40:58end scale
00:40:58of status
00:40:59and the really
00:40:59high end scale
00:41:01of status
00:41:01tend to show
00:41:02pretty high certainty.
00:41:03but the mid-ranking animals
00:41:06show the most
00:41:07uncertainty.
00:41:09If you are
00:41:09somewhere in the middle,
00:41:11you have the ability
00:41:11to be upwardly mobile
00:41:12or downwardly mobile
00:41:14and that creates
00:41:15this unpredictability
00:41:16and uncertainty
00:41:17which are affecting
00:41:18these stress biomarkers
00:41:19that in turn
00:41:20affect health outcomes.
00:41:21It's this kind
00:41:23of stressful uncertainty
00:41:24that we're seeing
00:41:26in our own
00:41:26shrinking middle class.
00:41:29There's this constant fear
00:41:31of downward mobility.
00:41:33When folks hear
00:41:34the economy is improving
00:41:35and they look at people
00:41:37and they say,
00:41:37that's great
00:41:38for you.
00:41:39we put two capuchin monkeys
00:41:47side by side
00:41:48and there's a very simple task
00:41:50that they need to do
00:41:51and if you give both of them
00:41:53cucumber
00:41:53for the task
00:41:55they're perfectly willing
00:41:56to do this 25 times
00:41:57in a row.
00:41:57If you give them grapes
00:41:58as a far better food
00:42:00then you create
00:42:01inequity between them.
00:42:03The one on the left
00:42:04is the monkey
00:42:05who gets cucumber
00:42:05the one on the right
00:42:06is the one
00:42:07who gets grapes.
00:42:08So she gives a rock
00:42:09to us
00:42:10that's the task
00:42:10and we give her
00:42:12a piece of cucumber
00:42:13and she eats it.
00:42:14The other one
00:42:14needs to give a rock
00:42:15to us
00:42:16and that's what she does
00:42:18and she gets
00:42:20a grape
00:42:20and she eats it
00:42:23the other one
00:42:23sees that
00:42:24she gives a rock
00:42:25to us now
00:42:26gets again
00:42:26cucumber
00:42:27so we're getting
00:42:51very close
00:42:52to the human
00:42:52to the human
00:42:52sense of fairness.
00:42:57The reaction
00:42:58especially this reaction
00:43:00that's so primate-like
00:43:03and so human-like
00:43:04I think people
00:43:05very much recognize
00:43:06that response
00:43:07that we all have
00:43:08to inequality.
00:43:12When humans invented
00:43:14socioeconomic status
00:43:16we found a way
00:43:17of subordinating
00:43:18our have-nots
00:43:19like no primate
00:43:20has ever come up
00:43:21with before.
00:43:22What's the surest way
00:43:23to make people
00:43:24feel poor?
00:43:25Put them in a lot
00:43:26of income inequity.
00:43:28Have them surrounded
00:43:29by all the stuff
00:43:31they don't have.
00:43:33Rub their noses
00:43:34in it over and over.
00:43:37It's a sledgehammer
00:43:38that overwhelms
00:43:39any of these
00:43:40sort of individual
00:43:41coping styles.
00:43:53I'm stressed
00:43:54because there is
00:43:55a city full of jobs
00:43:56out there
00:43:56and I don't have
00:43:57one of them.
00:43:59What does it say
00:44:00about us
00:44:01that we need
00:44:02these rage rooms
00:44:03to try and relieve
00:44:04our stress?
00:44:05It's become
00:44:06a fast-growing business.
00:44:08I just think
00:44:09there's so many
00:44:10demands on people
00:44:12now.
00:44:19Could it be
00:44:20that a society
00:44:22gets so stressed out
00:44:23that it actually
00:44:24starts to break?
00:44:39It's not that wealth
00:44:40doesn't buy you health.
00:44:41It does.
00:44:42The wealthy are
00:44:43better off
00:44:43than people at the bottom
00:44:44always in every country.
00:44:47But what's remarkable
00:44:48is that in a wealthy
00:44:49country like the United
00:44:50States
00:44:51that people
00:44:52at the top 10%
00:44:54or top 25%
00:44:55they are not
00:44:56the healthiest people
00:44:57in the world
00:44:58and they're not
00:44:59the healthiest
00:45:00by a long shot.
00:45:02and they're not
00:45:03the healthiest
00:45:03of society
00:45:04The evidence is
00:45:06inequalities in society
00:45:08affect the level
00:45:09of health
00:45:10for everybody.
00:45:12The greater
00:45:13the inequality
00:45:14the lower
00:45:15the levels
00:45:16of trust
00:45:16of social cohesion
00:45:18the higher
00:45:19the levels
00:45:19of social isolation.
00:45:21In human populations
00:45:29loneliness
00:45:30is associated
00:45:31with considerable
00:45:32morbidity and mortality
00:45:33and we've developed
00:45:34a monkey model
00:45:35of loneliness.
00:45:37And what seems
00:45:37to be happening
00:45:38with these animals
00:45:39is that
00:45:40they seem to be
00:45:42experiencing stress
00:45:43as a result of this.
00:45:44So individuals
00:45:45that are lonely
00:45:46are more likely
00:45:46to die
00:45:47from a number
00:45:48of different
00:45:48kinds of factors.
00:45:51animals
00:45:52who were
00:45:53connected to a lot
00:45:54of animals
00:45:54and those animals
00:45:55were connected
00:45:55to a lot of animals
00:45:56were actually
00:45:57kind of protected
00:45:58and so what we think
00:45:59is going on here
00:45:59is actually social
00:46:00buffering
00:46:01and it gets at
00:46:01an individual's
00:46:02susceptibility.
00:46:04So it's the idea
00:46:04that if you have
00:46:05a lot of really
00:46:05good solid relationships
00:46:07it kind of helps
00:46:09you maintain
00:46:09a healthy physiology
00:46:10and if you look
00:46:12at the evolutionary
00:46:12history
00:46:13we've been in
00:46:14social groups
00:46:14so long
00:46:15that it actually
00:46:15is part of our
00:46:16biology
00:46:17and there's a lot
00:46:18of research
00:46:18that shows
00:46:19that when you
00:46:19don't have that
00:46:20it can be really
00:46:21really damaging.
00:46:24Looking at
00:46:25female baboons
00:46:27out in the wild
00:46:28who had just
00:46:29lost a close
00:46:30relative
00:46:30who corticoid
00:46:31levels go
00:46:32through the roof
00:46:33they're grieving
00:46:34exactly as in a human
00:46:35and they increase
00:46:37their social grooming
00:46:38and their close
00:46:39social relationships
00:46:40their close relatives
00:46:41and the ones
00:46:41who do that
00:46:42recover faster.
00:46:43I mean we've known
00:46:52for a while
00:46:52that people
00:46:53who live
00:46:53in tight
00:46:53social structures
00:46:54have better health.
00:46:57There was this
00:46:57famous study
00:46:58out of a small
00:46:59town in Pennsylvania
00:47:00which directly
00:47:02showed how
00:47:02living in a
00:47:03close-knit community
00:47:04helped reduce
00:47:05heart disease.
00:47:06so the Rosito studies
00:47:13is a more than
00:47:1450-year-long
00:47:15follow-up
00:47:16of Italian-American
00:47:18immigrants
00:47:18from Rosito,
00:47:20Pennsylvania.
00:47:26They appear
00:47:27to have
00:47:28half the
00:47:29heart attack
00:47:30rates
00:47:30of the rest
00:47:31of America
00:47:32including
00:47:32neighboring towns.
00:47:34Here's a community
00:47:37within the United
00:47:38States
00:47:38that has
00:47:40a
00:47:40strikingly
00:47:42low death
00:47:42rate
00:47:43from heart
00:47:44attack
00:47:44which is
00:47:45the
00:47:45major
00:47:46killer
00:47:47in the United
00:47:47States.
00:47:48So they went
00:47:48about
00:47:49finding out
00:47:50everything they
00:47:50could about
00:47:51the citizens
00:47:52of Rosito
00:47:52measuring their
00:47:54blood pressure
00:47:55taking their
00:47:55cholesterol levels
00:47:56and diet
00:47:57and so forth.
00:47:58None of these
00:47:59things could explain
00:48:00their health
00:48:01advantage.
00:48:01The people
00:48:04in Rosito
00:48:04seemed to
00:48:05smoke at
00:48:05about the
00:48:06same rate
00:48:06as people
00:48:07in neighboring
00:48:07towns.
00:48:08They had
00:48:09cholesterol levels
00:48:10that were
00:48:10exactly the
00:48:11same.
00:48:13In the end
00:48:13they settled
00:48:14on one
00:48:14factor
00:48:15which is
00:48:16the magical
00:48:17ingredient
00:48:18which is
00:48:19the opposite
00:48:19of stress
00:48:20social support
00:48:21and social
00:48:22cohesion.
00:48:23People are
00:48:24not only happier
00:48:25but they're
00:48:25more effective
00:48:26and they're
00:48:27healthier
00:48:28if they
00:48:28are interested
00:48:29in each
00:48:30other.
00:48:35Interestingly
00:48:35today
00:48:36we still
00:48:36see something
00:48:37like a
00:48:37Rosito
00:48:38effect
00:48:38with
00:48:39Hispanics
00:48:39who
00:48:40actually
00:48:40live longer
00:48:41than
00:48:42whites
00:48:42and blacks.
00:48:44They even
00:48:45have a name
00:48:45for it.
00:48:46It's called
00:48:46the Hispanic
00:48:47Paradox.
00:48:51The other
00:48:52half of the
00:48:53story is
00:48:53that as
00:48:54Rosito
00:48:55became more
00:48:56Americanized
00:48:57their advantage
00:48:59in heart
00:49:00disease
00:49:00mortality
00:49:01gradually
00:49:01got whittled
00:49:02away
00:49:02until today
00:49:04it looks
00:49:04exactly the
00:49:05same
00:49:05as neighboring
00:49:06communities.
00:49:09Of course
00:49:10there is a lot
00:49:11about life
00:49:11in Rosito
00:49:12that we might
00:49:12find unacceptable
00:49:13today.
00:49:14The answer
00:49:15is not to
00:49:15go back
00:49:16but to take
00:49:17what is valuable
00:49:18and move
00:49:18forward.
00:49:20Mainly
00:49:20this idea
00:49:21that in order
00:49:21to best care
00:49:22for ourselves
00:49:23we have to
00:49:24care for each
00:49:25other.
00:49:26Do you get
00:49:27back into
00:49:28the field
00:49:28much?
00:49:29My last
00:49:30season was
00:49:31eight years
00:49:31ago and
00:49:33that turned
00:49:34out to be
00:49:34the last
00:49:34one.
00:49:35After 32
00:49:36years the
00:49:37sort of
00:49:38things kind
00:49:38of collapsed
00:49:39there.
00:49:40Most of my
00:49:40animals got
00:49:41shot by
00:49:41rangers.
00:49:46When you
00:49:47look to the
00:49:47animal world
00:49:48and think
00:49:48about what's
00:49:48happening in
00:49:49the United
00:49:49States now
00:49:50are you
00:49:50optimistic?
00:49:51Well
00:49:52there's
00:49:53definitely
00:49:53some grounds
00:49:54for hope
00:49:54since one
00:49:55of the
00:49:55big themes
00:49:55in
00:49:55neuroscience
00:49:56is very
00:49:57little
00:49:58is set
00:49:58in stone.
00:50:00There's
00:50:00a study
00:50:01of mine
00:50:01from some
00:50:02years back
00:50:03and this
00:50:04was my
00:50:05main
00:50:05baboon
00:50:06troop
00:50:06that I
00:50:07had been
00:50:07sort of
00:50:08living with
00:50:09intermittently
00:50:09for 20
00:50:10years at
00:50:10that point.
00:50:12The baboon
00:50:13troop next
00:50:13door had
00:50:14the tourist
00:50:15lodge in
00:50:15their
00:50:15territory
00:50:16that opened
00:50:17up a big
00:50:17garbage
00:50:18dump.
00:50:18Soon
00:50:19they were
00:50:19in there
00:50:19feasting
00:50:20off tossed
00:50:21food each
00:50:21day.
00:50:22along comes
00:50:25this TB
00:50:25outbreak
00:50:26and it
00:50:26killed
00:50:27all of
00:50:28my males
00:50:28who went
00:50:29over there.
00:50:32Half the
00:50:33males are
00:50:33dead
00:50:34but the
00:50:34most important
00:50:35thing is
00:50:35who were
00:50:36the males
00:50:36who survived?
00:50:38The guys
00:50:38who weren't
00:50:39aggressive,
00:50:40the guys
00:50:40who would
00:50:40rather sit
00:50:41and groom
00:50:41with somebody
00:50:42in the
00:50:42morning
00:50:42than punch
00:50:43it out
00:50:43with someone
00:50:43for some
00:50:44thrown out
00:50:44cake
00:50:45from last
00:50:45night's
00:50:46dinner.
00:50:47This
00:50:47became a
00:50:48troop
00:50:48with extremely
00:50:49low levels
00:50:49of aggression
00:50:50and the
00:50:51most extraordinary
00:50:52thing is that
00:50:53as new males
00:50:54would come in
00:50:55who grew up
00:50:55in the big
00:50:56bad real
00:50:56baboon world
00:50:57it would take
00:50:58them about
00:50:58six months
00:50:59to take on
00:51:00this behavioral
00:51:00style
00:51:01and it took
00:51:02one generation
00:51:03to completely
00:51:04upend this
00:51:05picture of
00:51:05what's inevitable
00:51:06in the social
00:51:07system.
00:51:09And somewhere
00:51:11in there is
00:51:11some room
00:51:12for optimism.
00:51:18so a year
00:51:29later
00:51:30I wanted
00:51:30to check
00:51:31back in
00:51:31with Angela
00:51:31she had
00:51:34gone through
00:51:35rehab
00:51:35I just
00:51:36wanted to
00:51:36make sure
00:51:36she was
00:51:37doing okay
00:51:38and I
00:51:40couldn't
00:51:40believe
00:51:41what I
00:51:41saw.
00:51:43Are you
00:51:44okay?
00:51:44I'm doing
00:51:45great
00:51:45I'm doing
00:51:46wonderful
00:51:46Are you
00:51:47off
00:51:47everything
00:51:48I don't
00:51:50take
00:51:50anything
00:51:51at all
00:51:51I feel
00:51:52like
00:51:52being on
00:51:53medication
00:51:54alters
00:51:54your
00:51:55mind
00:51:56it
00:51:56alters
00:51:56the way
00:51:57you
00:51:57think
00:51:57I mean
00:51:58people
00:51:58want
00:51:59to
00:51:59medicate
00:52:01away
00:52:01everything
00:52:01which it
00:52:02sounds like
00:52:02is what
00:52:03happened
00:52:03to you
00:52:03yes
00:52:04it was
00:52:05a year
00:52:05before
00:52:05my
00:52:06grandmother
00:52:06died
00:52:06that my
00:52:06best
00:52:07friend
00:52:07of 14
00:52:07years
00:52:08committed
00:52:08suicide
00:52:08in
00:52:092014
00:52:10I
00:52:11lost
00:52:11my
00:52:11daughter
00:52:12I
00:52:12honestly
00:52:13felt
00:52:14like
00:52:14I
00:52:14was
00:52:14dying
00:52:14I
00:52:15had
00:52:15pulled
00:52:16a
00:52:16shotgun
00:52:18from my
00:52:18husband's
00:52:19closet
00:52:19and put
00:52:20it in
00:52:20mine
00:52:20thinking
00:52:20that I
00:52:21was
00:52:21going to
00:52:22somehow
00:52:22find a
00:52:23way to
00:52:23not be
00:52:24here
00:52:24anymore
00:52:24when you
00:52:25decided
00:52:26to go
00:52:26to
00:52:26rehab
00:52:27how
00:52:28difficult
00:52:29the
00:52:29decision
00:52:29was
00:52:30that
00:52:30it
00:52:31was
00:52:31it
00:52:31was
00:52:32hard
00:52:33I
00:52:34consider
00:52:35everything
00:52:36I
00:52:36learned
00:52:37there
00:52:37a
00:52:37coping
00:52:37school
00:52:38they
00:52:38taught
00:52:38me
00:52:39to
00:52:39talk
00:52:40and
00:52:41I
00:52:41thought
00:52:41it
00:52:42was
00:52:42silly
00:52:42when
00:52:42the
00:52:42instructor
00:52:43came
00:52:43in
00:52:43and
00:52:43was
00:52:43telling
00:52:44us
00:52:44just
00:52:44sit
00:52:44back
00:52:44in
00:52:45your
00:52:45chair
00:52:45just
00:52:45relax
00:52:46take
00:52:4710
00:52:47deep
00:52:47breaths
00:52:47and
00:52:48halfway
00:52:48through
00:52:48I
00:52:48was
00:52:49like
00:52:49wait
00:52:49this
00:52:50is
00:52:50working
00:52:50and
00:52:51I
00:52:51just
00:52:51felt
00:52:52so
00:52:52much
00:52:52better
00:52:53that
00:52:53day
00:52:53was
00:52:54the
00:52:54best
00:52:54day
00:52:55that
00:52:55I
00:52:55had
00:52:55had
00:52:56in
00:52:56years
00:52:56just
00:52:56knowing
00:52:57that
00:52:57I
00:53:03typically
00:53:03as
00:53:03you
00:53:04know
00:53:04tens
00:53:05of
00:53:05thousands
00:53:05of
00:53:06people
00:53:06die
00:53:08every
00:53:08year
00:53:09from
00:53:09these
00:53:10overdoses
00:53:11but you
00:53:12came out
00:53:12the other
00:53:12side
00:53:13I
00:53:13definitely
00:53:14feel like
00:53:14if
00:53:14there was
00:53:15a lot
00:53:15more
00:53:15people
00:53:16like
00:53:16my
00:53:16husband
00:53:16and
00:53:17my
00:53:17mom
00:53:17how
00:53:17supportive
00:53:18they
00:53:18were
00:53:18that
00:53:19a lot
00:53:19of
00:53:19people
00:53:20would
00:53:20get
00:53:20help
00:53:20earlier
00:53:21you
00:53:22were
00:53:22so
00:53:22good
00:53:23I
00:53:24am
00:53:24really
00:53:24happy
00:53:24that
00:53:25you
00:53:25doing
00:53:25well
00:53:25thank
00:53:25you
00:53:26thank
00:53:26y'all
00:53:27for
00:53:27everything
00:53:27it's
00:53:27very
00:53:27clear
00:53:28Angela
00:53:28needed
00:53:29help
00:53:29she
00:53:31couldn't
00:53:32have
00:53:32done
00:53:32this
00:53:32on
00:53:32her
00:53:33own
00:53:33but
00:53:34too
00:53:34often
00:53:35today
00:53:35it
00:53:35seems
00:53:36like
00:53:36we've
00:53:36lost
00:53:36some
00:53:37of
00:53:37that
00:53:37care
00:53:37and
00:53:37compassion
00:53:38for
00:53:38the
00:53:39larger
00:53:39American
00:53:39family
00:53:40you
00:53:45have
00:53:45your own
00:53:46stress relieving
00:53:47techniques
00:53:48never
00:53:49never
00:53:49for me
00:53:51do you get a lot of time
00:53:52to walk through here
00:53:53pretty much
00:53:54sort of an hour a day
00:53:55in here
00:53:55with the big dog
00:53:57when you look at
00:53:59animal
00:53:59cultures
00:54:00and I don't want to be
00:54:01again sound too
00:54:02simplistic
00:54:03but the idea that we would
00:54:04ultimately evolve towards
00:54:06something that would be for the
00:54:07greater good
00:54:07and yet we have
00:54:09we have structures in place
00:54:11where people who are
00:54:12who are seemingly addicted to
00:54:13power and money
00:54:15who are really truly disconnected
00:54:17from the majority
00:54:18are the ones that are making
00:54:20decisions on their behalf
00:54:21our motivations
00:54:23are varied
00:54:25and
00:54:25often
00:54:26subterranean
00:54:28and no one could make a reasonable
00:54:29claim that we're
00:54:30consistently rational
00:54:31beings
00:54:32from my bias as a neurobiologist
00:54:37the most interesting realm of stress
00:54:38discoveries in recent decades
00:54:40is just how much it's doing to your brain
00:54:43and the frontal cortex
00:54:44and it turns out
00:54:46stress and stress hormones impair
00:54:48one of the most frontally demanding tasks we have
00:54:52which is to be empathic
00:54:54which is to take somebody else's perspective
00:54:57empathy goes down when you're stressed
00:54:59that's sure not going to do good things for the world
00:55:02so humans
00:55:03becoming
00:55:04more stressed
00:55:06or having these different types of stress
00:55:07is this just how we
00:55:09continue to evolve
00:55:11well essentially
00:55:12from a Darwinian perspective
00:55:14you're basically seeing
00:55:15you're basically seeing
00:55:15is slowly
00:55:16winnowing out
00:55:18people's whose stress responses
00:55:20are least adaptive in the face
00:55:23of these human psychological stressors
00:55:25there's this frightening concept
00:55:32this idea that some of what we're seeing here
00:55:34is a sort of social Darwinism
00:55:36I mean really
00:55:38I mean you know just being blunt about it
00:55:40people are dying at a faster rate
00:55:43is their utility used up
00:55:46you know you could say the capitalist system
00:55:48has very little use for people
00:55:50who don't have BAs anymore
00:55:51you know I don't know whether you'd call that
00:55:54social Darwinism or not
00:55:55we also have I think
00:55:58the idea that the poor aren't deserving
00:56:00because if they were deserving
00:56:02they wouldn't be poor would they
00:56:03we demonize those people
00:56:05and people will say
00:56:06why
00:56:07wait a second
00:56:08I am panked with people who
00:56:11are eating themselves to death
00:56:13they're taking opioids
00:56:15they're drinking too much
00:56:16whatever it may be
00:56:17why is that my obligation
00:56:18why am I saving them
00:56:20or why are we saving them
00:56:21and so you might as well kill them off
00:56:23with drugs, alcohol, suicide
00:56:26or not save them
00:56:27or let them go, not save them
00:56:33when someone is dying of an opioid overdose
00:56:36we know how to save them
00:56:38there's a medication called Narcan
00:56:40you give it to someone
00:56:41it saves their life
00:56:42who wouldn't want that?
00:56:44Dan Picard out of Middletown
00:56:47says his community should no longer respond
00:56:49to drug overdose calls
00:56:50because of the cost
00:56:51we've got to do what we have to do
00:56:53to maintain our financial security
00:56:55if it's somebody who's already been provided services twice
00:56:58we'll advise them that we're not going to provide
00:57:00any further services
00:57:02and we will not send out an EMT
00:57:04you know there's this talk about this three strike rule
00:57:10you know if you get hit with Narcan three times
00:57:12let them die
00:57:13and I said are you kidding me
00:57:14paramedics now are going to start carrying tattoo guns
00:57:17and there's a third mark
00:57:19they just let you die
00:57:20I said that's crazy
00:57:21well you know smokers it's the same thing
00:57:24because they did this to themselves
00:57:26heart patients if they don't take care of themselves
00:57:28exercise, eat the correct diet, diabetics
00:57:31are we going to tell those people
00:57:32okay you can once more with your sugar sky high
00:57:35we're not going to give you anything to take care of
00:57:38you just go home
00:57:38you had your chance
00:57:39it's the same thing
00:57:41it's hard for me to accept
00:57:46this idea of social Darwinism
00:57:48this idea that unless you're adding real value
00:57:53unless you're contributing in some way
00:57:55what use are you really to society
00:58:00but I got to believe
00:58:03thankfully that that is still the minority opinion
00:58:07most people I think their default position
00:58:11is to be compassionate
00:58:13I think it's how we humans survived and thrived
00:58:16we were communal
00:58:18and that's the only thing that's going to save us going forward
00:58:21I started my studies as a student to study aggressive behavior
00:58:30and chimpanzees have plenty of that
00:58:31then I discovered that they also reconcile after fights
00:58:34and that they share food quite easily
00:58:36and I got actually more interested in those phenomena
00:58:39than the fights that occasionally erupt
00:58:41the alpha female in the middle
00:58:43who's clearly dominant over the rest of the females
00:58:45and so she could easily keep all that food for herself
00:58:50but the others are allowed to take pieces out
00:58:53people who have this ideology that competition is good for you
00:58:57and greed is good for you
00:58:58they like to project that ideology on nature
00:59:01and they can find plenty of examples
00:59:03and then they come back and they say that confirms that this is the way we ought to behave
00:59:10but that's a bit of a trick
00:59:11deep down we are social animals
00:59:14social animals means that you compromise
00:59:19means that you are altruistic and help others
00:59:25and that creates an environment that is actually more productive for you
00:59:29so it is a self-interested strategy
00:59:30because you're better off in a society that is supportive
00:59:34our default position is to be empathetic toward others
00:59:39because the world doesn't seem that way sometimes
00:59:41hey hey MRA
00:59:43how many kids have been killed today?
00:59:45every day that goes by we wonder
00:59:47are we really safe in our schools?
00:59:51the other week a quarter of our school didn't attend
00:59:53because they were scared of guns
00:59:54and there were eight gun threats for one day
00:59:57if you want to see the future
01:00:00of what this stress epidemic looks like
01:00:03you just have to look at the children
01:00:05a lot of adults have stress
01:00:09yeah
01:00:10their jobs, their lives
01:00:11you teenagers
01:00:13how would you compare your stress to your parents or to other adults?
01:00:18our generation has a completely different perspective
01:00:20we're not as shocked when we hear that 17 students were murdered
01:00:24you know
01:00:25I've definitely felt that
01:00:26I've been so angry at the world
01:00:28and I just wanted to whoop everybody's ass
01:00:31because I was so angry
01:00:32it's a sickening feeling
01:00:35it's weird how you can physically feel your stress
01:00:38it's almost like impending doom sense
01:00:41you can't really focus on anything else
01:00:43except what you're stressed out about
01:00:45it's crazy to think about that
01:00:53you know
01:00:53back when our parents were young
01:00:56they were like practicing for like the cold war
01:00:59like nuclear threats
01:01:01and now we're hiding from ourselves
01:01:04yeah
01:01:04it's just something that we're scared of now
01:01:06I mean if you go and feel safe in a school or a church
01:01:12where are you going to feel safe?
01:01:13there's nowhere
01:01:14what is America doing wrong?
01:01:17people are more self-centered nowadays
01:01:19and they just really care about what they want
01:01:22it's all about the views you get
01:01:24and how many likes you get
01:01:26like retweets
01:01:27and another thing through social media
01:01:29you know
01:01:30I can post a post
01:01:31I'm like you're so ugly
01:01:33and I don't have to worry about seeing her face to face
01:01:36I can make her feel as crappy as possible
01:01:38and I don't have to worry about the repercussions
01:01:40we can't just keep going the way we're going
01:01:42because we're collectively kind of killing ourselves
01:01:46yeah
01:01:46I really worry about the pressures on young people today
01:01:58I mean as I've always said
01:01:59stress in and of itself is not a bad thing
01:02:01it's when it doesn't stop
01:02:03and I think social media
01:02:06and just that incessant nature of it
01:02:08puts a constant level of stress on kids
01:02:14it's probably topic number one
01:02:16I think when we parents get together
01:02:18our parents didn't have to deal with this
01:02:20when I go to my parents
01:02:22and ask them about some of this stuff
01:02:23they say we didn't have any of this
01:02:25can you help me get cute for this time?
01:02:27cute, cute, cute
01:02:28sit, hey, hey, come here
01:02:29hey, cute
01:02:30come here
01:02:31having a good day?
01:02:36my sisters were mean, horrible, terrifying creatures
01:02:48and like I said before, half woman, half birdies
01:02:50there's no question that I see everything as a dad now
01:02:56what's my kid going to be learning in school
01:02:58how are their brains going to develop
01:03:00what kind of world are we leaving behind for our kids
01:03:03the thing I want my kids to learn is empathy
01:03:07because I believe so many other good things follow from that
01:03:12but how do you teach empathy in a world
01:03:17where everything around you
01:03:19can seem like a potential threat?
01:03:21another shocker of the story
01:03:31life expectancy dropping
01:03:33in the U.S. for the third straight year
01:03:35let's talk to the doctor about this
01:03:37also jumping suicide
01:03:39I started this film when I saw that U.S. life expectancy
01:03:43had dropped for the first time in years
01:03:45now, two years later
01:03:47the CDC just announced
01:03:49life expectancy has declined in America
01:03:52for three years in a row
01:03:53that hasn't happened in a hundred years
01:03:56last time this really happened
01:03:59you know, there was a world war
01:04:00there was an infectious disease
01:04:02the pandemic spreading around the world
01:04:04so what's driving it now
01:04:07is a very different situation
01:04:08it does not appear
01:04:15that this epidemic
01:04:16is going to end
01:04:17in the foreseeable future
01:04:19who would disagree
01:04:21that we've got a very stressful situation
01:04:24in our country
01:04:25how bad is it now
01:04:26compared to what you've seen
01:04:27in decades past
01:04:29it is really
01:04:30a very bad situation
01:04:32at this time
01:04:33Sanjay
01:04:34you have people having guns
01:04:36and you have these
01:04:38physical, political, social confrontations
01:04:41put all of that together
01:04:43and then the stress
01:04:45let's say economically
01:04:46and you've got one
01:04:47hell of a mess
01:04:48and then you have
01:04:50the drugs that are available
01:04:52to deal with it
01:04:53and so on
01:04:53so you say
01:04:54gee, how come we have more drug deaths
01:04:56and how come we have more people drinking
01:04:58and how come we have more suicides
01:04:59as Pogo said
01:05:01we have met the enemy
01:05:02and he is us
01:05:03it is a critical time
01:05:20in our healthcare system
01:05:21sometimes as we talk about these issues
01:05:24and the solutions
01:05:25we put them in the bucket of medicine
01:05:28and health
01:05:29but for me
01:05:30that issue became one of justice as well
01:05:32and how do we think about medicine
01:05:35and health and justice
01:05:36we cannot ignore
01:05:38the impact of stress
01:05:39on our society
01:05:41and what it's doing to people
01:05:42in very, very tragic ways
01:05:44if the United States were my patient
01:05:52and I were the doctor right now
01:05:54looking at this patient
01:05:55I mean, the prognosis isn't great
01:06:00can you just point out the spot
01:06:02that's the problem spot here
01:06:04people are dying
01:06:06all because of policies
01:06:09that haven't reflected scientific knowledge
01:06:11it's like you're creating a problem
01:06:14than to have guys like us
01:06:16go in there
01:06:16and try and solve the end product
01:06:20you know
01:06:20and even worse
01:06:22in some ways
01:06:22it seems like we're manufacturing the disease
01:06:24bad food
01:06:25opioids
01:06:26gun laws
01:06:26our energy policy
01:06:27have led to these problems
01:06:28and as much as they make
01:06:30short-term sense
01:06:32for the people
01:06:32who are making money
01:06:33off of those problems
01:06:34it's bad for
01:06:35it's bad for people
01:06:36is he eating it all
01:06:40he's eating little bites
01:06:41but hopefully the two
01:06:43will come out
01:06:43in the next couple days
01:06:44the NG2
01:06:44how are you feeling?
01:06:48uh, good
01:06:49do you feel me touch you okay up here?
01:06:53yeah
01:06:53do you feel the same as over here?
01:06:55yeah
01:06:56how about this?
01:06:58want to try and stand up for us?
01:07:00yeah
01:07:01why don't you hold my hands?
01:07:03or hold
01:07:03that's pretty good
01:07:07yeah
01:07:08that's pretty good
01:07:09I thought the majority of the work
01:07:10that any of us do in this hospital
01:07:12is to take care of diseases
01:07:14that are almost entirely preventable
01:07:16and
01:07:17I think once you've seen that
01:07:19you can't unsee it
01:07:20but
01:07:21we could stop manufacturing
01:07:22the disease in the first place
01:07:24and that's
01:07:25that's a big
01:07:26a big idea for me
01:07:27a big idea for all of us
01:07:44and
01:07:45that's a big idea for us
01:07:50and
01:07:51the
01:07:51that's all
01:07:52the
01:07:53the
01:07:53the
01:07:54the
01:07:54the
01:07:54the
01:07:55the
01:07:55the
01:07:55the
01:07:56the
01:08:27...
01:08:57...
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