
What even is stress? And how did it possibly seem like a good idea when we were evolving 20,000 years ago??
Robert Sapolsky, a neurobiologist at Stanford University has spent a great deal of time asking and answering these very questions. As it turns out, stress was a wonderful idea when we were evolving into what we are. Now, though? Not so much, and therein lies the trouble.
In his book Why Zebras Don’t Get Ulcers, Sapolsky describes how the stressors of modern day life are completely different than they used to be:
It is a rare event when we have to stalk and personally wrestle down our dinner. Essentially, we humans live well enough and long enough, and are smart enough, to generate all sorts of stressful events purely in our heads. How many hippos worry about whether Social Security is going to last as long as they will, or what they are going to say on a first date? Viewed from the perspective of the evolution of the animal kingdom, sustained psychological stress is a recent invention, mostly limited to humans and other social primates.
(Chapter One, Why Zebras Don’t Get Ulcers, Robert Sapolsky)
So let’s take a quick look at stress: what it is, how it helps, and how it hurts.
What’s Stress?
(Sapolsky himself gives a great overview in this talk, and he’s hilarious! Literally one of the best speakers I’ve ever had the opportunity to see.)
Our body has two major modes of functioning in regard to utilization of resource: the sympathetic (“fight-or-flight”) system and the parasympathetic (“rest-and-digest”) system. When we’re about to perform on stage or ask that person out on a date, our heart beats harder and we sweat a little – our adrenaline is pumping, which means our sympathetic system is roaring. And when we’re chillin’ on the couch, watching TV right after a meal, and maybe snuggled up and just feeling ready to melt – our stress hormones are all pretty low and the parasympathetic system exerts its influence.
We call the sympathetic “fight-or-flight” because it gives a short-term boost to physiologic functioning, and then ideally it ends. We’ve either fought or run away, or our performance is over. Stress, Sapolsky states, is what happens when we start triggering that response because of that meeting, that exam, and the taxes – and the sympathetic system that’s designed for the short-term is kept “on” chronically. Instead of just an adrenaline boost, a long-term response becomes harmful to our body. See, we need frequent and regular intervals of parasympathetic-dominant influence in order to rejuvenate and build up energy stores.

A simplified view of the parasympathetic system puts it as the rest-and-digest system
So why do we get ulcers while zebras don’t? To paraphrase Sapolsky, we get ulcers because we’re able to activate our stress response with just our mental worries while zebras activate their stress response only during critical situations… like getting attacked by a lion.
My Stress and My Reflux
Let’s take a little trip back to January of my third year of medical school. I was starting my Surgery rotations for the first time, and I’d just developed a cough. It was a rattly, barking kind of cough and seemed to flare at night – I’d wake up in the middle of the night feeling like there was gunk in my windpipes. Fortunately, the cough wouldn’t be present when I would be observing surgery cases in the operating room but mostly just at night and early in the morning. It was also especially worse after eating chocolate. As much as I’d hoped that the gunk would clear and the cough would go away, it just didn’t. Months went on and the cough was still there.
About a month into this problem, I was talking with a friend, one of my classmates, about my cough. “Bro,” he said, “GERD [gastroesophageal reflux disease, or acid reflux] is one of the most common causes of chronic cough. Yeah, listen – I just had a practice question on this.” (Further reading here) As I thought about it, I realized that the pattern of symptoms and correlation with chocolate really did fit with GERD. As it happens, I also had a check-up at the student clinic and an x-ray for one of my applications during this time, which inadvertently ruled out some other things that could explain my cough.
N.B. This is classic med student syndrome – notice a constellation of symptoms and try to diagnose it myself. I did not see a certified health professional or receive a formal diagnosis.
Anyway, I addressed my symptoms by doing two things: 1) stop eating chocolate and 2) relax my body more, especially during and after meals. Once I started paying attention, I noticed that I kept my abdomen really tight all the time. It was the tip of my stress iceberg; I was much more tense and on edge these days than I’d ever been before. I started actively relaxing my body more often and I stopped eating chocolate, and by July, my cough had gone away. Something to think about.
I’m used to being vigilant about my stress levels and how I feel, and normally I cope well with stress through meditation and support. Most of the time, I feel like I’m either minimally or optimally stressed, but third year med school represented the beginning of newer challenges, and it took me some time to identify these issues and adapt to them. Yet, the ability to notice what’s going on within myself and feel confident in trying to address the problems really allowed me to embrace these challenges and overcome these hurdles – just like how I observed how and why my body was unwell and then took the right steps to make it better.
Does my meditation practice help me deal with stress? Absolutely. What does the science have to say, though? Let’s take a look next time at what the scientific community’s been able to discern about meditation and stress so far.
References
- Madanick, R. D. (2013). Management of GERD-Related Chronic Cough. Gastroenterology & Hepatology, 9(5), 311–313.
- Sapolsky, Robert M. (2004). Why zebras don’t get ulcers, 3rd ed.. New York: Owl Book/Henry Holt and Co..