It is all about how you define success.

Over the past year I have read a lot of self-help, reinvention, how to be happy, simple living and lifestyle altering books. Unanimously they seem to be written by people who have a few things in common. Firstly they are successful. They are on top of their game and have the money or the power or the fame or whatever it is they were after. Then they worked themselves into the ground and prioritised the wrong things and this resulted in some sort of ‘event’. Perhaps a breakdown, relationship troubles or maybe just a sudden realisation that they were wasting their lives or missing out on seeing their family, but whatever it was something made the sit down and re-evaluate what was important to them. They do this, and then they write a book about it.

Don’t get me wrong, I love these books. I have been incredibly inspired by these stories and as a result have identified which things make me happy and started trying to focus more on what is important to me.

I do wonder though, where are all the self-help books written by people that discovered these principals at a young age? People who dedicated their time and energy to the things that make them happy, eschewing our cultures standard measures of success, and are currently living their dreams? Can you be a CEO whilst maintaining work life balance? Can a highly respected journalist have achieved their success whilst insisting on decent holiday time, family leave, actually taking lunch breaks and not replying to emails after 9pm?

Perhaps the lack of literature produced by people with work-life balance and people who know what is really important is a direct result of their different priorities. They don’t want to be CEO. They know that happiness is not found in money and power. They don’t want to be a famous journalist because they feel that the cost of that kind of success isn’t worth it in the long run. They don’t write a book about their lives because they are too busy actually living their lives, playing with their kids or going on weekends away with friends.

For these magic people the whole definition of success may be different. Success might be the ability to take their kids on regular camping trips. It might be to cultivate a beautiful and thriving garden. It might be to create a supportive community around them. Success could be knitting a scarf for a friend, perfecting a bolognese recipe or harvesting a bountiful vegetable crop.

It follows on then that using the generic societal definition of success isn’t going to make everyone happy. Some people may enjoy nothing more than being responsible for hundreds or even thousands of employees, maintaining the entire image of a news network or being in possession of enough money to have holiday houses all over Europe. I have no doubt that there are people who get a real buzz out of the responsibility, importance and decision-making power involved in this and if this is you then fantastic. Pursue it with everything you have. The reality is though that most people don’t need this to find happiness.

What we need to do is create our own definition of success.

A cup of tea and a chat could be more beneficial for your health than another blood test.

In June an article entitled “How stress can clog your arteries” was published by the American Association for the Advancement of Science. A group of scientists have investigated why people who are suffering from chronic stress are more likely to have increased atherosclerosis (a build-up of plaque in their artery walls that can lead to heart attack, amongst other things). Blood samples from stressed-out medical students revealed they had increased levels of immune cells in their blood. Subsequent laboratory testing successfully duplicated these findings.1 The poor stressed-out mice had increased levels of neutrophils and monocytes as well as increased incidence of risky atherosclerotic plaques at danger of rupturing and causing life threatening blockages. The findings were conclusive; stressed-out mice are at greater risk of heart disease.

This is incredible news! They found a definite link between stress and cardiovascular disease. Alternative medicine has long emphasised the importance of reducing stress but conventional medicine has not explored the possibility of a direct connection in much detail before this study. It is well recognised that stress is contributing to the majority of illnesses such as high blood pressure, Irritable Bowel Syndrome (IBS), and susceptibility to seasonal infections. Despite this, little is taught of how to reduce stress and it is rare to find a GP who would suggest mediTation to a patient before, or even in conjunction with, mediCation. That is why the results of this study are exciting. A definite link means that this very important aspect of wellness may start to be recognised as a major player in overall health in the conventional medical model.

But in true conventional medicine style, the article then mentions some possible outcomes of this research including a pharmaceutical drug to block the excess production of the offending immune cells, and then this telling quote from Alan Tall, a physician and atherosclerosis researcher at Columbia University:

“Rather than asking four questions about stress levels, we could use their [patient’s] white blood cell counts to monitor psychosocial stress,”

A blood test for stress!? Is this a step forward or a step backwards? Increased diagnostic powers can have definite advantages, and sometimes patients might not know when they are stressed, particularly if it is chronic stress but Tall specifically refers to saving time. Why talk when you can test instead? This is concerning in an age of disconnect, where people are feeling more isolated and helpless. Over the past few decades the world of medicine and pharmaceuticals has become increasingly advanced and often beyond the comprehension of most people without specialist knowledge. The result is that patients lose their agency and ability to make their own informed decisions. Complicated, multifactorial conditions such as hypertension (high blood pressure), Parkinson’s disease and cancer can require this specialist medical knowledge, but reducing stress definitely does not. A blood test for stress would ‘medicalise’ it, taking it out of patients’ hands where it belongs, and putting the responsibility on the doctors and the health care system. Research should focus on how to best communicate the importance of stress reduction to patients, and diet too while they are at it.

There is a long way to go for our health system before GP appointments can be long enough for good conversation. Regardless, the results of this study could provide a fantastic stepping-stone in the path towards involving the patient back in their own health. It would be fantastic to see these results encouraging doctors to talk to their patients again and to build relationships with them. To find out about their lives, whether they are happy or unhappy, and what stresses are impacting on them. Engage patients, educate them, and encourage them to be partners in their own healing.

Reducing chronic stress is one area of health care where the patient has the ability to prescribe and initiate their own treatment. The link between stress and atherosclerosis paves the way for GPs and cardiologists to take a look at the sources of chronic stress in their patients’ lives and start referring them to psychologists, counsellors, massage therapists, yoga and meditation classes and suggesting long baths, cups of tea, and more convenient working hours. Give the power back to the patients!

  1. Here is the full reference for the paper. Unfortunately I cannot access it as it is behind a pay wall.

Heidt T, Sager HB, Courties G, Dutta P, Iwamoto Y, Zaltsman A, von Zur Muhlen C, Bode C, Fricchione GL, Denninger J, Lin CP, Vinegoni C, Libby P, Swirski FK, Weissleder R, Nahrendorf M
Chronic variable stress activates hematopoietic stem cells
Nature Med. 2014;20(7):754-758 – PMID: 24952646 – PMCID: PMC4087061