WALDEN POND AND SHARKNADO
Henry David Thoreau famously said,
“There are moments when all anxiety and stated toil are becalmed in the infinite leisure and repose of nature.”
How splendid. What’s more, there is good evidence that a nice walk in the woods actually can do wonders for the mind and body. But there seems to be something not quite right, or a little incomplete, about Thoreau’s statement. It seems that rather than being a purely unnatural phenomenon, certain aspects of anxiety are perfectly natural. For instance, anxiety in the face of a bear attack or an earthquake seems to be exactly what nature would want.
This natural response is of course not just present in humans. A gazelle being chased by a lion does not appear to have the “infinite leisure and repose of nature.” Neither does anything underwater when near a shark. Or above water during a sharknado. Ever watch videos of monkeys going batty when they think a predator is near?
Indeed, it appears that most animals, humans included, have a natural mode that we often describe as being in “fight or flight”. And it makes perfect sense that anxiety is a normal part of this mode. This mode is not leisure and it is not repose. But it is built in and therefore also not unnatural.
The converse of the fight or flight mode is the “rest and digest mode”. Rhyming is fun. If the fight or flight mode is called the sympathetic response, then the technical name for the rest and digest mode is called the “parasympathetic” response. Perhaps this parasympathetic response is what Thoreau was referring to. In fact, it appears that a good deal of Thoreau’s experience of nature was in the relatively lion and sharknado-free area in the back yard of his buddy Ralph Waldo Emerson, on a nice pond about twenty minutes walking distance from his mom’s house that was also a tourist destination. He also probably wrote this quote after eating some of his mom’s apple pie (which she brought to him in his little cabin once or twice a week). So, chances are he wrote of nature’s infinite repose while staring at Walden Pond, eating pie, and with nary a shark, bear, or lion to worry about. Rest and digest, my friend.
Whichever the case, it is obvious that having a sympathetic response is normal for humans and many other animals. Yet, there is nonetheless something about the sympathetic response that seems to have gone horribly awry in humans. So much so that it is no stretch to say that many of us have sympathetic responses that are out of control and have become pathological. And it is this pathological sympathetic response that forms a key part of the wheel of fire.
Consider some of the details of a normal sympathetic response. Heart rate becomes more regular (i.e. normal respiratory sinus arrhythmia decreases) and faster and the volume of blood pumped (a.k.a. stroke volume) goes up. Lung bronchioles dilate to get more oxygen in and carbon dioxide out. Blood vessels to muscles dilate to give them more oxygen. Baseline muscle tone goes up to prepare you to move. Blood vessels to the gastrointestinal tract constrict to shunt even more blood to the muscles. Brain usage of oxygen and fuel goes up. Pupils dilate. A sense of heightened alertness and anxiety builds. All the things happen that you would expect to happen to help someone escape from that lion-bear-shark.
The problem arises when the sympathetic response fires up when there is no lion-bear-shark. Such as with the wheel of fire. Remember, the metabolic syndrome is a sympathetic disease. And why wouldn’t it be? It makes perfect sense. The fight or flight response is made to help us either fight an attacker or run away from it. Chronic inflammation is an attack on our body. Of course chronic inflammation is going to therefore elicit some sort of chronic fight or flight response.
Thus, with the wheel of fire, what we see are hormones in the pituitary, like ACTH (adrenocorticotropic hormone) go up. This then causes numerous things to happen, including making the adrenal glands sitting atop the kidneys make more cortisol. Cortisol for a short period of time is beneficial (kind of like that Medrol Dosepack or week of prednisone you got the last time you had bronchitis). But chronic elevated cortisol does all of the harm that someone taking chronic steroids does, including that outlined in BSSHM and part 1 of this series.
Further, if the sympathetic stress is severe and long enough, eventually something even more not good than too much cortisol happens. While it is unfavorable for too much cortisol to screw up sex hormones and potentiate the metabolic syndrome, what is worse is when the adrenal glands start to fatigue or the pituitary gland gets injured (like with traumatic brain injury). In this scenario, less cortisol and attenuating hormones are made. In the latter case, now even the normal aspects of the stress response, such as pain relief and inflammation suppression, become compromised. Remember, cortisol is anti-inflammatory. The sympathetic disease thus increases inflammation and diminishes the body’s ability to compensate. As C.S. Lewis would say, “castrate the geldings and bid them be fruitful.”
While stress is found in all of nature, animals, and humans throughout time, this chronic stress is something new. That gazelle getting chased by the lion had a brief period of sympathetic activity when trying (and failing) to run away, but then it was over and done with. That lion chasing the gazelle had a brief spurt of fight, but then it was all rest and digest.
Consider modern life, however. A mortgage is like a lion slowly chasing you all of your life. As is a nine to five job in a cubicle. As is getting stuck in traffic. As is going to the mall (for me). As is watching CNN or Fox News. As is staying inside all day and never being exposed to the appropriate wavelength of sunlight that wakes you up. As is getting too much blue light at night, so you only go unconscious but never hit stage 4 restful sleep. As is competing with the next door neighbors regarding who has the best yard furniture, window dressings, or all terrain vehicle to take the kids to soccer.
These are all chronic sympathetic states.
Now, consider all of these things combined with an internal environment of perpetual attack from chronic inflammation from, say, visceral adiposity or smoking cigarettes. These stressors don’t add, they multiply.
Things get bad very quickly. Or, maybe you are lucky and you don’t realize they’re getting bad very quickly. Then, all of the sudden, you hit 30, 40, or 50, and the wheels fall off of the wagon.
Now, let us go back to the wheel of fire and its various on ramps. In this metaphor, the disease of chronic sympathetic activity is so fundamental that it deserves to be placed within the circle along with the metabolic syndrome and sex hormone dysfunction.
In doing so, it becomes obvious that the sympathetic disease is related to the metabolic syndrome and a proinflammatory state in the same way that sex hormone dysfunction is. Sex hormone dysfunction both causes and is caused by the metabolic syndrome. In the same way, the sympathetic disease both causes and is caused by the metabolic syndrome. And, through a variety of mechanisms, the sympathetic disease both causes and is caused by sex hormone dysfunction.
Let’s take a second and look at how this can be seen in certain specific disease states. I will then review some of the esoteria regarding a few more mechanisms, and then we’ll wrap up by talking about some innovative therapies that have come and are coming online.
This concludes part 3 of the Wheel of Fire: Walden Pond and Sharknado.