Stress Management – why the American work ethic is antithetical to wellness + tips

Below is just five of many high quality studies linking chronic work stress to serious physical and mental health outcomes:

1) A 2016 meta-analysis in The Lancet found that working more than 55 hours a week was associated with a 33% increased risk of stroke and a 13% higher risk of coronary heart disease compared to those working 35–40 hours per week (Kivimäki et al., 2015).

2) A longitudinal study in Journal of Occupational Health Psychology found that chronic job strain (high demands, low control) predicted depressive symptoms and fatigue even years later.
Melchior et al., 2007

3) A 10-year study in Circulation found that work stress significantly increased risk for metabolic syndrome, including hypertension, insulin resistance, and abdominal obesity.
“Work stress, particularly effort-reward imbalance, was associated with a 2x increased risk of developing metabolic syndrome.”
Chandola et al., 2006

4) The INTERHEART study (one of the largest global case-control studies on heart disease) found psychosocial stress (including workplace stress) was as predictive of myocardial infarction as traditional risk factors like smoking or diabetes.
“Chronic stressors, including those from work and home life, were associated with a >2-fold increased risk of heart attack.”
Rosengren et al., 2004

5) A 2025 study published in Occupational & Environmental Medicine found that individuals working more than 52 hours per week exhibited structural changes in 17 brain regions associated with executive function and emotional regulation. These alterations may lead to reduced emotional stability, increased anxiety, and challenges in managing interpersonal relationships. The researchers emphasized the need for workplace policies that mitigate excessive working hours to protect employees’ mental and cognitive well-being.
Cho et al., 2025

Beyond breathing exercises: what we’re really up against

Given the information above, it’s ludicrous to suggest that stress management is simply a matter of carving out a little extra time for yoga or breathing exercises. In America, stress isn’t just a scheduling issue—it’s a cultural one.

While it’s beyond the scope of this post to unpack fully, I’ll say this: yes, stress is deeply tied to financial realities. But in my opinion, those realities persist in part because of deeper cultural dysfunctions—patterns reinforced not just by media, but by the everyday choices and attitudes people adopt and normalize.

Therefore, adding a few “stress management techniques” can be helpful if they genuinely resonate with you—but they’re not the core solution. What most people need isn’t another task, but a different perspective around boundaries and values. Less overtime, more time on a lawn. More afternoons in a park, slow meals with friends, checking in with your body about what feels good.

But the money!

Despite the prevailing notion that economic development necessitates relentless work hours, the Netherlands exemplifies a more balanced approach. Dutch workers average just 32.2 hours per week—the shortest among OECD (high income democratic) countries—yet the nation maintains a high GDP per capita of $64,572 as of 2023. Furthermore, only 0.3% of Dutch employees work very long hours (50+ per week), the lowest rate in the OECD. This suggests that prioritizing work-life balance doesn’t compromise economic performance. Instead, it fosters a sustainable model where productivity coexists with personal well-being. The Times

Conclusion

I think the average wellness discussion around stress management unfortunately shares the same rotted roots as the problem it claims to address: subtly judging you for not managing to squeeze in a little meditation or yoga on top of an already overwhelming mix of work expectations, family responsibilities, and social obligations. If that kind of advice feels absurd given the scope of the issue—you’re not wrong.

Of course, in real life, we’re already in the thick of it. Financial stressors are real, and the system often feels designed to keep us too exhausted to push back. Still, carving out time for a walk or a bath can help. Yoga is a beautiful practice—so is canoeing, throwing a frisbee, or anything else that brings joy to your heart. These aren’t fixes, but they can be signals—small shifts that begin to bring your life back into alignment with what your heart actually needs.

Both the soul heart that longs for play, and the physical one—where chronic stress quietly takes its toll, and disease remains the number one cause of death in the U.S. It’s time we honor both.

Tips

Be kind to yourself.
Make space for quiet—and for joy—in each day.
Recognize your value beyond what you produce.
Set boundaries around work.
Prioritize sleep.
Take walks in nature.
Listen to the signals your body sends—with curiosity, not judgment.
Ask for help.
And sure, maybe do some yoga.

Lifestyle: The Third Pillar of Health

The Broad Strokes of Lifestyle

Lifestyle encompasses a range of habits and behaviors:

Movement: Regular physical activity supports cardiovascular health, maintains muscle mass, and boosts mental well-being.
Sunlight and Nature: Exposure to natural light and green spaces can improve mood and regulate circadian rhythms.
Substance Use: From alcohol to cannabis to medications, how we engage with substances affects our sleep, hormones, and resilience. Occasional, intentional use may not be a problem—but chronic use often comes at a cost.
Stress Management: Managing stress isn’t only about breathwork or meditation—it’s also about how we relate to our thoughts, reframe challenges, and regulate emotions under pressure.
Social Connections: Engaging with a community provides emotional support and has been linked to longer life expectancy.

While each of these elements plays a role, let’s delve deeper into a critical cornerstone of lifestyle: movement.

Exercise: The Cornerstone of a Healthy Lifestyle

Shared Benefits: Cardio & Resistance Training

Not all movement is the same, but much of it leads to similar outcomes. Whether you’re lifting weights or going for a run, both resistance and cardiovascular training offer a wide range of overlapping benefits:

Improved metabolic health: Both forms of exercise help regulate blood sugar, increase insulin sensitivity, and support healthy body composition.
Better mood and mental health: Regular physical activity reduces symptoms of depression and anxiety, improves stress resilience, boosts feel-good brain chemicals like endorphins and dopamine, and helps regulate the nervous system.
Cognitive support: Movement increases blood flow to the brain and stimulates the release of brain-derived neurotrophic factor (BDNF), which aids memory, focus, and long-term brain health.
Hormonal balance: Exercise can improve testosterone, estrogen, and growth hormone levels, while helping regulate cortisol when practiced consistently and mindfully.
Lower inflammation and biological aging: Studies show that both resistance and cardio training reduce markers of chronic inflammation and can even slow biological aging.

But while they share a lot, they also each bring something unique to the table.

Cardiovascular Exercise: Building Endurance from the Inside Out

Cardio exercise is especially valuable for:

Heart and circulatory health: Aerobic activity strengthens the heart, lowers blood pressure, and improves overall circulation—helping reduce the risk of cardiovascular disease.
(CDC)
Mitochondrial function and metabolism: Steady-state cardio, especially Zone 2 training, enhances mitochondrial health and supports long-term metabolic efficiency.
(Peter Attia, MD)
Brain health and cognitive protection: Regular cardio is linked to greater hippocampal volume and slower age-related cognitive decline, supporting memory and mental clarity.
(Harvard Health)
Accessibility and adaptability: Activities like walking, swimming, and cycling are low-barrier and easy to sustain. Even short sessions can deliver benefits, and interval training offers similar gains in less time.
(Harvard Medical School)

Resistance Training: Building Strength for Life

Resistance training is especially valuable for:

Muscle and bone health: It preserves lean mass, prevents frailty, and supports bone density—key factors in aging well and maintaining independence.
(NIH source)
Glucose control: While both cardio and strength training help, resistance work is especially effective by increasing muscle mass, which improves how your body stores and uses blood sugar—even at rest.
(Harvard Health)
Posture and injury prevention: Strong muscles support alignment, reduce back pain, and improve movement patterns that protect joints and reduce fall risk.
(Mayo Clinic)
Resilience and longevity: Grip strength and muscle mass are strong predictors of lifespan—arguably more useful than weight or BMI in older adults. Just 90 minutes of resistance training per week has been shown to slow biological aging by up to four years.
(Prevention.com)

Crafting a Sustainable Exercise Routine

Building a lasting exercise habit doesn’t require drastic measures. Start with manageable goals:

Consistency Over Intensity: Regular, moderate workouts are more sustainable and beneficial than sporadic intense sessions.
Find Activities You Enjoy: Whether it’s dancing, hiking, or sports, engaging in activities you enjoy will help you stick with the practice.
Pair It with Routine Anchors: Linking your workouts to an existing habit—like a walk after work or lifting before your shower—makes the behavior easier to stick with over time.

Bringing It All Together

Whether you’re lifting weights, walking in the woods, dancing in your kitchen, or easing into a gentle swim, the goal isn’t perfection—it’s momentum.

Start where you are. Pick something that feels doable. Keep showing up, and over time, even small choices compound into something strong, steady, and life-giving.

Sleep: The First Pillar of Health

It’s impossible to overstate how critical sleep is to our wellbeing across every metric. Quality sleep:

Restores dopamine and serotonin, boosting mood and motivation
Improves coordination, reaction time, and physical endurance
Clears metabolic waste from the brain, supporting long-term cognitive health
Releases growth hormone for tissue repair and physical recovery
Balances hormones that regulate mood, appetite, and libido
Strengthens the immune system and reduces inflammation
Helps regulate pain perception via increased activity in the brain’s pain modulation centers

And the list goes on.

Therefore, no matter the issue, I want to check on and support sleep for my patients.

So how do we do that?

Improving sleep starts with what’s often called sleep hygiene—the practical habits and environmental cues that tell your body it’s time to rest. While every person’s situation is different, there are key strategies that benefit almost everyone:

Regulate Light Exposure: Morning sunlight helps set your circadian rhythm; bright, especially blue light at night confuses it. Dim the lights in the evening and ideally limit screen time an hour before bed (blue-light blocking apps can help, but reduced exposure is best).
Develop a Wind-Down Ritual: Whether it’s reading, meditation, light stretching, or a warm bath, having a consistent pre-sleep routine cues your nervous system to relax. Ideally start this ritual at the same time every day.
Improve Your Sleep Environment: Cool, dark, and quiet is the gold standard. Blackout curtains, white noise machines, and keeping the room around 65-68°F can make a big difference.

I’ve struggled with insomnia myself for many years, and alongside the general strategies above, I want to share a few specific corrective measures that have personally helped:

Magnesium Support: Magnesium helps relax muscles by competing with calcium at muscle receptor sites, easing physical tension and reducing issues like restless leg syndrome. Epsom salt baths (aka magnesium baths) can offer similar calming effects through the skin.
Change Your Sleep Environment: Sometimes the usual bed becomes unconsciously associated with anxiety or the pressure to fall asleep. In these cases, even a less “ideal” environment can work better simply because it feels low-pressure.
Try a Firmer Surface: While it sounds counterintuitive, sleeping on a firmer surface can help some people relax more deeply. The additional support reduces the body’s need for subtle muscle engagement, allowing for a greater sense of physical ease.
Caffeine Abstinence: While most people find that stopping caffeine at least 12 hours before bed is enough to prevent it from affecting sleep, I noticed that cutting out even my morning coffee led to noticeable improvements.

Often, the moment you mention insomnia, someone will ask, “Have you tried melatonin?”

Personally, I don’t recommend it. While melatonin can be helpful in very specific, short-term scenarios (like adjusting to jet lag), regular use may reduce your body’s natural melatonin production over time. Many people also report side effects like vivid or unsettling dreams.

In my professional opinion, melatonin belongs in the same category as other pharmaceutical sleep aids: potentially useful in acute cases, but not ideal for long-term use. These substances can create dependency, and even if they “help you fall asleep,” the quality of that sleep is often compromised—which is why people still feel groggy or unrefreshed after using them.

As always, if anyone reading would like to talk about improving your sleep quality, I’m happy to help. Just text me to get started: 919-809-9355.

The Five Pillars of Health and Why They Matter

This is a core philosophy of mine: 90+% of people’s health needs can be improved—or even resolved—by addressing and balancing what I call the pillars of health.

So what are they?

Sleep
Nutrition
Lifestyle
Stress Management
Community

From one health professional to another, the language may vary—some might add or group things differently—but you’ll find versions of this framework across many holistic and integrative practices. These five pillars are, in my professional opinion, the foundation of a long-term health plan. They’re also the best place to start when working through chronic conditions, before jumping straight to complex protocols or exotic supplements.

Each of these deserves a deeper dive (and they’ll each get one in future blog posts), but let’s introduce them briefly:

Sleep
Sleep is non-negotiable. It’s when your body and brain repair, reset, and regenerate. Chronic sleep issues are linked to everything from mood disorders to blood sugar imbalances. The best keyword to search if you’re having trouble? Sleep hygiene. You’ll find plenty of science-backed strategies to help troubleshoot and improve your sleep quality.

Nutrition
You are what you eat—quite literally. Every cell in your body is made from the food you consume. (Fun fact: most cells in the human body are replaced every 7 to 10 years.) While there’s no universal “perfect diet,” some principles are nearly universal: nutrition matters, overeating is a common contributor to chronic disease, and whole foods generally beat food products in every way.

Lifestyle
How you live—how you move, rest, and spend your time—has a powerful impact on health. I know I feel my best when I’ve exercised regularly and spent time outdoors, and the research backs that up. Movement and nature both reduce inflammation, boost mood, and support immune function. A healthy lifestyle isn’t a single habit—it’s the rhythm of your daily choices.

Stress Management
Modern life runs fast—and it shows up in the body. Chronic stress increases the risk of nearly every major health issue, and often disrupts other pillars like sleep and dietary choices. Whether it’s breathwork, therapy, walks in the woods, or setting better boundaries, finding your way to manage stress is essential, not optional.

Community
This one surprises people—but it’s vital. A sense of connection and belonging isn’t just emotionally nourishing; it’s physiologically protective. Studies on centenarian “Blue Zone” populations show that tight-knit communities correlate strongly with longevity and life satisfaction. In the often-isolating landscape of modern American life, rebuilding community is real health work.

Why Pillars?
They’re called pillars because they support one another. When you’re consistently tending to even one area of your health, you often feel better—and that momentum makes it easier to show up for yourself in other ways too. For example, regular exercise—a lifestyle choice—can significantly reduce stress. And with less stress, it becomes easier to sleep well, make nourishing food choices, and engage with community. It’s all connected.

Final Note
To be clear: there are specific conditions that need specific interventions. Antibiotics have their place. Supplements and pharmaceuticals can be crucial tools. And yes, sometimes you might just need vitamin C because you’ve unknowingly been living the life of a pirate. But for most people, most of the time, real, lasting health begins by tending to these five pillars.

Stay tuned—I’ll be exploring each of these pillars in more depth in upcoming posts.

Meditation 101

Often, meditation is something my patients say they’ve tried but that “didn’t work” for them. I usually respond with this thought exercise:

Let’s say you lived in a world without Spotify, radios, or any easily accessible music. In this imaginary hellscape, you only have a violin, which you’ve never played before. You might pick up the violin specifically when you want to hear music, but unfortunately, your first experiences won’t be sweet, melodic sounds — just a screechy mess.

I think this is why meditation can turn so many people off. Meditation, in essence, runs counter to our very nature. It’s entirely natural to want to problem-solve, to have the “monkey mind,” as the Buddhist texts call it. We constantly seek something to keep us interested — even if that thing is our own discomfort, something upsetting a friend told us recently, or getting cut off in traffic. In a funny way, even these more “negative” thoughts can feel more natural than just noticing the breath.

But with practice, the music improves. Whether you’ve read some of the many research papers on the benefits of meditation, or just heard a friend say it helped her sleep, something keeps you coming back. You push past the initial discomfort and start to build a habit.

Lo and behold, those discordant sounds — the uncomfortable thoughts made louder by the silence — finally give way to moments of real calm. The practice of setting down whatever mental object arises and returning to the breath gradually allows your soul, mind, and nervous system to find ease for longer and longer stretches of time.

Over time, meditation becomes a great tool for self-regulation — a practice that helps you simply be with yourself, without the constant push and pull of craving and aversion.

Five to ten minutes each evening before bed is a great place to start, and has been shown to improve sleep quality.

To start meditating, find a comfortable seat — ideally upright on a small cushion, or in a chair with your spine tall and the crown of your head gently reaching toward the sky. Begin breathing naturally, and notice the sensation of your breath. At first, it might be helpful to count each breath: [Inhale] 1, [Exhale] 2, [Inhale] 3, etc., up to 10, then start over at 1.

Possibly the most important part of the practice is the very moment you notice you’ve been distracted. You realize you’ve been thinking about work for the last five minutes. Don’t fret, don’t chastise yourself, and don’t rush off to write down what you were thinking. Ideally, the moment you realize you’ve drifted, you simply come back to the breath.

If you find yourself getting distracted a lot, congratulations — you’re human. I genuinely don’t think the process needs to be any different for someone with full-on ADHD versus someone without. Like any other practice, it might take more time for one person than another, but the basic process is the same for everyone. Everyone will find stumbling blocks when learning to meditate. The important thing is not to let those challenges grow into their own story.

If needed, remind yourself that meditation time — like violin practice time — isn’t the time for ruminating on why you aren’t a natural savant. If you really want to, you can spend the rest of the day contemplating whether meditation “just isn’t for you,” but during your practice time, simply practice. Save the self-criticism for later.

In the end, unlike the music metaphor, meditation really is something only you can do for yourself. You really are the only person who can always be there for yourself, hear all your own thoughts — and you get to decide how to shape your inner landscape.

There are many other kinds of meditation. Another favorite of mine is a body-scanning practice called Vipassana. There’s also loving-kindness meditation, which focuses on cultivating positive emotions rather than bare awareness of sensation. And there are many others to explore.

If you’re interested in learning more about meditation, there are tons of great resources online, as well as many local meditation centers. And I’m always happy to talk more with any patient who’d like to dive deeper.