Chronic Stress is Making Us Sick

I learned the hard way that we are not designed to live this way

This essay is adapted from a piece that was originally published in December 2023. I’m resharing for the many new subscribers who have joined since then.

Americans suffer from chronic illness in a way that is unique among industrialized nations.

The insane levels of stress we live with is a major factor in this.

A year-long Washington Post examination sounded the alarm in An Epidemic of Chronic Illness Is Killing Us Too Soon, noting that while the US once had a similiar life expecancy as it’s peer countries, “chronic ailments are the primary reason American life expectancy [is now] poor compared with other nations.”

In a recent report, Stress in America 2023, the American Psychological Association found that among those aged 35-44, nearly 60% reported they suffered from a chronic illness, and 45% percent said they had received a mental health diagnosis. Adults ages 18 to 34 reported the highest rate of mental illnesses at 50%.

When I was younger, the idea that I could burn out or come down with a chronic illness seemed fantastical.

Until, that was, it happened.

Whereas now chronic illness is fairly common, it wasn’t when I was growing up in the 1970s and 80s or even in my early adulthood. The first time I knew someone who had been diagnosed with chronic fatigue syndrome, I was in my early 30s. Over the years, more people I knew developed chronic illness.

Then, in my late 30s, I was the one who started to develop fatigue that I could not shake. By my early 40’s, it had turned into full-blown chronic fatigue syndrome. I would come home from work and collapse fully clothed with all the lights on and wake up 14-18 hours later. No matter how much sleep I got, I was still exhausted, with a brain fog that would never clear.

My official diagnosis was “reactivated Epstein-Barr,” and the infectious disease doctor who diagnosed me told me to take a minimum of six months off from work. He suggested I take disability leave and would provide me with the documentation I needed. “If you don’t do this, one day you will lie down and not be able to get up again,” he said.

I was a consultant and, therefore, did not have access to any disability leave. I needed to work to pay my rent. So, I worked. And I got more sick. Eventually, I could barely function and was mired in a deep depression and anxiety.

Life was beyond miserable; sometimes, I thought I would not make it.

This went on for almost a decade.

I eventually regained my health (that’s another story), though I still feel the repercussions of pushing my body too far for too long. I think having this experience has made me extra-attuned to the pressures our culture puts on our bodies. I will never go back to feeling that way, and nothing seems too dramatic — including moving to another country — if it means I can maintain my physical and emotional health.

Last year, I was talking to a top executive coach about how I wished I could go away for a month just to heal the damage I had done to my body and mental health through three decades of overwork, pushing it beyond anything it should have reasonably asked to do. I wanted my poor nervous system—which was perpetually dysregulated until a few years ago—to have an extended break.

She looked at me with something akin to pity. 

Oh, you poor dear.

“It will take a minimum of a year of not working to undo the damage,” she told me. I knew instantly that she was lowballing it. “Think of how many years it took to create the problem. It won’t be undone with a month of rest in another locale.”

Of course, a month can’t fix this.

But who can take a year (or more) off from work? I couldn’t and I still can’t.

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We need to stop normalizing chronic stress, and recognize that we are not designed to live this way.

Pushing your body beyond its breaking point in a quest for achievement should not be a point of pride. Being “crazy busy” is not something we should brag about. Pulling all-nighters to finish a work or educational project should be seen as problematic behavior, not proof of dedication and discipline. Employers should not believe they own every minute of your life, nor should you feel afraid to go on vacation because you might be punished for it or even be replaced, a commonplace worry for workers in the US.

I’ve long been concerned about the toll life in America has been taking on people's physical and mental health. Then I picked up Canadian doctor Gabor Mate's latest book, The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture.

I went from concerned to terrified pretty quickly.

Throughout this Bible-sized book, Mate methodically makes the case that chronic stress and trauma are destroying our health. Mate then unequivocally lays our current state at the feet of post-1980s American capitalism, which has introduced a level of unrelenting financial pressure and uncertainty that makes life so hard for so many people.

Mate writes:

Thus, on the very terrain in which capitalism stakes its greatest claims to success—economic achievement—we find many people in a state of chronic uncertainty and loss of control, subject to stress-inducing fears that translate into disturbances of the hormonal apparatus, of the immune system, and of the entire organism.

The Washington Post examination came to a similar conclusion regarding the scourge of chronic illness in the United States:

[E]xperts studying the mortality crisis say...poor life expectancy…is the predictable result of the society we have created and tolerated: one riddled with lethal elements, such as inadequate insurance, minimal preventive care, bad diets and a weak economic safety net.

Almost everyone lives with chronic stress in the United States. But if you are a member of a marginalized community, it’s a million times worse. The health impacts of systemic racism—on top of all the other stressors—for example, are undeniable.

Self-reported racial discrimination is just as harmful as any of the commonly named “lifestyle” culprits: lack of exercise, smoking, a high-fat or high-salt diet. Black women are three to four times more likely to die from pregnancy-related complications than white women, according to the Centers for Disease Control and Prevention—and a big reason for the disparity may be racism, say experts.

This recent CNN story highlighted a Black American man who moved to Italy to improve his life expectancy.

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Chronic stress keeps you in a trauma response — fight, flight or freeze.

In this state, your body never gets a break because you are always on high alert and living in survival mode. The chronic uncertainty and anxiety naturally leads you to overwork so you will have the resources to survive.

This is a very primal state. You know that if you fall, society will not catch you. (Though you will be given the opportunity to amass credit card debt that will follow you for the rest of your life thanks to criminal levels of interest)

Most people who overwork will eventually burnout. At this point, functioning becomes almost impossible as your body and mind have been maxed out.

You are running on fumes.

We don’t have to live this way. It’s not normal.

In an article about life expectancy, the Washington Post interviewed a cardiologist in Milan, Nicola Triglione, who frequently visits the United States to study the latest health-care innovations:

[Mr. Triglione] said he would never move to the United States. He knows too many Italian doctors who moved to the country but found the lifestyle unsustainable. The problem wasn’t their patients’ health — it was their own. “After maybe 10 years, they come back, and they say: ‘I’m done. [The Americans] work too much, it’s a money game, they have, I don’t know, four weeks of vacation a year?’” Triglione said.

Of course, it’s actually two week’s vacation for most Americans, if they get a paid vacation at all. In Europe, paid vacation time is mandatory; four weeks is a minimum.

The U.K. writer

Emma Gannon

makes the interesting point that burnout is often about overwork—but not always. Sometimes, she says, it can be an existential burnout. This could occur even if you are keeping reasonable work hours and not pushing your body too hard.

“Essentially this kind of breakdown is a way of life saying to you: this current way you are living isn’t working,” she writes.

Gannon quotes the writer Kendra Patterson:

"Existential burnout is a whole-life phenomenon when you begin to question the very foundations of your life and beliefs. It is the state of emotional, psychological, and spiritual confusion and exhaustion that results from years or decades of trying to follow conventional paths and not finding satisfaction or happiness through them."

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I have experienced both kinds of burnout, but these days I relate most to the existential burnout.

Indeed, the “conventional path” got me to a lot of places I didn’t want to be.

So, now I’m going to try the unconventional path and move to a country that offers a slower, more humane pace of life where I won’t have to work constantly to make sure I have enough money just to cover basic necessities or be ready to be bankrupted if I have a medical emergency. I am going to do my best to stop adding more chronic stress to my already worn-out body by living among people for whom “hustle and grind” has no meaning.

I hope to learn a different way of being.

I hope it’s not too late.

After a lifetime of pushing my body beyond it’s limits, I often wonder if I can repair the damage.

What’s interesting to me is that I’ve written multiple essays about why I think leaving the US makes sense for me and many others, and I haven’t even mentioned the political situation, which, for many, would be reason enough alone to go. I haven’t raised it partly because I think it’s pretty well understood to be a factor for many people who want to leave.

But I mostly haven’t raised the political situation because I want people to see how fundamentally broken American society is, even if we weren’t looking down the barrel of a potential authoritarian government.

The point of writing these essays is not to convince people to leave the United States. While that may be the right decision for some, it isn’t for others. I’m writing them because I think the fact that so many people are reaching the same conclusion about how unlivable the US has become tells us just how off course we are. Most of us are people who, in the past, would never have considered leaving the United States.

We all need to be clear about what is wrong—about how unbelievably abnormal our way of life is—so we can have a plan to fix it.

As I’ve written before, we don’t need ‘self-help’ or ‘wellness’.

We need support.

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