Dr. Joan Vernikos with Dr. Barb
Dr. Joan Vernikos retired in 2000 as director of Life Sciences at NASA, where she was both a researcher and an administrator. Initially recruited by NASA because of her expertise in stress, she pioneered research on how living without gravity affected the health and post-flight recovery of astronauts. She’s published several books on gravity, aging, and stress, including The G Connection: Harness Gravity and Reverse Aging, Stress Fitness for Seniors, and Sitting Kills, Moving Heals. When she isn’t writing or keeping herself in motion, Dr. Joan consults with organizations on product development and whole workplace design, and serves as chair of the Taksha University School of Integrative Medicine’s Institute for Space, Health, and Aging.
Dr. Barb: Our guest today is Dr. Joan Vernikos, who was an early guest here on our Fullness of Midlife podcast. I found our previous conversation fascinating, so I’m very happy to have Joan back. The last time we talked about gravity and movement, subjects Joan learned about over a lifetime of researching health including at NASA as director of life sciences. A friend sent me a copy of Joan’s most recent book titled, Stress beyond 50: Tools & Wisdom for a Happier, Longer Life. Welcome Joan.
Joan: Thank you. I’m pleased to be here.
Dr. Barb: You are here to talk about your new book. I think stress is a topic most of us have some interest in, and certainly in my practice stress is a topic of conversation, so I’m curious about what drew you to this topic?
Joan: I’ve spent a lifetime, my entire career, basically, it started out with researching how the brain regulates the hormone response to stress as opposed to the psychological response to stress, but that came into it a bit later. With a colleague at Stanford we developed a concept of coping. Interestingly enough, "coping" was the term we used, but it hadn’t been defined in physiological terms. And what we found—he was studying aggressive behavior in rats and in order to get them to fight each other he gave them a bit of an electric shock. I thought this was a fantastic stress that I can measure in terms of magnitude of response and how it’s controlled. And when we measured the circulating hormone levels, ACTH and cortisol at the time, the animals who were stress-stimulated electrically alone, showed huge responses. But the animals that had a chance to fight another rat showed almost no response. So we didn’t know what to do with it. And we said what is this: They had the same amount of electrical stimulation, but in one case they showed a huge response and in the other they showed almost no response. And so talking to other colleagues in the field, they said, oh, that’s coping, and that’s how “coping” came into the mainstream language, but it was an early indication that stress is not one absolute thing, and depending on what we do or what situation we’re in, can modulate it.
Dr. Barb: You say that stress can be both good and bad. It sounds like that’s what you’re referencing here. How would you explain that?
Joan: The way I look at it is that stress is a stimulus certainly in physical terms and engineering terms, applying the stress to a piece of wood, a piece of metal, until it bends and until it snaps, they describe that as applying stress, and the flexibility with which the material responds, is a measure of the stress and the responsiveness and the material. I see it, if you step back and look at it from a physical perspective it is a stimulus. How we respond to it is what makes the difference. It’s not a stressful event, it’s how we respond to it, that is really what we need to address In it’s very raw terms, the body responds, attempting to survive the stimulus if it’s extreme. If the stimulus is mild, or milder, or manageable, then the stress can be beneficial because the response it stimulates can be advantageous at the time when you’re trying to escape the tiger or at the time when a catastrophe happens or adverse reactions happen and you want to be able to tackle it well. So it’s not so much the stress or the intensity of the stress, but how you perceive it in that situation. If you find yourself in an awkward marital situation or family situation, or encounter with a boss, whether you’ve experienced it before and how you’ve experienced it comes into the calculation. Is your relationship a friendly one, and therefore when you encounter a more adverse reaction, you know you have the tools-you have the psychological tools to solve the problem or to escape the problem.
The actual physiological response is one of survival, and therefore the hormones that pour out as we have found in later times can actually be helpful. So it’s good when it stimulates us to do superhuman things or give a talk or step out on a stage or run a race where we need the energy that the hormones provide to do our best, to excel.
Dr. Barb: So if I can just extrapolate on that a little bit, it sounds like coping is to some extent is a learned behavior that we accumulate over time. And I think we’ll touch on this a little about how stress beyond 50 might be a little different. So, it strikes me that there’s some benefit to being exposed to stressors to some degree over a lifetime, probably including childhood and adolescence and young adulthood so I think about as a mother and now a new grandmother, our attempt to minimize the stress that our children, for instance are exposed to. In a way maybe we shouldn’t have that fear, we should allow for exposure to build up those coping mechanisms.
Joan: Absolutely you’re absolutely correct and the trick is to expose them to milder versions of adverse conditions so they can learn and build up their ability to respond or to sift out what is adverse and what is beneficial. For instance, we go and step on a treadmill, and we think of exercise as a good thing. Well, exercise is a stress, by any other measure or it should be, if one pedals more vigorously than at other times. So we are physically deliberately stressing ourselves when we step on the treadmill. Why? And yet it’s good for us, we know it’s good for us we’re told it’s good for us. Over a period of time we accumulate the resilience. We accumulate the ability not only to respond to stress, but to respond to stress, within limits that are actually beneficial.
The original marathon runner that we all admire and refer to, dropped dead when he arrived, but he got there. So, there are limits, and we learn over the course of childhood and a lifetime, how to navigate within those limits where we are are stimulated by stress. We do enjoy stress because, you know, times in your life, you ride on the roller coaster and it’s wonderful, at times in your life, I don’t want to ride on a roller coaster any more. The roller coaster hasn’t changed, I have changed, the way I respond to the roller coaster-if you can take that analogy-has changed. And I have to relearn how to work within my manageable limits of how I respond to stress so that it’s beneficial and not adverse.
Dr. Barb: In your book, early in the book, on page 17, you include a life stress inventory. I think it includes about fifty items. It was a list that was created many years ago, but it was updated for the book. I found it interesting that sexual difficulties is, I think, in the top 20 of stressful situations. Part of my practice is helping women navigate sexual dysfunction so I took note of that as a fairly high stressor, which I’m not sure all individuals acknowledge that, but I’m wondering if you could just generally talk about kind of what that inventory might mean and the importance of that.
Joan: It was a starting point. When I first came across it, it was the only thing around and you can see, for instance, reading through it, there are lots of things, even today, I would change or I would add or some would move up or down in the scale. And I think it’s interesting as we move along in life how things are less or more significant depending on our environment for instance. I think they were very polite in the original table for instance, they talk about marriage, it’s a sort of a hidden hint about what it’s about, but there’s no doubt that sex and sexual life and sexual relationships have to come up very high. And the other thing is that the questionnaire is not gender specific, and I’m sure that the ratings for men and women would be very different. So I’m looking forward, perhaps, to updating it and perhaps doing a survey of a larger population of men and women of different ages, because I think it really deserves to be looked at in that way.
Sex is, no doubt a very stressful thing. It doesn’t matter if you are a child and you’re just discovering what it’s about, whether you’re presented with menstruation at an early age, so it’s a very interesting thing, and the more we can bring children up to look at situations, to look at the pluses in every situation whether it’s a new job or a new school or a new friend or sex with someone new and different, it’s all in the eyes of the beholder. It’s all in the perception and how we view it as a threat, in which case we need to invoke survival tactics, or a benefit and a joy and something to be relished.
Dr. Barb: As a menopausal health care provider I talk to women a lot about how as they get older, health maintenance and keeping a healthy lifestyle becomes more and more important and the changes they need to do to adapt to that. So your book, specifically Stress beyond Fifty: Tools and Wisdom for a Happier, Longer Life, I think addressed that same subset of individuals. So tell me how stress might change for us as we get older, why did you target that?
Joan: Well, primarily because I’m in it. [laughs] I’m part of it, and that’s where the wisdom comes in. And the tools I learned along the way, which it’s also interesting is not only do the stresses change as we move along our age scale in life, but also our bodies have changed, our family environment changes, the dynamics in our family are different, how do we cope with loneliness, if loneliness is a factor, and many women especially as they get older find themselves alone, and they have to cope with loneliness. Money issues that perhaps they hadn’t had to worry about before, become more of a concern, with the money lost perhaps due to retirement. Are you prepared to lose a loved one? Have you documented what you have and what you don’t have? Do you know how to drive? You’d be amazed how many women I come across who are suddenly widowed and never learned how to drive. Now obviously in the newer generations that’s not as much of a problem. But in our generation, well certainly in my generation, I have been surprised how many women lose a husband and they don’t know how to drive and they have no idea of what their financial status is.
It’s really a question of being prepared; it’s only stressful because they have not prepared adequately. Prepared means, really both physically, health-wise and in terms of the issues that become issues as we get older. Perhaps we have to figure out how to handle money ourselves, less so perhaps now, because I think young women are more adept at financial planning and knowledge of what’s what and more informed than the earlier generations were or are. Can you delay your decline in health as you get older? Of course you can. I’m sure you see that all the time that maintaining your health and staying interested and keeping a circle of friends, people you can rely on, people you can call on.
Dr. Barb: Throughout the book you talked about planning to minimize stress, and I think that’s one area where I’m not sure people understand the benefits of planning, the strength training that’s required to be independent for the many years ahead of them. And I wish individuals valued that a little bit more and understood how prevention could very much change the trajectory of their later years in life. I thought that was an important focus in your book. And I also was a little bit surprised, but you also referenced retirement a fair amount, and I think culturally we like to think about retirement as mostly looking forward to enjoying it and the leisure associated with it, but I would say, I encounter many individuals who find it a quite stressful new reality. So, can you talk a little bit about that?
Joan: There are two parts to retirement. One is to make the decision when to retire and what you base it on. And then the actual retirement, what you had anticipated and how it turns out to be and are you prepared and how can you prepare. So there are really three elements, not two. And making the decision of when to retire is not given as much importance, I think as it is, and it’s worse for men than it is for women, because we’ve had two jobs or parallel processing, whatever you want to call it, throughout our lives. And even if we retire from one job, which might be an office job, we always will have the household job, the parent job, the grandparent job, the marital set-up job that we have had along the way, or we learned and used along the way. So it is easier for women to retire than it is for men. But the actual decision for retirement depends on how prepared you are, and there’s a lot people don’t realize just how much work, just as keeping your body fit and healthy, that keeping what you do, your interests, your activities, your circle of friends, what would you do, would you enjoy doing, and how would you spend your retirement time. And it is not something that’s going to be handed to you. It’s something you have to develop. And it’s sad when you see perfectly active, energetic individuals drop dead a year after they retire, just as having heart attacks or heart conditions that are really increased tremendously after so-called retirement. It is, just as keeping yourself healthy, you have to keep your preparation for what you’re going to do with yourself, encourage interests, hobbies, activities, whatever they are well before you retire.
Dr. Barb: You spend the last part of the book in talking about some practical advice in what to do about it. And you talk about stress as a choice and whether we create stress and how we respond to stress is in our control. Can you share some of the tips from the book as to how to manage stress?
Joan: Well, I look at it generally as physical and mental, I mean you have both physical things that you can do quickly to cope with stress, to manage with stress when you find yourself in a stressful situation. One of my favorite ones along the way, which surprised me every time I got it to work, was to drop your jaw. I tell people, you can’t frown if you’ve dropped your jaw.
Dr. Barb: So does relaxing your jaw have have a physiologic more general relaxation response?
Joan: Just like breathing does. Breathing probably is the most fundamental way to relax and we tend to breathe with shallow breaths and the upper part of our lungs and that’s where most of our sympathetic adrenergic nerves are, which raise blood pressure and make you anxious. So that’s the last thing you want. You don’t want to take short, shallow breaths. You want to take deep breaths that go right down to the bottom of your lungs and you can feel them push out your abdomen and your diaphragm and those and slow breaths and especially slow exhalations that completely empty your lungs of the air you breathe and and start again and relax as you breathe out slowly. And you can count to 7 or 8 if you like; if it helps you breathe in for 4 and breathe out for 7 or 8 and deliberately concentrate on exhaling every part of air that’s in your lungs right down into your abdomen. And that’s probably the most relaxing and calming way of breathing.
Laughing, of course, if you can think of something funny, or watch a comedian and laugh, it’s very relaxing. Play, children play and you hear them giggling and shrieking with joy. It’s something to learn from that, that play—swing on the swing for instance, why should we stop swinging on a swing? it is exhilarating and it’s probably one of the best stimulants of our inner ear and balance, which is one thing that goes with age. And nobody’s using the playgrounds, so you have the playgrounds free to use for yourself to go there and play. And there’s no age limit to playing.
There are things like exercise and what I call non-exercise activities that if you maintain throughout your life will help you be physically stronger and physically active and independant. And that is the things of daily living: do you make your bed when you wake up, do you stand up and stretch when you wake up? Do you pick up something that has fallen on the floor, do you reach up to reach something? Do you vacuum clean? It does something that is satisfying, that is an accomplishment. And that feeds back onto the fact that it reduces your stress at the time. Learning ways to relax, like meditation has really proven itself and fortunately has become so popular that learning to be mindful and focused breathe slowly and meditate and that’s a great way to calm. And of course sleep, sleep is paramount in importance. It’s not just our body and a cleansing of our body and cleaning out of toxic materials, but our brain needs to be detoxified and the way it detoxifies is with good sleep. You need to get seven, seven and a half, eight hours of sleep to be a healthy person and to clear out your brain of all the cobwebs that it accumulates during the course of a day.
Then you have the mental things, which are if we feel stressed and we panic, we need to step back and say wait a minute. Let’s reassess the situation. If you’ve misplaced your keys or your glasses, we panic. Just step back and reassess the situation, so shrug your shoulders, learn how to shrug your shoulders. Prepare and anticipate, of course, terribly important. Choose. Everything you come across has a positive and a negative. Ask for help, share, socialize, make friends. These are all positive inputs, positive assertions that help you be stronger and be mindful. Focus, balance. These are all tricks you can learn of how to go about doing things to keep your stress within limits. And if you find yourself over-stressed, say how much of this pile of stress can I now get rid of? It might be one thing, or two things, say oh yeah, but that’s not-in the grand scheme of things that’s not important. And then you can make yourself reduce the pile of stressors that have accumulated. So you don’t get what is called in the parlance “burned out.”
Dr. Barb: So you feel like individuals at any age can continue to be intentional and learn to better manage stress.
Joan: I think we have a database of experiences of how we have managed stress, and when they were successful, and we came out feeling better and when they were detrimental and we can learn to avoid them. As seniors, as 50-pluses, we have a much better database than if we were five or six or ten, and we over a lifetime have developed this database. So when something comes up, we say, have we encountered this before, yes or no, if no it’s a different issue. But if we have encountered a situation before and if we have successfully managed it, then we are more likely to successfully manage them throughout our life.
If it is something we never experienced before, but we have experienced similar situations, we also can draw on that database that we have self-confidence, for instance.
Dr. Barb: As we finish our time together, the last time we sat down together I asked you where you find richness at this stage of your life, you talked about your passion for your work, which obviously you are still continuing to engage and be passionate about. Are there any other areas that you could identify that bring richness to your life at this stage?
Joan: Yes, definitely my work evolved not through any particular planning, but it happened. I had never written books, I had contributed to books, I had written chapters, I’d edited books that were technical. When I left NASA, I found that I would talk to them about what happens to the health of astronauts in space and at the end people would come up and say how come we never heard about this? And I would scratch my head and thought, gosh, I really need to do something about that and I decided to leave NASA and start developing notes and going on public speaking about that and gradually that evolved to a variety of books and to the point where I didn’t talk much about stress. And my husband said you really must write about stress that’s been your life-long thing in this house, and that’s how Stress Beyond Fifty came about, because I’ve never really let go.
But I’m a problem-solver. I like to step back and look at a situation as if it’s a project I’m solving. It’s a curiosity element and I didn’t have time, while I worked at NASA to think; I literally didn’t have time to think. So it was a luxury when I retired, from that point of view, because I had time to go back and look at what I had done and what other people had done and what I found and observed and share my own feelings and experience as I was getting on. So it has been an extremely exciting problem-solving adventure, and it is an adventure because I learn every time I speak, and it doesn’t matter who I speak to. I learn from the questions people ask, and i realize how much is not known. It’s an education for me. I’m continuously learning, and by learning I become more curious, what have I experienced that can help them and what have they experienced help me in the way I think. And you know something, I don’t think I’ll ever quit.
Dr. Barb: Well, I want to say thank you for your life of curiosity and the fact that you continue to be productive in sharing your insights. And your book again, Stress beyond 50: Tools & Wisdom for a Happier, Longer Life, I think is another value-added piece of information that most of us can benefit from. So thank you, Joan, for years of exploration and investigation and now sharing it in writing.
Joan: Thank you very much for the experience. I enjoy our conversations immensely. I think we could solve all the problems of the world.
Dr. Barb: Good! Let’s do it.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.