How to Turn Off Stress, Calm Your Body, & Rewire Your Mind to Handle Anything

Things happen. Things go wrong. Things go bad. We face challenges. A lot of people think, if I get hit with something, I'm going to fall apart. We are so much stronger than we think we are.

Dr. Nalrula is a board-certified cardiologist. She's here to teach you how to handle the stress and pressure of life right now and become more resilient.

There are patients where I can't give them back the heart cells that have died. I can't give them back the movement of their arm when they've had a stroke. We can't go back, but we can still help them find a different path toward adds meaning in their life if they have that flexible thinking.

We talk about stress and it's like, I feel stressed, but what is stress actually?

And I think people just think of stress as this invisible force that we don't really understand. But Mel, a whole cascade of events happens inside your body, particularly in your cardiovascular system, which are all negative. And cardiovascular disease is already the leading cause of death for men and women. So you add to that the stress and it's just a recipe for disaster. This is so important and we are not talking about it.

Why is hope important and what does it actually mean?

You have to find hope in the small moments of every single day. It's not losing the vision of what you want for your life. It's holding on to that.

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Thank you for having me. It's a pleasure to be here.

Well, thank you for writing this extraordinary bestselling book, The Healing Power of Resilience. I cannot wait to dive into the research, the tools. But I wanna start by having you explain to me, how could my life be different and feel different if I really take to heart everything that you are about to teach us today and I apply it?

Yeah. You know, Mel, we have one precious life. One. And in the time that we're here on Earth, everybody wants to be able to take the most out of every moment, every experience. Every day. I know that's what I want, that's what my family wants, that's what my patients tell me they want, is that quality of life. The problem is that, as you know, during life things happen, things go wrong, things go bad, we face challenges. And so for many people, that challenge, that traumatic event, whatever that may be— a divorce, a financial loss, a medical diagnosis— it stuns us and we get frozen and stuck, and we're not able to really take all of the things out of life that we want. And so, you know, resilience is really about Finding your way to that space where despite what happens to you in life, you can still cull and glean and take everything amazing from your experience in life and not let life take over you. And, you know, I, I obviously have so many examples of resilience that I've seen in my life as a doctor, as a journalist, as a friend. I think about often, um, a friend of mine actually from college. We met Stanford, our intern year. She's from Massachusetts and she was single. She wanted to have a child for many years. Mm-hmm. And she finally went through IVF. She got pregnant and about 3 months into her pregnancy, she called me and told me she was diagnosed with ovarian cancer. Oh my God. So if you can imagine, you know, waiting and pushing and struggling so hard to have a baby, finding out during your pregnancy you have ovarian cancer. And it was one of those moments where, I mean, she, she had a choice, right? Where do you go at? This unimaginable moment. And she was resilience personified. She finished her pregnancy, she delivered her beautiful baby. She lived those last 2 years that she was alive with her daughter full. And she wrote about her journey. She was present for her daughter. She made plans for what would happen for after she passed. It was this incredible, beautiful story, my friend Kaz, as we called her, of resilience despite the literally unimaginable happening. And so, that's what I want for people. No matter what I get hit with or slammed with, I can still enjoy my life. I can thrive. That is the word that I think about.

Just in that story of your dear friend Kaz, I think every one of us can think of somebody in our lives or somebody that we've seen as they've had tragedy hit their lives, they somehow seem— to be able to rise to the moment and meet that moment in an extraordinarily inspiring and kind of, in some ways, jaw-dropping way. And yet, you wonder personally, "I don't think I could do that." Like, if that were me, I would be breadcrumbs on the floor.

Exactly.

And yet, we are all one phone call, one diagnosis.

That's right.

One accident. One tragedy away from having life run you over. And I love in that story how you combine the medical piece, the hope and aspiration of getting pregnant and going through IVF, the devastating news, and the fact that despite— and I thank you for saying the word "despite"— despite all that, there is still this well of strength this fight that can be brought out inside you when this happens.

And when I started to dive into the research psychologically, what fascinated me was exactly what you said, that I think a lot of people think, if I get hit with something, I'm going to fall apart. And when I interviewed psychologists and they said to me, no, that, that is actually the small fraction of people that develop PTSD in the setting of trauma. The majority of people are going to be okay when something happens. And I thought, Why don't we tell people that? That's actually really empowering to know that no matter what happens, I'm gonna be okay. And then the second thing they taught me, which is that resilience is a skill. It is something that is not just fixed. You either have it or you don't. It is something that you can absolutely strengthen and build just like a muscle. And again, it was like, again, here's something that's really powerful information that people don't know. And so it was really important for me to kind of tell people both of those things. You have this real amazing gift inside you, but also, So you can, you can practice it, you can grow it, you can build it. And that's a really important empowering thing for people to understand.

Well, Dr. Nerula, maybe where we should start is what is resilience? Like, how do you define it?

Yeah, and that's another interesting question. And I think when you listen to or read the psychology research, they all have different definitions.

Yep.

And so for me, it was important to kind of cultivate my own definition. And what became clear to me was what we just talked about, which is resilience is the ability, in my opinion, to retain your wonder, joy, excitement, investment, engagement in life, despite what happens to you. So you are not ever going to go back to where you were. You're going to move in a different direction. And this again comes out of my clinical experience. You know, when I am telling someone who has no idea they have heart disease, that they have coronary artery disease or plaque in their arteries, and they thought they were completely healthy, or I'm telling someone, your heart function is 20%, not 50%, you have heart failure. The look that I see on their face, Mel, is the same every time. It is kind of a look of just fear and paralysis. And they ask me, "When am I gonna be myself again?" That's what they wanna know.

What do you say?

And I say, "You will never, ever be yourself again." I don't want that answer. You will— I don't want you to tell me that. You will never be yourself again. But, and here's the big thing, you can be a beautiful, different version of you. Your life can be an incredible different version or chapter. And, you know, I think a lot about the quote of Michelangelo, which I used in the book about, how he said he carved the marble to set the angel free. He saw the angel in the marble and he carved until he set the angel free. This idea that, you know, we are this piece of marble and life is sort of changing us and we're evolving, but there's still something beautiful that can come out of it. And I just thought that's such a beautiful visual image. If we could just think of our lives that way, that change is inevitable, adversity's inevitable, bad things are gonna happen, but we can still emerge as this beautiful creation.

Well, if you hold on to that vision that there is an angel inside you to be set free, it is very empowering.

Right.

And what I also love about the way that you're explaining this is that you're not saying that you deserve to have this happen. You're not saying that you needed to have this happen. Like, I hate it when people are like, "Everything happens for a reason." I'm like, well— Sometimes things happen because it's just really horrendous what's happening. You didn't deserve it. You have to find a reason to keep going despite what happened. I want to read to you from your bestselling book. This is in the introduction, and you talk about resilience. You say, "Resilience is not the capacity to return to the same place you began after trauma or tragedy. Neither our minds nor our bodies are built like rubber bands. We do not bounce back." back. We are influenced and affected. We recover, we grow, we change. This, I believe, is what the core of resilience is: the ability to embrace change. We are constantly being shaped by our experiences, change affecting the composition as a whole even as we remain ourselves. We are the marble and we are the angel.

Exactly. Or both.

It's so beautiful. Because oftentimes, I think when you hear the word resilience, and it's kind of thrown around loosely a lot, I always just thought it was the ability to bounce back.

Or to not feel. To just put my head down in the sand and keep going forward without processing what's happened, you know? Yeah. Just keep moving.

And you're saying, no, inside you is the ability to adapt to the change and not lose yourself, but to— remember how to and to learn how to still find joy and wonder and connection despite all of what's going on.

It's a different version of you, right?

It's beautiful. And that, you know, what I also love about our conversation today is that you have very specific skills that you're gonna walk us through, a bunch of them, that will help you adapt and change when this happens. Can you give me some examples of smaller moments, like maybe that happen to kids in school or that happen at work when you get an email, or just like the little things that are also quietly building resilience in you?

Yeah, I mean, melitz everywhere, right? And so the common denominator, and again, the reason it was important for me to, to talk about this is stress. So our lives are full of stressful events.

Now you're a cardiologist.

Yes, I am.

Could you medically explain to me what stress is? Because I think, you know, we talk about stress and it's like, I feel stress.

Right.

I feel stressed because of the headlines. I feel stressed because of what's happening to my kid at school. I feel stressed because, you know, I'm mad at my spouse right now.

Yeah.

But what is stress actually?

Stress in and of itself is not a bad thing.

Okay.

We all need some stress in our lives.

Why?

Stress can be positive because it can push us. It can push us to evolve and change. Okay. The point is that there's a tipping point where the stress then becomes negative. One of my favorite professors from Stanford, Robert Sapolsky, wrote a book called Why Zebras Don't Get Ulcers. And he studies primates, um, and studies the stress response. And, you know, talks very openly about this idea that our stress response is meant to be a place or a function for us to survive, so that if we're escaping a lion in the wild, we turn it on, our heart rate goes up, our blood pressure goes up, our respiratory rate goes up, we turn off all the nonessential functions, our digestion, our reproduction, our growth, so we can live. The issue is that when you're in the wild and you're escaping an animal and then you escape, your stress response goes off. In our current-day society, we turn on the stress response for all those things you just talked about. We get a bill in the mail that's difficult to handle. We hear something at school. Our friend says something to us, we feel bullied. We, uh, you know, go to work and our boss is, you know, tough on us. Every little insult during our day causes a stress reaction. And you can imagine how damaging this can be to our bodies on the inside. So the point is, even though we have this stress response, guess what? We are not victim to it. We can mount a resilient response. We can actually turn it off, dial it down, and counteract it, right? That's the purpose of the resilient response. But I think it's important to understand how negative and destructive stress can be. And I hear it from my patients all day long that they're stressed.

Dr. Nerula, how can a person tell the difference, just like normal everyday stress, modern life, and stress and pressure that is becoming a problem?

Yeah, well, the stress is there all the time, every day. And so it's really, again, our reaction to it. So if you are able to, you know, take on the stress and then within a few minutes you feel the same way that you did, it's probably not an issue. But that's not how it works for most of us. And so for most of us, it is that that stress response stays on. We sort of feel our muscles clenched, we're not breathing as much, you know, our heart rate is a little bit faster, our mind continues to cycle and think about it, you know. So it's when that's happening over and over again throughout the course of the day that it becomes an issue. And I will say this, Mel, I mean, there is such a thing as a stress-induced heart attack from an acute stress. Women tend to be more prone to this than men. So even acute stress can cause problems. But yes, we think more about that chronic, low-grade, constant stress that's happening day after day, couple hours during the day, on and off, on and off. So I always tell people, you need to find time to turn your stress response off. And whether that is a walk, music, meditation, exercise, breathing exercises, meeting a friend, like those moments where you're dialing it down from 10 to 0, that is going to help your body on the inside be able to move through the stress.

Dr. Nerula, I would love to have you speak to the person listening and to me, who not only just feels the pressure of their own life and the stress of getting through the day and dealing with things going on in their family, but the ongoing pressure and stress of all the events going on in the world, all of the global unrest, just this tremendous pressure that comes from a sense of hopelessness. Mm-hmm. And a lack of power and an inability to, to feel like you can do anything to change. Like, why does paying attention to your resilience— why is it critical in a moment like now?

Because you can't change the world around you, right? You cannot stop what's happening around you from happening. You can't change those stressors. I tell people, you know, you maybe you can't leave your job that's stressful. You just can't. You can't, you know, get out of the situation. We don't have control over that. What do we have control over? We have control over how we respond to the stress, right? It's not the stress that kills us. It is our reaction to it.

So what do you think is a really great, just first small way to think about the stress that so many people feel about the state of the world? Like, what is one recommendation when it comes to something that you see going on, whether it's in your community or the world at large, that's really bothering you?

Well, I think one is you don't have to take it all in, right? So for a lot of my patients, I'll say, don't— I mean, I'm on the news, don't turn the news on, you know? I mean, if that means it's going to give you that peace, like, you're entitled to not watch morning television if you don't want to, right? Um, I think also finding ways that you can make those small changes. So maybe it means like going out and marching for something you believe in. You know, maybe it means writing an essay and pub— You, again, have agency and power to cause change in the opposite direction, even those small little steps. So, there's so much I think we can do. We just need to give people, like, the ability to do it. We need to give them—

Well, let's go back to your friend Kaz.

Yeah.

Like, what a terrifying and horrendous set of circumstances, and still, That's right. She said, this is horrible and I have a choice about how I respond to it.

Correct.

Well, one of the things that you write about just right in the introduction, and we're gonna unpack all of the skills, but one of the first one is getting to a point where you accept your current situation. And on that note of acceptance, right? Because it is one of the stages of grief to just be in denial of it. This can't be happening. How could I possibly have ovarian cancer? I just got pregnant. This can't be happening. We live in the United States. How is this happening here? This can't be happening. I worked so hard. How am I losing my job? What do you mean that there are layoffs? Acceptance doesn't mean you're giving up, right? What does it mean?

Yeah. And this, I, you know, in laying out the book and figuring out what skills, what blueprint did I want to give people, acceptance had to be the first one. It had to be the first tool because you can't do anything else until you've accepted what happened. And one of the women that I interviewed for my CBS News story, who also feature in the book, is Lucy Hone, who is an incredible resilience researcher of her own right. She studies resilience, she writes about it, she talks about it. Her 12-year-old daughter died in a car accident. Oh. And suddenly the resilience researcher had to use the skills that she had learned to move forward. And she's given one of the most watched TED Talks in the country. And the first thing she says is, "Adversity doesn't discriminate." And I think that is such an important thing. We're all gonna get hit. At some point in time, something bad's gonna happen, but we can't change that. We have to accept it. And so to your question, when I was in medical school, I had my own experience where I had to learn acceptance acceptance. I was in my second year of medical school. I was in these lecture halls, started to see colored lights in the bottom part of my right eye when they would dim the lecture hall lights. Didn't know what was going on. Went home to Miami over Christmas break and suddenly discovered through a battery of tests that I had a visual field loss in the bottom part of my right eye.

Wow.

I was a healthy 23-year-old and suddenly I had, was blind in the bottom part of my eye. Nobody knew why. They told me I might have had a stroke, I might have multiple sclerosis. So I went back to medical school thinking I might have multiple sclerosis. I might not be able to walk, see, finish medical school. It was, Mel, the absolute worst, most scary moment in my life because again, I had fought really hard to get to medical school.

Yeah.

I was excited to be there. And now I thought the whole trajectory of my life is gonna go in a different direction. And my mother, um, sent me on a card in the mail, the Serenity Prayer. And the first line is, God grant me the serenity to accept the things I cannot change. The courage to change the things I can and the wisdom to know the difference. And I read her words and she called me, she said, "You can spend every day the next 2 years of your medical school worrying about what might happen and wasting that time, or you can imagine it might never happen, your worst thoughts, and just put one foot in front of the other and go day after day." And that advice really saved me. And that is advice I give many of my patients when things happen to them is put one foot in front of the other. This happened, now we're gonna move forward. Day by day by day. And the farther you get away from the event, the further the pain and the fear becomes. Just a few weeks ago, I had a patient who went in for a routine surgery, should have been in and out. Something went wrong in the operating room and he came out 70% blind. And I saw him, you know, 6 months ago in the aftermath of that, and he was sort of broken. I mean, he didn't He was as anybody would be. And then I saw him a couple weeks ago and there was a lightness to him and he was smiling. And I said to him, you know, how did you get to this point? You know, it's been 6 months and you seem so different from where you were. And he said to me 2 things. He said one was acceptance. I couldn't change what happened and I had to learn to accept it. And then he said social support, his friends, those 2 things. But acceptance is the beginning of your journey, it is the opening of the door to everything else.

So for somebody who's listening right now and you have felt so much pressure, you've been under stress, you can't even remember a time when you weren't stressed. Maybe you're caring for aging parents. Maybe you've got the new class of stress, which is parenting young kids.

That's me.

Yeah. You know, maybe like there's just— you don't even remember a time. Is what you're about to teach us for that person? And can you talk to the person who doesn't even remember life when they didn't feel pressure?

It is for everyone. You know, what, what I'm gonna tell you is for everyone. It, the resilience is something we can all use. And it is so critically important because we have stress at every angle, at every point in our life. Caregiver stress is real.

Mm-hmm.

And again, it's something I see, especially in a lot of my female patients In the last month, I had 3 female patients who are married to male patients of mine talk to me about the stress that they are having because they're caregiving for their husbands, their kids, uh, and everyone else in their life. I had one whose husband was diagnosed with Parkinson's, and she's trying to manage his failing health and dementia that's developing. Another one whose husband had a stroke is not— no longer who he was. And the third one was a woman who said her husband had his own mental health issues the last 6 months. And so all 3 of these women were talking to me about the massive stress that they were facing being caregivers. And we talked about how to manage that stress and how to handle that stress and the fact that they needed support and help in order to continue to be caregivers to their spouses, but also to protect their, their own health.

Why do you think it's so hard when you're in the caregiving role to really understand the critical nature of taking care of yourself?

Because you're so overpowered and overwhelmed by the care and love and empathy and responsibility that you feel for another human being. And so that's an amazing thing, right? To have so much love for someone that you're giving up everything, but you can't, you know? We, we have to take care of ourselves in order to be able to be there for someone else. You have to.

Why?

Because it is critical to your survival, and it's going to be critical to the survival of the person that you're caring for. Because if you decompensate, if your health declines, it's game over, right? And so, again, I think people just think of stress as this invisible force that we don't really understand. But Mel, I mean, I will tell you from a cardiovascular perspective, a whole cascade of events happens inside your body particularly in your cardiovascular system, which are all negative. And cardiovascular disease is already the leading cause of death for men and women. And I'm telling you, I'm seeing it every day in my exam rooms. I'm hearing it. This is so important, and we are not talking about it. We're not educating about it. We're not helping our patients manage it. We are totally living in, you know, a world where you have divide, a divide between psychology and clinical medicine. We gotta do a better job. We cannot have a siloed world of psychology and clinical medicine and no one bridging this gap.

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What's fascinating about resilience is it's, it's not just a tool for healing, which, you know, the book is called The Healing Power of Resilience, but it is a tool for prevention. So the more that you practice this tool, these tools of resilience, and utilize this blueprint and this roadmap, the more likely you are to not go down the road of developing chronic disease because you are going to be less stressed and have less inflammation and have your, you know, lower levels of cortisol, less vascular reactivity of your blood vessels. You are going to do those things we talked about that are going to keep you healthy, like exercising and eating well and sleeping well. So it really is both prevention in terms of chronic disease, and also a way that you can move out of a diagnosis or a disease process.

Well, that's why you're here, Dr. Nerula, and I wanna just bring back that beautiful image that you talked about, both as we've been speaking and that you write about in your book, that if you are under this chronic pressure, you are both the block of marble and the angel within it. Mm-hmm. And you talked about the first step being acceptance, accepting that you are in this chapter of your life. You are in the role of a caregiver, or you are under the gun of severe financial pressure in order to pay off debt, or whatever it may be. There's tons of ways that people find themselves in a state of chronic stress. Maybe you're dealing with a long-term diagnosis yourself for chronic pain. But acceptance that this is the way things are, and I can't change that fact right now, is step one. In your book, you also talk about about a flexible mindset being the next step?

That flexibility of saying, you know, I thought my life was going down this course, but now it's going down a different course or direction, and I'm okay with that.

But I'm not okay with that. Like, that's the problem with the flexible mindset. Like, part of it is, I don't want this.

I know. And that's where, you know, Acceptance Commitment Therapy and CBT therapy and other forms of mindfulness and meditation can help. But truly, you know, again, referencing back to Lucy Hone, who I talked about earlier, you know, she gave a great analogy of, you know, imagining you have these goalposts in front of you. You're kicking the ball in a certain direction through the goal. Yeah. And she said she realized when her 12-year-old daughter died and she still had her husband and sons, like she had to live for them. She had to keep going. So she picked up the goalpost and moved it somewhere else. Mm. So this, and I thought that was such a great, easy to understand image. So good. You can still have a goal, you can still aim for it, It's just in a different place, right? And I see this a lot in medicine. You know, there are patients where I can't give them back the heart cells that have died. I can't give them back the movement of their arm when they've had a stroke. We can't go back, but we can still help them find a different path towards meaning in their life if they have that flexible thinking. I thought I might be able to do this. Okay, I can't do that, but I'm gonna shift and I'm gonna do this. And so really that flexible thinking is sort of the second key. To remodeling, reshaping the vision for what you thought your life was going to be into something else. And that's okay. But the point is, you know, whatever life hits you with, if you can pick up that goalpost and put it somewhere else and know you can still move forward towards it, that image is, is, can be life-saving.

Dr. Nerula, I personally feel that the image of the goalpost is probably gonna cause the single biggest change in people's lives that listen to this. And as you're listening, I want you to think about just in your own life, are you still trying to aim for a goalpost that's no longer there? Right. Because you can see how if you're looking at a goalpost that's no longer there, you're not gonna find joy, you're not gonna find meaning, you're not gonna find all the things that you deserve in your life if you keep moving in that direction. So from a medical perspective, how does choosing to change the goalpost, accepting that you have a different life now— Yeah. How does that help you get through a challenge?

It's like the lighthouse that draws you forward. It pulls you forward. And that kind of goal, we all need that. We all need something to continue to strive for that gives us meaning in life, right? We all have our different meanings for why we're here. But I think when you lose that, meaning, you lose that sense of like, "I don't know why I'm here," it's like, kills you on the inside. And so, and you feel stressed. But when you say, "Okay, I thought I was here for this reason, but now I'm here for this reason," it's like a light that turns on inside. And so, it's just, you know, it's just a reframing and reshaping of what you, again, the marble and the angel, it's a reframing and reshaping of who you thought you were, what your life would be, and recognition that like, No, life is change. It is constantly changing.

If something in your life has changed, somebody's died, you didn't get into the dream school, you lost your job, the divorce has happened, like, here's the diagnosis, your kid's really struggling, and you are so stubborn or scared or whatever that you continue to look at the old life that you wanted, you're creating more stress for yourself. That's right. That's right. Because you're resisting what's actually happened.

You're resisting the change. You're fighting against it. So, you know, we use the analogy in the book of, "Be the river, not the rock," right? You have to flow with life to get the most out of life, right? That's— that malleability, that flexibility is really critical. One of the exercises that one of the psychologists I interviewed told me about, which, again, I loved because it was very visual, was the identity pie. He said he has his patients draw a circle and cut into the circle pieces of a pie. I'm a mother, I'm a writer, you know, I'm a dog owner, I'm an athlete, you know, I'm a baker. And a small slice of the pie is their medical diagnosis. And when you look at that and you see, that's right, I am not my diagnosis, I am so much bigger than that, I am so much more than that. And again, it lets you see My life is so much more full. It has so much more meaning. It has so much more, you know, direction for where I can go. I'm not stuck in that vision of being a victim of my disease process.

That's really helpful because you're right, kind of like the goalposts, that when something happens, we kind of laser focus on that thing and you forget there's all these other aspects to who you are and what your life contains.

That's right. And what your life can be. You have to see that right now.

What happens— you talked about the kind of be the river, don't be the rock in the river resisting everything. Just kind of, you gotta learn to go with the way that life is taking you. What effect does that have on your stress and on the kind of physical impact in your body when you really start to accept and you have a flexible mindset And you use some of these tools like the identity pie to say, well, I'm more than this diagnosis. I'm more than this moment. I'm the kind of person that can get through something like this. Yeah. Well, two things.

I mean, when we turn off the stress response, it means that we are using our parasympathetic, for example, nervous system. So the one where we lower our blood pressure.

So does accepting and does kind of doing these tools like help you turn on the parasympathetic response?

Correct. It helps you turn on the parasympathetic.

It's not just intellectual?

It's not just intellectual. Oh. But also you're not then activating the stress response. So there is a clear pathway when we activate a stress response, you know, our amygdala, this very basic structure in the brain that senses threat and fear is kind of the signal that sends a signal to the hypothalamus in our brain, these deep structures that then send signal to the pituitary and the adrenal glands and that whole cascade where you're essentially then releasing cortisol, the stress hormone from your adrenal glands, epinephrine, you know, adrenaline, norepinephrine, that's all turned on when you're under stress. But if you counteract that, and that's where things like therapy and meditation and mindfulness can come in, or your thought process, um, you're not allowing that pathway to turn on. You're turning it off, number one. Number two, when you're not living in a state of stress, you're actually making lifestyle choices, which we haven't talked about, that help you live a healthier life. So you are exercising, you are eating healthier, you are getting more sleep, you're not missing your medical appointments. You're not maybe using substances. So it all kind of goes together. What's happening on the inside, you know, you're dialing everything down, but also you're making choices that are also helping you be healthier and lower your stress response. If you exercise, you're decreasing your stress, right? If you sleep more, you're turning down a lot of these hormones. So it all goes hand in hand. You know, I talk to my patients about sitting down with a therapist, and many times they say, well, I don't have anxiety, or, you know, I'm not depressed, I'm just caregiving and I'm under stress. And I say, That's, that's enough. That's enough of a reason to sit down with someone who can, you can just download on, somebody objective who can be there for you so you can just let go of your thoughts because that in and of itself will lower your stress. You are allowed to spend an hour, you know, a week or, you know, once every 2 weeks talking to someone who's in your corner to help you. So therapy can be just to help you through a stressful time. Maybe you don't do it forever. But do it while you're in this period of stress to help you get through the caregiving journey. And then people are really surprised when I say that, like, really, I should see a therapist for that? Yes, yes, you absolutely should.

Um, let's talk about just like ways to calm yourself when you get that wave. You know how it like comes in waves, whether you're like, oh my God, the text that comes in, or, you know, layoffs are coming, I need to see you in the office tomorrow morning, or A million ways you could feel stressed out. Is there something that you love, Dr. Nerula, that you do when you feel the quick wave?

I love exercise. So for me, you know, finding a way to get my heart rate up and exercise and move my body is my stress relief. So I find time to carve that out. Being outside, I feel like in nature, is a very underrated way to feel better. So, you know, we have a home in Connecticut, which is like very rural. Just taking a walk, seeing the birds, you know, seeing the trees, getting the fresh air. I feel like nature is extremely powerful. And then, you know, breathing exercises. And I think some of the techniques that I've learned about, you know, kind of taking 5 breaths in and then letting them out, you know, a lot of these things we can do, the breathwork can actually help sort of, again, in the moment, really turn down the stress response.

This message is brought to you by Apple Card. For a limited time, when you get a new Apple Card and purchase AirPods Pro 3 at Apple, you can earn back the cost up to $250 daily cash. New AirPods Pro and up to $250 bonus daily cash back. Now that's music to my ears. Subject to credit approval, limitations, and spend requirements apply. Apple Card is issued by Goldman Sachs Bank USA Salt Lake City branch. Terms and more at apple.co/airpods. I'd love to talk about negative and positive self-talk and how the way that you talk to yourself in your own head can compound the stress and make it worse. What did you discover about the way that negative self-talk versus positive self-talk can increase stress or even have a physiological, like, do damage to you.

Nobody's perfect. We're flawed human beings, um, but that's okay. And I think the moment we show ourselves the same love and the positive talk that we would show our child or our spouse or anyone else that we care about, that is the moment where we start to, to kind of become more resilient because we see ourselves in the same way that we would see someone that we're caring for as a caregiver. Um, but that positive self-talk is really critical. That's self-love.

Like, I always tell people, you're— I don't know what's gonna happen, but you're not gonna go through this alone, and you are capable. Yes. Of managing this. You are.

Yes, you're so much stronger than you think. And that is really what the book also was about, was this idea that like, we are so much stronger than we think we are. We all have this capacity, and we're not gonna crumble and fall apart. We can get through it. Again, if we put one foot in front of the other.

Let's talk about social support because it is one of the pillars in the book. And I know when I'm stressed out, mm-hmm, if I'm going through something traumatic, I tend to become a little bit of a hermit. Mm-hmm. And what does love and support from other people do?

And like, how do you get it? Social support, again, is something that's so underrated but so easily accessible to all of us. Mm-hmm. You know, my friend, my former resident at the Brigham, Vivek Murthy, I was his intern. You know, he thankfully, I think, opened our eyes in this country to how negative loneliness can be and how important it is for us to cultivate social relationships for our health. The famous study out of Harvard, Robert Waldinger's study that followed men for years, what was it that sort of translated into, you know, the best quality of life? The quality of their social connections. It wasn't anything else. And so we have just this growing body of data and literature showing the power of social connection. And I think for a lot of people, you know, they think, oh, well, I need to have a big group of friends. And so for a lot of my patients, we talk about, it doesn't have to be, you know, a large group of friends. It can be one friend that you pick up the phone and call. It can be joining an art class because you love art. And so there's so many outlets that we can explore to find that. You know, I recently told the story of, again, another patient of mine who retired and he started smoking marijuana and felt very depressed, wondering, where am I going with my life? And one of his friends said, you know, Central Park is right there. They have a group, the Central Park group that goes and picks up the garbage and trims the trees. And we meet every, you know, twice a week. And he joined the group and he said just that one step of joining that group. And now he does it twice a week for about an hour. Saved him because it gave him a group of people who he could meet every week. He was outside, um, and he started to feel so much better about his life. So it's these micro small changes that we can make, and all of us could do it every single day.

It is easy to sit on the couch and feel sorry for yourself. It is easy to feel overwhelmed by the state of the world. It is easy, and it's an appropriate response to be shocked by like life when it's not how you want it to be. That's right. But at some point you got to do something. And just this social support, going to bingo night, joining a— it seems so dumb, but when you're in the throes of the stress and the overwhelm, you don't feel empowered to do it. But it works. And that's an example of you putting a deposit in the bank of resilience.

It is an investment, you know, and I tell people resilience training and the skills we're talking about, it's work. Yeah. It's work. Just like exercising. I hate getting up at 5 in the morning and exercising during the week. You know, I don't—

I knew I liked you.

I, I don't like, you know, looking at the nutrition labels to figure out how much saturated fat it is. Do I want this one or this one? But like every single thing we do in life, everything, whether it is, you know, for our career, our family, our health, It's an investment and it's hard. And no one is gonna say that becoming more resilient is easy, but the investment, the payoff that will come by building this toolbox of skills is so important because the next time something happens, you will reach back in and say, I can, I can do this.

I think it's, it, it's also important to say if you're going through a very difficult time, it is human nature to not want to reach out. And you shouldn't have to. But if nobody knows what's actually going on, they don't know to show up to support you, right? And they might be drowning in their own issues. And I know a lot of the times if you're really struggling, the last thing you want to do, because you've been thinking about it all day, you've been talking about it all day, particularly if you're dealing with a diagnosis, you don't want to call a friend and then have to talk through it all again today. And the— that's really understandable, but also recognizing that if you simply were to text them and to say, I have a lot going on, it's exhausting to share the details, but I could really use a morning out on Saturday with a friend right now.

That's right. That's right. Just those small little tiny changes. And, you know, speaking to what you said about a diagnosis, that's a whole nother topic, but for patients who've been diagnosed with something, you know, joining a group of other survivors can be really a powerful way to build connection. You know, I volunteer for the American Heart Association and Go Red for Women, and, you know, seeing a community of other female cardiac patients and connecting with them and learning that you're not alone and sharing your struggles, those kinds of, you know, community advocacy groups for whatever your concern or health issue is can be really helpful as well.

You know, you have an entire chapter, chapter 9, on the critical importance of finding hope. And I'm reading to you from page 191. Sometimes a health event can be so scary that a patient can't believe another day will come. Sometimes a diagnosis can be so dire that a patient can't imagine what the next day will look like. When we learn we don't have much future left, or if what lies ahead looks completely unlike the life we have known so far, what happens next? That's when we need hope the most. Hope is the foundation that allows us to build a resilient response in the moment, whatever happens next. What is hope? And why does having hope, especially in moments, whether it's the world at large that feels lost and things feel hopeless or something going on in your family makes you feel like all is lost. Why is hope important, and what does it actually mean, Dr. Nerula?

I had a patient in my office— again, I told you, a wife and a husband. The husband was diagnosed with Parkinson's, and he looked at me, Mel, and he said, "How do I not lose hope?" Yes. He said to me, "How do I not lose hope?" And you can imagine, as a doctor, that's a very, very hard question to answer. And I'm a cardiologist, and this was about a neurological disease. Degenerative condition. It's not my field. And I— but I could see that he was struggling, and his wife was in the room with him, and he said, "I still have so much I want to write. I love my wife so much. I have so much I want to do with her. I'm getting, like, emotional thinking about it, and I'm falling apart, you know, from my disease." And so, you know, I just sat there with him, and I said, you know, "You have to find hope in the small things." moments of every single day. So every day that you wake up and you see your wife and you can say, "I love you," and hear her say, "I love you," that's hope, right? Every day that you can sit at your computer and still write your book that you're writing, that's hope. It is the fact that there could be a treatment tomorrow that you don't know about that comes down the pipeline for your condition. It is literally finding those small moments of joy and— Looking for something that you may not know that exists and believing in that. Something that is further down the future. That's hope. And I want you to lean into that, I said to him. I want you to kind of fall towards the side of hope and not towards the side of despair.

You know, one other thing that I think helps a lot, or at least this helps me in regard to the state of the world, is if I read something that makes me feel despair, I then look for someone doing good.

I think you're totally right. And, you know, as someone who works in the news, I've had so many several conversations with the networks that I've been at about how we need to tell more stories of hope. Yes. We need to put that out there because people need to see it.

Is there a daily habit that you can practice to help you cultivate this hopefulness as a skill set and a mindset? Because I refuse to succumb to the despair. I re— and that's not— being naive, it's, I just choose to believe there's always something you can do.

So my husband gave me the book, "The Secret" and "The Magic." Yeah. Yeah. 'Cause he knows I believe in manifesting and dreams and all that sort of stuff.

Of course, proven by neuroscience. I mean, it's not even believing in it, it's proven, yeah.

So one of the exercises says, you know, in the morning when you wake up or before you go to bed at night, you think about 6 things, you know, that you're grateful for. And at first when I started doing it, I thought, oh my God, 6, that sounds like a lot. 6 things. But then you start to think about it and they're small things. They're, you know, my daughter told me about something that really great happened, that happened really great in her day today. You know, my patient, I helped them, you know, with this. I was able to get up and exercise on the treadmill today and walk 'cause I'm able to use my legs. Yeah. You know, I, the subway came on time today and I didn't have to wait 10 minutes. And suddenly as you're doing, you start to realize there's actually a lot of things that really went well that I'm grateful for. And your mindset shifts.

Well, the way you described it, Dr. Nerula, you're intentionally directing and programming your mind. Yes. To notice what's going well, which if you notice things that are going well, you naturally start to feel more hopeful.

Is that how that works? That's what I'm saying. Yes, exactly. You start to feel more hopeful. I think, you know, putting out— we talked about manifesting, but putting out into the universe the energy that you want to bring back to you. That gives me hope because you feel control. You feel like I'm putting out this and that's gonna help me get what I want, right?

So as a medical doctor and a cardiologist, talk to me a little bit more about using the tools of manifesting, which is really getting intentional about what you wanna see. We've moved the goalpost. How could you use this to help you move toward a goalpost that has shifted in your life and to change your own attitude.

Yeah, I mean, my kids and everyone, you know, talk to me about, "You're a cardiologist, but you talk so much about psychology." Yes. And that's because they really are, you know, intertwined.

Do you think it has a health benefit to manifest?

I do. I mean, I think, again, you're— anything that gives us a sense of agency over our life, I think helps us feel better and less stressed. And so when you feel like you have the power to get things that you want by simply believing in them, that makes us feel better.

Well, if you really think about it, stress is the same thing as manifesting. It's just doing it in the negative. That's right. Because you're allowing all of the things that are happening outside of you to become the things you're expecting to have happen.

And that you're focusing on, like, an endless loop and thinking about.

But is there anything specific that you personally do, Dr. Nerula, as a manifesting practice, like to really train your mind? I'm serious. Like, I know I have stuff.

I have written down things that I want, you know, and put them on a piece of paper and put them up in my home or in my office. Yeah. And then I look at it and I say, this is where I want to be and this is what I want. And there it is. That's it.

I'm putting it out in the universe. So when you write something down that you really want, and you're signaling to your mind, Dr. Narula, like, do you— is there a specific time of year you do it?

Is there— No, it's whenever there's something that I want to achieve in my life.

Okay. And is there a certain way that you write it down?

I just write it on a piece of paper and take a little thumbtack and put it up on the wall. And I have my kids doing it now too, you know? And we sit at the dinner table and I'll say, you know, "Let's manifest that this is gonna happen." You know, we talk about it out loud in my family because I want them to start to do it at this age. They're 13 and 9, to believe that, they have, you know, control and power over their future and what they want. And yes, I agree with you. I think when you're living in a state of constant stress, you can't refocus your mind. And the brain is plastic. We keep saying that it is plastic, it can change, we can rewire it. And part of the way we do that is by the thoughts we choose to focus on.

Dr. Narula, can manifesting help even during times of stress?

Manifesting can help at all times, Mel. Why? Because again, you're taking your mind and you're taking it from one, thought process, and you're literally picking it up and putting it in another thought process.

Oh my God, it's like moving the mental goalpost.

It's moving your mental goalposts from a negative thought process to a positive, I want this thought process. Again, it just, you know, the hope is that people start to recognize we have so much more power over our bodies, over our lives, by what we do up here, by how we think, by what we believe, by how we talk to ourselves. You know, that, that we have that ability. We just don't teach people to harness it. We don't teach people to use that.

Well, I agree with you. Even the identity pie, which forces you to see that your life is bigger than the current circumstances or the caregiving role or the job that you have, that there are so many different parts of you. And taking a moment to remind yourself of that lowers your stress. It reminds you of who you are. It gives you an access point to start to shift your life in a different direction. And I believe that the intentional act of manifesting and allowing yourself to say, even if you're writing down, "I am capable of getting through this. I want to carve out 6 hours a week, which seems unthinkable, just for me." Yeah. "I am going to be singing in the choir this fall again." Like, there are ways that you can grab onto what you're talking about because stress and pressure and the world around us is bombarding us and it's changing the way we think about what's possible. And so I think you need to fight back. And this is an important tool.

Yes. Yeah. And it's so simple. We can all do it. And it's free. It's free. My daughter showed me her— my daughter's turning 10, and last night she took my laptop and she came and showed me and I said, what are you doing? And she said, I made a vision board. My 10-year-old daughter, for where she wants her 10-year life to go and what she wants to happen. And I thought, okay, I'm doing something right. If my 10-year-old—

You're doing a lot more than that. But you're— doing a lot right. That's fantastic. Why shouldn't she?

Why shouldn't she? That's what I said. I said, otherwise society's telling her.

That's right. And her friends are telling her she, she can have a vision for her life. Great job, Mom. Great job. I want to read you again from your bestselling book. This is page 211, chapter 10, Pursue Your Purpose. It happens to all of us. We find ourselves at a moment when the life we know and are accustomed to is suddenly, inalterably changed. It often arises unexpectedly. It may be that we don't get into the college of our dreams or land the job we had been working toward for all of our career, or our partner of 30 years announces that she wants a divorce, or we're diagnosed with heart disease and we're told that if we don't alter our lifestyle quickly, as soon as possible, we run a high risk of soon having a heart attack or stroke. These moments create a sense of great vulnerability. Our sense of who we are, our identity is called into question. What all of these wake-up calls offer us is a chance for introspection, to take a closer look at our priorities and our path and to see if they are aligned toward what we might call our purpose. How does having a sense of purpose help you live a happier and more fulfilling life, especially when the world or when life just feels really awful?

Yeah, I mean, this, as I said, was purposefully the last chapter in the book because, as I mentioned, I call it, "Your purpose is your lighthouse." When things are dark, when you can't see how you could possibly be happy or have meaning in your life, your purpose calls you there. And we all have it. We all have something that really drives us in this life. And for everyone, it's a little bit different. And I think what can happen is when something happens to us that challenges us, that stresses us, it forces us to either reevaluate the purpose that we never pursued. So for a lot of people, they have the purpose, but they were too afraid to go after it. They didn't think they should, they didn't think they deserved it. And, you know, a stressful traumatic event will open your eyes to saying, my life is short and I'm gonna make the most of it. I'm gonna go after that purpose. The other thing it can do is really open your eyes to a purpose that you never thought would be your purpose. So we talked about advocacy. So for a lot of people, You know, it shows them that they want to become the voice for other people who have survived what they have survived. And that becomes their purpose for living, for kind of changing the way other people see whatever the disease process is or whatever the issue is that they're fighting for. And so the purpose is just such an incredibly amazing force. And I think I would just encourage everyone to seek that out inside of them.

So Dr. Nerula, For the person who's listening, who's like, I have no idea what my purpose is right now, do you have any really small examples of how some of your patients might have found a sense of purpose while they're going through a really difficult time that you might overlook? Because, because I could see a sense of purpose might be, my purpose this year is to take better care of myself while I'm caring for my parents. A sense of purpose might be, I want to be part of the wave of positive change that needs to happen in the world. Yeah. A sense of purpose might be, I don't know, going back to school because you haven't really learned anything new in a very long time. I mean, can you give us just a sense? Because I think that— how do I feel? That's a big topic. Yeah.

Yeah. No, and I think I see it in all of those aspects in my patients. I do have patients who've had something happen to them and they were in one career, and they have said, you know, I am going to go back to school and study something else that I didn't pursue before, but now I'm going to do it. Or other people who have been maybe miserable in their jobs close to retirement, didn't wanna retire, but say, you know what, it's time. I'm gonna stop. I'm gonna travel. I'm gonna spend time with my husband and my dogs, you know, and I'm gonna enjoy my life. So I think purpose can be as simple as that. It can be as simple as, you know, finding what you wanna do at that point in your life and going after it.

Well, it's kind of a reason to get outta bed. And you know, if we go back to the story in the beginning about your friend Kaz, her sense of purpose became to live the biggest, fullest, boldest life she could with the time that she had.

Exactly, exactly.

For the person who's listening right now and is just kind of wanting to know what to do, what's one small thing you could do today to start to build the skill?

Is it to start with acceptance? I think acceptance would be key, um, of whatever your condition or state is. But I think the social connection is a big one, and that is the easiest one, I think, to start. I mean, some of these tools are inward and some of them are external, right? Some of them are, yes, flexible thinking and acceptance, but some of them are, you know, getting fit and getting up and exercising or eating healthier or sleeping more. That's something that people can easily start to do is changing those little things in their lifestyle or reaching out and developing your social connections. And it's maybe just saying, I didn't talk to this person in the last 6 months, but I've been wanting to. I'm gonna pick up the phone today and give them a call and have a conversation, you know?

Well, I think it's really helpful to hear that because think about it. You already mentioned this word, like an investment that you're making a deposit in the bank of resilience. That's right. And if your world's not falling apart at some point, you're going to be just like the rest of us. And it will. Yeah. At some point. At some point. And reaching out to somebody or finding an interest and getting into a group or getting yourself out of your house. Yeah. And going for a walk with somebody is a small investment that you can make. In terms of the resilience that we all need to tap into when the fight comes.

That's right. And, you know, again, not to bring love back into this, but I think, you know, we all usually have someone in our lives, whether it is a sibling who is still living, or a parent, or your spouse. And that love, that deep, intimate connection, is something that we can, again, easily focus on and cultivate. I, you know, think of the story that we put in the book of my colleague at ABC, Will Reeves' father, Christopher Reeve, and his wife, Dana. And if you haven't seen the documentary about their life, I suggest it. It's beautifully done. But there's a moment in time where, you know, she says to him, "You're still you, and I love you." And he said, "Had she not said those words, I don't think I would be here." And it just speaks to the power of one person in your life, one sentence, one love that can kind of draw you out of something. Been so devastatingly difficult and deep. And so that's worth the investment. Those relationships in your life are worth the investment.

Well, Dr. Narula, I cannot thank you enough. The visual examples, the framework that you gave us, the redefining of what resilience isn't— bouncing back— what it is— adapting to change and being able to adapt and still find all the meaning and purpose and joy in the life that you now have, and the strength that we have inside each and every one of us to do it. But you have laid out a roadmap for us to be able to tap into this innate strength, and I am so grateful that you spent the time to write the book and that you're here today sharing it with us.

That's worth everything, you know? So, if one person comes away feeling that they— are better off because they realize their resilience and how they can build it to tackle life, then, you know, I've done my work. So—

Well, you did your work because there's no doubt that as you've listened today, you have come away feeling stronger and more resilient and able to face whatever it is that life is going to bring your way. One of my favorite things that Dr. Narula said, I'm gonna come back to this over and over, "You are the marble, and you are also the angel." And if you put the tools to work, there is no doubt in my mind that whatever it is that you're facing or seeing in the world, you will be able to adapt and change and be part of the positive wave that comes with it. Alrighty. In case nobody else tells you, as your friend, I wanted to be sure to tell you that I love you and I believe in you, and I believe in your ability to create a better life. And the fact that you spent time listening to this particular episode proves to me that you will create a better life because you got the tools that you needed. In order to adapt to any change that's coming. Alrighty, I'll see you in the very next episode. I'll welcome you in the moment you hit play. And thank you for watching all the way to the end. And you're gonna love this next video, and I'll be waiting to welcome you in the moment you hit play.