Earlier this year (Spring 2021), my editorial, “Cultural Stress: The Ubiquitous Stressor Hiding in Plain Sight,” was published in Advances in Mind-Body Medicine. Although the article was written primarily for healthcare providers, its message is for non-providers, too.

That’s because, while most of us are generally aware of the role that stress plays in the development of many diseases, few of us realize the impact of a new kind of stress that is with us virtually every waking hour. This new kind of stress I call “Cultural Stress.” We don’t recognize it as stress because we’re swimming in it; it has become the new normal of our daily lives. For that reason, however, it is all the more dangerous because we don’t take steps to manage it.

Cultural Stress is the constant, pervasive, ever-increasing stress of modern living. It includes:

• Over-exposure to technology at the expense of in-person relationships;
• 24-hour connectivity, which blurs the boundaries between work and personal life;
• On-demand delivery of goods and services, which severs neighborhood and community relationships and results in long sedentary hours in front of our screens;
• The pace of technological change, which contributes to professional, economic, and social insecurity as one can never stop “keeping up”;
• Our global economic system, which sows uncertainty as it outsources jobs overseas or to new technologies;
• Environmental contaminants that expose us to thousands of new chemicals our bodies didn’t evolve to handle, as well as to noise, crowding, and various new sources of radiation;
• Changes to our diet, which has become heavily reliant on a few processed commodities (corn, wheat, sugar, and soy) disguised as millions of “different” products; and
• Changes to our urban development and transportation patterns, which result in less physical activity and more hours spent sitting—whether passively or in anger and frustration.

It is the chronic nature of Cultural Stress that distinguishes it from conventional stress. Conventional stress is acute, by which I mean short term and incident-specific: a job loss; a divorce; the death of a loved one; an injury or accident. In most cases the body can recover from conventional stress once the stressful incident has passed. This is not the case with Cultural Stress, however, because Cultural Stress is unceasing.

As a result, stress has become a factor in most of the leading degenerative diseases of modern humans: cancers, cardiovascular disease, diabetes, Alzheimer’s, dementia, Parkinson’s, and more. Moreover, when modern humans say they are “stressed,” or that they had a stressful day, they are usually referring to Cultural Stress, which like chronic inflammation, has become the matrix in which we live, compounding all other types of stress.

I began noticing Cultural Stress in my patients about 20 years ago, when the men and women who came to see me appeared chronically exhausted and emotionally distressed. They generally had no specific complaint; they were just overwhelmed in general.

This development in patient dis-ease roughly coincides with the global dissemination of the smart phone, cellular networks, and internet service, all of which have enabled technology to pervade our lives as never before.

Although this technology has conferred many benefits, it also has created new forms of Cultural Stress. For example, constant comparisons to the lives of others as portrayed on social media have led to an increase in low self-esteem, depression, and even suicide, particularly among adolescents and young adults. Constant connectivity has also made it more difficult to leave work at the office, infringing on time that is meant to be spent relaxing, rejuvenating, and enjoying relationships with family and friends.

As noted, the blurring of boundaries between work and rest has also affected sleep. For Americans overall, sleep duration has been decreasing since the mid-1980s. Sleep deprivation can have long-term consequences on health: sleep-deprived individuals are more prone to obesity, heart disease, stroke and diabetes, as well as mental health problems such as anxiety, unstable moods, and even thoughts of suicide.

Cultural Stress is also likely to indirectly accelerate aging. My own studies have shown the detrimental effects that Cultural Stress can have on hormone levels, cells, and connective tissue. Other researchers have found a direct correlation between sleep loss/sleeplessness and telomere shortening (an indicator of aging).  Of course, the reason most often given for adult sleep deprivation is stress, or, as I define it, Cultural Stress.

Since the early 2000s, email, social media networks, and phone texting have replaced regular in-person communication. All of this “connectivity” has, ironically, increased our sense of physical isolation. The COVID-19 lockdown has demonstrated this on a global scale: increased rates of anxiety, depression, suicide, substance abuse, and domestic violence have coincided with the requirement that people stay home. Isolation also has been shown to have a causal relationship with chronic disease.

I am not the only researcher to consider cell phone use a major factor in Cultural Stress. Although cell phones help people stay connected, they also obliterate personal boundaries. Recent studies suggest Americans check their phones an average of 100 to 150 times a day—checking news updates, monitoring their social media feeds, texting, or reading emails. However, it’s not just information we get from our cell phones, but constant micro-doses of hormones that activate the sympathetic nervous system, which responds with a cascade of chemicals that accelerate heart rate and pulse, increase muscle tension, and divert energy from the brain to the muscles. It can take from five to 30 minutes for hormone levels to return to normal, but given constant cell phone notifications, this seldom has an opportunity to occur.

So what can we do about all of this?

The most important step is recognizing that Cultural Stress is everywhere and that it compounds the impact of all other stressors. Because of this, effective stress management is an essential health practice for everyone.

Effective stress management requires a holistic approach to well-being—what I call the Four Pillars of Modern Wellness. These include a healthy diet and adequate hydration (“Eat your water!”), daily exercise, good sleep habits and, on the psycho-social-emotional level, reclaiming authority over your own life. Rather than allowing technology to violate the boundaries between work and play, professional and personal, healthy living may now require silencing one’s cell phone notifications; turning off devices an hour before bed; and even unplugging from devices entirely one day each week.

We also need to recognize the importance of nurturing in-person relationships, not just virtual ones. Finally, effective stress management requires some kind of mindfulness practice. This can be yoga, meditation, journaling, or inspirational reading. My own patients have benefited from a daily practice as simple as reflecting on 11 “Insight cards,” which consist of simple, positive affirmations such as “Be thrilled with who you are.”

The point is to reverse the dynamic that seems to place all value and worth in the virtual “out there” and return it to the “in here” of the individual patient—you!—an inherently valuable and worthy human embedded in a culture of actual human relationships.

It’s not the stress; it’s how you deal with it!