“I hope you’re taking care of yourself.”
That’s the line that’s been coming at me for years now –– across my texts, LinkedIn DMs and voicemails, across dinner tables and Slack messages, and haven’t-seen-you-in-forever emails.
I know people mean well. I can feel their complicated mix of sympathy, pity and thank-God-it’s-not-me relief.
But the words roll off tongues with an ease and frequency usually reserved for basic, mindless tasks –– not the truly daunting business of righting yourself after being pummelled by one (or more) of adult life’s most stressful experiences.
According to The Holmes-Rahe Stress Inventory, I’ve been through a whole host of those experiences –– some of them a few times over.
My father and maternal grandmother both died of cancer the same year, I’ve moved more than a dozen times since graduating from college, and I’ve lost three jobs.
In the past year alone, I’ve gotten laid off; had my 3-year-old son diagnosed with a rare, difficult-to-control epilepsy; and tested positive for COVID on my birthday.
My friends have dubbed me “a warrior,” “a real-life superhero,” and “the queen of coping.” And while I don’t know if those are fully-earned monikers in a country where almost 38 million people are living below the poverty line, I’ve admittedly asked myself: Is this a normal amount of stuff to deal with?
But at the end of the day, I know I’m not special. At the very least, we’re all being subjected to the truly head-banging soundtrack of everything that’s going wrong in this world, including deep-rooted racism, misogyny, gun violence, natural disasters, political turmoil, the aftershocks of a global pandemic, and more.
And these chronic stressors –– in addition to isolated events –– are heavy contributors to any given person’s cumulative stress level.
But we keep on keeping on, right?
After being repeatedly Whack-a-Mole-d by a few of life’s most stressful events, I continued making plans where I could. I started my own business, and I scheduled an elective plastic surgery I’d been considering for a long time. I was excited about the expected results after staring at a postpartum body I barely recognised for three-plus years.
So, on Jan. 17, 2023, at 5:30 a.m., I arrived at the hospital for my surgery. The night before, I half-jokingly said to my mom and my husband, Pearse: “If anything happens to me, I love you!”
“You’ll be fine!” They both replied in rapid succession.
“I know, I know,” I said. “I’m just saying it.”
They put me in bay number 13 for the surgery prep. I wondered aloud to Pearse over the phone if that was bad luck. We quickly chuckled about it and then it was time for me to go to the induction room.
The anaesthesia team gave me some medication to calm my nerves, wheeled me into the operating room, and put me to sleep.
About 10 minutes later, everything went sideways.
My medical team couldn’t get a pulse on me –– femoral, radial, carotid –– nothing. They started CPR.
After a few minutes, they were able to resuscitate me, and I was urgently transferred to the cardiac catheterisation lab.
When I regained consciousness later that day, I tried to take stock of my surroundings and my body.
I was still out of it from the anaesthesia, but I knew this wasn’t the way I had expected to wake up –– with a breathing tube down my throat and a still-undetermined amount of lines coming out of my neck, arms and hands.
I eventually learned I was in the cardiac intensive care unit, where I stayed for the rest of the week recovering from being brought back to life, undergoing invasive cardiac testing, and hosting a revolving door of medical professionals.
“Are you under any significant stress?” One of the cardiologists asked me during rounds the next morning.
I stared at him blankly.
I thought about all the days when even four anti-epileptic drugs couldn’t stop our son from having close to 1,000 seizures. I thought about all the nights I’d spent picking up and putting down our resurrected baby monitor, in a constant panic that every breath, every shift, every groan from his room was a seizure. I thought about his medical ketogenic diet that requires us to painstakingly weigh every morsel of food to the tenth of a gram. I thought about holding him on his side time after time as he convulsed, staring at the stopwatch on my phone, silently begging some unknown higher being to make it stop.
I thought about losing my job six months ago in the never-ending river of tech layoffs meandering through the workforce. I had vowed to myself I wouldn’t lose my professional edge through parenting, the pandemic, and getting cut from yet another full-time gig. Was that happening now that I’m self-employed and only working part-time? And do I even care anymore?
I thought about my dad –– a former paediatric anaesthesiologist –– and how I wished he was there to tell me everything’s going to be OK. I thought about how grief has a cruel way of forever siphoning off just a little bit of the joy that comes with every celebration-worthy event, every achievement. And I thought about how ironic it was that I’d coded on the operating table after getting anaesthesia –– my dad’s exact work.
Ultimately, my heart function eventually returned to normal and my medical team ruled out every cardiac condition except one: stress cardiomyopathy, also known as “broken heart syndrome.” It’s a complex condition in which the heart muscle is quickly, but temporarily, weakened, often as a result of intense emotional or physical stress.
According to my cardiologist, Dr. Anna C. O’Kelly, a fellow in cardiovascular medicine at Massachusetts General Hospital, my case, like many stress cardiomyopathy cases, isn’t clear cut –– and was likely multifactorial.
“It is hard to know which came first,” said Dr. O’Kelly. “Did you develop stress cardiomyopathy from all the many life stressors you have... which placed you ‘at risk’ for the cardiac arrest? Or did your body interact poorly with the anaesthesia leading to your cardiac arrest, which then caused a stress cardiomyopathy?”
The role stress played in my situation is a mystery I’m still very much grappling with. And a frustrating mystery at that, because while I probably had above-average stress in my life, I wasn’t just letting it go unchecked.
I’ve been seeing a therapist regularly since my dad died, I’ve test driven many stress management techniques over the years, and I’m hyper-aware of what I’m doing (or not doing) on a daily basis to fortify my mental health and well-being.
I now take an hour-long walk every day, I just finished a 12-week cardiac rehabilitation program, I joined a gym, I’m on a beta-blocker, and I’ve finally let myself spend a few nights away from home to sleep without staring at the baby monitor all night.
But fitting all that in on top of day-to-day life –– figuring out how to “take care of yourself” today –– sure feels like a bonafide burden. Like that to-do list item you can never cross off. An extra responsibility that comes at you day after day with the cliché laundry list of yoga and just-10-minutes-of-meditation and daily exercise and weekly therapy and time with family and time with friends and time to yourself and time for the hobbies that help you feel like a person.
And if I –– an upper-middle class, straight, white homeowner, with a master’s degree, community support, a stable of resources, and an incredible amount of privilege –– can’t take care of myself in America today enough to avoid stress-induced heart failure, then how can anyone?
So, where do I go from here? Where do any of us go from here?
After all, when it comes to stress, I’m certainly not alone. According to the American Psychological Association, 27% of Americans report they are so stressed they can’t function.
“That’s huge,” Dr. Lynn Bufka, associate chief for practice transformation at the American Psychological Association, and a licensed psychologist in the state of Maryland, told me.
Dr. Bufka also says this type of collective, debilitating stress produces a ripple effect that seeps into just about every crevice of society.
“It’s not about one person being so stressed they can’t function,” she said. “It means workplaces aren’t functioning as well, students aren’t learning as well.”
This type of widespread underperformance as a result of our stress only adds to our stress level, creating a vicious cycle that’s very hard to break.
Plus, chronic stress –– the kind that comes from things like having your basic human rights stripped away based solely on your gender identity or sexual orientation, or caring for someone with a disability –– can impact almost every system in the body. And those resulting physical health issues (hello, broken heart syndrome) are, you guessed it, stressful.
“There is definitely a link –– which we are increasingly appreciating –– between our psychological and cardiovascular health,” said Dr. O’Kelly. “The exact mechanism is not entirely clear, though it is likely bidirectional. For example, depression is a risk [factor] for heart disease, but you can imagine ways in which heart disease is also a risk factor for depression if you aren’t able to be as active, or have shortness of breath, or frequent hospital admissions.”
Nevertheless, many of us who have the means and wherewithal, try and try again to tunnel our way through the stress wall, doing our yoga and just-10-minutes-of-meditation and daily exercise and weekly therapy and time with family and time with friends and time to ourselves and time for the hobbies that help us feel like people.
But this isn’t something an açaí bowl or putting down your phone during dinner can fix. We need a lifeline.
Because in the face of no federal bereavement policy, 12 weeks of unpaid family leave, average annual child care costs coming in north of $10,000, average bachelor’s degree loan debt clocking in at $28,400, a health care system that will bankrupt most people at the first sign of a significant health complication, and much more, another thing is becoming abundantly clear: Even those of us with a roof over our head and food on our table are out here falling through a safety net that was already tattered and torn at best.
Dr. Bufka acknowledges that constructing an adequate safety net –– in addition to pursuing the activities and boundaries that keep our individual stress levels in check –– is crucial in helping Americans manage their stress levels.
To be sure, that’s a daunting challenge all around.
Just to lay a strong nationwide foundation, we’re talking universal access to annual mental health check-ups, improved distribution of stress management resources in communities across the country, every workplace and school being equipped to take on mental health challenges, and fixing complex systemic issues –– like racism, sexism and food instability –– that contribute to chronic stress.
Of course, there are many dedicated professionals already working to make progress in these areas. But when 76% of people nationwide have stress-induced health problems, doesn’t it seem like our leaders’ urgent duty to help us move the needle? Shouldn’t their main responsibility be to hold fast to the ideal of having a country full of people who are in a position to achieve contentment?
Can we really say we’re the home of the American dream –– the land of equal opportunity for success –– if we don’t address the stress elephant in the room? The simple fact is that a bunch of us are out here not functioning or literally coding on operating tables, because no matter how hard we try to chip away at our individual stressors, our country isn’t meeting us halfway.
I’ll happily relinquish the “queen of coping” crown and the “real-life superhero” cape in exchange for more systems and policies that take a little pressure off everyone.
After all, I’m just one member of an army of stressed out soldiers who I can only imagine are waving their white flags, ready to openly admit that a few weekly down dogs and sun salutations will never fully combat the stress that comes from living paycheck to paycheck, worrying your child is going to catch the next bullet, or grappling with medical trauma.
We’re all warriors. We’re all resilient. We can move through hard things. We can withstand the blows life deals us. We just need a little help stopping the bleeding along the way.
Melisse Lombard is a writer, editor, content professional and former journalist, now running her own editorial content production company. She lives outside Boston with her husband, Pearse, their son, and their pup. Melisse is also a co-founder of and singer in award-winning professional a cappella group, Sound Off.