How Long-Term Stress Affects Health

Show: FRESH AIR
Date: AUGUST 17, 1998
Time: 12:00
Tran: 081701np.217
Type: FEATURE
Head: Interview with Biologist Robert Sapolsky
Sect: News; Domestic
Time: 12:06

TERRY GROSS, HOST: This is FRESH AIR. I'm Terry Gross.

Well, I'm back from my summer vacation. It was great, but you know what happens after vacation: It's back to the stress of real life. So my guest today, Robert Sapolsky is going to share some of the latest scientific and medical information on stress, its impact on the mind and body, and how to cope with it.

Sapolsky is a MacArthur Fellow and a professor biological sciences and neuroscience at Stanford University. He's just updated his book, "Why Zebras Don't Get Ulcers." He points out that our bodies are in some ways outdated models. They respond to the stresses of too much e-mail and traffic jams with the same physiological reactions that enabled early man to flee from predators.

I asked Sapolsky about some of the costly things our bodies do to respond to emergencies.

ROBERT SAPOLSKY, BIOLOGIST; AUTHOR, "WHY ZEBRAS DON'T GET ULCERS: AN UPDATED GUIDE TO STRESS, STRESS-RELATED DISEASES, AND COPING"; PROFESSOR OF BIOLOGICAL SCIENCES AND NEUROSCIENCE, STANFORD UNIVERSITY: All sorts of logical stuff, if you think about stress as, as you said, being a short-term crisis; you're sprinting for your life; some predator is coming after you. What do you want to do? You want energy. You want energy not tucked away in your fat cells for some building project next spring. You want energy right now in circulation, going to whichever muscles are going to save your life.

You want your blood pressure to go up. You want your heart to beat faster so you can deliver that energy as rapidly as possible. And also, another thing you want to do is, you want to shut down everything in your body that's not essential for the next three minutes: turn off growth, turn off digestion, turn off reproduction, turn off the immune response. Basically, you know, make your sperm, make your antibodies tonight if there is a tonight -- shut down everything that's not critical for right now.

GROSS: So this is really good if you're being pursued by a villain and you -- you really need that energy for the next three minutes until you get out of his grasp. But if the stress that you're facing is a long-term project that's going to last for six months, you're in big trouble.

SAPOLSKY: Yeah, and that's essentially the centerpiece of why we as humans get a lot of stress-related diseases. Not a whole lot of us are wrestling somebody for a canned food item in the supermarket or having, you know, an axe fight in the jungle clearing. What we do instead is sit and think about taxes and the ozone layer and mortality -- and these things that make no sense at all to 99 percent of the mammals out there.

And we have this amazing ability to turn on the exact same stress response worrying about a mortgage that a zebra does when it's sprinting away from a lion. And the punchline of the whole field is: If you turn it on long-term for psychological reasons, you get sick.

GROSS: So this answers the question that your book title poses: Why Zebras Don't Get Ulcers. They don't get it 'cause they really are running away from a lion or something as opposed to worrying about taxes.

SAPOLSKY: Yeah, exactly. And you know, very few of them stay up at night worrying about lions.

GROSS: Right. Now, doctors seem to be finding more and more connections between stress and the immune system. And stress seems to weaken our immune system, leaving us more prone to infections of every sort. What is the connection that you can find in your research between stress and the immune system?

SAPOLSKY: Well, it's an extremely hot topic these days. It's this whole new multi-syllabic field -- this field called psycho-neuro-immunology (ph) -- this whole notion that's what's going in your head affects how well your immune system is working. And this notion that what's happening in your head has an influence there -- this has been around for decades, even centuries -- you know, back when people were first noting somebody who was very allergic to roses, for example, would start sneezing at a plastic one; that your mind has a very large influence over what you perceive to be a challenge to your immune system.

What the field is about these days is bringing a lot of really hard-nosed science, cell and molecular biology -- all of that -- to figure out how this works. And what's pretty clear is psychological events, emotional turmoil -- things of that sort can very dramatically change the number of white blood cells you have in your circulation; how well they work -- very dramatic examples of that. What's the big question in the whole field is how readily that translates into a greater risk of a disease, more problems defending yourself against the disease once it occurs -- that's where the real controversy is in that field.

GROSS: You say something in your book that is probably just, you know, a little simplistic, so as we can -- to help us better get a grasp of it -- but you say, say the immune system's job is to like look for new tumors. Well, in an emergency response, that energy's going to be devoted to something else -- look for those tumors some other time. But if that response goes on and on and on, then looking for those tumors is going to be put off as well.

How -- how good a metaphor is that?

SAPOLSKY: Well that's -- it's a very reasonable metaphor, king of the Holy Grail of this whole field of psycho-immunology these days is figuring out: Is that actually what happens?

GROSS: Mmm-hm.

SAPOLSKY: And what people are pretty certain of is the boring, mundane aspects of the field -- absolutely solid. Go get yourself stressed all the time, and the common cold becomes more common. I mean, that's absolutely clear. You're more likely to get mononucleosis. You're more likely to a get a cold sore flare up -- that sort of thing. That end of the field is absolutely solid.

What's the totally controversial aspect of this field is the interactions between stress and, as you said, the formation of the tumor; once you have a tumor, how fast it's going to grow. That's where there's a huge contentious fight. How real are the connections there? Can stress cause cancer? Can stress worsen preexisting cancer? And what I do pretty -- I think sort of pugnaciously in this book at one point, after consulting with lots of lawyers, is going after what I think is a lot of emptiness in that literature.

Basically, I think when you apply some pretty rigorous rules as to which studies you pay attention to -- what constitutes sort of rigorous, objective science -- there's actually virtually no evidence of all of the link between stress and cancer. Stress has something to do with a zillion different disease processes out there. This is one area where you really don't have to worry about it too much.

GROSS: Now, you are a neuro-endocrinologist. So part of what you study is hormones.

SAPOLSKY: Yes.

GROSS: And what is the impact of stress on our hormonal system? What are some of the hormones that are increased and other that are inhibited by the stress response?

SAPOLSKY: Well, number one on the list is the one we all know about: When you get your proverbial adrenalin surge; when you've just barely missed being, you know, broad-sided by somebody running a stop sign -- that kind of thing.

Adrenalin is the defining hormone of the stress response. It's got another name in the United States, epinephrin (ph). This is the main hormone you secrete within a couple of seconds. There's a second wave of hormones you secrete as well called glucocorticoids (ph) -- these are steroid hormones that come out of your adrenal gland. And I guarantee everybody out there has heard of the synthetic version of glucorticoids -- hydrocortizone. Hydrocortizone or prednizone (ph), a bunch of other synthetic versions -- and these are hormones that are very commonly used in clinical medicine -- these are central to saving you during the stress response.

At the same time, there's a whole bunch of hormones you stop secreting, and they make perfect sense, given sort of the stuff I outlined before -- turn off everything that's not essential; shut off growth -- grow tomorrow if there is a tomorrow. One of the things that happens with the onset of stress in lots of species is growth hormone disappears from the bloodstream.

Turn off reproduction -- you're running for your life. You know, thicken your uterine wall some other time -- that kind of thing. Along with that, along comes stress and down goes the level of every sex hormone you can imagine. So those are the hormones that tend to get shut off during stress.

GROSS: Does libido get shut off too?

SAPOLSKY: Oh yeah, oh yeah -- very effectively. You can show this. There's all sorts of hard-nosed scientific ways in which you could measure the libidinous drive of your lab rats, and you can show that stress does really disruptive things to that. Or you can ask any person at all who has had a stressful period in their life, and suddenly, you know, that's no where near even the top of the list as it used to be. Sexual physiology, sexual behavior, sexual drive -- all of them go down the drain real effectively during stress.

GROSS: I find that funny in the sense that in so many Hollywood movies when the hero and heroine are about to be attacked, and they have like five minute before they're probably going to die -- they usually like have their first big love scene.

SAPOLSKY: Well, and you know, real life doesn't come to the good movie score either in most cases -- yeah, this one -- if they consulted with stress physiologists they would realize the erroneous nature of what they're presenting to the (unintelligible) ...

GROSS: There you go.

SAPOLSKY: ... the horrible damage they're doing to science education in this country. Yeah, this doesn't usually happen. I mean, the more likely outcome if there really is something stressful is the protagonists just lose control of their bladders. But that doesn't sell as many tickets in my experience.

LAUGHTER

GROSS: If you're just joining us, my guest is Robert Sapolsky. And he's just updated his book "Why Zebras Don't Get Ulcers: A Guide to Stress, Stress-related Diseases, and Coping." He's a neuro-endocrinologist at Stanford University who studies the cellular mechanisms of stress-induced disease.

I think a place where a lot of people are very immediately hit by stress is the digestive tract. I mean, you get stomach cramps. It's hard to digest your food. A lot of people get the runs when they're really nervous. So let's talk about digestion a little bit. Oh, did I mention ulcers? And -- why is it hard on the most simple level just to digest your food well when you're under stress?

SAPOLSKY: Well, it's -- the logic of it is, you know, digestion is -- turns out to be this big-time expensive process, and you use a huge amount of your calories just for the process of churning in your stomach and peristalsis (ph) in your intestines and all this muscular stuff going on. And it's the same logic -- you know, the saber toothed tiger's coming after you; worry about breakfast some other time. You try to avoid being somebody's lunch and you promptly shut down digestion during stress because that's not where you're getting your energy from. You get your energy within a couple of seconds from your fat cells and your liver. Digestion takes hours. Don't worry about it right now.

And we all know the first step in that, which is, say, you're speaking in public and you're a little bit stressed by that and you discover your mouth is dry. You've stopped secreting saliva, which is the first step of shutting down the whole digestive tract.

GROSS: Why do so many people get the runs when they're under a lot of stress, especially if there's a big event or something coming up -- a big thing that they're facing?

SAPOLSKY: Aha -- OK, you have now asked: What are the central remaining questions in the latter part of our millennium, as to why some people have this problem?

Turns out, it actually makes some sense in terms of how your small and large intestines work. OK, here it is. During stress, here's what you do. You shut down your stomach. You shut down your pancreatic juices. You shut down your small intestine -- all as part of this logic of, you know, you got better things to do right now. Your large intestine, something else happens in there which is: Your large intestines are not very useful to you for nutrition. Anything in your large intestines, you're not going to get any nutritional value out of. That's what's your small intestines do.

Large intestines, you just move the junk along there. You absorb some water so you don't defecate every time you go to the bathroom -- that kind of a thing. That's what the large intestines are good for.

OK, so you're running for your life -- lions coming after you. You've shut down every step along the way except for your large intestines. They're sitting there full of something or other that's going to provide you with zero nutritional value, and you've suddenly got this choice: You can go sprinting for your life with or without, you know, five pounds of dead weight sloshing around in your lower torso. And suddenly, it makes a great deal of sense to increase activity in your large intestines -- get rid of that dead weight. And that reflex is well enough understood that in lots of cases when people are executed in this country, they are executed wearing diapers because you lose control over your large intestines at that time -- part of this logic -- get rid of your dead weight.

So if you are chronically stressed, there is a tendency, a sub-type of colitis -- a tendency for your large intestines to get just a little bit out of control and unregulated, and just have too much of a tendency to dump whatever comes in there as fast as possible; you've got stress-induced diarrhea.

GROSS: Well, let's get back to the Zebra of your title -- "Why Zebras Don't Get Ulcers." If a zebra is under stress, so to speak, it's because they really are being chased by a large animal and they're fleeing for their lives. Is that zebra likely to -- to relieve himself before fleeing for his life?

SAPOLSKY: Oh absolutely. Carefully documented in many doctoral theses.

GROSS: Really.

SAPOLSKY: This is a very, you know, probably somebody out there no doubt studied this, but ...

GROSS: Oh.

LAUGHTER

SAPOLSKY: ... in just passing observation will confirm this out in the field. Yeah, this is exactly what happens. I mean, animals in a panic do that. Humans in the middle of battle will do that as well, and that -- that's, you know, a consistent sort of anecdotal experience of people when they're really, really terrified, you wet your pants for the same logic of emptying your bladder of all that dead weight. And you empty your bowels, you know -- bodies run faster under the circumstances -- nice logical reflex to have.

GROSS: What about memory? You say even memory is affected by stress.

SAPOLSKY: Yeah, that's actually one of the hot topics in this field. That's the stuff I work on in my laboratory. You know, we all know examples of this. We all learned somewhere back when, you know, that the stresser of staying up for two straight nights studying for finals doesn't make for the sharpest memory when you actually sit down with the exam. And we actually know something about the science of this by now -- why, after a couple of hours of stress, neurons, brain cells and the part of your brain that's involved in learning and memory -- why neurons there aren't getting as much energy as they normally do and aren't functioning as well.

What's also clear is by the time you've had a couple of weeks, a couple of months of stress, it looks as if some of the processes -- the means by which neurons connect to each other -- these processes will atrophy. And by now, there's even some evidence emerging that really big-time chronic stress could actually damage -- kill some of these neurons. And we're beginning to think that's got lots to do with why some of us age with our memories intact and some of us don't do as well in that realm.

GROSS: Well, I'll tell you what. Why don't we take a break here, and then we'll talk more about stress-related diseases and how to cope with stress. My guest is Robert Sapolsky. He's the author of the new, updated version of his book "Why Zebras Don't Get Ulcers: A Guide to Stress, Stress-related Diseases, and Coping."

This is FRESH AIR.

BREAK

GROSS: My guest is Robert Sapolsky, and he is the author of "Why Zebras Don't Get Ulcers: A Guide to Stress, Stress-related Diseases, and Coping." He is a neuro-endocrinologist at Stanford University. He studies the cellular mechanisms of stress-induced disease.

Well, you've made it very, very clear that stress has a lot of very bad effects on our bodies. So now I'm interested in what your suggestions would be on how to control stress. Two of the things you hear mentioned most often, I think, are, you know, meditation-type approaches and exercise-type approaches -- one in which you consciously slow your body down and the other exercise in which you work so hard that you -- you kind of work out that energy of the stress, instead of like if it's the flight or fight response, you're moving. You're working that energy out and getting rid of some of the adrenalin and whatever.

Do you have a preference between the two?

SAPOLSKY: Well, my personal bias is the exercise, but probably the most important message to get across is: One's personal bias makes a huge difference. I mean, does meditation decrease the likelihood of stress-related disease? And the answer is: It depends. Does daily exercise decrease the likelihood? It depends. Does going up on the roof of your building and playing the trombone for 30 minutes a night decrease the chances? It depends.

What it depends on very heavily is the psychological interpretation you give to doing that. There are definitely some stress management techniques out there that are being sold by card-carrying stress management experts, where doing that every single day would give me an ulcer. And I guarantee that whatever I find to be calming, somebody else out there would find it to be the most awful thing they could ever experience. By definition -- by the time you're dealing with humans and what counts as stress management, one person's stressful misery is what somebody else would pay to do as their favorite hobby.

GROSS: Theoretically, why does exercise help control stress?

SAPOLSKY: Well, it's part of that logic again of what the stress response is actually about. For 99 percent of the beasts on this planet, what a stresser is is you are about to run for your life or run for your next meal -- some huge outpouring of energy. And we as humans will be having the exact same physiology while we're sitting there being stressed, you know, having to smile at the boss' idiotic joke in the middle of a conference. And what you really want to do is, you know, savage the person with your canines.

I mean, what exercise essentially allows you to do is, as you said, do with your body what you are being primed to do, instead of sitting there in a state of psychological duress. It's a great releaser.

GROSS: And meditation?

SAPOLSKY: I think meditation, where it fits in is this pattern of what works in terms of stress management techniques, which are things which you do on a regular basis. And one of the sort of truisms of the field is, you don't do your stress management on the weekends. You do it virtually every day. Another truism -- it's something you set time aside for. You don't do it when you're on hold on the television. And another common theme is: It's something which causes a very dramatic change in the tempo of how you live your typical day.

And what that translates into is why meditation can be stress-reducing for some folks; why sustained aerobic exercise can be very reducing for others as well. It's the contrast.

GROSS: You suggest that predictability can help control stress. How does predictability fit in? Oh, this -- shirt sort of plugs into a classic -- a very elegant literature. Surely, basically what is it about psychological stress that is stressful? And once again, getting gored by an elephant is going to be stressful. Why is it that that being on the slow bank line ulcerates only some of us?

And what these studies show is essentially for the same exactly physical stresser, an organism, an organism -- a lab rat, a lab primate, a college freshman's who has volunteered -- for the same physical stresser, you are far less likely to get a stress response if you have a sense of outlets for the frustration that's been building up; if you have means to get out the tension -- exercise, meditation et cetera being prime examples.

If you feel like you have a sense of predictive information -- how bad is the stresser? How long is it going to last for -- that sort of thing. If you feel like you have a sense of control -- this is miserable, but at least I can end it whenever I want to. And we're all familiar with everyday examples of that -- the predictive element.

OK, you're sitting there in the dentist chair -- dentist is drilling away. It hurts. You're miserable. You finally say: Are we almost done? And you know the difference between the dentist who can tell you "two more bits of drilling and we're finished" and the dentist that says: "Hmm, I don't know -- could be all day; you could be here hours" -- that sort of thing. Predictive information -- knowing how bad it's going to be -- makes stressers far less stressful.

In the same way, that sense of control is very powerful as well. I saw a great example of this a while back, talking to somebody who worked as a temp in a secretarial agency. And I was sort of commenting: "God, that must be terribly stressful -- you know, every week, you're sent to a new place and very different people and having to figure out what the rules are there, and people no doubt dumping on you because you couldn't possibly be on top of the job as the person who's on vacation. Must be terribly stressful."

And she said: "Actually, it's not stressful at all because, you know, I know the minute it gets to be too much, I'm out of there." A sense of control -- and my bet is that person hardly ever walks out of a job. It's not the leaving the job -- it's the sense of control that she could. She has the option. These are really powerful variables when you think about psychological stressers.

GROSS: Robert Sapolsky -- he is a professor at Stanford University. He's just updated his book about stress-related diseases called "Why Zebras Don't Get Ulcers." He'll be back in the second half of the show.

I'm Terry Gross and this is FRESH AIR.

BREAK

GROSS: This is FRESH AIR. I'm Terry Gross, back with Robert Sapolsky, who studies the physical and mental effects of stress. He's a professor of biology and neuroscience at Stanford University. Sapolsky has just updated his book "Why Zebras Don't Get Ulcers: A Guide to Stress, Stress-related Diseases, and Coping."

We seem to be having an epidemic of depression, and I'm wondering if you see depression as being a stress-related disease.

SAPOLSKY: Boy, if you have to teach somebody the -- the archetypical stress-related disorder, depression is it. This is a disease you cannot understand without understanding the effects of stress and the genetics of depression, the neuro-chemistry, the hormones, the psychological factors. This is not depression -- you get some bad news and you feel down for a couple of days. This is this horrible, major crippling psychiatric disorder that gets nearly 15 to 20 percent of us at some point in our lives.

And it is a disease that is absolutely stress related, and that is in no way saying that this is a disease that's purely environmental. This is a disease with a heavy biological component, and this is one that people absolutely have to get help for. And this is something I'm often on the bandwagon about. People very frequently view a depression as: "Oh come on, pull yourself out of it. We all get depressed. Get yourself together. Stop indulging yourself."

And when you look at the biology of depression, it is as biological as is having diabetes and you don't tell a diabetic: "Oh, come on -- what's this insulin stuff? Stop babying yourself." It's a highly biological disorder whose trigger is stress. Real critical for people to understand it.

GROSS: What is the connection between stress and depression?

SAPOLSKY: On a brain chemistry level, stress brings about some of the neuro-chemical changes that are the leading candidates for what's wrong in this disease. On a hormonal level, those glucacorticoid hormones I mentioned before can cause depression. Give somebody a whole bunch of synthetic versions of them to control some disease, and you've just dramatically upped their chances of getting clinically depressed.

On a psychological level, that whole business of stress being about loss of control, loss of outlets, loss of predictability -- that's your shopping list as to what psychological events you need to set somebody up for a depression. And the sort of most catchy phrase out there for cognitively what a depression's about is when somebody has learned to be helpless. And that's psychologically what stress is all about.

GROSS: Well, what is meant by "learned helplessness"?

SAPOLSKY: Classic idea -- this is actually stuff pioneeered by psychologists -- University of Pennsylvania -- a man named Martin Seligman (ph) in the '60s -- showing essentially if you take these elements of loss of control, loss of predictability, and take it to an extreme with an organism, including humans in experimental studies, you get somebody who not only sits there during the stressful period saying: "This is awful. There's nothing I can do about it. There's nothing I can do about it." This is somebody who 10 minutes later in a circumstance they do potentially have control over, they sit there and they say: "There's nothing I can do about it. It's hopeless. I'm helpless." You have taught that individual to be helpless, to be cognitively distorted, to decide there's nothing they can do.

And that's exactly what a depression is about. You have some individual trauma during development. You have a trauma as an adult. By all logic, you should react to that by saying: "This is awful, but you know what? That's not the whole world." And you look at somebody whose sunk in a clinical depression and this is their whole world -- everything's awful; everything is hopeless. What do you expect?

You have taught them to do this irrational act of generalizing from one stressful event to deciding that that's the whole world.

GROSS: Robert Sapolsky is my guest. And his new book is called "Why Zebras Don't Get Ulcers: An Updated Guide to Stress, Stress-related Diseases, and Coping."

Now, I know that you spent some time in Kenya studying babboons, while you were working at an institute of primate research. Did you learn anything about human stress by studying babboons?

SAPOLSKY: Well, that's sure what I keep telling the grant agencies.

LAUGHTER

What I study out there -- this is actually the last 18, 19 years, I've spent part of my summers out in the Serenghetti in East Africa looking at this troupe of baboons. And it's the same wild animals I've been going back to each year, where I can observe them and I can also dart them, anesthetize them, and while they're down, check their blood pressure and cholesterol levels, and whose ovulating and whose got stress hormone levels through the roof -- that sort of thing.

I'm trying to figure out basically who gets the stress-related diseases. And there's a bunch of punchlines there that I think are fabulously appropriate to us as humans. The first one, and the most boring one, is: If you're going to be a baboon, you want to be a high-ranking one. In a stable hierarchy, these are the guys who have the psychological advantages. These are the guys who have the fewest stress-related diseases.

That one is the least applicable to us as humans because the notion of rank as it works for a non-human primate has absolutely no mapping onto the human experience. What's really interesting and relevant about these guys are the two other variables, and these are ones having to do with personality. A male baboon, regardless of his rank, who cannot tell the difference between his worst rival on the planet, threatening him from a foot away, and his worst rival on the planet taking a nap at the other side of the forest -- a male baboon who can't tell the difference between those two things is going to have the crummiest physiology you can ever imagine in terms of being vulnerable to stress-related diseases.

This is what type-A behavior is. This is hostility. This is seeing everything as a provocation; everything in your face; everything is personal. And these guys have the high blood pressure and the elevated stress hormone levels and the shorter life expectancy.

GROSS: How can you tell whether these are baboons who can't judge whether the big ape is there to attack them or just to take a nap?

SAPOLSKY: Oh, here is how you do it. You look at, for example, your study subject is sitting there grooming happily somebody else -- nice, calm moment. Worst rival on planet shows up, threatens him from a foot way. What's the likelihood over a course of a year and 50 times that this has happened -- what's the likelihood that this guy is going to stop grooming and, for example, get into this very tense defensive stance?

OK, pretty good chance of that. Now, look at the same guy when he's grooming; 50 different occasions over the course of the year when his worst rival shows up and takes a nap at the other end of the field. What's the likelihood that the guy stops grooming and gets into a crazed defensive stance? Guys who get just as thrown into a tumult by their worst rival taking a nap -- these are the guys with the high blood pressures et cetera -- essentially are asking how readily are their calm, affiliative social behaviors disrupted by the presence of somebody else. Guys who see all the glasses as half empty -- these are the ones who have the stress-related diseases.

So that's one big variable: Can you tell the difference between the big things and the little things? The even more powerful predictor is: Do you have social support? And amazingly enough, even for a bunch of baboons running around the Serenghetti, it is not anthropomorphic to talk about ideas like "friends." Some baboons have friends; some don't. Some grooming, some are groomed, some sit in contact with other animals, some play with infants, and some are relatively loners -- and that's the single best predictor of all these health-related variables.

And you know, in a sense, this is reinventing the wheel. Ninety percent of stress management techniques are built around: Can you tell the difference between the big things and the little things? Can you tell the difference between what you can control and what you can't control? And when the outcome is bad, do you have somebody's shoulder to cry on? Hugely powerful variables.

GROSS: So the longer baboons have more stress-related problems?

SAPOLSKY: Yeah, yeah -- to a very striking extent. And of course, the question immediately becomes, you know, one of these confound issues: Does having less social affiliation mean crummy physiology? Or does crummy physiology get you less social affiliation? And that's not a chicken and egg-type question. You can actually see what comes first, and it's the social behavior. That's the determining factor. These personality differences are there real early in life, which is one of the neat things about being able to go back to these same animals year after year. You have information on these guys back when they were just hitting adolescence and now you see what their old ages are like. And it makes a difference.

GROSS: So you could see the social habits forming before you see the stress-related physiological problems?

SAPOLSKY: Yeah, yeah. And you see the same thing in studies with captive primates, where you can study animals right the first day when you formed the group, and then look at them two months later when the hierarchy or when the social relations are sorted out -- behavior comes first.

GROSS: What are some of the connections you'd like to see that aren't much being made yet in medicine between -- trying to help people reduce their stress while treating them for whatever problems are manifesting?

SAPOLSKY: Probably the most relevant area -- well, two that come to mind. One is to understand individual differences in this regard, you know, for people who are stress physiologists who are now 50, 60 years into thinking that how healthy your stomach walls are what your blood pressure is and how regular your menstrual cycles are -- all of these are sensitive to stress. That's perfectly solid.

What we don't really understand is why some folks are so much better at handling stress than others, and it's going to be issues related to personality and psychological makeup and all that sort of stuff -- that's an area where there's a tremendous amount of work that's still needed.

The second area is this funny sort of policy implementation realm where more scientific research is needed at this point. This is one where we need a medical system where a doctor sitting in their HMO with, you know, 11.23 minutes per patient or else they get penalized, and that sort of schedule -- where a doctor could instead sit there with somebody whose come in complaining about a bunch of somatic symptoms, organic symptoms -- something is wrong with their body -- and would have the mindset and the time and the training to say something like: "How's your life going? Do you have any stressful things going on? Are you involved in any risk factors that I can tell you about that are not clever things to be doing? Are there nutritional things you should pay attention to?"

You know, this is a subject that has been covered at great length by all sorts of folks out there -- the realm of preventive medicine includes stress management. And this is a country that has horrifying little respect for doing that, and gives its physicians very little training and very little orientation or time to do that sort of thing.

GROSS: My guest is Robert Sapolsky, a professor at Stanford and author of "Why Zebras Don't Get Ulcers." We'll talk more after a break.

This is FRESH AIR.

BREAK

My guest is Robert Sapolsky, who studies the effects of stress on the mind and body. He's updated his book "Why Zebras Don't Get Ulcers."

You had an article recently in The New Yorker on a subject that's pretty unrelated to stress, but very interesting. And the question you posed basically was: Why, after a certain age, do people seem to gravitate toward the old familiar records, and be totally uninterested in hearing records by artists or composers that they've never heard of before? Whereas young people are always seeking out new performers.

Well, first of all, what made you even ask that question as a researcher?

LAUGHTER

SAPOLSKY: Yeah, not quite my usual petri dish-type studies. This was actually a couple of years ago. I had this kid working for me as a secretary for a couple of years. He had just graduated Stanford and was spending a couple of years before going to English lit. grad school. And he was great at his job, but I found that nevertheless he was just irritating the hell out of me.

And it was because of his music tastes. And he'd be in there in the outer office with some CD blasting some, you know, horrendous music from whatever 20-year-olds are listening to these days. And you know, even though it is scientifically provable that his music is inferior to the stuff that I listen to, you know, that's his prerogative. He can listen to that all day long. That's what 20-year-olds are supposed to do.

The problem was that wasn't what he was doing. He'd be listening to that junk one day, and the next day it's late Beethoven string quartets, and the next day he's listening to, you know, pygmy folk music and the next day it's klesmer (ph) music and the next day it's Puccini. And this kid was incredibly open-minded.

And he was that way in like every possible way. He had a beard and long hair. One day, he walks in, he'd shaved everything off. He wanted to see if people would interact with him differently. He spends a weekend at an Indian music, you know, movie festival because he'd heard this might be interesting -- you know, this this incredible open-mindedness. And at some point, you know, you kind of reflect on where you're at, and I suddenly discovered -- just on the edge of middle age -- that you know, I listen to basically the same Bob Marley Greatest Hit tape about four times a day, and how long has it been since I've gone to a restaurant and tried a new type of food, and that sort of thing.

And suddenly, you wonder: How did this happen? Why am I now, you know, the sort of person who buys these "best of" anthologies from late-night TV? And I thought about it, and you know, this might be a juncture where you do some, you know, painful soul-searching. And being a scientist, what you get to do instead is scientific study.

So what I wound up doing was, I called 50 radio stations around the country that did period music, and found out from them what's the period of music you play; what's the average age of your listeners. And came up with a number: What's the average age of which those people form their music taste? Called 50 Midwestern sushi restaurants -- what's the average age of
your customers? When did you show up in the small midwestern town? Figure out what's the average age at which somebody is still likely to try sushi. Called up 50 body-piercing parlors in San Francisco and New York and asked them: When did you start offering tongue studs and what's your average customer's age, and figured out a window for that.

And came out with this horrifying set of findings, which was basically by the time you're 23, if you haven't gotten a tongue stud, 95 percent chance it's never going to happen; by the time you're 35, 95 percent chance you've already settled on your music taste; by the time you're 39, 95 percent chance if you're not already eating sushi, you're never going to try the stuff. This window just appears to close in most of us to novelty.

And that was real interesting to me.

GROSS: Now, some of this I would just write off to the fact that, you know, youth culture is youth culture and always will be. And you know, so one has to accept in a world of pop culture that there's always people -- there's always kind of music and fashion that young people will be interested in that older people won't. But there does seem to be something really physiological behind some of this.

So what do you attribute it to?

SAPOLSKY: Well, one fact about it that totally blows me away in terms of initially thinking there was some kind of social explanations, you take a rat -- a laboratory rat -- and by the time that rat is getting into early middle age, it doesn't like trying new foods. You find the same thing in a mekak (ph) monkey. You find the same thing in all sorts of other animals. This is not just some sort of human cultural phenomenon. Organisms go through this phase around adolescence where they really gravitate towards novelty, and somewhere shortly after that they decide they get a lot more comfort out of repeating the old stuff.

What's interesting to me as a neurobiologist is there isn't a shred of evidence to think: Oh, there's a novelty center in the brain and we lose neurons and they're right on cue at age 23, and you never get a tongue stud again. There's not a neurobiology for it. There's some very interesting psychological evidence that it has to do with how eminent you are; sort of how much of a status quo you're invested in. But that certainly doesn't explain rats not willing to try out new foods or you know, 40-year-olds not listening to 20-year-olds rock music.

It's a very puzzling phenomenon, and basically nobody has a clue what it's about at this point, but it is sure widespread.

GROSS: Are you going to try to keep studying this?

SAPOLSKY: Well, sort of along the way in doing this, and this was obviously utterly sort of just jumping into the deep end in an area I knew nothing about. It became apparent there's some very serious scholars out there who think about this stuff; who've gone at it much more systematically. I will certainly continue to think about it, and it really is a subject I have, you know, returned to for years, ironically, thinking about this sort of stuff.

And why does that strike me as an interesting thing? You know, it's not clear to me we really do have to figure out how to get more 80-year-olds out there, you know, eating raw eel with tongue studs -- 80-year-olds with tongue studs eating raw eels -- not to fall into the, you know, shooting an elephant in your pajama syntax problem.

Why is this an important thing to do? Mainly because one of the things that I see hanging out with 20-year-old college students all the time is when you're 20, it's a lot easier to have this open-mindedness that's a prerequisite for trying to help somebody who's in a very different position in life. When I see my 20-year-olds, you know, planning to run off to the Congo in the Peace Corps after they graduate and help lepers or, you know, go help some kid in the barrio across town who's, you know, from a very different culture, then I realize that it's not so easy for me to be that open anymore. You're suddenly struck with the fact: An open mind is a prerequisite for an open heart.

And that's a real important thing, I think, to figure out and to facilitate.

GROSS: Well, I want to thank you very much for talking with us.

SAPOLSKY: Well, thank you -- a real pleasure.

GROSS: Robert Sapolsky is a professor at Stanford University. His book about stress-related diseases, "Why Zebras Don't Get Ulcers," has just been published in a new updated edition.

This is a rush transcript. This copy may not
be in its final form and may be updated.

TO PURCHASE AN AUDIOTAPE OF THIS PIECE, PLEASE CALL 888-NPR-NEWS

Dateline: Terry Gross, Washington, DC
Guest: Robert Sapolsky
High: Biologist Robert Sapolsky. He's one of the first researchers to chart the effects of chronic stress on the brain in the animal kingdom and in humans. He adds a touch of humor to his findings, as well. His new book is called "Why Zebras Don't Get Ulcers: An Updated Guide to Stress, Stress-Related Diseases, and Coping." (W.H. Freeman and Co.) It's a revised version of his 1994 publication. His other book is called "The Trouble With Testosterone and Other Essays on the Biology of the Human Predicament." Sapolsky is Professor of Biological Sciences and Neurosciences at Stanford University. He lectures throughout the country on the effects of stress.
Spec: Science; Animals; Haelth and Medicine
Please note, this is not the final feed of record
Copy: Content and programming copyright 1998 WHYY, Inc. All rights reserved. Transcribed by FDCH, Inc. under license from WHYY, Inc. Formatting copyright 1998 FDCH, Inc. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to WHYY, Inc. This transcript may not be reproduced in whole or in part without prior written permission.
End-Story: Interview with Biologist Robert Sapolsky
Show: FRESH AIR
Date: AUGUST 17, 1998
Time: 12:00
Tran: 081702NP.217
Type: FEATURE
Head: Swamp Pop
Sect: Entertainment
Time: 12:52

TERRY GROSS, HOST: Tucked away in rural Louisiana, a musical genre came and went in the 1960s with very little attention paid to it by the rest of the country. It was only just as it was dying out that some British record collectors provided it with a name and its first international hit.

Today, rock music historian Ed Ward takes a look at swamp pop.

(BEGIN AUDIO CLIP -- ROCK PERFORMING SWAMP POP)

(SINGING)

Got you on my mind
Really kind of sad and low
Got you on my mind
Really kind of sad and low
Wondering where you are
And wondering why you had to go

ED WARD, ROCK HISTORIAN: It's a given that one generation rebels against the previous one, and by the late '50s the reaction to traditional cajun music was in full swing in southwestern Louisiana. A number of artists had started making cajun-flavored country music and, with the French language suppressed by the schools there, the old ways were dying out.

But the new generation not only didn't want to have anything to do with cajun music, they hated country music, too. Then in 1958, along came the record that galvanized the change.

(BEGIN AUDIO CLIP -- "COOKIE AND THE CUPCAKES" PERFORMING)

(SINGING)

You're love for me will always be
Just a faded memory
Until (unintelligible) for you
There's no matter what you do

Until I've cried and cried for you
There's no matter what you do
Yes, I've cried and cried in vain
I want my baby back again

You gave me love when there was none

WARD: Cookie and the Cupcakes were a show band from Lake Charles -- all black, but they played for white audiences too. "Matilda," their first record, was a local smash -- never denting the national charts, but it was probably bought by every teenager between Henderson and Houston. There was something about that bassline, the creaky horns, and Cookie Terry's (ph) passionate delivery that inspired white cajun kids to try to imitate it.

One of the first was Rod Bernard (ph).

(BEGIN AUDIO CLIP -- MUSICIAN ROD BERNARD PERFORMING "THIS SHOULD GO ON FOREVER")

ROD BERNARD, SINGER: (SINGING)

This should go on forever
It should never ever end
It it's wrong to be delove (ph) you
I'll forever live in sin

This should go on forever

WARD: "This Should Go On Forever" had been recorded by Guitar Gable (ph), a black musician, but not released. When Bernard, who fronted a band called "The Twisters," heard them play it in a club, he asked King Carl (ph), the song's composer, if the band could record it. It took off like a rocket, and Gin (ph), the small label in Vilplatt (ph), which had released it, had to license it to a Chicago label to meet the demand. It eventually reached number 20 on the pop charts.

Bernard's success was challenged by Johnny Allen (ph), who had played traditional cajun music until he saw Elvis on the "Louisiana Hayride" in 1956. Renaming his band the "Krazy Kats," (ph) he let it be known that he wanted to make a record, and Floyd Swallow (ph), who'd made a star out of Rod Bernard, was happy to oblige.

(BEGIN AUDIO CLIP -- JOHNNY ALLEN AND "THE KRAZY KATS" PERFORMING "LONELY DAYS, LONELY NIGHTS")

JOHNNY ALLEN, SINGER: (SINGING)

Lonely days, oh lonely nights dear
I cry myself to sleep
Thinking how much I love you
Wondering why I brought you (unintelligible)

In my heart there's only you, dear ...

WARD: "Lonely Days, Lonely Nights" didn't repeat Bernard's success, but it was only the beginning for Allen. Because the scene thrived so well at home, it wasn't dependent on national hits to keep happening. Countless bands played the circuit, often fronted by singing drummers like Warren Storm and Clint West. The bassist from "Clint West's Boogie Kings," Tommy McLean (ph), was the last swamp pop artist to have a national hit, with a moody reading of a country tune in 1966.

(BEGIN AUDIO CLIP -- MUSICIAN TOMMY MCLEAN PERFORMING)

TOMMY MCLEAN, SINGER: (SINGING)

Sweet, sweet dreams of you
Every night, I go through
Why can't I forget my past
And live my life (unintelligible) through
Instead, I'm having sweet dreams
About you

WARD: Psychedelia (ph) swept swamp pop from the map, but in 1974 British disc jockey Charlie Gillet (ph) compiled "Another Saturday Night," an album of the music for Ace Records in Britain. And a very unlikely thing happened: Johnny Allen's 1971 recording of Chuck Berry's "Promised Land" became a British hit.

(BEGIN AUDIO CLIP -- MUSICIAN JOHNNY ALLEN PERFORMING "PROMISED LAND")

SINGER JOHNNY ALLEN: (SINGING)

And if my home in Norfolk, Virginia
California on my mind
I spotted that Greyhound rolling on rally
Going across Caroline

We stopped in Charlotte
We bopped past Rockville
We never once were really late
Ninety miles out of Atlanta by sundown
Rollin' across the Georgia straits

Right away I bought me a through train ticket
Right across Mississippi green
I was only at midnight flying out of Birmingham
Smoking into New Orleans.

Somebody help me get out of Louisiana
Help me get to Houston town
(unintelligible) some folks who care a little about me
And they won't let the poor boy down

WARD: The accordion break in the middle of the record not only helped sell it, but pointed to another change going on in swamp pop's home. Cajun pride was on the rise and the old sounds were on their way back.

GROSS: Ed Ward currently lives in Berlin.

This is a rush transcript. This copy may not
be in its final form and may be updated.

TO PURCHASE AN AUDIOTAPE OF THIS PIECE, PLEASE CALL 888-NPR-NEWS

Dateline: Terry Gross, Washington, DC
Guest: Ed Ward
High: Rock historian Ed Ward tells us about a fleeing genre of music known as Swamp Pop.
Spec: Music Industry; Entertainment; Art
Please note, this is not the final feed of record
Copy: Content and programming copyright 1998 WHYY, Inc. All rights reserved. Transcribed by FDCH, Inc. under license from WHYY, Inc. Formatting copyright 1998 FDCH, Inc. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to WHYY, Inc. This transcript may not be reproduced in whole or in part without prior written permission.
End-Story: Swamp Pop
Show: FRESH AIR
Date: AUGUST 17, 1998
Time: 12:00
Tran: 081703NP.217
Type: FEATURE
Head:
Sect:
Time:

This is a rush transcript. This copy may not
be in its final form and may be updated.

TO PURCHASE AN AUDIOTAPE OF THIS PIECE, PLEASE CALL 888-NPR-NEWS

Dateline:
Guest:
High:
Spec:

Please note, this is not the final feed of record
Show: FRESH AIR
Date: AUGUST 17, 1998
Time: 12:00
Tran: 081704NP.217
Type: FEATURE
Head:
Sect:
Time:

This is a rush transcript. This copy may not
be in its final form and may be updated.

TO PURCHASE AN AUDIOTAPE OF THIS PIECE, PLEASE CALL 888-NPR-NEWS

Dateline:
Guest:
High:
Spec:

Please note, this is not the final feed of record
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Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.