Chapter 22
Downtime and the Pace of Ageing — Part 1
Usually, stress affects a number of systems together, not just a single one. The phenomenon of rapid greying of hair due to acute stress has captured storytellers’ imagination like few other afflictions. The likely explanation for overnight or rapid greying is that stress induces loss of pigmented hair with retention of non-pigmented and thus white or grey hair. Rapid greying is often called ‘Marie Antoinette syndrome’. The name refers to Queen Marie Antoinette of France (1755–1793), whose hair, allegedly, turned white during the night before her walk to the guillotine at the time of the French Revolution. She was only 38 years old when she died. This is evidence of the acute and extreme stress she experienced on that night. History also records that the hair of the English martyr Sir Thomas More (1478–1535) turned white overnight in the Tower of London before his execution. More modern accounts refer to the hair of survivors of bomb attacks during Second World War turning white. In a published case I came across, an American dermatologist described a 63-year-old male patient who he attended after the man had fallen down the stairs; his hair turned white after the accident, again reflecting the shock and stress for that individual. Senator John McCain was a member of the US Congress from 1983 until his death in office in 2018 and a two-time US presidential candidate. His biographer describes how, as a prisoner of war in Vietnam, McCain’s hair rapidly turned white as a result of gruesome torture.
Chapter 6: Downtime and the Pace of Ageing
Harvard researchers have shed further light on how stress causes such rapid greying and what this tells us about the wider impact of stress on our bodies and biological systems. Stress activates nerves that are part of the fight-or-flight response – the sympathetic nerves. When scientists explored the impact of different degrees of stress on the hair follicle they found that the sympathetic nerves, which feed each hair follicle, release the chemical noradrenaline. The intensity of noradrenaline release equates to the intensity of the biological stress response and depletes hair pigment in addition to accelerating hair loss. Because the sympathetic system is involved in innervation of almost all organs, the authors concluded that greying is indicative of the pervasive biological effects of stress. We only have a finite amount of hair pigment and once depleted, it cannot be replenished – once grey always grey (visits to the hairdressers excluded). This is why ageing is associated with grey hair. We have evolved to gradually tap into the pigment source over many years and not to empty our stores of pigment over a short period.
Chapter 6: Downtime and the Pace of Ageing
The principal author of this Harvard study stated, ‘When we started to study this, I expected that stress was bad for the body – but the detrimental impact of stress that we discovered was beyond what I imagined. After just a few days, all of the pigment-generating stem cells were lost. Once they’re gone, you can’t regenerate pigment anymore. The damage is permanent.’ By understanding precisely how stress affects these cells, the authors have laid the groundwork for discovering how stress impacts other tissues and organs in the body – the first critical step towards eventual treatment that can halt or revert the adverse impact of stress and possibly of accelerated ageing. The good news is that we become less stressed with age. In a large Gallup poll from 140 countries, of respondents aged 15 to 29 years, 64 per cent reported they were stressed, 50 per cent reported they were worried and 32 per cent were angry. In contrast, respondents aged 50 and above were less stressed (44 per cent), less worried (38 per cent) and less angry (16 per cent). And these figures were even lower again in respondents over 70. Another large series from the University of Southern California similarly showed that ratings of daily perceived stressfulness yield a paradox, with high levels from the twenties through to about age 50, followed by a precipitous decline through the mid seventies and beyond. Compared with 50 per cent of younger participants, only 17 per cent of older participants were stressed. Many factors such as less financial pressure, retirement, grown-up families and a more positive outlook contribute but they don’t entirely explain the reduction. This nicely aligns with our research on life satisfaction and happiness, which similarly shows a U-shaped curve – happiness is high in our twenties but drops thereafter, bottoming out in our forties and fifties, then rising again and continuing to increase until our seventies. Life gets better for most of us from age 50 to our mid seventies, after which quality of life slowly and gradually starts to decline, mostly due to physical ill health. However, quality of life scores do not reach the same levels as those seen at age 50 until after our eighties – so we have, on average, 30 good years after age 50 for good quality of life, contrary to popular views. This is explained by the fact that with age comes more realistic expectations and people become increasingly selective about how, and with whom, they spend time. Older persons are wiser, more likely to live in the present, take each day as it comes, savour the positive, dwell less on the negative, overreact less, set realistic goals and prioritise people and relationships. We become more adept at dealing with stressful challenges as we age and we have more accumulated wisdom, which buffers stress and helps us to cope. The potential for wisdom is at least partly neurobiologically based. In other words, it’s hard-wired. Brain-imaging supports a biological explanation for wisdom, showing areas of the brain consistently lighting up when we carry out tasks which involve wisdom, particularly empathy, decision-making and reflection.
Chapter 6: Downtime and the Pace of Ageing
Imparting wisdom, through inter-generational sharing, positively influences mental health and well-being and helps to reduce stress in young and old. Teresa Seamen is the senior researcher behind a new and innovative experimental programme of mentoring that illustrates evidence-based benefits for this ‘wisdom sharing’ experience. It is referred to as Gen2Gen and started in the city of San Jose, California. Designed ‘to make great things happen with older adults through volunteering for mentorship, and to lift the aspirations and opportunities of thousands of young people’, retirees help to educate under-privileged children and young adults for an average of 15 hours per week. Retirees are paid stipends and engage pro-actively in a strategy and planning programme, and give regular feedback to the formal educators overseeing the scheme. The programme is a huge success, both in terms of enhancing education and destressing the young and the retirees. It’s a simple model that’s proven to work and will hopefully be replicated in other countries. Believe it or not, we need to turn to inflammation yet again to understand some of the biological markers of stress and how it affects diseases. Both acute and chronic stress trigger an inflammation cascade. This inflammation builds up with time, creating the familiar chronic age-related conditions, such as heart disease, cancers, Alzheimer’s – and more wrinkles!
Chapter 6: Downtime and the Pace of Ageing
Whereas people in the Blue Zones do experience stress, they have developed buffering techniques against it from which we can learn. What the world’s longest-lived people have, that most of us do not, are routines to shed stress so that it does not become chronic. Okinawans take time each day to remember their ancestors; Adventists pray; Ikarians take a nap and Sardinians share wine with friends and family. Life unfolds more slowly, more quietly, and with less urgency in the Blue Zones. The daily rhythm has been crafted such that life is less likely to be laced with worry, hurry and the constant need to be elsewhere. It is not a coincidence that people there live longer lives.
My recommendation to patients for downtime, stress reduction and relaxation is to have a period or periods each day when the phone and other internet communications are switched off. Do this regularly and acclimatise to switching off, gradually extending the time period. Let people know that you will be doing this. In that way, you will feel under less pressure when temporarily parted from your technology. If possible, leave your phone outside the bedroom door at night and try not to engage with it for up to one hour before bedtime. Furthermore, if you can get together each day with friends, you will certainly reap the rewards.