RHR: Community Q&A: Hyperthyroidism, Psoriasis, Burnout, and Human Polarization

In this episode, we discuss:

• Natural ways to treat hyperthyroidism
• A Functional Medicine approach to reducing psoriasis and eczema
• Practical strategies to overcome burnout
• The accelerating polarization of people in today’s world

Show notes:

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Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week, I’m excited to answer a few of your questions that you’ve sent in.

And the first one is about natural ways to treat hyperthyroidism.

The key understanding to begin with here is that hyperthyroidism is almost always an autoimmune condition called Graves’ disease. There are some exceptions, of course, but that is definitely the most common cause of hyperthyroidism. And it’s unfortunate that in the conventional model and in the conventional approach to treating hyperthyroidism, this is rarely acknowledged. The most common treatments for Graves’ disease and hyperthyroidism are toxic drugs like [propylthiouracil] (PTU) and methimazole, [which] suppress the production of thyroid hormone, or surgery to remove the thyroid gland. These may sometimes be necessary if the symptoms and signs are extreme. For example, excessive production of thyroid hormone can speed up heart rate and lead to stroke and even death as a result. So if the symptoms are this severe, hyperthyroidism is definitely not something to be trifled with. And those drugs or even surgery might be necessary to address the condition if it’s become that extreme. Having said that, if the condition is not as extreme, or if and when it’s under control with medication, it’s always better to turn our attention toward addressing the underlying causes so that you can get better and stay better without unnecessary drugs or surgery. That’s a core principle of Functional Medicine, of course.

So what does that look like in the case of autoimmunity, in general, and then Graves’ disease, specifically? Well, as you probably know, I’ve written and spoken a lot about addressing autoimmune conditions from a Functional Medicine perspective over the years, so I’m not going to rehash all of that here. There’s lots of good information on my website and podcast related to that, but I’m just going to give you an overview of how we approach it. And then I’ll mention some specific things that can be helpful in the case of Graves’ disease and hyperthyroidism. So with autoimmunity, we always want to address the triggers of immune dysfunction. And the most common things would be diet. A diet in processed and refined food, standard American type of diet, but there are also even healthy foods that can trigger autoimmune symptoms in certain people. These would be things like nightshade plants, tomatoes, peppers, nuts, and seeds, [which] can be a problem for some people; dairy products, eggs, [and] whole grains can be an issue and legumes, as well.

One of the most common dietary approaches to addressing autoimmunity is called the autoimmune protocol (AIP). This is an elimination diet that removes those foods for a period of time until the individual is feeling better. And then you gradually add some of those foods back in to see which ones were the biggest offenders, and then try to expand your diet over time. Other dietary approaches that can be helpful include the Wahls protocol, from Dr. Terry Wahls, who suffered from progressive secondary [multiple sclerosis] (MS) and was basically in a wheelchair. And then through her diet, which is similar to AIP but has some differences, [she] was able to get out of that wheelchair, ride a bike for 18 miles soon after that, and now she’s walking and doing phenomenally well today and is helping thousands of people around the world with her protocol. So that’s the Wahls protocol. And then a standard Paleo type of diet can work well for some people; a ketogenic diet can work well. For others, [there are] a lot of different options. But diet is almost always a key in recovery.

Another focus would be the gut. We know that imbalances in the gut from everything from disrupted gut microbiome to undetected bacterial or parasitic or fungal infections, to intestinal permeability or leaky gut, to [small intestinal bacterial overgrowth] (SIBO), can all dysregulate the immune system via several different mechanisms. So the gut is always a major focus. We look at food intolerances above and beyond things that you might generally remove from your diet from using [the] AIP or Wahls protocol. Some people may have specific intolerances that need to be diagnosed with testing or through elimination and provocation protocols. Sleep is a major factor. Stress management is another important one. Getting the right kind of exercise or physical activity. Sometimes people with autoimmune disease overdo it, actually, and they do too much exercise for what their body can handle due to the systemic chronic inflammation. And in other cases, of course, [they do not exercise enough], and both can contribute to problems.

So we look at things holistically and try to identify and address those triggers. We go deeper with things like heavy metal toxicity or other toxins, mold and biotoxins that you might find in a water-damaged home. Latent infections or other intracellular tick-borne diseases like Lyme disease, which are often underdiagnosed. That’s another layer down. But those causes are quite common, actually, in people with autoimmune conditions. We’d look at nutrient deficiency. So it’s really a much more comprehensive approach than what you see in the conventional paradigm. And the overriding goal there is to identify and address the triggers. Once we’ve done that, the next step is to help balance and regulate the immune system. Sometimes, addressing the triggers is enough, and the immune system snaps back into balance on its own after that. Other times, it’s not enough. It’s an important and necessary starting place to address the triggers. But even after those triggers are addressed, the immune system can sometimes remain out of balance. And probably one of the best examples of this is, in the scientific literature, we’ve known for decades that viral infections are triggers of autoimmune disease. And this is, of course, relevant today with COVID[-19]. But it’s been the case for many, many years.

So the scenario would be you get infected with a virus, and then that virus triggers immune dysfunction. Your body deals with the virus, it’s gone, but that immune dysfunction remains and manifests as autoimmune disease. So in that case, it’s not so much about addressing the trigger because the trigger is no longer present. It’s about helping the immune system rebalance and deal with the impact that that trigger caused even if that was years ago. So that’s a pretty common scenario. And in fact, long COVID, a lot of researchers now believe, is autoimmune, or that’s at least a significant mechanism. So that’s exactly what’s happening there. Somebody gets the SARS-CoV-2 virus, that virus passes, the body deals with it naturally, and it leaves the body, but then the after-effects, that immune imbalance persists even after the virus has gone. So this is a scenario that indicates what I’m talking about here; the triggers are important to address, but that isn’t always the end of the story. You may need to put attention toward balancing and regulating the immune system after those triggers are gone.

Lots of natural treatments can help there. Things like glutathione, vitamin D, curcumin, [and] probiotics all have immunoregulatory effects and sulforaphane. Then you have non-dietary or nutritional treatments like sauna or pulsed electromagnetic field therapy, stress management, [and] mindfulness; all of those can play a role. And all of these steps, when you put them together, addressing the triggers and balance and regulating the immune system can have pretty dramatic impacts. For example, I’m thinking of one of my patients with Graves’ disease and hyperthyroidism. She was in her 60s when she came to see me, and she had been on PTU, which is one of the thyrotoxic drugs they used to suppress thyroid function for more than 30 years. And through a combination of the strategies that I just mentioned, she was able to get off her PTU medication, which was shocking to her and her endocrinologist, and basically manage it naturally and felt better than she had felt at any point during the 30 years of taking that medication. But, again, it’s really important to do that under the supervision of a clinician because hyperthyroidism can be serious and lead to serious complications, including death. So please don’t just stop taking a medication without that supervision if you’re taking one of those drugs.

I want to finish by talking about a few of the botanicals that I’ve found to be helpful for hyperthyroidism. These are not for autoimmunity in general; they’re specific to hyperthyroidism because they have specific effects on thyroid function. The first is bugleweed, and this herb decreases [thyroxine] (T4) production. So, in some ways, it acts similarly to PTU [and] methimazole but without the toxic side effects. The next is Prunella, which can reduce thyroid nodules, nodules on the thyroid gland, which is part of the autoimmune process. Another one is lemon balm, which can reduce the conversion of T4 to [triiodothyronine] (T3), and T3 is the most active form of thyroid hormone. So if you’re reducing the conversion of T4 to T3, that will tend to slow things down a little bit. Motherwort can reduce tachycardia or that sped-up heart rate that a lot of patients with uncontrolled hyperthyroidism have. And there’s a good formula by a company called Herb Pharm. They’re one of my favorite botanical companies [and have] really high-quality extracts, and they have a product called Herb Pharm Thyroid Calming extract, which contains some of the ones I just mentioned, [like] bugleweed, motherwort, lemon balm, and cactus. I really like this blend, and I’ve seen it help a lot of my patients.

All right, so let’s move on to the next question.

In this episode of RHR, I answer some questions from our audience. We cover topics such as natural ways to treat hyperthyroidism, tips for reducing psoriasis and eczema, practical strategies to overcome burnout, and the contributing factors that have led to a worldwide problem of polarization.

This is about the best ways to reduce psoriasis. So, similarly to hyperthyroidism, [which] we just talked about, psoriasis is an autoimmune condition. And again, most of the time, if you go to your conventional doctor with this complaint for psoriasis, they won’t tell you that it’s an autoimmune disease or give you any guidance on what to do about that. And again, that’s not an indictment of individual doctors because I think most doctors are doing the best they can with the training they’ve had in a really broken system. And in a 10- to 12-minute appointment, there’s just not enough time to cover all of these things. I just went through all the things that we would look at in a Functional Medicine model addressing autoimmunity, and as you can imagine, that’s time-consuming. There’s a lot to do there. So in some ways, it’s understandable that that doesn’t happen in an appointment with an endocrinologist or a dermatologist that lasts for 15 minutes. So it’s a systemic problem, and it’s one that I’ve, of course, written and spoken a lot about in my last book. Unconventional Medicine addressed this at length if you’re interested.

But back to psoriasis. It is autoimmune, so [it] can basically repeat all of the things that I mentioned just now with hyperthyroidism looking at all of the triggers like diet, gut health, food intolerances, sleep, stress management, and exercise. Environmental toxins and undiagnosed infections. Those can all be at play with psoriasis, as well. But in terms of specific things to consider for psoriasis, there are a few that I found to be really important parts of treatment for most patients over the years. One I already alluded to, which was probiotics. So with psoriasis, there are different types of probiotics. One is just an internal probiotic that you swallow [a] capsule for your gut microbiome. And my favorite option here is Seed. This is actually a synbiotic that combines probiotics and prebiotics, and it’s, I think, probably one of the most evidence-based products on the market. [It] has multiple different scientifically validated strains and a unique delivery system that helps it actually survive the stomach acid, which most products don’t, and get to the colon where it’s needed. So if you want to check that out, go to kresser.co/seed and enter promo code KRESSER.

But with psoriasis, there are actually probiotic products that you can put directly on your skin in the affected area, and this is often a game-changer for people with this condition. One is called Gladskin. This is a cream that came out of Europe. It was used in Europe for many years, and now it’s available in the [United States], and it actually restores the balance of the skin microbiome. So we have a microbiome in our gut, which most people have heard of; we also have one in the skin. And a lot of research indicates that skin conditions like psoriasis and eczema can be due to a compromised skin barrier. So we might even call it “leaky skin” instead of “leaky gut.” And just like probiotics can be helpful in healing leaky gut, probiotics directly applied to the skin can be helpful in healing leaky skin. So Gladskin is a great product for that. They have different formulas: one that’s more relevant for [the] acne rosacea phenotype and another that’s more relevant for eczema. And I’ve seen better results for [patients with] psoriasis with the eczema formula, but you could try both.

Another consideration with psoriasis and many skin conditions, and this is relevant to what I was just talking about with the skin microbiome, is [that] a lot of the bacteria that live on and in our skin are ammonia-loving bacteria. And we produce ammonia naturally when we sweat. One of the downsides of our modern hygiene where we’re using soaps every day, taking a shower, and scrubbing our skin with soap, is that soap actually washes away that ammonia, and it disrupts our natural skin microbiome. There is a product called Mother Dirt that you can use as a spray, and it adds back [those] natural ammonia-loving bacteria to our skin. And the idea there is similar to Gladskin [in] that it will restore the balance of the skin microbiome. But that’s only part of the equation. If you’re using soap every day that washes away the ammonia and then alters the skin microbiome, then using the spray to add it back is helpful, but it would be better not to challenge the microbiome that way all the time. So you may have seen or heard [that] some people have addressed that by just not using soap anymore. And that might sound disgusting to some listeners, but it’s kind of amazing. I’ve done that experiment myself. And you might think that you start smelling really, really bad. [And] sometimes [there] is a period that you have to get through where that happens. But what happens for most people over time is that once the skin microbiome reestablishes itself, then that’s what takes care of the body odors, and the body odors are not as significant, really, for many people. So that’s one option.

But another option is to use cleansers that don’t wash away that don’t have the same impact on the skin microbiome. Mother Dirt also produces some of those cleansers. So this is different [from] spraying the microbes back onto your skin. This is using cleaning, cleansing, personal cleansing products that don’t wash away that microbiome. So it’s a two-part approach, and I’ve seen that together with Gladskin or even separately be a huge game-changer for people with psoriasis. Another consideration is phototherapy, so photo [means] light here. So this is light therapy. Ultraviolet light, which you would get from being exposed to sunlight, for example, can really improve psoriasis for a lot of people. And other options here would be infrared light. So near-infrared light and a near-infrared sauna, or a device like Joovv that gives you exposure to different wavelengths of infrared light can be really helpful. And there are even some specific phototherapy devices that are available in some doctor’s offices and some other places that are designed for skin conditions like psoriasis and eczema. They’re a little more difficult to come by, but that’s worth considering, as well. If you live in a place where it’s sunny and you have access to sunlight most of the year, that’s going to be a great option because not only do you get the benefits of ultraviolet light for your skin, [but] you get all of the other benefits for going outside. The same is true for near-infrared sauna. There’s lots of other benefits of sauna above and beyond the impact that it will have on skin. So that’s something to add to your routine for sure.

Then there are many different nutrients that have a specific impact on the health of our skin, and several years ago, I put together a free eBook on this topic because there’s a lot to know, and we cover all of the nutrients and how to get them in food. So if you’re interested in that, go to ChrisKresser.com/skin-health, and check that out because those nutrients can make an enormous difference in skin health.

And then the last thing to consider is detoxification. The skin is the largest organ system in the body; it’s the largest organ in the body, and if we have problems with toxic burden, [it] almost always will manifest in the skin. And so again, I’ve written a lot [and] talked a lot about detox over the years, so I’m not going to rehash it all here. But things like [an] anti-inflammatory diet, regular exercise, sauna, which I just mentioned, [and] a lot of the nutrients that are for skin health also support detoxification. Removing toxic cleaning products, like home cleaning products and personal care products, and replacing them with better alternatives. And then supplements like glutathione, curcumin, [and] sulforaphane can all be really helpful. Sulforaphane, in particular, I think, is the most powerful nutrient for detoxification that I’ve come across. And there are literally thousands of studies supporting sulforaphane’s role in removing toxins ranging from glyphosate to particulate matter, air pollution. So if you want to check that out and learn more about it, go to kresser.co/brocelite. That’s really the only sulforaphane supplement that I can recommend on the market at this point, and there are a lot of reasons for that, [which] I explain on that page. But check that out to learn more. Okay, I hope that was helpful on psoriasis.

The last topic, oh actually, there [are] two more questions. The next one is about burnout. So many people are struggling with burnout right now. COVID[-19] has really accelerated that, I think, and this is a question we’ve gotten a lot over the past few months, so I wanted to address it here. The psychologist Herbert Freudenberger first coined the term “burnout” back in the 1970s to describe the stress and emotional depletion he saw people experiencing in helping professions, in particular, such as medicine. But of course, burnout is not limited to medical professionals. It can affect anyone in any profession and even people who are not working in the traditional sense. A Gallup survey that was done before COVID[-19] found that about two-thirds of full-time workers experience occupational burnout. So I wonder what that number is now post-COVID[-19]. It’s probably 75, 80 percent or up.

In this survey, there were about 7,500 employees across a variety of fields, and 23 percent reported feeling burned out at work very often or always, while an additional 44 percent reported feeling burned out occasionally. And they cited things like unmanageable workload, unreasonable deadlines, lack of clear communication, and support from their managers. And then if you add to that the fact that in this day and age, we’re expected often to work away from the office almost 24/7 via our phones and laptops and tablets and the fact that so much of work has now moved to online and virtual [during the COVID-19 pandemic], it’s not hard to see why this burnout phenomenon has become such a big issue.

So Freudenberger defined three key characteristics of burnout. Number one, overwhelming exhaustion, number two feelings of cynicism, along with frustration and anger that lead to detachment from your job, and number three, a sense of ineffectiveness or failure. And further research that’s been done since that time [has] noted that burnout can lead to ruin personal relationships, anxiety, depression, and substance abuse. It’s found to be a significant predictor of type 2 diabetes, high cholesterol, coronary heart disease, gastrointestinal issues, respiratory problems, and even a predictor of death in those under the age of 45. So this is no joke. Burnout is a real thing, and it causes real and sometimes very serious consequences. Some more recent research has found that burnout can literally be overwhelming for our minds, too much for our minds to handle, and it causes neuroplastic changes that make it hard for us to cope with stressful scenarios. And then [it] can eventually even lead to structural changes in brain anatomy and cognition. So again, this is real; it produces measurable changes in the brain and nervous system, and it’s something that, if it’s present, we want to do everything we can to address it. But how do we do that?

Well, if we go back to the three key characteristics that Freudenberger defined, we can work backwards from those to address them. So the first one was overwhelming exhaustion. So of course, getting more sleep, making more time for rest, doing things that recharge your batteries, incorporating more play and pleasure and fun into your life, spending time in nature, and spending more time with loved ones, friends, family, people that you can confide in, and that you feel connected with. Those are all strategies that can help with exhaustion. Now, of course, it’s a bit of a chicken and egg thing for many people, because if you’re feeling burned out, there are often real reasons for that, like too much time at work or too much time in front of a screen, and it makes it harder to do some of these things that I just mentioned. And I know from my own experience of dealing with burnout at various times in my life that even small changes can make a huge difference. I think we often tend to get stuck in the mentality that we have to make these broad sweeping changes, like totally rearrange everything about our life and quit our job and all of that, in order to make progress. And that hasn’t been my experience. Even adding, for example, getting to bed a half hour earlier or setting aside 10 minutes in the morning for meditation or mindfulness practice or spending 15 minutes playing with your kids in a very focused way where you’re not distracted by a screen or with your pets or something like that. Or taking a walk for a half hour after work in a park or going outside in the morning with your coffee and sitting in the sun and just feeling the sun on your skin. It’s a series of these kinds of small changes that often make the biggest difference rather than huge, dramatic changes. So that’s something to keep in mind. And you can just start putting together a little program for yourself with all of the things that I just mentioned and start really small, even smaller than you think you should. One of the key core principles in health coaching is shrinking the change. So commit to something very small, and then when you’re successful with that, you’ll gain confidence, and that will help you build momentum and make more changes. So that’s the first step, addressing the overwhelm and exhaustion.

The second characteristic of burnout was feelings of cynicism, frustration, and anger. Options for addressing this would include things like gratitude journaling. This can help you focus on the things that you’re thankful for, and that will definitely change your mental state. There’s actually a lot of research on the beneficial impacts of gratitude practice. You might think that this is sort of like a soft thing, or anecdotal, but there, if you go on PubMed, and you look in the peer-reviewed literature, you’ll find a lot of research supporting pretty dramatic changes from gratitude journaling. And that’s because as one of my [Zen] teachers, Cheri Huber, used to say, “The quality of our experience is determined by the focus of our attention.” So if we’re always putting our attention on what’s wrong, and what’s not working, and negative things in our life, then that’s going to define the quality of our experience. But if we shift our attention to the things that we’re grateful for and appreciative of, then that has a positive impact on the quality of our experience. And this is common sense, but it’s also supported by a ton of research.

Similarly, I’m a big fan of positive psychology. This was a pretty big shift in the world of psychology to tap in over the past few decades, where instead of just putting our attention on what’s broken and not working, we shifted toward what is working. And for the same reasons that I just mentioned with gratitude journaling, this can really change the quality of our experience in positive ways. Along those lines, one of the acronyms that we often use in health coaching to talk about how to do this is HERO. H stands for hope here, E is for efficacy, R is for resilience, and O is for optimism. And when you put all these things together and focus your efforts here, it builds what psychologists call “psychological capital,” or psycap. So one easy way to think about this is a bank account analogy. We know that if we’re constantly making withdrawals on the bank account, and we’re not putting anything in there, we’re not doing enough deposits, then that’s not going to go well, right? And it’s the same with our mental health. If we are making deposits in the form of things that give us hope, building efficacy, cultivating more resilience, doing things like gratitude journaling, and using positive psychology to build optimism, that will shore up our bank account. Those are all deposits into the bank account. And then when we have the inevitable withdrawals that come in the form of all of life’s challenges and stresses that we can’t avoid, we’ll still be in the black, to use that financial analogy. We’ll still have that psychological capital, and we’ll still be able to bounce back from all of those challenges and stresses of life.

For gratitude journaling, you really don’t need much, just [a] pen and paper. But there are many different apps now, iOS and Android apps, which make it even easier because they can remind you every morning or at whatever time of day that you want to be reminded to do it. And then you can have a running record of it. And there [are] some other tools that add to the experience, as well. So if you just go on the App Store and search for a gratitude journal, you’ll find a bunch of really great options. And some of those apps have been used in studies on gratitude journaling, so that’s a really good way to do it. And then, of course, working with a health coach can be extremely helpful in shifting your mindset. You can go to KresserInstitute.com and click on the directory link and search for a health coach that we’ve trained, and that’s really what coaching is all about, helping people to develop these types of skills and capacities, which really ultimately lead to a much higher quality of life and help people to be the healthiest version of themselves that they can be.

The third characteristic of burnout is the sense of ineffectiveness or failure. This refers to the E in HERO that I just mentioned, efficacy. We all want to feel like we’re effective in our lives, both our personal lives and our professional lives. And taking steps to increase our efficacy, whether through learning, education, or retraining, can be really helpful. It’s true that part of what is difficult about this during COVID[-19] is that there are a lot of things happening that are outside of our control. And that’s one of the most stressful experiences for human beings to have. When we are under threat of some kind, but we are not able to mount an effective response against that threat, that is a uniquely stressful experience for all animals, including human beings, to have. And so I think this is one of the reasons why stress and burnout are off the charts during COVID[-19] because there’s this big threat that we’ve been living with, and not just with the virus itself, but with all of the responses to the virus and how that’s impacted our lives economically and socially and politically. Those are big threats that we don’t necessarily have an effective response to. So I just want to acknowledge that, that that’s probably in my mind one of the biggest reasons that burnout has become such an issue in this day and age.

And having said that, there are steps that we can take, even in that situation where we have these large, looming threats that will help us cultivate more efficacy. For example, if we’re under threat of losing our job, we can learn a new skill or go back to school or retrain to do something new. And that’s one way of building efficacy that can help us recover from this kind of stressful situation. So that’s, I think, a good place to start for burnout. There’s a lot more to it, but those are the things that come to mind for me. And just a couple of additional thoughts on COVID[-19] and then specific steps that we can take. I think it’s really, really important in a time where there is this much stress and we’re experiencing all of these threats to remember to continue to live our lives, to celebrate, to play, to have fun, [and] to connect with people we love. And going back to the Cheri Huber quote that I shared, “The quality of our experience is determined by the focus of our attention,” if throughout every day, we’re just seeing one news headline after another about how bad things are, and what’s going on with COVID[-19], and what’s happening with the economy, and all of the political and social divisions, we’re getting these notifications on our phone, we’re going to be pretty miserable because that’s what we’re attending to all day long, every day, and that’s going to shape the quality of our experience. And so I think it’s really, really important to be able to unplug from that. Disconnect from that endless news cycle of negativity. I guarantee that if you set aside a half hour a day or even 15 minutes to catch up with the news and headlines, that will be enough to keep you informed and enable you to respond in appropriate ways and be an informed citizen. We really don’t tend to need much more than that, in my experience, to fulfill that social duty and also just maybe that personal need to stay aware of what’s going on so we can protect ourselves and our family.

But hours a day or just being notified every time a news story is published does not add to that, in my experience, and it significantly negatively affects our mental health because of these principles that we’ve just been talking about. So I think it’s really important to control our access to information, especially the kind of information that’s going to impact our experience in this way. Mindfulness, meditation, or prayer depending on your persuasion can all help us accept the things that we don’t have full control over and also work to change the things that we do have some influence and control over. And just to cultivate more awareness of our own thoughts and feelings and sensations of our reactions. I think that these capacities or practices are really crucial to focus on at all times, but especially during times of crisis and a lot of stress.

Likewise, I think it’s really important to learn how to turn off at the end of a day. So if you’re working, we now are in this place, as I mentioned earlier, where it’s possible for us to work 24/7. We can respond to emails at 9:00 p.m. or 2:00 a.m. A lot of people, I can’t remember the percentage, but a very high percentage of people bring their phone into their bedroom and respond to emails and texts at night. A lot of people have personal and work emails coming into the same inbox. So anytime they might check their email on the weekend, and they see a disturbing message from their boss, it just throws them right back into [a] work mindset. I’ve talked a lot about this over the years. I think it’s really, really important to establish healthy boundaries. I did a podcast with Cal Newport on a lot of these topics recently, so check that out if you missed it. But one thing that he and I both do at the end of a day is we have a ritual for shutting down. I think he even has a phrase like shutting down or I don’t remember, that’s not it; I don’t remember the exact one. It’s a ritual phrase that he uses where he closes his computer and says that phrase, and then he’s done for the night. No going back to open the computer and check email, no checking work email on the phone, just shutting it all down and going to spend time with family or go out for a walk or a run or a bike ride and cook dinner, and do whatever it is that you’re going to do. But just really create that solid boundary between work and personal life. I think that’s really important.

Along the same lines, I’ve had a ritual for many years of having one screen-free and work-free day a week. For me, it’s typically on Sundays. Our whole family does it. And I find that to be incredibly restorative and don’t know how I could go on without it, frankly. It’s such an important part of my life. And if that sounds like too much for you to begin with, then try a half day or even try a couple [of] hours, and I think what you’ll find, if you’re like most people I’ve recommended this to, [is] that you’ll want more and more of it. And it becomes easier and easier over time and harder and harder to re-enter the hectic typical day after a day like that. I also do longer periods of digital detoxes or periods where I’m not working, and I’m not in front of a screen. I try to do three or four days of that quarterly, and often on longer trips, seven to 10 days, once a year when I’m doing that. And it again makes a huge difference on everything from my mental and physical health to my creativity, innovation, my experience of life, and my mood. It’s a game-changer.

Lastly, don’t forget to reach out to friends and family and schedule time to be together. It’s really critical. We now know from a lot of research over the past few decades that loneliness and not having a confidant in your life is a bigger risk factor for early death than things like having a high body mass index and even smoking 15 cigarettes a day. So just take that in for a second. Loneliness is a bigger risk factor for early death than smoking 15 cigarettes a day. But you rarely hear it talked about. So I think it’s critical for us to reach out to our friends and family for support, especially during this time. So that’s burnout. Actually, we are going to be doing a workshop or releasing a course that I created a few years ago. I actually created it for our [ADAPT] Practitioner Training Program because we found that so many of the practitioners we were training were suffering from burnout, and we wanted to help them address that to be able to be successful in the training program. That was back in 2016, and then we incorporated it [into] the [ADAPT] Health Coach Training Program, and also everyone in my company goes through that course when we onboard them as new employees. So it’s been enormously popular in those audiences, and we’ve never actually offered it to our broader population. But given what’s going on right now, we’re going to do that very shortly; maybe [it] even might already be happening by the time this podcast comes out. So if you go to ChrisKresser.com and sign up for my email list, you can be notified about that. And we’ll update you on the podcast, as well.

The last question is a really good one, and I certainly can’t do it justice. But I want to address it briefly. And the question is, “Why are we so polarized?” And this polarization, we can see it in so many different areas now of our discourse. We see it in science, clearly. We see it in our social discourse; we see it in politics. And to some extent, it’s not new. Tribalism is part of our evolutionary heritage for better and for worse, it’s always been present. Humans have always been tribal in our associations and affiliations. But I think it gets much worse, that tribalism, when it’s under stress. And it really impacts the way that people tend to process things and respond to things like COVID[-19]. And we choose a side, we identify with that side or with that tribe, and then all of our responses and reactions tend to be filtered through that identification. And that leads to an inability to have nuanced and open-minded conversations and dialogues about some of the issues that we’re facing, which is really a dire situation to be in. I think this is one of the biggest existential threats that we face.

If you saw The Social Dilemma, which is a film by Tristan Harris, about how social media has contributed to polarization, he says very clearly in the film that one of the biggest threats we face as human beings right now is a lack of shared reality. This is what he meant here is that now, because of social media and because of the algorithms that have driven this kind of polarization, you have a situation where different people are seeing different information and they’re not operating from the same facts and assumptions. So they have an entirely different shared reality. Tristan argues that having a shared reality is actually a requirement for being able to make progress and have real conversations and make progress on everything from social to scientific to political issues. And I really agree with him there, and I think that that’s one of the things that we’re suffering from most. And as I’m sure many of you know now, these algorithms were created by social media companies like Facebook to maximize advertising revenue. So these were machine learning algorithms, and what that means is that humans that created them don’t even fully understand how they work. The algorithms were just given basically the instruction to maximize clicks, which, in turn, maximizes advertising revenue. And what the algorithms seemed to figure out is that the more polarized the content was that they presented to users, the more clicks that content would get, and thus, the more time the user would spend on the platform and the more advertising dollars that Facebook would make.

I think that these social media algorithms have played a very direct role in this polarization because they would gradually make people more and more polarized in their views by showing them more and more polarized content. So you might have had, if you took someone who is maybe moderate Republican initially, and showed that person more and more polarized content that would push them further and further out onto the periphery of their political persuasion party, and then the same thing would happen with a moderate Democrat or someone who identifies as being a progressive, then you show them more and more polarized content that would push them further and further out on the periphery. This is all document[ed]; this isn’t speculation. It’s detailed in The Social Dilemma and many other sources. And I also did a podcast with Tim Kendall, who was involved in a lot of this in a lot of different tech companies in the Silicon Valley. And we talked at length about [how] this was done to some extent by design, I think. Maybe not initially, the developers didn’t really understand the impact it would have. But they did come to understand it, and they didn’t stop it. And it’s, I think, really kind of wrecked our social discourse. And we have to find a way to create new business models for these platforms in social media that aren’t driven by ad revenue. Because as long as they are, then we’re going to keep seeing these algorithms doing their profit-maximizing thing and pushing people further and further into the state of polarization. So I think that’s one big reason for why we’re so polarized.

Another interesting way of looking at it is crowd or mass formation theory, which wasn’t developed by a Belgian professor, Dr. Mattias Desmet. He’s been kind of the modern proponent of it. It comes out of someone else’s work back in the early 20th century, whose name I’m unfortunately forgetting. But the basic theory is meant to explain how large groups of people can enter a collective trance, and this can manifest in different ways. That it can manifest in polarization as we’re seeing. It can also lead to totalitarianism and fascism. It was used to explain some of the stuff that happened back in [the] World War II era. And it can lead to human beings seeing other human beings as less than human and some of the deeper and more dramatic social and cultural divisions that we’ve seen in human history.

In order for this mass or crowd formation to happen, four conditions have to be present. The first is social isolation and lack of meaningful social bonds. And I think we’re definitely experiencing that today. There’s no question about it. Loneliness has become rampant. As I mentioned earlier, there’s lots of research on this. There are a lot of people who don’t even have a single confidant. A confidant is, of course, someone you can confide in. And in-person interaction has become even more rare than it, with social media and the amount of time that we’re spending online, especially with COVID[-19] and Zoom, and people working from home, that in-person interaction has become more rare. The second condition is a lack of sense-making, or being able to make sense of what’s happening in a cohesive and internally consistent way. And I think that this has been, again, harmed by the polarization of our social discourse, and the social media algorithms have threatened or have decreased people’s ability to make sense of what’s happening in that cohesive and consistent way.

The third condition is what Dr. Desmet refers to as free-floating anxiety. This is like a background anxiety that doesn’t really have a specific cause, and because of that, it’s difficult to respond to. And as I mentioned earlier, it’s really one of the worst kinds of stress for humans to have this vague threat looming in the background that we can’t mount an effective response to. And then the last condition is a lack of meaning or purpose. I think today we’re in a situation where a lot of people are working in jobs that are not meaningful to them, that don’t have any value in their lives. They don’t feel like they’re making a difference. They don’t feel like they’re contributing in any significant way. And they don’t have maybe a sense of purpose outside of their work either. And when you put all those together, you get a situation where people can form into these groups, and these groups can get increasingly polarized, can really stop being in touch with a shared reality or with facts, can start to villainize and see other humans as less than human, and can even lead to movements like totalitarianism and fascism. So that sounds a little bit dark, and it is. I think we’re in a really challenging place right now in our history, as here in the [United States, but also around the world in both the developed and developing world. And when the COVID[-19] pandemic started, my hope was that we would rally together and it would bring us together in response to a common threat, which certainly has happened at various times, like during World War II in the [United States].

There was a great sense of social cohesion against a common enemy. I’m not suggesting that was a highlight, and going to war is a terrible way to resolve conflicts, and, at least, within countries, there was a great sense of unity that came out of that. And that’s not happening in the [United States], it’s not happening in many countries; it’s not happening globally. And in fact, these challenges, I think, in part because of everything that we’ve discussed, the social media algorithms and the lack of shared reality have pushed us further apart. So, my hope is that the growing awareness of this, which I do think is happening, will lead us to some solutions that can bring us together again as a species and in our local communities and in our states and countries and as a global community because if we have learned one thing with COVID[-19] and coronavirus, it doesn’t really know about any borders. For better or for worse, we’re globally connected now, and this is something that we’re going to have to work out in order to be able to move forward and address the other challenges and problems that we’re facing as human beings.

So that’s it for today. I hope you enjoyed the episode. Please keep sending in your questions to ChrisKresser.com/podcastquestion. I’ll see you next time.

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