Introducing: Call to Mind

Today, we're sharing an episode of another podcast we think you'll enjoy: Call to Mind, from American Public Media. Call to Mind is American Public Media's initiative to foster new conversations about mental health. This episode, The Strain of Stress, looks at the many pressures Americans are facing today, how chronic stress can affect both mental and physical health, and how to manage the strain. You’ll hear from two familiar voices: Arthur C. Evans Jr., CEO of the American Psychological Association, and Dennis Stolle, APA’s head of applied psychology. Learn more about Call to Mind at calltomindnow.org. Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Kim Mills?

  Hi. This is Kim Mills, host of Speaking of Psychology. Today, we're sharing an episode from another podcast that we think you'll enjoy, Call to Mind from American Public Media. Call to Mind is American Public Media's initiative to foster new conversations about mental health. This episode, "The Strain of Stress," looks at the many pressures Americans are facing today, from financial worries to political division, how chronic stress can affect both mental and physical health, and how to manage the strain. You'll hear from two familiar voices, Arthur C. Evans Jr., CEO of the American Psychological Association, and Dennis Stolle, APA's Head of Applied Psychology. If you enjoy this episode, you can find more from the Call to Mind team at calltomine

• 0:45Kim Mills?

  now.org or wherever you get your podcasts. We hope you enjoy this episode.

• 0:53Speaker 01

  You're listening to "The Strain of Stress," a special report from Call to Mind, American Public Media's initiative to foster new conversations about mental health. I'm Angela Davis.

• 1:09Speaker 02

  What stresses me out, I think, like most people, current times are very stressful.

• 1:16Speaker 01

  This is Gina Marie, a New Yorker who generously agreed to share her experiences with stress.

• 1:24Speaker 02

  As a Black woman, a middle-aged Black woman, I do not feel protected at all. I wake up in the morning, almost with a coat of armor that I need to put on before I leave my house. I think that that just sets the foundation of stress even before I get to work.

• 1:45Speaker 01

  Experts who study stress say it's deeply personal. And what stresses us can seem big or small, but almost anything can cause a person to feel stress.

• 1:55Speaker 02

  And now work is another circumstance. You know, the company I work for just laid off almost 15,000 people, I believe it was. Those of us who are left behind feel a great deal of stress and that my day could end at any moment. You know, as a mom, that makes me nervous.

• 2:13Speaker 01

  Gina Marie's family stress is real. She and her husband are foster parents on the way to adoption. And their case has been going for years. She says the love she feels for her kids is incredible, but it can't erase how overwhelming the journey has been.

• 2:29Speaker 02

  I had no idea, I was naive admittedly, about the emotional toll, the marital toll, the everything toll that it takes. Just being in it now has presented several years of stress that I had not imagined I'd be having at this point in my life, being middle aged and perimenopausal, which is another set of stress.

• 2:55Speaker 01

  Gina Marie's story shares something common about stress. It's rare for us to deal with one demanding thing at a time. Typically, there are many. And there's usually some nuance to what stresses us. For example, it's great to have family and friends, but sometimes, family and friends are stressful. One thing is certain: we all have stress, and we can feel it. Think about situations where your heart starts to pound or your mind begins to race. Maybe your palms get sweaty or you feel like you are carrying an invisible weight. These are natural responses to stress, and they can overwhelm us. National surveys confirm. People in the US have experienced historic levels of stress

• 3:40Speaker 01

  since the COVID-19 pandemic started in 2020. And what stresses us out ranges from personal pressures, like money and jobs, to large societal issues like politics or the impact of racism. Experts warn that living with so much stress doesn't just make us feel bad in the moment, it can cause serious health issues. Chronic stress puts us more at risk for a mental illness or a substance use disorder. This report is about stress, the kinds of stress that we all deal with by just being alive. We won't cover trauma or post-traumatic stress disorder in this program, but we will talk about the everyday issues that overwhelm us

• 4:24Speaker 01

  and the impact of stress on our well-being. I'll also talk with experts seeking solutions and get tips on how to best manage stress.

• 4:34Speaker 01

  Let's start with Dr. Arthur Evans Jr. in Washington DC. He's a clinical and community psychologist and currently the CEO of the American Psychological Association. Dr. Evans says stress isn't inherently a bad thing. It can actually be useful.

• 4:52Speaker 03

  Stress actually helps us when we need to be motivated to do something. The problem is when that stress is very acute, or when it's very intense, or when we are dealing with it over a very long period of time. That's when we really have to worry about stress in our lives.

• 5:07Speaker 01

  And there are different kinds of stress, too.

• 5:09Speaker 03

  There are absolutely different kinds of stress. There's certainly stress that is caused by psychological issues. That could be a relationship, that could be just dealing with what people are seeing happening in the world around us. There is stress that's related to our ability to actually get things done. I'll tell you, when I was in graduate school, the stress that I looked at was economic stress. Economic stressors can cause significant psychological distress. So when we see, for example, the economy have a downturn, we will also see an increase in the number of people coming into treatment.

• 5:46Speaker 01

  Dr. Arthur Evans Jr. says there are two main kinds of stress: acute stress and chronic stress. Acute stress is something that's short term. It comes and goes quickly, like a difficult exam at school, or getting stuck in traffic when you're running late. Chronic stress is long term. It can last months or even years. Living with relentless financial problems, or caring for a really sick family member, Dr. Evans says chronic stress can trigger serious health issues. And you might start to recognize it's a problem when your work or your everyday activities get unusually challenging.

• 6:27Speaker 03

  And so what you start to see is problems in your activities of daily living. So if you're a parent, you start to see you're not on top of your parenting. If you're a worker, you're starting to see that your work is slipping. So the issue for us is... Is really one making sure that we understand what are the signs that we are stressed. I'll give you an example. One of the things that I know about me, I'm a pretty optimistic person. And when I start to get cynical, I know that that's because I'm feeling stressed. And so I've come to know that if I start to get a little cynical, I start to pay attention to, okay, so what's going on with me? Why am I feeling stressed? And then I can take steps to deal with that.

• 7:09Speaker 01

  So what are some common mental illnesses that stress can actually trigger?

• 7:16Speaker 03

  Certainly substance use. People can start drinking or using drugs as a way of managing their stress. One can become depressed. You know, post-traumatic stress syndrome is an anxiety disorder that is caused by experiencing a traumatic event that was overwhelming to the person and having a stress reaction in relationship to how they recover and deal with that particular traumatic event.

• 7:41Speaker 01

  Dr. Evans says someone living with chronic stress is more likely to develop cardiovascular problems, type 2 diabetes, or a dangerously weakened immune system. It can also make existing mental health conditions worse. For nearly 20 years, the American Psychological Association has published an annual report called Stress in America. It's a national study about what's stressing out people in the United States. And this year, half of the folks who participated said societal division stresses them out, and they feel more isolated because of it. Here's Dr. Evans.

• 8:19Speaker 03

  We know that social connection is enormously important to our health, probably one of the strongest predictors of how well we do in life. And what we're seeing is that the stressors, particularly around the social divide, are leading to people disconnecting from relationships that they have historically had. And we know that when people are less connected, that it leads to a whole variety of challenges. Loneliness can have a tremendous impact on our health status, both our psychological health and our physical health. And so if we Look at stress from purely the standpoint of the stressors that we're experiencing are only affecting the individual. What we're seeing is, no, it's affecting all of us.

• 9:04Speaker 03

  And it's affecting how we then relate to each other. And to the degree that we are more disconnected, that in fact exacerbates the impact that stress can have in our lives.

• 9:14Speaker 01

  Yes, the words societal division is in there a lot. But, you know, an interesting finding, 62% of adults in the US reported societal division was a significant source of stress in their lives.

• 9:27Speaker 03

  Yeah, and that was really surprising. If you think about this, half of Americans are feeling lonely and disconnected. That is just an astounding number that that many Americans are feeling like they don't have the adequate support. Those relationships are what keeps us healthy. Those are the things that are most related to our health status.

• 9:51Speaker 01

  When we think about what's at stake when people are increasingly stressed about society, politics, and the nation, how can that show up?

• 9:59Speaker 03

  Yeah, well, one of the ways is that we stop trusting people who we should be in a more trusting relationship with. You know, society works when there is some level of trust. You trust the person who's teaching your child. You trust the healthcare provider that you're going to. You trust your colleague. When that starts to break down, it really impacts a lot of areas of our society. And I think all of us then need to be concerned when we know that there are these issues that are in our society that are leading to not only this disconnection, but this erosion of trust between one another.

• 10:37Speaker 01

  That's Dr. Arthur Evans Jr. from the American Psychological Association. You're listening to The Strain of Stress, a special report from Call to Mind. I'm Angela Davis. As we heard from Dr. Evans, political division is a significant source of stress for adults in the United States. And if it feels like we are less politically united, that's true. And there's even some data to back it up. A long-running survey conducted by the University of Michigan, Stanford, and other universities found that Americans give their opposing political party the lowest approval rating since the 1960s. And these political rifts are fracturing some friendships and families. Reporter Chris Benderev has more.

• 11:22Speaker 04

  This story begins where so much political division begins: on Facebook. In this case, with a woman named Sarah. We're not using her last name for privacy reasons. Anyway, Sarah works as a Spanish interpreter. And way back in 2015, she got one of her most exciting assignments ever.

• 11:39Speaker 05

  And I was, you know, basically saying I'm really proud of myself. Today was a really important moment. I got to interpret for Michelle Obama. I mean, it was just, you know, me tooting my horn a little bit that I had gotten to meet her and got to interpret for her.

• 11:51Speaker 04

  Sarah's a Democrat, but she says the post was not explicitly political. I checked, by the way. The entire post was one sentence. Quote, "I got to interpret for Michelle Obama today," and then two exclamation points. But soon, a lot of people Sarah knew started commenting under the post about their dislike for Michelle Obama and President Barack Obama, and their dislike that Sarah had gone to the Obama White House. Now, Sarah grew up in a fairly conservative part of Colorado. She disagreed with people from her hometown online for years. But still, she was disheartened at how quickly a few of her friends had made things contentious.

• 12:26Speaker 05

  I did respond. And my response was something along the lines of, "It's really sad that you can't even be proud of me for an accomplishment." And then I did quietly unfriend them.

• 12:38Speaker 04

  I called up Sarah to talk about unfriending people over politics. But actually, this wasn't even the main Facebook event that I'd called about. It was something that happened a little later in the 2016 election cycle.

• 12:50Speaker 05

  I don't remember a specific time, but I do remember whenever it was, I would tell my husband, "Wow, my dad unfriended me."

• 12:57Speaker 04

  Sarah's dad lives near her in Colorado. He's a lifelong conservative Christian, but politics had never caused a rift between them before this. She says he was an outstanding dad who she lived with exclusively as a teenager after her parents divorced. But as the 2016 presidential election ramped up, the conversations became more political, intense.

• 13:18Speaker 05

  We were just unable to have conversations. Every conversation he had had to be about politics.

• 13:25Speaker 04

  Would you actually, do you remember, would you say like, I don't know, Dad, let's talk about something else? Like, what were your-

• 13:29Speaker 05

  All the time.

• 13:30Speaker 04

  Oh, really?

• 13:31Speaker 05

  All the time.

• 13:31Speaker 04

  Did you have to be subtle about it?

• 13:33Speaker 05

  No, I have to be very direct about it. Dad, I don't want to talk about this.

• 13:36Speaker 04

  Sarah kept trying unsuccessfully to change the subject, but her dad wouldn't budge. And then, finally, in 2016, he pulled away from Sarah. First, it was the Facebook unfriending, and then fewer and fewer phone calls.

• 13:51Speaker 05

  We used to talk at least one or two times a week before, and then it got to the point where we talked maybe once a month. And so that switch of having him being very present in my life to not being present almost at all was really devastating.

• 14:09Speaker 04

  The situation was a shock to Sarah, but it was a scenario cropping up more and more for psychologist Joshua Coleman.

• 14:16Speaker 06

  I wrote my first book on estrangement in 2007, and I don't recall working with families who'd been estranged over politics, but now it's not uncommon at all.

• 14:26Speaker 04

  Coleman is the author of the book Rules of Estrangement. He lives in the San Francisco Bay area, and he sees a lot of clients who've been estranged by other family members. But it never used to be over politics until Donald Trump first ran for president. Now, according to a survey Coleman commissioned, 1 in 5 estranged family members cite political differences as the cause. Coleman says typically it's a Trump-supporting parent being cut off by an anti-Trump child, so Sarah's case is a bit different. But in any case, Coleman thinks there are a couple reasons for all this. One is the more controversial and heated rhetoric that President Donald Trump has been charged with introducing to national politics. But Coleman thinks we're to blame, too. Because as a society, we seem to prize our political convictions more and more in recent decades.

• 15:11Speaker 06

  We're in an era where people are sort of led to believe that their identities and the preservation of their mental health are the most important North Stars to orient themselves towards. And it turns out that's actually not really the case. The research shows that it's much more community and relationships and involvement and voluntary associations are much better North Stars for happiness and resilience and joy.

• 15:40Speaker 04

  I should say that the research Coleman is pointing to shows social connections are strongly linked to happiness. It's harder to say for sure if they cause it. But either way, we know people fare better when they aren't lonely, and estrangement obviously stands in the way of that. Coleman is open about the fact that he tends to be against the so-called no-contact movement. It's an increasingly common trend where people, often adult children, cut off all communication with certain family members when they experience the relationship as harmful or unmanageable. In full transparency, by the way, Joshua Coleman was estranged from his own adult daughter for years, although not over politics, and they've since reconciled. So what does he think people experiencing stress over a political disagreement with a family member should do? Well, first off...

• 16:24Speaker 06

  It's good to be proactive. You know, before you go to that lunch or whatever, say, "Look, you know, let's just agree we're not going to talk about Trump or politics or, you know, Israel or whatever." You know, it always goes poorly. So can we just have that agreement? And the person says, "No, I want to talk about what I want to talk about. Don't limit what I can..." They say, "Okay, well, you can, but I just want to let you know that I won't be participating in that conversation because I don't think it's very productive."

• 16:51Speaker 04

  Back in Colorado, Sarah's stalemate between her and her dad that had started around Donald Trump's win in 2016, it extended well into 2017, Trump's first year in office. It went on for seven or eight months, until finally...

• 17:05Speaker 05

  My husband actually called my dad and said, "Listen, you have one daughter..."

• 17:12Speaker 05

  And you're losing time with your daughter. You're losing time with your grandson. It's not worth it. You need to let it go. And you need to be OK with Sarah not having the same political opinions as you do. And that doesn't mean that you're any less of a person or that she's any less of a person.

• 17:29Speaker 04

  Do you remember what your dad said when your husband talked to him?

• 17:33Speaker 05

  He told him, I'll pray about it.

• 17:35Speaker 04

  And then what?

• 17:36Speaker 05

  And then I think he actually did go pray about it because I genuinely think he went and had a come to Jesus moment. I don't even say that lightly because all of a sudden it was like, I'm going to come to your house and there was more phone calls. And so I was very happy to have him back.

• 17:52Speaker 04

  By the way, Sarah requested that I not interview her father. She doesn't want to cause a new rift. Sarah's husband confirmed the basic outlines of the story, though. Sarah did want me to clarify that she is not in favor of reconciliation in all cases. She says if someone has a toxic or abusive relationship with a close family member, then it can be best to let go of that relationship. But that's not the relationship Sarah had with her father before all this, which aligns with what I heard from Joshua Coleman. He agrees sometimes there have to be hard boundaries, like, for instance, if someone's parent kept demeaning or insulting the sexuality of their grandchild. But even then, Coleman says-

• 18:30Speaker 06

  I think people deserve kind of a period of education where you're sort of saying, look, we can either agree that, I know how you feel. You already told me. I don't need to hear it again. And we can either agree that we're going to have different ideas about this and you'll never speak of it again, or it's going to make it really hard for me to want to spend time with you. You get to decide, mom or dad, kind of thing.

• 18:51Speaker 04

  As for Sarah and her dad, their reconciliation in 2017 was not entirely permanent. There've been ups and downs. During COVID, Sarah and her dad nearly had a falling out again over her getting the COVID vaccine while pregnant. Her dad was convinced it would harm the baby, which it did not. But overall, even though nationally, politics are more divisive than ever, Sarah says she and her dad are in a good place.

• 19:13Speaker 05

  I talk to him every single day.

• 19:15Speaker 04

  You talk to him every day now?

• 19:17Speaker 05

  Every day. I see him at least once a week. We usually go down there on Saturday or Sunday with our kids and spend the afternoon with him. We have a very loving relationship. And, you know, when he does get a little heated about politics, I typically just say, Dad, I don't want to talk about this, or I'll just leave my husband talking politics with him and I'll walk out of the room. But we have learned how to manage our emotions and just prioritize the fact that we're a family.

• 19:49Speaker 04

  Sarah and the psychologist Joshua Coleman have a couple of things in common. First, and Coleman confirmed this with me, they are both not fans of President Trump and his policies. But also, while it isn't always possible, they both believe in attempting to maintain your closest connections across stark political divisions. Because if you don't, it might not just hurt the other person. It might hurt you just as much. For Call to Mind, I'm Chris Spenderiff.

• 20:18Speaker 01

  Let's take a break. And when we come back, we'll tell you about an industry that's trying to stay afloat while trade turmoil and financial strain are causing the workers to wonder if they should just give up and get out. That's coming up on The Strain of Stress, a Call to Mind special report from American Public Media.

• 20:46Speaker 01

  Welcome back to The Strain of Stress, a special report from Call to Mind, American Public Media's initiative to foster new conversations about mental health. I'm Angela Davis.

• 21:01Speaker 07

  My name is Andrew. I live in Philadelphia, Pennsylvania. Something that stresses me out is the expenses of everyday life in America right now. Expenses continue to rise on what feels like a monthly basis. It costs more to keep my car insured. It's going to cost more for rent next year. It costs more to get food and groceries. I am on an Affordable Care Act plan. I fear that my premiums will go up by hundreds of dollars monthly. That is a major source of stress. And things that would typically bring me relief from stress in everyday life,

• 21:44Speaker 07

  such as streaming TV shows or movies, those leisure activities are also getting more expensive. A way that it's impacting my mental health is that it's hard to even get relief from these everyday stressors.

• 22:01Speaker 01

  That was Andrew. He's a media producer in Philadelphia.

• 22:07Speaker 01

  Earlier in the hour, we heard that chronic stress, persistent and long-term pressure, is tied to serious health problems. Chronic stress can trigger mental health challenges and make existing mental illnesses worse. National surveys report one of the most common and often the primary source of stress in our lives is work. Whether it's hustle culture, a difficult workload, conflict among colleagues, or never being able to get ahead, nearly seven in 10 employed adults identify work-related stress as a significant burden.

• 22:45Speaker 01

  High on the list of work stress: a difficult or toxic workplace. Also high on the list: job insecurity. A good example is the agricultural industry. Farmers face a lot of job insecurities. There's trade conflict, rising costs, climate change, and farmers bear the brunt of it all. Studies show that all of this leads to increased rates of stress, depression, and suicide in farm country. Mental health providers say some farmers seek help, but they also say our healthcare system needs to rethink how care is delivered to farmers. Minnesota Public Radio's Molly Castlework and Tadeo Ruiz-Sandival have more.

• 23:36Speaker 02

  It's a chilly November day in north central Minnesota. Dave Gary, a soybean and corn farmer, is driving his truck heading home. He just dropped off some of his corn harvest at a grain elevator in the town of Warren. This is where most farmers in the area sell their crops. Dave expects his corn to sell at a loss due to ongoing international trade turmoil that is hitting corn prices hard. It's a situation that's made the local grain elevator feel to Gary less like a place of commerce and more like a casino.

• 24:11Speaker 06

  It's a crap shoot. It's the roll of the dice.

• 24:14Speaker 02

  Two years ago, Dave Gary almost went bankrupt after a business he contracted with to sell his crop of sunflower seeds went bust.

• 24:23Speaker 06

  We couldn't pay our bills. And it about took us out of farming. It really did. If it wasn't for our family, we probably would have been done farming.

• 24:35Speaker 02

  If farming was ever once a simple life, it no longer is. Today, more farmers are piling up high levels of debt and filing for bankruptcy. The average age of farmers continues to skew older, and few young people are interested in continuing farm work. Dave says this has stressed both him and his wife.

• 24:59Speaker 06

  She's like, why do you want to keep doing this? Well, it's in my blood. I just, I don't know what else to do.

• 25:07Speaker 02

  Dave Gary's family arrived to the United States in the 1900s via ship from Ireland. His grandparents--

• 25:15Speaker 01

  Survived the Great Depression while his parents weathered the 1980s farm crisis. So there's a little legacy there. And I don't want to be the generation that loses the family farm. But it's getting tougher and tougher to hold on every year. Gary is like many American farmers today, feeling isolated, unprofitable, and putting huge amounts of pressure on themselves to keep the farm going. Tracy Rutherford Self is an agricultural mental health specialist for the state of Minnesota. She says the mental health landscape for farmers across the country is unsettling.

• 25:51Speaker 02

  I always ask people about suicide. I mean, when I'm working with farmers, it's going to be one of my first questions.

• 25:56Speaker 01

  Farming is one of the industries with the highest risk for suicide. A common thread? Finances especially are taking their toll. Purdue University reported that nationally, farmers are feeling more pessimistic about the future of US agriculture. The feeling rose sharply at the start of 2026 amid growing economic concerns. And Rutherford Self says finances have been extra unpredictable lately with the rapidly changing federal tariff policies.

• 26:25Speaker 02

  Right now, for many farmers, things change again almost daily, where markets will swing because of things that are happening at the government level. The amount of things that you can control all year are shrinking and shrinking.

• 26:38Speaker 01

  That's Kayla Rosina, a corn and soybean farmer who lives in northeast North Dakota. Kayla became a full-time farmer two years before the US entered the trade war with China, a major American trade partner. That caused Rosina to bleed money. It just came altogether to a point where you just didn't feel like you had control of anything. And it was very frustrating. Government subsidies helped Kayla stay afloat, barely. Now amidst the second agricultural trade war, Rosina's wallet is once again under strain. And once more, he's expecting government farm subsidies to help some, but not enough. How many years can we keep doing this?

• 27:24Speaker 01

  How many years?

• 27:24Speaker 02

  Are we gonna have the social capital of the American taxpayer to keep bailing out the American farmer? Which we don't want the payments, we just want the price of the market. Who do you talk to about this? It's gotta go somewhere, right? Like I can't imagine it's healthy or easy to just keep it in.

• 27:51Speaker 02

  Well, I have got a lot of farmer friends and we're all in the same boat, um, talking to them. Um, they share, they're in the same situation you are, talking to them, talking it over, seeing what they're gonna do. It gives you kind of some reassurances that you're not, you're not the only one going through this.

• 28:08Speaker 01

  Farmers in the US have a reputation for stoicism. So when therapy is based on talk, it can be hard to get them to come in and speak with a stranger about their problems. It's just very difficult for farmers to ask for help. You know, they're very independent, so I think they just really try to solve their own problems. That's Cynthia Christensen, a therapist in Minnesota who has counseled farmers for eighteen years. Christensen grew up on an Iowa cattle farm and says she understands how farmers can feel judged for admitting that they're struggling. There's a lot of stigma attached to seeking a therapist in the rural environment. I, I wish I wasn't saying that, but I think it's, it, it, I feel like people, it takes a lot of courage for somebody to call me.

• 28:52Speaker 01

  So if mental health professionals want to help more farmers, Christensen and her colleague Tracy Rutherford Self say the industry needs to rethink how their services are provided. For example, Rutherford Self visits her clients on the farm or neutral spots like community college campuses.

• 29:10Speaker 02

  They don't want to be seen coming into an office, and that's not even stigma. There's some reality to, hey, if somebody sees me going into a therapy office, what are they gonna think about me? And what they think about me literally could impact my livelihood.

• 29:24Speaker 01

  Rutherford Self says if the local banker knows a farmer is struggling, it might be harder for that client to get a loan for seed or a new tractor. And if mental health providers want to build trust with their clients, they need to show that they understand the unique pressures of farming. Rutherford Self says she explains Early on in sessions about her own rural upbringing and that her husband comes from a farm family. If farmers do come in for a therapy session, out of touch comments can discourage them from returning.

• 29:57Speaker 02

  I had a client who recently told me they went to see a provider and at the end of the session, the provider told them that they would just be better off not farming. And while on some level, there actually may be some truth to that as far as finances and stress, I think it really shows a lack of understanding of what our farmers really value, and that is legacy and being able to continue to do the work.

• 30:21Speaker 01

  Tracy Rutherford Self says not only do communities need to train more providers to work in rural areas, but the mental health care system also needs to think more expansively about who can help.

• 30:33Speaker 02

  I have a really big philosophy that if you wait for the first call to come straight to me, we're going to miss people.

• 30:40Speaker 01

  When people are struggling, especially farmers, their first call isn't to a therapist. It's to family, a friend. Rutherford Self says mental health providers should leverage this, training all kinds of community members to recognize mental health warning signs. She's training some bankers right now because they're often the first to hear if a farmer is struggling financially. Christensen suggests that more everyday people in rural communities should get trained to recognize and watch for the signs of mental health issues.

• 31:13Speaker 02

  In rural communities, you know, because of the population numbers, you know, we all have to kind of know some CPR, something about the Heimlich maneuver. And I think it's the same kind of life-saving thing that we know something about the questions that we can ask to see if our neighbors are struggling with their mental health. The farmers we met for this story, Dave Gary and Kayla Rosenau, both say they're not planning to seek mental health support right now. Dave laughs, actually, when I ask him about the hardships. He says he's going to rely on his friends and they, in turn, rely on him.

• 31:50Speaker 01

  I get a lot of calls.

• 31:52Speaker 06

  From friends and neighbors that are having tough days and they don't want to take it home with them. So they end up calling you and you talk them off the ledge.

• 32:04Speaker 01

  But, mental health experts say Dave Gary's approach isn't sustainable for everyone. They say the mental health system across the country needs to adapt so that farmers like Dave Gary trust that when they are struggling or stressed, they can come in and get help. For Call to Mind, I'm Molly Castlework.

• 32:25Speaker 02

  And I'm Tadeo Ruiz-Sandoval in Minnesota.

• 32:31Speaker 01

  You're listening to The Strain of Stress, a special report from Call to Mind. I'm Angela Davis.

• 32:38Speaker 01

  At this point in the hour, it should be clear that ongoing stress is bad for us. Not only does it change our mood, but it can damage our health and well-being. Psychologist Alyssa Epple at the University of California, San Francisco, is an international expert on stress. Alyssa has contributed groundbreaking research on how stress changes the brain and can even accelerate aging. Here's Dr. Epple.

• 33:05Speaker 05

  We know from many studies now that chronic stress actually changes the structure of the brain. It can shrink parts of the brain, like the hippocampus, which is so sensitive for memory and emotion processing. It can enlarge the amygdala, which again makes us more sensitive to threat. And it can damage or impair our prefrontal cortex, our ability to really regulate stress and problem solve.

• 33:35Speaker 01

  Can you give me an example of how chronic stress could change a person's cognition or how it would change the brain?

• 33:42Speaker 05

  It creates cognition that's much more narrowly focused on looking for stress and danger in our environment. And so instead of- Seeing beauty or noticing what's right. It's the opposite.

• 33:56Speaker 01

  So it's like focusing on what could go wrong rather than being present in the moment and appreciating what is there in front of you and what is good?

• 34:03Speaker 05

  Exactly.

• 34:06Speaker 01

  When we're stressed, our bodies release cortisol to stay alert. And cortisol signals glucose, which is sugar, that gives us a boost of energy during stressful times. So when cortisol is constantly triggering glucose and other hormones that activate during stress, that's when problems can show up in our bodies. Our blood pressure can change. Our metabolism might slow down. And even our bones can get weaker.

• 34:35Speaker 01

  Dr. Alyssa Apple says some people gain weight or develop belly fat. But there are other clues, changes in our well-being, to look for if the flood of cortisol becomes a problem.

• 34:49Speaker 05

  When we feel that we are not able to sleep well due to stress, that is one of the biggest signs that we better pay attention and make some changes to manage our daily stress response. When we are feeling particularly irritable, when our appetite becomes untied to meal times and we just feel hungry all the time, when we feel lack of appetite, those are often signs we are under chronic stress.

• 35:18Speaker 01

  I think we've all felt that our stress can age us. But your research has found it actually does. How does stress age a person?

• 35:29Speaker 05

  When we have a stress response that's prolonged and we don't get recovery, we know that the cellular aging processes are impaired and accelerated. So for example, when we have chronic stress for years and years, we tend to develop inflammation. We tend to develop shorter telomeres. That means our cells can't go on and keep replicating and dividing and replenishing tissue. We also are changing our epigenetic patterns. And so we now know that we can measure how old our cells are and that chronic stress accelerates our epigenetic age.

• 36:11Speaker 01

  The term Dr. Apple just used, epigenetic age, is a measure of a person's biological age, not the calendar. Instead of counting the years a person has been alive, epigenetic age, it reflects how fast our cells are aging due to our genetics, lifestyle, environment, and stress.

• 36:31Speaker 05

  All of our organs are vulnerable to the effects of chronic stress. The common pathway is the immune system. Stress causes premature aging of the immune system. And of course, that is the fuel source and the life source for every cell in our bodies.

• 36:48Speaker 01

  Are people who have many beautiful, high-stress moments, like the winning athletes or business owners who love their jobs, but they have a lot of stress to keep it going? Can that good stress, can that accelerate aging?

• 37:00Speaker 05

  In general, no, they don't. Because our body is exquisitely adapted to recover from those peaks of stress arousal. The hard part is that we really need to be honest with ourselves and ask, is this good stress or is this too much? Too much of a good thing, in a sense.

• 37:21Speaker 01

  That's Dr. Alyssa Apple from the University of California, San Francisco. We'll hear from her again later. You're listening to The Strain of Stress, a special report from Call to Mine. I'm Angela Davis. People generally think of stress as a negative feeling, but as we've learned, stress can also be positive. For example, people who work in healthcare can experience tremendous stress in their jobs. Each day, they are tasked with high-stakes decision-making and work with folks who are dealing with illness, pain, or medical emergencies. But after seeing a patient pull through a difficult episode, a healthcare worker may not feel stress. They

• 38:03Speaker 01

  feel joy. But as we just heard from Dr. Alyssa Apple, an important question to ask is, when is stress, even the good kind, just too much? Call to Mine's Jessica Bari takes us to a big-city hospital.

• 38:22Speaker 01

  This is the emergency department at Rush University Medical Center in Chicago. It looks similar to a hospital you might see on a nighttime TV show. Staff and scrubs and white coats are quickly moving in and out of their workstations. There are constant beeps and ringing noises. I'm here to meet. Corey Goldstein, and I am an attending physician in the emergency department. Dr. Corey Goldstein is supervising the shift tonight. He's in his 50s and has practiced emergency medicine for almost a decade. The first thing Dr. Goldstein does to start his hospital shift is a sign-off meeting with the morning team. They cycle through their cases. All right, next one.

• 39:07Speaker 05

  Female in her 30s, history of basically anxiety on coephedrolol. Coming in with bilateral lingual. 60-year-old male, presenting with AB with double pain, history of diabetes and hypertension. He was very tender to her.

• 39:22Speaker 01

  Mid-forty male with voice paralysis disorder. There are about 90 patients in the emergency department and another 20 people waiting in the lobby. The unit is busy. Rush University Medical Center is a Level 2 trauma hospital. That means the staff typically doesn't treat gunshot injuries or survivors of bad car accidents, but any shift could involve heart attacks, overdose cases, bad allergic reactions, stroke symptoms, and all manner of illness. There is no way of knowing what will happen each shift, which in itself seems stressful. Once the sign-off meeting is finished, Dr. Goldstein starts making rounds.

• 40:02Speaker 01

  So the patient I'm going to go see has multiple medical issues, including an organ transplant. I tag along, but I don't go into any examinations to respect people's privacy.

• 40:19Speaker 01

  Looked like she was in significant discomfort. Dr. Goldstein says this is a complicated case and the person will probably be admitted to the hospital for a few days. Dr. Corey Goldstein moves to the next patient and the next and the next. Over the course of an eight-hour shift, he rarely quits moving or takes breaks. Considering the fast pace, the high volume of patients, the constant noise and beeping, and the often high-stakes decision-making, this is a stressful job. To understand how people work in such tense environments, I talked to psychologist Dennis Stolle. He's the head of applied psychology at the American Psychological Association.

• 41:01Speaker 01

  Much of his research is focused on the workplace, human performance, and leadership. Dennis Stolle says every job involves some amount of stress, and that's not necessarily a bad thing.

• 41:14Speaker 03

  That stress in the right dose is part of what helps us get out of bed in the morning because we're concerned about the consequences of not getting those things done. And so generally speaking, stress is not a bad thing. It's just part of life. It only becomes a bad thing when it starts to become unmanaged.

• 41:36Speaker 01

  Well, the number of patients in the emergency department stresses me out, and I have to imagine it's overwhelming for the staff at times, too. But when I asked Dr. Corey Goldstein about it, he was matter-of-fact. Yeah, we are taking care of a lot of people simultaneously, but you know, when you do anything a lot, you get used to it, right? Yeah. So. Psychologist Dennis Stolle of the American Psychological Association says high-functioning teams in stressful work environments like this typically have good communication and strong psychological safety. Here's what he means by that.

• 42:17Speaker 03

  People feel safe to speak up and ask questions, to admit mistakes, without a fear that they're going to be punished or embarrassed for doing so. And it's that kind of communication that can really be effective and let people work together in a productive kind of way. It can become very unproductive if people feel a fear of speaking up.

• 42:41Speaker 01

  I definitely saw moments when the emergency department staff seemed to have strong psychological safety, like when a resident named Tim was briefing Dr. Corey Goldstein about a case. You put in the time room? I did, and I'll tell you why. Okay, tell me. He's coming with Disney as a chemo water rest today. He described his idiot as part of his decision, lightheadedness, and it's like a rope spinning. Everyone on the emergency department team seemed sharp. Roles were well defined and Dr. Corey Goldstein was calmly in charge. I asked psychologist Dennis Stolle how much strong leadership factors into workplace stress levels.

• 43:19Speaker 03

  For a highly skilled, more junior worker, a critical resource to have is a highly skilled leader. And that reduces your stress level tremendously because you know you've got that person there who you can count on. Now, vice versa, for the leader to know that they have highly skilled workers who are gonna feel free to speak up when they have something to say and know what they're doing dramatically lowers the stress level for the leader.

• 43:50Speaker 01

  It's obvious to me Dr. Corey Goldstein is good at his emergency medicine job and likes it. But even if a person loves what they do and works on a strong team, stress is still stress. Psychologist Dennis Stolle says ongoing occupational stress can obviously burn some people out.

• 44:11Speaker 03

  It is a situation where stress is unmanaged to the point that a person begins to experience emotional exhaustion and beginning to feel ineffective. Oftentimes, it may be there's so much work coming at me that nothing I can do will ever allow me to catch up.

• 44:29Speaker 01

  Stolle says unmanaged workplace burnout can have serious consequences for a person. Chronic stress can lead to clinical depression and anxiety. He says a protective tool for mental health is something called psychological capital. That's different from psychological safety mentioned earlier. Stolle says it's basically values a person can lean on during tough times.

• 44:53Speaker 03

  Psychological capital includes the elements of having hope and a sense of personal efficacy and resilience and optimism. One of the things that can actually make an individual begin to develop more psychological capital is by being around team members who already have a lot of psychological capital. It's almost contagious in that sense.

• 45:25Speaker 01

  So even if workers in high-stress jobs have all the protective factors we've heard about, psychological capital, being on a skilled team with strong leadership and having a healthy amount of psychological safety, is it really good for a person to work in this kind of high-pressure job day after day? The American Psychological Association says employers can do all kinds of fundamental things to prevent workplace burnout, like make sure workers have realistic workloads and regular check-ins with their managers. Psychologist Dennis Stolle says one of the best things workplaces can offer their employees is vacation time. The research is clear.

• 46:07Speaker 01

  Time away from work is essential, but it has to be a real break.

• 46:12Speaker 03

  It's not the vacation where you take your laptop and work from the beach. That's not a vacation. It's actually taking time away from work.

• 46:21Speaker 01

  I followed up on this with Dr. Corey Goldstein at Rush University Medical Center in Chicago. He says he takes vacation time and has no problem disconnecting from the emergency department when he's out. He says working in emergency medicine gives him a certain perspective on stress in general. A challenging shift can make the rest of his day feel pretty manageable. For Call to Mind, I'm Jessica Bari in Chicago.

• 46:54Speaker 01

  You're listening to The Strain of Stress, a special report from Call to Mind. I'm Angela Davis.

• 47:02Speaker 01

  As we just heard, taking time off from work is a great way to manage stress and prevent job burnout. But it's just not possible for everyone to take a vacation. And some of the factors that stress us are things we can't take a break from. The research is clear. Stress is something that needs to be managed, and our mental health depends on it. Dr. Alyssa Apple, who we heard from a bit ago, wrote a book called The Stress Prescription. She shares science-backed tips that everyone can do to reduce stress in just minutes. She suggests doing mindful check-ins, slowing down, breathing, and focusing on where you feel the stress in your body.

• 47:45Speaker 01

  Dr. Apple also says nature is a powerful tool we just don't use enough. Being outside to breathe fresh air and take in natural sounds and sights can turn down our stressful thoughts and make room to relax. Plus, nature is free. No prescription needed. When I spoke with Dr. Apple, we also discussed how to handle all the uncertainty of stress. I think a lot of what is stressing many people out right now is this feeling of, there's so much I can't control.

• 48:18Speaker 05

  I couldn't agree with you more. So if you think about what is bothering you most right now, it's very likely a situation where you don't have much control. And yet, our mind so easily creates a big stress response around that, even though we can't resolve the situation. Once we recognize what we can and can't control, we can actually, what I call, drop the rope. I suggest starting with thinking about one of the situations that you are carrying around that creates a lot of stress in your life, and asking yourself, how much of this situation do I control? In many cases, there's very little.

• 48:57Speaker 05

  And so, in this moment, allowing ourselves to realize that we cannot solve it, that our mind may be problem-solving, may be worrying, but that the most-

• 49:09Speaker 02

  Healthy thing we can do right now is to allow ourselves to put that down for now. Those repeated experiences of letting go is one of our most important survival skills.

• 49:23Speaker 01

  Just thinking about that makes me feel lighter.

• 49:25Speaker 02

  Yes, and we might not even be aware that we're carrying them. So I like to picture us trying to pull on a boulder that can't move. And if we can then just say to ourselves, drop the rope and let yourself feel relief from all of that strain, that can be very powerful. I say to myself, drop the rope several times a day.

• 49:47Speaker 01

  That was psychologist Alyssa Apple from the University of California, San Francisco, and author of the book, The Stress Prescription.

• 49:58Speaker 01

  I have to admit, these interviews and reports about stress have hit home for me. In August of 2025, a phone call from a nurse revealed I had breast cancer. My first response was, I don't have time for this. I am already stressed. I work full time as a journalist, and much of the news is about division, uncertainty, and violence. I'm a wife and the mother of two young adults who are navigating new jobs in cities far away from home. I have high blood pressure, and now I have to handle a cancer diagnosis? Well, I learned I can handle it as long as I ask for help and use some of my coping

• 50:43Speaker 01

  skills. Here's what works for me: music.

• 50:48Speaker 01

  I listen to music a lot. For me, it's healing. I put together a recovery playlist when I was on leave of absence from work. Here's one of the songs I've been listening to repeatedly.

• 51:07Speaker 01

  It's called Handle That, and it's a collaboration by Arton, Simo, and FKA Jazz. Movement also helps me manage chronic stress. It does wonders. Going to the gym to walk on the elliptical machine or treadmill, then sitting in the steam sauna. It boosts my energy level and relaxes my mind. Getting outdoors and taking in some fresh air has been powerful as well. I also meet with a therapist every two weeks to talk about my worries and how setting boundaries can help me have more joy. I am now cancer-free, but I still deal with stress. The difference now is that I have a much better idea of

• 51:52Speaker 01

  how to drop the rope.

• 52:07Speaker 01

  You've been listening to The Strain of Stress, a special report from Call to Mind, American Public Media's initiative to foster new conversations about mental health. This program was produced and written by our senior producer, Jessica Bari, and edited by Stephen Smith. Our technical director is Alex Simpson, and Hans Bueto scored the show. I'm Angela Davis. It's been a pleasure to be your host. To find all our past programs, visit our website at calltomindnow.org. Thank you for listening to The Strain of Stress, a special report by Call to Mind. This is APM, American Public Media.

• 52:52Speaker 01

  If you liked this podcast, make sure to follow and subscribe to Call to Mind in your favorite podcast app and leave us a review. Thanks for listening.