疫情一年多下來，尤其最近一個半月在台灣突然惡化， 即使你到目前為止都還未被感染，疫情帶來的壓力早已對你的健康(不止在心理層面，還包括生理上) 產生很多負面衝擊，只是你不自知。本文主要訊息有二：1. 壓力如何導致其他疾病，2. 介紹一種有科學根據的舒壓方法(雖然咋聽之下似乎違背官方要我們宅在家裡的勸告) 。 這裡的分享主要是Ben Greenfield六月初發表的一篇文章的重點摘譯 (包括文末11個參考文獻)。
Even you are healthy or lucky enough not to be infected by the coronavirus so far, the unprecedented prolonged stress you have endured might have taken a toll on your health while you are fully unaware of it. In this article, I am sharing highlights from an early-June article by Ben Greenfield. The highlights are bilingual, mainly to serve Chinese-only audience and those of you who are too busy to read the entire article. If you prefer to read Ben’s entire article in English, here is the link: https://bengreenfieldfitness.com/article/forward-motion/.
我常常說，“在我分享的議題裡我都不是專家， 我只是一個資訊使用者： 在養生和抗老化的領域，我是一個很有經驗的資訊篩選者”。 除了嚴選資訊，我分享的資訊絕大部分自己都親身驗證過：我是一個身體力行的生理駭客。 前言講完了，我們開始分享吧。
As I have always said: I am no expert in the domains I share and discuss. I am just an informed consumer of the relevant content – when it comes to staying healthy and anti-aging, I am a pretty experienced information curator. Beyond curation, I usually have personally tested and proved the tips and regimens I shared. I am a biohacker who walks the talk. Here we go.
腦神經科學的一個重要觀念: 不確定性最容易導致壓力和憂鬱症Uncertainty and Stress: A Neuroscience Perspective
“哈佛醫學院的一項研究指出(Ref 1)，(美國) 90%的醫師門診的起因跟壓力有關… 長期面對不確定性其實是大部分人都會有但卻不自知的壓力源頭。”
“According to research from Harvard Medical School (Ref 1), stress is responsible for 90% of all doctor visits… with prolonged uncertainty being one of the most insidious stressors you face.”
“人腦基本上是一台高效率的預測儀器，它持續不停地在作判斷，讓你可以對周遭環境更有掌握，以踏出下一步… 當你的腦子高速運轉，評估瞬息萬變的周遭環境，以最快的速度降低不確定性時， 它就會進入所謂的過度警覺的威脅偵測模式(Ref 2)。 為了降低不確定性，大腦必須消耗巨大的能量。 如果你的腦子無法降低不確定性， 根據所謂的生理恆定負荷失衡理論 (Ref 3)，可能就會導致生理上一些系統性的問題和腦部功能失衡(包括記憶力退化、血管內脂肪堆積、糖尿病、和後續的心血管和 腦部血管病變)。”
“Your brain is a prediction machine—constantly trying to make assumptions that allow you to comprehend and navigate the world around you… When your brain is working to evaluate the changing environment (looking to decrease uncertainty as fast as possible), it enters a hypervigilant threat monitoring mode (Ref 2). Reducing uncertainty requires cerebral energy. If your brain cannot reduce uncertainty, allostatic load (Ref 3) can contribute to systemic issues and brain malfunction (impaired memory, atherogenesis, diabetes, and subsequent cardio- and cerebrovascular events).
“Nature Communication雜誌2016年發表的一篇研究報告(Ref 4)讓我們更深入地了解面對不確定性和壓力之間的關係； 報告指出，大部分的人寧願接受電擊也不願意忍受無法預測下一步的不確定性。 之所以會這樣，是因為當你面對不確定性的時候(如上面說的)你的腦子必須進入威脅偵測模式， 你的大腦就會一直維持警戒狀態(但你可能不自覺)，思考如何做下一個決策， 你的壓力自然就會升高。“
“A 2016 study published in Nature Communications (Ref 4) gives some insight into the basis of the relationship between stress and uncertainty, finding that most people would rather know for certain that they’re going to get an electric shock than to not be able to predict it… One of the reasons for this response, as mentioned above, is the need for your brain to enter that threat monitoring mode in the presence of uncertainty. You need to be on alert, figuring out which decisions to make, and constantly being on high alert increases your stress levels.”
腦部神經運作會影響你身體的生理狀態(但你卻不自覺) The Mind/Body Connection
“人體在生理上對周遭環境變遷的反應是透過所謂的穩態恆定(Ref 5)。穩態恆定是一個很複雜的生心裡醫學理論，簡單說，是身體內大大小小器官和細胞在感受到環境改變的刺激並產生預期後，所做出的內部調整和適應。在這樣的過程中，你的生理、心理、和心靈上的調適機制被操爆了， 就會導致上面提到的生理恆定負荷失衡“
”The way your body reacts to the demand for change is through allostasis (Ref 5), defined as the “process of maintaining homeostasis through the adaptive change of the organism’s internal environment to meet perceived and anticipated demands.” When your physiological, psychological, and spiritual adaptations have been significantly taxed, allostatic load comes into play.“
“這裡很重要的一個問題是：在大部分的情況下， 我們對於壓力的源頭是完全不自覺的，很可能覺得生活一切都算正常，但其實你的身體卻是持續地發出警訊準備作戰，因為你的身體感受到周遭環境是不安全的… 所有的動物都一樣，當前面的狀況不清楚， 身體就會感受到不確定性； 一旦覺得往前走可能有危險，焦慮就會立即產生。“
“One of the big issues is that many of these potential sources of stress might pass below your conscious awareness—you more than likely live a seemingly comfortable lifestyle, yet your body could be constantly sending a message to prepare for battle, that the environment is not safe… uncertainty emerges when an animal is not clear about the way forward, and anxiety emerges when the perceived way forward may contain a threat.
“所以，即使你的認知是一切好像都沒事，你的身體可能因為一直在算計下一步該怎麼走而早已承受相當大的神經系統壓力； 在這種狀況下，你身體內的諸多生理系統早已疲於奔命，但你卻毫無自覺，導致你的自主神經系統一直陷於驚慌逃命的交感神經系統泥沼內。 安全感是人類身心靈存活的必要條件，然而，當眼前的路撲朔迷離，不確定性取代了安全感， 生理上就會產生很多負面結果。“
”So even though you might feel safe, your body could potentially be under a significant amount of nervous system stress, trying to calculate the next step, often spinning and searching subconsciously and keeping you hardwired in a fight-and-flight, sympathetic nervous system mode. There is a human need to feel safe, and when the way forward is hazy at best, uncertainty throws that safety into question, resulting in agitation and a host of negative health effects.”
三個方法幫你維持「大步向前行」的心態 3 Ways To Adopt A Forward Motion Mindset
“紓解壓力的關鍵不在於避免壓力來源和不確定性(因為能不能避免往往不是我們能掌握的)， 最重要的是學習如何管控和調節面對壓力和不確定性時自己的反應。Antifragile: Things That Gain From Disorder 這本書(Ref 6)的作者 Nassim Taleb 在書裡提出了反脆弱的觀念。Taleb 對反脆弱元素的定義是：「越是承受壓力和不確定性，越會變得更強大的元素」(小編註：例如 運動員的肌肉 和 賭場老手)。所以，如果你有辦法養成一種反脆弱的心態， 你就有辦法面對甚至珍惜眼前的壓力，因為你知道「不要逃離壓力、接受並通過眼前的壓力」會讓你有更大的收穫。 你的目標是要「重新看待」眼前的狀況，把各種迎面而來的狀況(壓力源頭)當成改善自己適應不確定性能力的機會，永遠維持一種 大步向前走 的心態。”
“It is not an avoidance of stressors and uncertainty that is necessary (because of course, that’s not possible), but rather it is necessary to learn how to control and modulate your response. Author Nassim Taleb introduced the concept of antifragile in his book Antifragile: Things That Gain From Disorder (Ref 6). Taleb defines antifragile entities as those that get stronger when subjected to stress and uncertainty. So if you are able to adopt an antifragile mindset, you can realize and even appreciate the stress that you face, knowing that you will benefit from moving through rather than resisting. You can aim to reframe your outlook and use a set of stressful circumstances as a way to become better at adapting to the unknown with a mindset of forward motion.“
1. 凡事往正面的方向去想 Positive Association
“不去正視壓力的存在不是一個有效的策略。要在諸多的壓力源頭之間不被打敗，你就必須專注在眼前所有的狀況(包括壓力來源)，把它當成向前行的起點… 即使是痛苦的創痛經驗，也要只聯想到正面的感覺和記憶。“
“ignore your stress… is not an effective strategy. Navigating stressors productively actually requires turning your attention to what’s happening as a starting point for forward motion… attach positive sensations and memories to the traumatic event.”
2. 設定里程碑 Setting Milestones
“科學家早已發現，當你感覺你已經在朝目標的方向前進時， 你就會很快地連接到腦神經系統裡的的酬賞迴路 (reward pathwasy or mesolimbic pathway, 參考文獻：Ref 7)，會釋放多巴胺… 多巴胺可以緩衝承受壓力時飆升的腎上腺素… 在朝向目標的路途上設定合理的里程碑對啟動腦部的酬賞迴路會很有幫助。”
“it has been found that when you feel you are simply on the path to achieving a goal, you’re able to tap into reward pathways (such as dopamine release)… Dopamine buffers the adrenaline that surges through your body when you’re experiencing stress… Establishing doable milestones on the path to a final goal is critical to activate that reward system.” (Read more about the reward pathway here: Ref 7)
3. 大步向前行 Moving
“… 向前移動 (是的，就是很單純地在空間裡讓你的身體向前移動) 在生理和心理的壓力連結上扮演重要的角色。 史丹佛大學的安德魯．休伯曼博士做過很神奇的一個研究(Ref 8)，證明了人的視野、壓力、和向前移動這三者間有很重要的關聯。 他發現人在激動的情緒下身體向前移動會啟發腦中的獲勝迴路(跟激發膽識和勇氣有關) (Ref 9)。”
“… literal forward motion, as in moving your body through the space in front of you, plays a role in the mind/body stress connection as well. Stanford’s Dr. Andrew Huberman has conducted fascinating research (Ref 8) to support the connection between the visual field, stress, and forward motion. It’s been shown that forward movement in the face of agitation activates the winning circuit in the brain (linked to boldness and courage) (Ref 9).
“身體向前移動就可以減壓，這是什麼道理呢？ 關鍵因素之一就是光流的概念(Ref 10)。所謂光流，指的是當雙眼相對於兩側的環境向前移動時，眼球接收到的景象連續移動和變化。「我們向前走時，眼球兩邊的景物從兩側往後移動的現象(光流)， 對於腦中專責產生壓力的迴路有一種特殊的安撫作用」，安德魯．休伯曼博士的研究裡這麼說 (Ref 11)。 藉由走路或任何向前移動的運動來擴展你的視野是一個很簡單的舒壓方法。即使只是很簡單的到外面散個步，遠眺地平線，或不要一直盯著螢幕看， 舒壓的效果可能就超乎你的想像 。”
“So why might physical forward motion help to reduce stress? One of the key factors is the concept of optic flow (Ref 10), the motion pattern generated to an eye that is moving relative to the environment. ‘The actual movement of objects past us as we walk quiets some of the circuits that are responsible for stress’, according to Dr. Huberman (Ref 11). Expansion of vision through walking or forward movement can be a straightforward way to look at reducing stress. Something as simple as going outside for a walk, looking at the horizon, or getting your eyes off of a screen will go a long way.”
防彈大叔補充說明：
- 大步向前行，我個人喜愛的方式是出門騎車，疫情下為了維持社交距離，到山上去騎爬坡路段， 沒車沒人，是很棒的一個選擇。
- 一般人是不必像鐵人阿北我這麼重口味啦～ 但話說回來，研究報告裡雖然沒有提到，我個人的感受是移動的距離越遠、速度越快，舒壓的效果越好。
“向前移動(或是藉著眼球向一側移動造成的類似感覺)可以讓我們遠離創傷經歷帶來的負面情緒。 眼球向側面移動有降低腦部杏仁體活動的效果，而杏仁體就是人腦邊緣系統裡負責 偵測威脅 和 產生壓力 的主要迴路。“
“Forward motion (or the perception of forward motion with lateral eye movements) may create distance from the negative emotions of a traumatic experience. Lateralized eye movements quiet the activity of the amygdala, the limbic structure in the brain that’s primarily responsible for threat detection and stress.”
防彈大叔補充說明： 所以在跑步機上跑步(或快走) 和 踩踏室內單車訓練台，在舒壓的效果上跟戶外跑步、快走、或騎車完全不能相比。
Coach Denys’ remark: So running/walking on a treadmill and peddling on a stationary bike trainer don’t have the same effect for stress release as running/walking/cycling outdoors.
防彈大叔總結心得分享
為了控制疫情，努力宅在家裡是好樣； 但即使你生性樂觀，毫無恐懼，每個人心中其實都有與日遽增的不確定感。 從腦神經科學的觀點來看，長期面對不確定性很容易累積壓力，會導致諸多生理病變而不自知，包括免疫力的降低。 這篇文章告訴我們身體在戶外空間的移動 (運動或走動) 對於長期面對不確定性而堆積出來的壓力有很好的紓解效果。 建議大家為自己設定目標，每週幾次出門走動(戴口罩，維持社交安全距離)，不管是騎車100公里或快走ㄧ公里， 對與疫情的長期抗戰都會很有幫助。
Summarised takeaway from Coach Denys
The more we stay in lockdown, the more we need to find ways to creatively and safely get outdoors and “move forward”, physically and mentally to reduce the stress imposed by uncertainty. Set milestones to walk, run, or bike a few times a week, be it just 1KM or 100. Before you know it, this pandemic of fear should all be literally behind us.
References 參考文獻：
Ref 1: The Health Burden of Stress (Harvard School of Public Health): https://theforum.sph.harvard.edu/events/the-health-burden-of-stress/
Ref 2: Uncertainty and Anticipation in Anxiety – An integrated neurobiological and psychological perspective (NIH, 2013-07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276319/
Ref 3: “allostatic load 身體調適負荷”, Scientific America “致病的社經落差 – 社會的外部不平等會導致身體的內部不平衡，造成身體及大腦的生物性傷害” https://sa.ylib.com/MagArticle.aspx?id=4282
Ref 4: “Computations of uncertainty mediate acute stress responses in humans”, Nature Communication (2016-03) https://www.nature.com/articles/ncomms10996
Ref 5: “Allostasis: Allostasis is defined as the process of maintaining homeostasis through the adaptive change of the organism’s internal environment to meet perceived and anticipated demands.”, ScienceDirect (2008 – 2017) https://www.sciencedirect.com/topics/immunology-and-microbiology/allostasis#:~:text=Allostasis%20is%20defined%20as%20the,meet%20perceived%20and%20anticipated%20demands
Ref 6: “Antifragile: Things That Gain from Disorder” by Nassim Nicholas Taleb (Jan. 28, 2014) https://www.amazon.com/Antifragile-Things-That-Disorder-Incerto/dp/0812979680?dchild=1&keywords=antifragile&qid=1621866579&sr=8-1&linkCode=sl1&tag=bengree-20&linkId=faf20958a4ee07cb2c7c0ac5ad17db7a&language=en_US&ref_=as_li_ss_tl
Ref 7: Mesolimbic Pathway (Reward Pathway), ScienceDirect (2013 -2019) https://www.sciencedirect.com/topics/veterinary-science-and-veterinary-medicine/mesolimbic-pathway
Ref 8: “A midline thalamic circuit determines reactions to visual threat” by Lindsey D. Salay, Nao Ishiko & Andrew D. Huberman, Nature, 2018-05 https://www.nature.com/articles/s41586-018-0078-2.epdf?sharing_token=p2UzdMPooyCx94wCmteRk9RgN0jAjWel9jnR3ZoTv0N7LNPtyt24kJUb6fcoG7oz5k1aLZNMW5HRMMzeNl4Rw5jrMEG6mGGD30qcY4221bnbNhRUVP8a-1cSgXlo7Gyhg2HiZ3fuhFE2wvVLmBJzHQQM5sXoxJVvfmSOXhLHYNcun-6DFm9r79C4sVWdCRXkNVowKUb8yVq_LDC5IKI5r0EhchYvQFWyeXRMcqoIF8VvElqtq8PxX_8xrXFPGwweqluRA-I6X2OpoYyJXDKiF1OlQfJHr_UiLRuCFx57j3g02yzoQEPU3jnwAd2MSIrk&tracking_referrer=www.scientificamerican.com
Ref 9: This Neuroscientist Shows You the Secrets to Obtaining A Growth Mindset | Andrew Huberman, 2020-05 https://www.youtube.com/watch?v=OGa_jt3IncY
Ref 10: Optic Flow, SiceDirect (2000 – 2016) https://www.sciencedirect.com/topics/medicine-and-dentistry/optic-flow
Ref 11: “Setting your biological clock, reducing stress while sheltering in place” by Mandy Erickson, Stanford Medicine, 2020-06 https://scopeblog.stanford.edu/2020/06/03/setting-your-biological-clock-reducing-stress-while-sheltering-in-place/
