I Lost My Shit (and Other Stories My Cells Remember)

A couple of weeks ago, I lost my shit.

At least that is the story I told myself afterward.

In fairness, there was plenty leading up to it. I am closing a medical practice that has been an enormous part of my life for over a decade while simultaneously trying to build a completely new business. I have employees I love and feel deeply responsible for, patients I have known for years and care very much about, and a never-ending list of things that need to be handled. Somewhere in the middle of all of that, I am trying to process the fact that I am walking away from something that has been such a huge part of my life, my identity and my purpose.

I wasn't sleeping. I wasn't eating enough real food. Siete chips and salsa are not a food group, despite my best efforts to prove otherwise. I was working constantly - nothing particularly new about that - drinking way too much tequila and doing what I have always been exceptionally good at doing when life gets hard: making sure everyone else was okay.

Until one particular Friday, at the end of a rather challenging week, I very much wasn't.

I was having lunch with a friend at a restaurant I frequent. We weren't having some deep, emotional conversation. We were talking about normal things, the kind of conversation you have over lunch with someone who knows you well, and then she said something. I honestly don't even remember exactly what it was, but whatever tiny thread had apparently been holding me together snapped.

I started crying. In public, at a restaurant where people know me. I was mortified.

And this wasn't cute-girl crying, the kind that makes you want to hug the poor soul. This was ugly crying, in a restaurant where I know people. There was no recovering at the table, I just had to leave. My friend stayed behind to pay the bill while I made my escape, which somehow added another layer of humiliation to an already spectacular afternoon.

Unfortunately, leaving the restaurant didn't mean I left whatever had happened there behind. I wish I could say I went home, pulled myself together and woke up the next morning feeling better. I didn't. Whatever had been holding me together had apparently given way, and it took more than a week before I started to feel like myself again.

So when I say I lost my shit, I'm not just being snarky. That's genuinely what it felt like.

And that's exactly how I started telling the story.

A few days later, I was sitting with my mentor. By then, I had told the story enough times that I had the language down: I lost my shit. I had a nervous breakdown. I completely fell apart.

She stopped me and asked me to pay attention to the words I was using. She reminded me that words have energy, that the language we use matters and that our bodies are listening to the stories we tell ourselves.

I know this. This was not exactly breaking news. I've spent years talking about stress and the nervous system and watching what happens when people live in a constant state of fight-or-flight. I meditate. I breathe. I understand the connection between our thoughts and our bodies.

And yet, apparently, when you're the one sobbing in the restaurant, all of that wisdom goes straight out the freaking window.

She asked me to tell the story differently. Instead of I lost my shit. I had a nervous breakdown. I completely fell apart, what if what happened was simply: I'm human. Things are intensely emotional right now. I'm going to breathe.

My immediate reaction was, Okay...but I did lose my shit.

Changing the words felt like minimizing what had happened. I hadn't just had a bad afternoon. I couldn't stop crying, I had to leave a restaurant and I felt emotionally wrecked for more than a week. Putting a nicer sentence around it wasn't going to magically make it less awful.

But that wasn't what she was asking me to do. She wasn't asking me to pretend I was fine or slap some positive affirmation over the whole thing and call it growth. She was asking me to notice the difference between what happened and the story I immediately started telling myself about what it meant.

The facts hadn't changed. I was overwhelmed, exhausted and emotional. But I am having an intensely emotional response to an intensely emotional time in my life is a very different message than I am falling apart.

And that got me thinking about who, exactly…was listening.

I spent the last decade watching people's lives show up in their bodies. Someone would come into the office because they couldn't sleep, their gut was a mess, they were exhausted, consumed with anxiety, their heart was racing or their memory was fading. We would talk about symptoms and labs and all the things you would expect to talk about in a medical appointment, but eventually the rest of the story would come out.

Their mother was dying. Their marriage was slowly falling apart. Their child was struggling in school. Their bills were overwhelming. They hated their job. They were terrified about their health. They were taking care of everyone except themselves.

After enough years and enough patients, it became impossible not to see it: the body was never separate from the story.

Stress doesn't stay neatly contained in your head. Your brain and body are in constant conversation, and what is happening in your life can show up in your sleep, digestion, heart rate, immune system, hormones and a hundred other places.

What I hadn't spent nearly as much time thinking about was what happens when the stressful thing is over, but we keep telling the story.

Because that is exactly what I had been doing. Lunch was over. I wasn't sitting in that restaurant anymore. I was home and safe. But for days afterward I kept replaying it: I lost my shit. I had a nervous breakdown. I completely fell apart.

There is actually a name for some of this: rumination. Basically, our uniquely human ability to experience something stressful and then keep experiencing some version of it long after the actual moment has passed. Research suggests that repeatedly dwelling on a stressful experience can prolong parts of our physiological stress response, including cortisol, even after the original stressor is gone.

Sometimes the stressful thing ends before our body gets the message.

That made me wonder how many times I had made my body relive that Friday afternoon simply by telling the story the same way. Not because saying I lost my shit is toxic or because one shitty thought is aging my cells - thank goodness, because if that were true, mine would currently be eligible for Medicare - but because the body is paying attention to how we experience our lives.

Our stress response is designed to keep us alive. When the brain perceives a threat, it starts preparing us to deal with it. Heart rate changes, stress hormones are released, energy gets redirected and the immune system responds. Very useful if something or someone is actually chasing you.

Of course, most of our modern-day tigers look different. The tiger might be an email you don't want to open, a lab result you don't understand, money, a relationship, a sick parent, a child you're worried about or lying awake at 3:00 in the morning rehearsing a conversation that hasn't even happened yet.

And sometimes, apparently, we are the tiger - the ones saying, You can't handle this. You're failing. You're falling apart. What the hell is wrong with you?

I'm not suggesting that every negative thought sends your cells into biological panic. It doesn't work that way. The physiology of stress is much more complicated than thought in, cortisol out. What we do know is that prolonged psychological stress can affect our stress response, immune signaling and inflammation. There is also fascinating research looking at chronic stress and cellular aging, including telomeres - the protective caps at the ends of our chromosomes - and telomerase, the enzyme involved in maintaining them. Studies have associated chronic psychological stress with shorter telomeres and changes in telomerase activity, suggesting that the stress we carry over time may leave traces all the way down to the cellular level.

Which is how I ended up thinking about my own cells.

Not because I imagine them sitting around discussing whether lost my shit was really the best choice of words, but because my body had been living this story long before I cried in that restaurant. It had been keeping track of the nights I wasn't sleeping. It knew that chips and salsa had somehow become dinner again. It knew about the tequila, the work, the grief, the uncertainty and the constant low hum of what am I forgetting and who needs something from me? It knew I was carrying the emotions of a lot of other people while continuing to insist that I could handle all of it.

And maybe that's the piece I had backward.

I thought crying in the restaurant was the moment something went wrong. Looking back, it feels like it was simply the moment my body finally got my attention.

For weeks I had been asking it to function on too little sleep, too little food, too much work, too much stress and not enough space to actually feel any of what was happening. I kept going because there were things that needed to be done and people who needed me, and because continuing to go is something I am very good at.

Until I couldn't.

I called that a nervous breakdown because that's what it felt like from inside my head. But I've wondered since then what my body might have called it.

Maybe it would have simply said, Finally.

Nothing particularly dramatic changed after that. The practice is still closing. I still have a ridiculous amount of work to do, groceries are still stupid expensive and I still have the deeply ingrained instinct to make sure everyone else is okay before I check in with myself.

I also haven't suddenly become some enlightened person who catches every negative thought before it leaves the station. I still get overwhelmed. I still occasionally have chips and salsa for dinner. And I am certainly not breaking up with high-end tequila over this.

But I have started paying more attention to the story.

I've also started using the sentence my mentor gave me: There is emotional intensity right now. I'm going to breathe.

For me, it has become a pattern breaker. It interrupts the story my brain is already halfway through writing and makes me stop long enough to acknowledge what is actually true: there is a lot of emotion here, I am feeling it, and right now I can breathe. That is the control I DO have.

That interruption gives me somewhere else to go, and for me that place is usually gratitude. Gratitude has always been my lowest-hanging love-based emotion. I can be overwhelmed and still be grateful for the friend sitting across from me. I can be sad about closing the practice and grateful for the years I had there. I can be scared about what comes next and genuinely excited about it at exactly the same time.

Gratitude doesn't cancel out the hard thing. It just reminds me that the hard thing isn't the only thing that is true.

I'm also learning to ask better questions. Am I actually falling apart, or am I exhausted? Is something wrong with me, or is my body having a pretty reasonable response to what I've been asking it to carry?

The answers usually lead me back to decidedly unglamorous things: sleep, actual food, movement, breathing, getting outside, saying no occasionally and remembering that the world will continue spinning if something waits until tomorrow.

If my friend had been the one crying across the table that Friday, I wouldn't have thought, WTF, get it together. I would have known there was more to the story and given her some grace.

Apparently, extending that same courtesy to myself remains a work in progress.

I'm probably not going to stop saying I lost my shit. It's a good phrase, and sometimes there really isn't a more eloquent way to describe a complete clusterfuck of a day. I'm just trying not to confuse the day with the whole story.

Maybe the goal isn't to never lose your shit. Maybe it's to notice what was happening long before your body had to resort to sobbing in a restaurant to get your attention. For me, that means catching the story a little sooner. There is emotional intensity. I'm going to breathe. Find the gratitude. Eat some actual food. Go outside. Walk. Sleep. Set down my phone. Unload some things I've been carrying that were never mine to begin with.

I will definitely eat chips and salsa for dinner again, and tequila and I are in a long-term relationship. But I'm listening a little differently now.

Turns out my cells weren't being dramatic. They were just done whispering.