This is a great book (with a shed load of references to boot) about what stress is, how it works and how it's caused. Others have complained that this book has a relatively short section on "Managing Stress" for a book that claims to be a "Guide to Stress". I believe that decent understanding of the condition effecting me is the best step I can take towards self healing, and as such I find this book extremely useful and brimming with knowledge I can apply in my own stressful life. This may not be the case for everyone so take my praise with a grain of salt.

The writing style is very academic, it's written to inform and is structured so it's easy to skim and find the content that's relevant to you. Most of the book can be skimmed, I'd suggest looking at topic sentences and reading a paragraph only if the topic seems surprising or interesting—reading this cover-to-cover would be a bore unless you had an existing interest in biology, psychology and neurology all at once.

How stress interacts with existing mental conditions, such as depression and anxiety, is also covered in great detail giving a very down-to-earth explain-like-I'm-five description of how they're triggered in the brain. Requires you to remeber a few complex chemical names like 'glucocorticoids' and 'beta-endorphins' but is pretty accessible once you grasp the meanings of these.

Recommended for anyone who wants to understand more about their mental health, why they get so stressed all the time and why stress need to be seriously dealt with.

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“The mind is its own place, and in itself can make a heaven of hell, a hell of heaven.” – Paradise Lost, John Milton

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I have always loved this quote from Paradise Lost. I have it written down in several notebooks, typed out on a sticky note on my laptop that I frequently scroll over, and even had it framed on the wall of my room when I lived with my parents. From the time I first read it, back in second year university, it became a sort of mantra for me, providing me with comfort and reassurance that even if times seemed particularly bad and I felt incredibly stressed, my mind was strong enough to control those feelings and to get me through whatever stressors I encountered.

But, what I have learned in the last year is that (sometimes…often) the mind isn’t enough. Robert M. Sapolsky has a similar quote in his book Why Zebras Don’t Get Ulcers: “To a certain extent, our perceptions and interpretations of events can determine whether the same external circumstances constitute heaven or hell…” The crux of Sapolsky’s text, though, is that the mind isn’t always strong enough to overcome external circumstances and put them in perspective and, what’s more, sometimes the mind isn’t even capable of doing this sort of heavy lifting if there is a disorder or disease (such as depression or anxiety) that prevents it from doing so. To believe that the mind can persevere in all instances and actually change one’s perspective on reality 100% of the time is foolhardy and naive, and probably was incredibly detrimental to me back in university and had adverse effects on how I would learn to cope with stress as an adult. The point being that understanding stress and the science behind it is no simple task and certainly can’t be reduced to the belief that the mind, if persistent enough, can get a person through anything.

I don’t often read non-fiction books. In fact, I rarely read them, if ever. However, it seems that this year I have done a lot of reading of non-fiction and the main reason for this is that I have felt empowered and motivated recently to finally try to understand my anxiety. When it became evident, towards the end of my third trimester of pregnancy back this past March, that my anxiety was going to be made much more severe by my pregnant condition, I knew (partly because my doctors were telling me) that something had to give and that I needed to get a better handle on my anxious condition once and for all. Not only for my baby’s health, but also for my present and future well-being and overall happiness. Part of this process has involved seeing a psychiatrist and learning about meditation and mindfulness techniques. Part of it has been about exercising as often as possible and forcing myself to go out and interact with my friends and family members even when I don’t feel up for it. But, I have always been an avid learner, a true student at heart from the moment I entered my grade one classroom, and so I felt that I wanted to supplement my doctor’s appointments and daily activities with reading material that would allow me to come to grips with feelings I have had for my entire life. I never have put in the effort to truly understand my anxiety in this way, and I immediately picked up the self-help book Let That Sh*t Go by Kate Petriw and Nina Purewal hoping that it would be a quick and easy read that would at least help me feel a little bit better. It certainly did and it was good, but it wasn’t anything truly groundbreaking or earth-shattering and it didn’t by any means fundamentally change my perspective on anxiety. I next delved into a book recommended by my psychiatrist, Mind Over Mood, and this was of course a huge eye-opener to me in that it taught me the basics of cognitive behavioural therapy and worked wonders to help me reframe my insecurities and fears and better manage my heightened emotions. What I felt these two books lacked, though, was an explanation of what was going on in my brain, of the chemical, biological and physical mechanisms that were clearly contributing to my anxious state and probably had been since my birth. It was a desire to get to the bottom of these internal processes that led me to pick up Sapolsky’s book.

Why Zebras Don’t Get Ulcers is easily one of the best books I have ever read, of any genre or category. (That’s right, I’m putting it right up there with Jane Eyre although it is, naturally, a very different text!) I was utterly blown away by Sapolsky’s work, and as someone who has never studied psychology and who only studied science up until the end of high school, I was thoroughly impressed by how accessible and relatable he made the scientific explanations in this book. This type of text could easily become overwhelming, but Sapolsky is very careful to keep things manageable for his reader, and he even infuses dry humour, jokes and wit into the text (especially in his often unexpectedly hilarious footnotes, which are a must-read in themselves). He of course uses terminology like “glucocorticoids” and names of “catecholamines” like “epinephrine” and “norepinephrine” often, but he uses them so frequently and explains them so thoroughly that the reader gets the sense, by the end of the book, that these concepts aren’t all that incomprehensible. 

I also made a conscious effort to take my time while reading this book, not because it felt dense at all, but because it did feel heavy. I admit, it was an emotional read for me because I could so easily and fundamentally relate to the findings that Sapolsky examined; I became one of the test subjects he discussed because I recognized how my experiences fit into the results and conclusions. On the one hand, it was nice to know that there is a scientific explanation for why I feel a certain way, but it was also jarring and terrifying to be confronted with so much evidence and research to explain something that I have kind of taken for granted for my entire life. It made my anxiety feel that much more real and that much more difficult to ignore.

Chapter 15, thus, became an incredibly meaningful chapter for me as it investigated anxiety disorders and the personality types that lend themselves to these sorts of disorders. Needless to say, I checked pretty much every box, and that was, as I mentioned, both liberating and scary. There was this sense, as I read, that Sapolsky just understood ME, on a fundamental level, and again, while it was nice to know that I am not alone in any of my feelings, it was also emotional. It made me even more moved when Sapolsky began to call anxiety a “disease” and distinguished it from chronic stress as being rooted in “a cognitive distortion”. Sapolsky posits that, whereas chronic stress is normally a response to an actually perceived external stressor (whether physiological or psychological), anxiety can arise due to stressors that are entirely imagined. This is definitely in-line with my own personal experiences, and while I appreciated the understanding Sapolsky’s description provided to me, no one ever wants to hear that they suffer from a disease. That’s not an easy pill to swallow, and I found myself realizing that I even exhibited anxious tendencies and behaviours as a young child (such as obsessive thinking and phobias) and becoming a bit saddened and melancholy about this. With my increased knowledge certainly came a better understanding of myself, but this wasn’t always a pleasant experience to be sure.

What I did gain, most definitely, was a better comprehension of the biology of anxiety and a greater appreciation of the fact that it is a physical, scientific condition rooted in the brain. I’ve always known deep down that my anxiety is not something I have very much (if any) control over, but it is easy to believe, when something is a mental struggle, that if you can just be stronger, you can get past it. That is, after all, what Milton suggests and that quote from Paradise Lost is still one of my favourites. What is important to remember, however, is that mental illnesses are in fact just as physical as clearly physical ones, and although I always had an inkling of that, Sapolsky’s book solidified it for me. It made it clear to me that I shouldn’t be hard on myself, that I might not be able to conquer this all on my own, and that is okay. It made me realize that, just as I would seek help for a broken leg, there is nothing at all embarrassing or shameful about seeking help for a troubled mind. On the contrary, it is actually quite important and necessary.

I’d like to close my review with a few quotes that particularly spoke to me from Sapolsky’s text. I will never be able to explain myself the concepts he espouses (he is a scientist, after all, and I don’t claim to be), but hopefully these quotes will give you a sense for how he writes and what value can be derived from picking up this book. It is one that has undoubtedly changed my life in so many ways and I would not hesitate to recommend it to those who wish to get to the root of what their brains might be undergoing on a daily basis.

Quotes That Particularly Resonated with Me:

“Anxiety is about dread and foreboding and your imagination running away with you.”

“the distorted belief that stressors are everywhere and perpetual, and that the only hope for safety is constant mobilization of coping responses. Life consists of the concrete, agitated present of solving a problem that someone else might not even consider exists.”

“most things that make us anxious are learned…we��ve generalized them based on their similarity to something associated with a trauma.”

“For all anxious people, life is full of menacing stressors that demand vigilant coping responses.”

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“Find ways to view even the most stressful of situations as holding the promise of improvement but do not deny the possibility that things will not improve…Hope for the best and let that dominate most of your emotions, but at the same time let one small piece of you prepare for the worst.”

“Find that outlet for your frustrations and do it regularly.”

“Have the wisdom to pick your battles. And once you have, the flexibility and resiliency of strategies to use in those battles…”

“Sometimes, coping with stress consists of blowing down walls. But sometimes it consists of being a blade of grass, buffeted and bent by the wind but still standing when the wind is long gone.”

I just really love Robert Sapolsky. I was familiar with a lot of stuff covered in the book but I still really enjoyed reading through it. Personally feel like he's a very good science communicator and makes things digestible in a way that's accessible for everyone without really losing much of the nuance. I really don't know what else to write, usually when I write long reviews its because I have a lot of pent up irritation to vent but when I love things I'm just like guys this is good totally would recommend. I do think I enjoyed Behave a lot more though because it covers a lot more biology/plus I learnt a lot of new things from it. Also really appreciate him providing context on the limitations of what one can really do to cope with inequity especially when I see so much pop psychology being about just trying to make everyone have grit or whatever.

Sapolsky is an amazing writer and Primate's Memoir ranks as one of my favorite books. That said, the title, cover, and prior experience with Primate's Memoir led me to have unrealistic expectations of this book. It is thorough and well-written, but approaches the topic of stress from a phsyiological perspective that doesn't spare any of the details. As such, it often calmed my stress by putting me to sleep. The subtitle's promise of a section on "coping" with stress didn't pan out, and amounted to a few pages of an attempt at the end of the book. If you're looking for a tutorial on the physiology of stress and its relationship to a wide variety of human ailments and conditions (sickness, age, gender, etc.) then you might like this more than I did.

A brilliant and incredibly well-written book.

Every time I read something by Sapolsky I get amazed with how prodigious he is. No matter what he's talking about, everything he says is interesting and engaging. That summarises my feelings with this book. I don't find the stress subject very interesting, just because I often suffer from it, therefore I prefer to act like it doesn't exist, but unexpectedly, this helped me realize that I've been doing the entirely wrong thing (want to know why? read this book). However, don't come to this book expecting to get advice for your stress problems. This book will teach you about how your body reacts to stress, why it happens, the biology and chemistry behind it and also, how it could end up killing you. Just in the last chapter, Sapolsky will specifically talk about what could you do about it, though repetively saying that it's an entirely subjective thing. This summarizes it:

By now, if you are not depressed by all the bad news in the preceding chapters, you probably have only been skimming. Stress can wreak havoc with your metabolism, raise your blood pressure, burst your white blood cells, make you flatulent, ruin your sex life and if that's not enough, possibly damage your brain. Why don't we throw in the towel right now?

One of the greatest things about Sapolsky's books, it's that though some things are difficult to get, he will continually repeat what you have learned and how everything it's connected. Some topics may be hard, but he will do everything to make it clear for you.

This book is simply exquisite. Sapolsky is a fantastic scientist as well as a wonderful writer. In this book, he will help you understand the evolutionary purpose of the stress response and elucidate why we differ so much from other animals. We humans have a useful stress response but use it in very unuseful ways.

If you read this book, you will be treated to the wonderful and unexpected story of J.M. Barrie, author of Peter Pan. What does his life have to do with the neuroscience of stress? Read and find out! You will not be disappointed.

Finally, a book written by zebras for zebras. ⭐⭐⭐⭐

If all I had to worry about was lions, I wouldn't get ulcers either. But life isn't as black and white as that.

Although this reads more like a textbook than a self-help or pop-science book, the author does pepper it with some humor to keep you going. For example: “This is how gratification postponement works—the core of goal-directed behavior is expectation. Soon we’re forgoing immediate pleasure in order to get good grades in order to get into a good college in order to get a good job in order to get into the nursing home of our choice.”


Big Ideas:

+ Acute and chronic stress are different, as are physiological and psychological stress. Humans have a unique capacity to stress about perceived future dangers and to ruminate on past stressors
- “It is not so much that the stress-response runs out, but rather, with sufficient activation, that the stress-response can become more damaging than the stressor itself, especially when the stress is purely psychological. This is a critical concept, because it underlies the emergence of much stress-related disease. That the stress-response itself can become harmful makes a certain sense when you examine the things that occur in reaction to stress. They are generally shortsighted, inefficient, and penny-wise and dollar-foolish, but they are the sorts of costly things your body has to do to respond effectively in an emergency. And if you experience every day as an emergency, you will pay the price. If you constantly mobilize energy at the cost of energy storage, you will never store any surplus energy. You will fatigue more rapidly, and your risk of developing a form of diabetes will even increase. The consequences of chronically activating your cardiovascular system are similarly damaging: if your blood pressure rises to 180/100 when you are sprinting away from a lion, you are being adaptive, but if it is 180/100 every time you see the mess in your teenager’s bedroom, you could be heading for a cardiovascular disaster. If you constantly turn off long-term building projects, nothing is ever repaired”
- “If stress enhances some function under one circumstance and disrupts it under another, think time course, think 30-second sprints across the savanna versus decades of grinding worry. Short-term stressors of mild to moderate severity enhance cognition, while major or prolonged stressors are disruptive”
- “One of the themes of this book is the goal of contrasts. Physical stressor, you want to activate a stress-response; psychological stressor, you don’t. Basal conditions, as little glucocorticoid secretion as possible; real stressor, as much as possible. Onset of stress, rapid activation; end of stress, rapid recovery”

+ As with so many situations in life (so far this is the theme of 2019), when it comes to coping with stress, CONTEXT MATTERS!
- “Sometimes, coping with stress consists of blowing down walls. But sometimes it consists of being a blade of grass, buffeted and bent by the wind but still standing when the wind is long gone”
- Not everything is purely psychological, especially once we have a disease. We can’t psychologically heal ourselves from cancer and it’s dangerous to imply that we can.
= “Stress is not everywhere. Every twinge of dysfunction in our bodies is not a manifestation of stress-related disease. It is true that the real world is full of bad things that we can finesse away by altering our outlook and psychological makeup, but it is also full of awful things that cannot be eliminated by a change in attitude, no matter how heroically, fervently, complexly, or ritualistically we may wish”
= Yet, “there remains a whole realm of health and disease that is sensitive to the quality of our minds—our thoughts and emotions and behaviors. And sometimes whether or not we become sick with the diseases that frighten us at two in the morning will reflect this realm of the mind. It is here that we must turn from the physicians and their ability to clean up the mess afterward and recognize our own capacity to prevent some of these problems beforehand in the small steps with which we live our everyday lives”
- Socioeconomic status impacts which coping methods are most effective. Internal locus of control is more effective for higher SES individuals. When we really can’t control a situation, it’s important to acknowledge that
= “Certain techniques for reducing stress work differently depending on where you dwell in your society’s hierarchy”
= “Always attributing events in life to your own efforts (an internal locus of control) is highly predictive of lifelong health among that population of individuals who are the epitome of the privileged stratum of society—Vaillant’s cohort of Harvard graduates. However, in a world of people born into poverty, of limited educational or occupational opportunities, of prejudice and racism, it can be a disaster to be a John Henry, to decide that those insurmountable odds could have been surmounted, if only, if only, you worked even harder—John Henryism is associated with a marked risk of hypertension and cardiovascular disease”

+ Some potentially universal principles of stress management
- “I would apply the 80/20 rule to stress management: 80 percent of the stress reduction is accomplished with the first 20 percent of effort”
- “This business about the calm amid the arousal isn’t just another way of talking about ‘good stress’ (a stimulating challenge, as opposed to a threat). Even when the stressor is bad and your heart is racing in crisis, the goal should be to somehow make the fraction of a second between each heartbeat into an instant that expands in time and allows you to regroup. There, I have no idea what I’m talking about, but I think there might be something important lurking there. Enough said”



Other Ideas:

+ The placebo effect is important and real. It operates in some areas but not others and involves endorphins
- “Believing you’ve received an effective medical treatment when you actually have not has no beneficial effects for epilepsy, elevated cholesterol levels, infertility, a bacterial infection, Alzheimer’s disease, anemia, or schizophrenia… [And there is] a clear indication that placebo effects are highly effective against pain”
- “[Placebos] work by releasing endogenous opioids. As but one example of the evidence for that, block opiate receptors with naloxone, and placebos no longer work”

+ Hostility, rather than “type A personality,” increases the risk of disease. This may be due to underlying time-pressuredness and insecurity that lead to hostility
- “More recent studies have shown that hostility is associated with a significant overall increase in mortality across all diseases, not just those of the heart. Friedman and colleagues stuck with an alternative view. They suggested that at the core of the hostility is a sense of ‘time-pressuredness’... and that the core of being time-pressured is rampant insecurity. There’s no time to savor anything you’ve accomplished, let alone enjoy anything that anyone else has done, because you must rush off to prove yourself all over again, and try to hide from the world for another day what a fraud you are. Their work suggested that a persistent sense of insecurity is, in fact, a better predictor of cardiovascular profiles than is hostility”
- “The 'executive stress syndrome' is mostly a myth—people at the top give ulcers, rather than get them. Most studies have shown that it is middle management that succumbs to the stress-related diseases. This is thought to reflect the killer combination that these folks are often burdened with, namely, high work demands but little autonomy—responsibility without control”

+ Trying to avoid our emotions may actually amplify them physiologically
- “Repressing the expression of strong emotions appears to exaggerate the intensity of the physiology that goes along with them”
- “A lesson of repressive personality types and their invisible burdens is that, sometimes, it can be enormously stressful to construct a world without stressors”

+ Male erections don’t always signal sexual arousal. This is especially important information for male victims of sexual assault who had an erection during the incident
- “Among many social mammals, males have erections during competitive situations as a sign of dominance. If you are having a dominance display with another male, you get an erection and wave it around in his face to show what a tough guy you are. Social primates do this all the time”



Potent Quotables:

“In the face of strong winds, let me be a blade of grass. In the face of strong walls, let me be a gale of wind.” Quaker saying

As a physiologist who has studied stress for many years, I clearly see that the physiology of the system is often no more decisive than the psychology… [There are] things we all find stressful—traffic jams, money worries, overwork, the anxieties of relationships. Few of them are “real” in the sense that a zebra or lion would understand. In our privileged lives, we are uniquely smart enough to have invented these stressors and uniquely foolish enough to have let them, too often, dominate our lives. Surely we have the potential to be uniquely wise enough to banish their stressful hold.

Gostei muito do primeiro livro do Robert Sapolsky, o Memórias de um Primata. E este não me desapontou. Muito bem embasado, com bastante pesquisa (e prática) sobre o que é o estresse, como funciona e como nós lidamos bem ou mal com isso. Com aquela discussão necessária de natureza vs. criação, bons exemplos e um bom humor que te mantém ligado ao texto. Do tipo de livro que recomendo para leigos também.

Review it later.

"Be abejo, viena pagrindinių šios knygos temų: kiek daug žalos stresas gali
padaryti organizmui ir kaip svarbu, kad visi tai suprastume. Tačiau pervertinti iš to išplaukiančias išvadas būtų siaubingai trumparegiška. Negali visi vaikai užaugę tapti prezidentais; pasirodo, susikabinę už rankučių ir kartu traukdami liaudies dainas karų neužbaigsime, o alkis neišnyksta ėmus pasaulį įsivaizduoti be jo. Ne visos šiuolaikinės žmonių sveikatos problemos kyla iš streso, klaikiausių medicininių košmarų nenusikratysime vien tik vengdami streso ir užpildydami protą sveikomis, drąsos, dvasingumo bei meilės kupinomis mintimis. Norėčiau, kad taip būtų. O bandantiems pelnytis pardavinėjant tokias idėjas turėtų būti gėda."

"Pasaulis gali būti baugus ir visai imanoma, kad mūsy organizme atsispindi
pastangos atsargiai ir sėkmingai įveikti tamsių ir grėsmingų gyvenimo girių
takus. Išties būtų daug maloniau atsipalaidavus sėdeti saulės užlietoje vilos terasoje, toli toli nuo to laukinio kauksmo. Tačiau tai, kas iš pirmo žvilgsnio primena atsipalaidavimą, iš tiesų gali būti išsekimas: žmonės išsenka bestatydami
sieną aplink savo vilą, dėdami visas pastangas neįsileisti nestabilaus, iššūkių
kupino gyvo pasaulio. Išstumtų / užgniaužtų emocijų charakterio žmonės ir
ju nematoma našta mus moko, kad kartais pasaulio be stresorių kūrimas gali
sukelti nepaprastai daug streso."

I only read 25% of it so far and I learnt that I’m prone to cancer and some of my brain cells died due to glucocorticoid usage. This book is my worst nightmare already. This is a book I can only suggest to the people who doesn’t have auto-immune diseases and/or who have nerves to handle it.