Welcome to my absolute least favorite day of the year.

Last night, an hour was stolen from most of America. We don't get it back until we return to standard time in the fall. This morning, millions of people dragged themselves out of bed feeling like garbage. Tomorrow morning is going to be worse, because the acute hit of the clock change compounds when the work week starts and the alarm goes off earlier than your biology is ready for.

It's asinine. I hate it. I've hated it for years, and the data keeps giving me more reasons to.

The Numbers Aren't Subtle

The Monday after spring forward is one of the most dangerous days on the calendar. Not because of anything mysterious. Because sleep deprivation is hitting an entire population at once.

Heart attack rates spike roughly 24% in the days immediately following the spring transition. Stroke hospitalizations increase in the two days after the clock change. Car accidents go up. Workplace injuries climb. Suicide rates tick higher. Produc...

The first two posts in this series were about that angry little toddler in your head. The default mode network. The voice inside your head that is not really you.

That's the hard part to actually accept. Because at least for me, that internal dialogue always felt like who I was. It's the voice I hear when I read. The voice I hear when I think. I spent decades assuming that voice was me. It isn't. There's something underneath it: that breath, that moment of awareness that is more than just words and internal commentary.

The first two posts explored that. And if you've had any kind of trauma (most of us have, by the way: look up the ACEs test, Adverse Childhood Experiences, and see where you land), that early wiring runs deep and colors the dialogue you have with yourself for decades. One of the more sobering things I've come across is the idea that the way you talk to your kids becomes their internal dialogue later in life. Build them up. That's all I'll say about that.

Post one cove...

Your adrenals don't just suddenly fail. They break down in stages.

Most people don't realize they have a problem until they're in Stage 3, completely crashed, unable to function. By then it takes months or years to recover.

If you catch it in Stage 1 or 2, you can reverse it in weeks.

Here's how to know which stage you're in, and more importantly, what to do about it.

What Adrenal Dysfunction Actually Is

Your adrenal glands sit on top of your kidneys. They produce cortisol, your primary stress hormone. Cortisol isn't bad. It's essential. It helps you respond to threats, regulate blood sugar, control inflammation, and maintain your sleep-wake cycle.

The problem is chronic, unrelenting stress.

When stress is acute and short-term, cortisol spikes, handles the threat, and returns to baseline. Your adrenals recover. The system works.

When stress is chronic and continuous—work pressure, relationship problems, financial instability, poor sleep, blood sugar crashes, chronic pain, infla...

So what the hell does it really mean for your health when the angry dictator of your thoughts (the guy with the German accent and the shitty little mustache, you know the one), that petulant little toddler of a hypercritical internal dialogue, rears his ugly little attitude?

One post wasn't enough. Learning why something works helps you figure out how to unplug it and unwind it.

In the last post we talked about the default mode network: the internal dialogue running old programming, generating anxiety about things that either haven't happened yet or already happened twenty years ago. In its misguided stupidity it's trying to keep you safe. Most of the time from imaginary nonsense, but I guess sometimes it's actually useful in modern society. Just not on social media. Just saying.

This one is about what happens in your body when you actually get out of it.

This isn't just psychology. Presence has a physiology. And if you're already dealing with adrenal exhaustion or a nervous system...

We've all seen it. Or if you have kids, you've had the humbling experience of living it.

There's a kid at Target absolutely losing it. Full meltdown. They want a toy, a piece of candy, some form of dopamine hit, and when the parent says no, the little turd erupts into a torrent of crying, wailing like a banshee, kicking, screaming, and becoming a menace to everyone within a thirty-foot radius. And in a moment of pure exhausted embarrassment, the parent just gives in.

When my son was about two or three, he had one of those overtired, over-sugared meltdowns in the checkout line at Target. Full-blown fit about a Lego or something. We leaned in and whispered, "If you don't stop, I'm going to spank your butt." The wail immediately transformed into a tearful "don't spank my butt." Over and over. DON'T SPANK MY BUTT. My wife was mortified. It was the most awkward checkout I have ever been through in my life.

The best part came about a week later. There was another kid having a similar melt...

 You can't fall asleep at night. Your mind won't shut off. You're exhausted but wired. When you finally do sleep, you wake up at 2 or 3 AM and can't get back to sleep.

Then morning comes. The alarm goes off. You feel like you've been hit by a truck. You can't get out of bed. Coffee doesn't help. You're a zombie until 10 or 11 AM.

This sounds like two separate problems. It's not.

It's one problem: your cortisol rhythm is broken.

What Cortisol Is Supposed To Do

Cortisol is your primary stress hormone, produced by your adrenal glands. But it's not just about stress. Cortisol has a natural daily rhythm that governs your entire sleep-wake cycle.

Here's how it's supposed to work:

6-8 AM: Cortisol peaks. This is what wakes you up naturally, gives you energy to start the day, gets you out of bed without hitting snooze five times.

Throughout the day: Cortisol gradually declines. You maintain steady energy but you're not wired. You feel alert and functional.

Evening (8-10 PM): Cortisol ...

I've been doing this for 24 years.

I started my first day of clinic on September 11th, 2001. I made it through the end of the dot-com bust. The housing crash in 2008. I had two kids 13 months apart (that stress was personal, not global). The pandemic. Riots. All of it.

This week feels different.

I don't know how else to say it. It feels deeper. Spiritual. Subconscious. Almost like a universal subconscious shift that everyone's picking up on whether they realize it or not.

And I don't like it.

What's Different This Time

Previous crises had boundaries. Economic collapse. Health crisis. Political chaos. They were massive, but they were contained within specific domains.

This one feels like all of them at once, plus something underneath that nobody's talking about openly.

It's not just fear. It's the sense that the ground itself is unstable. That the rules we thought governed reality don't apply anymore. That the institutions we relied on—even if we didn't trust them—are either bre...

This may come as an absolute shock to you, but everyone is stressed as hell right now and they're getting their ass kicked.

I wrote most of this after teaching at ICAK's winter meeting in Orlando last weekend. What became clear in the days after: everyone, and I do mean everyone, is getting crushed by adrenal exhaustion right now.

Every person. Every appointment. Every conversation.

Anxiety. Stress. Fear. Sitting in the chest. Crushing.

Almost all of my patients this week said some version of "I don't know what's wrong with me. I'm just off." The anxiety is overwhelming. They can't sleep. They're waking up in the middle of the night. Can't focus. Stuck in doom scrolls. Actively avoiding their phone so they don't see the news, then consuming all of it anyway. Heart racing for no reason.

I'm experiencing every single one of these symptoms too.

Here's what's actually happening: your adrenals are trying to keep up with the world right now, and they're losing.

What Anxiety Actually I...

I ask every patient the same question: "Are you experiencing stress?"

Nine times out of ten, the answer is: "No, Doc. I'm good. Life is good. The kids are fine. Job's stable. House is safe. I don't experience stress on a daily basis."

Then I examine them. And everything I find tells me the opposite. Their body is screaming stress signals.

Here's the disconnect: when most people hear "stress," they only think about the emotional stuff. The difficult boss. The relationship problems. The financial pressure. Th...

We wonder why no one trusts science anymore.

And anyone who says "trust the science" without being willing to actually look at the science is probably full of it. A new study published in Diabetes Care, the American Diabetes Association's journal, is making the rounds claiming that low carb diets increase your risk of Type 2 diabetes by 31%.

Nearly five million person-years of follow-up. Over 20,000 documented Type 2 diabetes cases. Three massive cohort studies spanning 30 years.

That's a ground-shaking study. Low carb is the devil. It's gonna kill you.

Except I read past the abstract.

Here's what the study actually measured, and here's the much more interesting finding the researchers buried in their own results.

Problem One: That's Not a Low Carb Diet

The researchers built something called an "LCD score" and divided everyone into five quintiles ranked from most to least carbohydrate intake.

The highest quintile, the group they labeled "low carb," ate approximately 40% of th...