Trump, traffic and your brain

With an increasing number of medical studies linking cortisol spikes to cognitive decline, one sort of has to wonder if President Donald Trump and American motor vehicles shouldn’t come with a warning that they are a threat to your brain.

Trump’s role is tied to Trump Derangement Syndrome (TDS), something well explained by neurologist Robert H. Lustig way back in 2018.

In an essay titled “This is Your Brain on Trump,” published  by MedPage Today, the professor of pediatric endocrinology at the University of California San Francisco questioned the diagnosis of this mental condition ostensibly “driving people ‘insane’ due to their dislike of Donald Trump to the point at which they abandon all logic and reason.”

He then proceeded to explain the chemical process that might actually cause this sort of insanity in the brains of vehemently anti-Trump Americans. By using greed and fear as motivators, Lustig wrote that Trump had “ramped up dopamine and cortisol” production in people’s brains.

Dopamine and cortisol are chemicals naturally produced by the body. They are among more than 60 such chemicals – glutamate, epinephrine, acetylcholine, gamma-aminobutyric acid (GABA) and more – that function as neurotransmitters.

Neurotransmitters play a key role in determining how we think, or don’t. Lustig described dopamine as the feel-good chemical which, when overproduced (or overused), “drives severe irritability, as chronic cocaine users can attest to.”

Cortisol, on the other hand, is a fear-activated hormone that triggers the fight-or-flight response, which can help save your life in a dangerous situation but plays havoc with a brain too often exposed.

“Chronic stress and cortisol kill neurons in the prefrontal cortex (PFC), as is seen in people who were victims of child abuse or other adverse experiences like war,” Lustig wrote. “What’s the quickest way to short-circuit the PFC? Multitasking. Even pilots, the ultimate multitaskers, experience inhibition of their PFC with enough stress.”

Lustig worried that Trump’s Twittering was whipsawing the dopamine and cortisol levels in too many Americans with dangerous consequences.

“…Many of us have now become Trump,” he wrote. “The more dopamine and cortisol, the more we lose our ability to discern truth from post-truth, the more irritable we become, and the more we abandon our cognitive control with little regard for the consequences.”

This problem didn’t end after Trump’s first term in office, however, and it might now be worse in his second term. If you don’t know a few people who’ve been hit so hard with TDS that they now sometimes, if not regularly, sound irrational when politics are discussed, you’re lucky.

If you do know some, as most Americans probably do, you should be worrying about how much worse their problems could be years from now, especially if they’re already of a certain age. Because what scientists are finding is that yo-yoing levels of cortisol damage the brain.

Doctors involved in the latest research,, as reported to the Alzheimer’s Association International Conference this month, documented a clear connection between widely fluctuating cortisol levels and faster cognitive declines as people age.

“Our study suggests that how cortisol fluctuates across the day may provide important insights into cognitive aging,” Dr. Ted K. S. Ng from the Rush University Medical Center in Chicago told MedPage. These findings aren’t totally new. They only add to a developing picture of brain health.

The stress factor

Researchers publishing in the peer-reviewed journal Dementia & Neurophysiology in 2011 reported that “stress hormones are strongly linked to memory performance” and “thus may play a role in the development of age-related cognitive disorders such as Alzheimer’s disease.” 

And researchers reporting in the peer-reviewed Frontiers in Aging Neuroscience eight years later said clinical evidence showed “that elevated cortisol was associated with poorer overall cognitive functioning, as well as with poorer episodic memory, executive functioning, language, spatial memory, processing speed, and social cognition.”

Those researchers further noted that when the cortisol levels of test animals were manipulated, the results were “cognitive impairment and abnormal behavior.”

Some of these problems with cortisol might help explain the country’s rising rate of “cognitive disability.” The peer-reviewed journal Neurology last year labeled this “a Public Health Concern Among U.S Adults.” The journal went on to say that the country’s Behavioral Risk Factor Surveillance System (BRSS) in 2022 found that “cognitive disability had become the (country’s) most frequently reported disability, with a prevalence of 14 percent.”

This was up from the 6- to 11-percent level six years earlier, and the most troubling part of the newest BRSS report was the skyrocketing rate of the disability among those aged 18 to 39. The group saw the prevalence of cognitive disability nearly double from 5.1 percent in 2013 to 9.7 percent in 2023.

Trump might be responsible for some of this. Eight years ago, Lustig observed that “many have remarked that Trump operates out of his “‘lizard brain.’ Rather, I would argue that Trump has turned our brains reptilian.”

Reptiles, though they have been described “as smarter than some think,” aren’t exactly known for their intelligence. They aren’t up there with dolphins or dogs or even ants on the list of “The Top 30 Smartest Animals in the World.” That list starts with humans and ends with magpies, with bees put smack in the middle below dogs above and cats above.

Suffice to say, even the now dumbest of humans has to lose a lot of brain cells to get down to the reptile level, but Trump may be helping. Then again, it’s probably unfair to put too much blame on the current president for the growing rate of “cognitive disability” because there are other factors here driving with cortisol.

And motor vehicles are chief among those other things.

Stressful by design

After 75 years of designing cities more for cars and trucks than for people, the U.S. has managed to create a transportation system that can drive people nuts. Lustig’s essay on Trump Derangement Syndrome could easily be retitled “This is Your Brain on MVs” with every reference to “Trump” in the copy simply changed to “MV.”

Take it from the Foundation for Traffic Safety, an arm of the American Automobile Association (AAA), which reports that its fall sampling of motorists found that “96 percent of drivers reported engaging in aggressive driving or road rage behaviors at least once in the previous year.”

But this was just the tip of the iceberg. The survey also found that “11 percent of drivers reported engaging in violent behaviors.

‘While anger and frustration were the emotions most commonly associated with aggressive driving and road rage, drivers also spoke of anxiety, fear and pleasure in their experiences of aggressive driving and road rage.”

Does anything here sound familiar to what Lustig was describing with TDS? The dopamine pleasure, maybe? The cortisol fear and anxiety?

The drive-everywhere-always society that the U.S. has created has already been linked to the country becoming the fattest, unfittest nation among the world’s high-income countries. After looking at data on walking from the United Kingdom and Europe, researchers at Virginia Tech reported that “Americans make fewer than half of the walking trips per day compared to Britons.”

Nearly 80 percent of Americans are so now so addicted to their car or truck that they won’t walk more than 10 minutes out the door to get somewhere, according to the U.S. Centers for Disease Control (CDC). Nearly a quarter of this I-hate-to-walk group freely admits to a preference for driving.  The rest offer various other excuses from “inconvenience,” 21.5 percent; to “no places to walk within 10 minutes,” 24.9 percent; to conditions too “hot and humid” for walking, 36 percent.”

The latter might help explain why eight of the country’s 10 fattest states are in the south, with West Virginia, Arkansas and Mississippi boasting obesity rates of more than 40 percent. And it’s not that easy to create populations where two out of every five people are obese.

To qualify as obese, a 5-foot, 9-inch man – this being the height of the “average” U.S. male – has to reach 203 pounds. For the average woman at 5 feet, 3.5 inches, obesity kicks in at 172 pounds. That is almost six pounds heavier than the weight of the average U.S. male for the period from 1960 to 1962, according to CDC data. 

More than two decades ago, the CDC headlined “Americans Slightly Taller, Much Heavier than 40 Years Ago.” This was in 2004, and the average male had by then gained more than an inch in height while ballooning to 191 pounds. It was then hard to believe that he could pack on many more pounds.

But the CDC today says the average male has shrunk to a tenth of an inch under 5 feet, 9 inches, but now weighs 199 pounds. That puts the “average” male well into the overweight category and knocking on the door of obesity.

He’s also shopping for fat-man pants, given the CDC reports an average waist size now blown out to 40.6 inches.

The average female, meanwhile, today has a waist of 38.5 inches – two and a half inches bigger than the bust size of the late Marilyn Monroe – and weighs 171.8 pounds despite maintaining that 5 foot, 3.5-inch height of 1970, according to the CDC.

This puts the “average” American female within two-tenths of a pound of being classified as obese.

Some people blame this on diet. Some blame it on a lack of physical activity. Stress seldom gets mentioned, but it probably should be in the mix.

Researchers in 2020 published a peer-reviewed study in Translational Psychiatry that linked cortisol to obesity, but they couldn’t determine if the cortisol was causing the obesity or simply ” a marker of other psychological trait factors that influence stress-induced eating.”

They did note that “other studies…suggest that dysfunctional emotion regulation may lead to increased food intake. Furthermore, there is evidence of an association between different body weight disorders and difficulties in emotional regulation,” which brings one back to those dopamine-cortisol swings about which Lustig wrote.

It’s more than a little depressing to think that while these swings are driving people insane, they might also be making them fatter, which brings metabolic-syndrome-associated health problems into the picture, along with increasing their risks of dementia whether in their senior years or earlier.

Failing brains

Should you be worried? Maybe.

“Early-Onset Dementia and Alzheimer’s Diagnoses Spiked 373 Percent for Generation X and Millennials,” the insurance company Blue Cross Blue Shield reported in 2020. “The number diagnosed with these conditions increased 373 percent among 30- to 44-year-olds, 311 percent among 45- to 54-year-olds and 143 percent among 55- to 64-year-olds from 2013 to 2017.”

One can’t help but wonder how much that older cohort was protected by having grown up in a country where physical activity was far more a part of day-to-day life than it is now. There has been a lot of talk about the dangers of the now common “sedentary lifestyle” in the U.S., but little to nothing has been done to try to encourage more active lifestyles.

Other countries have been much more proactive. Finland transformed itself. The United Kingdom is in the process of trying to do the same, with government-supported British Cycling now running a “Sofa to Cycle” program with support from Lloyds of London, the government-backed insurance marketplace, and the country’s National Health Service (NHS) pushing a “Couch to 5K” program.

The latter is described as a simple program in which anyone can participate to “improve your heart and lung health, help you manage your weight (when paired with a healthy diet),  strengthen your bones and reduce the risk of osteoporosis, (and) boost your mood, ease stress, and give you more confidence.”

The former program aims “to get a million more people on bikes by 2028” in light of “research showing cycling in the UK saves £72.7 million to the NHS” while bringing “huge social and economic impact to people’s lives.”

And now you can almost see the cortisol spiking among car-brained American drivers who believe roads should be kept free of bicycles and pedestrians, even though what far, far more often causes their cortisol spikes is other drivers, and the reality that the decades of effort put into designing cities for motor vehicles has done nothing but encourage everyone to get into a car and truck.

All of which has proven massively counterproductive on several fronts.

“People walk less in the United States because it’s more dangerous to walk here and walking conditions are worse compared to other countries,” said Ralph Buehler, a professor of urban affairs and planning at Virginia Tech involved in that school’s walking study. “So we’re caught in a bit of a spiral that discourages walking and encourages driving in the U.S.”

Thus, instead of cities with transportation systems full of walkers who take up 3.2 square feet of space each, according to the Federal Highway Administration, the city has streets easily overstuff with vehicles that take up each take up 34 to 40 times as much space.

This might not be so bad if these vehicles were vans or buses carrying large numbers of people, but in most cases they cars, occupying 108 to 129 square feet, or trucks, taking up 130 square feet or more not counting side mirrors, with only one person aboard.

As a result, streets quickly become congested with motor vehicles, traffic snarls, and the cortisol production among drivers skyrockets as they try to deal with the stopping and going, the drivers around them going too fast or too slow, the erratic lane changes of the drivers trying to beat the rest of the traffic, the irritations of the seemingly endless number of Ameircans who don’t seem to understand the idea of ‘keep right except to pass,’ the drivers ignoring traffic control devices, the crashes closing roads and bring traffic to a halt, and the simple, overall lack of courtesy displayed by most American drivers these days.

In some ways, Trump look almost like a prince by comparison.