Dr. Elissa Epel is well-versed in the effects of chronic stress on the human body as expressed through biological aging and other impacts, including depression. As a result, she’s become an advocate of a very low-tech and simple mechanism that can help our systems not only recover but shift into a state of repair: rest.
“It absolutely slows [stress] down and amps up all of the gene expression for repair for maintenance,” says the Vice Chair, Psychology Research and Community, Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco.
Epel notes that people can change their stress “within minutes.” Spending just 10 minutes a day on rest-related actions, from mindfulness work to “social environmental interventions,” she says, can reduce depressive symptoms, for example, in as little as three weeks.
You can hear more about Epel’s work in her talk from the DOC 2025 session, “Sex, Stress and Social Nutrition: Get Your Groove On,” in the video or read our lightly edited transcript below.
TRANSCRIPT:
Dr. Elissa Epel
Thank you. Brian. George. It’s very exciting. I’m going to touch upon salutogenesis mechanisms for healing. But first we have to go to the dark side and talk about stress. I am excited to share what I think is really the edge of the next generation of understanding the fundamental basis of not just disease, but also healing and, healthy longevity. And that is energy, energy, science, energy, bioenergetics and mitochondria. So that will be a theme. Let me just start by asking, you to think back to a typical work week. Work day, busy and, high paced. How much energy do you have at the end of the day? How tired do you feel at the end of the day?
If you feel the impact, raise your hand. If you feel like you want to lie down, that might be some of us. You don’t have to raise your hand, but you might have even experienced like hitting the wall, feeling exhaustion. That’s clearly energy imbalance. We need to make more mitochondria than we are burning. When we don’t, we become, under a state of mitochondrial stress and strain. That creates cytokines, inflammation like GDF 15. The basis of healing in every cell is, of course, the energy source of mitochondria. So what does feeling tired, exhausted have to do with healthy longevity or health span? This is also a result of chronic stress.
I don’t have time to go into the spiritual crisis, but I believe that we are in an intersection of a spiritual crisis, a bio energetic crisis, and the health endemic that we all know well. The interrelated set of chronic diseases and mental, conditions that that arise together. So I’m going to just address how has stress changed now?
What is the energetic cost of different types of stress if they’re really different? And can we reverse stress effects through manipulating allostatic states to extremes to very high and to very low? What do I mean by that? Mounting a stress response. All we have to do is create stress, but it happens at every single level within the cell, within our systems, within our psychological perceptions. And we can harness that stress and use this for healthy longevity. And of course, the question has been, why don’t we do it? Exercise as an example. We know that’s a positive for stress. That’s a discussion I hope that we’ll have. Here’s just a sampling of stress is a bit different these days. We have, for example, technology stress information onslaught, cognitive load. We have existential stress from the ecological crisis that often comes along with, lack and purpose and meaning, moral distress from being part of or seeing our values violated. Uncertainty stress, which I will say that we all we’re in the matrix of uncertainty, stress with change, with political change, etc. all on top of the usual personal daily drama that humans have always had financial survival, self-care, relationships, social stress.
It’s a lot what we do know from several decades of research is that chronic stress accelerates the hallmarks of aging biological aging at the cellular level, as does depression. You see inflammation, epigenetic clocks and telomeres, the protective caps at the ends of chromosomes. What’s new here is that we also now have shown in humans that might that chronic stress impairs mitochondrial enzymes. Let me just show you an example of this study. This is in collaboration with Martin Picard, the mitochondrial psychobiologist. We’ve been studying caregivers and have shown several years ago that chronic stress impairs the bioenergetics capacity of mitochondria to such an extent that some of our participants under chronic stress looked as impaired as people with mitochondrial disorders.
If you’re wondering if chronic stress should be on the map for what you address for medical education, is it clinically significant enough? I think of it as an umbrella that is, of course, affecting mental health. We know that it affects physical health, but it also shapes every health behavior. We have sleep, etc.. So in this diagram, you can see we’ve followed people longitudinally and have found that not just that chronic stress is related to illness. Shortening a signature effect. I wrote a book about that with, Nobel laureate Liz Blackburn. Dean Ornish is going to talk about some of that telomere work, but that this is through a pathway. We think of mitochondrial impairment. Starting off, if you have poor capacity, you’re more likely to have dampened telomerase, the protective enzyme, and rapid telomere shortening over the next year.
Sex probably takes a lot of energy stress probably takes more energy over a day than anything else we do. Especially if we’re kind of having chronic, vague, pervasive uncertainty stress. So we all know what that looks like when we, you know, we take care of our phone pretty well. But by the end of the day, if we feel like that, we really haven’t recharged and it’s really not hi tech.
I’m going to talk about lying down and rest. It’s very low tech and we know what it does to our stress and immune gene expression. It absolutely slows it down and amps up all of the gene expression for repair for maintenance. We call this set of genes growth maintenance and repair. And so typically we’re going to put energy into survival stress. A lot of ATP is going to go toward that.
We have our basic vital functions. And then maybe if we’re lucky we get that much growth maintenance repair. When we think about aging, the daily damage that we need to repair from oxidative stress, we must have that daily repair. That is what is going to slow aging. But if someone is under chronic stress, they’re using their limited energy budget for survival, less for maintenance and repair.
And then here’s what’s interesting. Here’s what I want to pay attention to is that big blue box. Where is that in your day? How much time are you spending in true relaxation or restoration or how many times a week? So if you have a mind body practice, you’re obviously, devoting some gene expression toward more toward reparation, rejuvenation.
But also when we have acute or positive stress, we are turning on recovery and repair during that period. So there are several ways to turn on GMR. I like to think of how we want to not live in that subtle, pervasive chronic stress mode where our battery is leaky, the yellow mind state. But we want to be living in our allostatic extremes that is, acute bursts of controllable, healthy stress and recovery, or more green and blue mind states, relaxation or deep rest.
I actually lead retreats called Deep Rest where people have new experiences relaxing like they didn’t know they could, and resetting. And I also use, unnamed biosensor rings that help us understand how much people are responding to our different interventions. And we have really been interested in what is the different biological mechanisms to inform stress and deep rest.
We’ve been doing some studies on this with my colleagues, Wendy Mendez, Eric Prather and other colleagues. And we’re testing high arousal like HIT, high intensity interval training, Wim Hof breathing versus the restorative activities, slow breathing, which changes everything within seconds. And as well as mindfulness meditation. I heard someone say earlier, that we all know that lifestyle doesn’t change. I don’t think you were saying we should give up, but, I will say that, we need to talk about this because you can change stress within minutes. And we have many validated ways to do that. We also can do better at lifestyle change. We know that it changes.
So what did we find? We’re starting to publish some of our findings. All of these interventions improve vitality and, reduce depression equally, pretty much a big chunk. If you’re going to spend ten minutes a day on these within three weeks, you might have a reduction of almost 20% in depressive symptoms if you do it right. This is all about adherence.
In our well-controlled studies, we get phenomenal adherence because we’re texting them every day. We know, with time stamps if they’re doing their practices. So we believe that these are working through very different systems. We can move people in these allostatic systems. And that is the extent of allostatic change is related to the extent of recovery from depression.
I have, of course, after hearing Brit have to show you that we also have, looked at chronic stress at sex as a buffer to chronic stress effects. We find that sexually active couples have longer telomeres. They also have less of the pre-diabetes that we tend to see with caregiving. So we know that some cellular sources of exhaustion, inflammation, mitochondrial, depletion, we also know how to create vitality. We have control. And the question is really how can we use technology. And, you know, not just individual interventions but more social environmental interventions to really increase our health span. And I’ll end with that. And, I have free chapters of both Telomere Effect and Stress Perception on my website, right there. And feel free to join me in a few weeks lying down and learning some some new allostatic states.