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WW-Johnson & Johnson Women’s Health Fellowship

Elissa Epel

WH ’97

Minding Stress: “The Power of the Very Basics”
Elissa Epel WH ’97 explores the biopsychology of chronic stress

Stress is inevitable, but suffering—accelerated aging, weight gain, and other physiological fallout—may be optional, says Elissa Epel WH ’97. Dr. Epel, an associate professor in the University of California-San Francisco Department of Psychiatry, explores the effects of chronic stress and ways to alleviate them.

“We can’t get rid of stress,” she says. “I’m studying how people cope and change over time. What do people who thrive do differently, and how are they different from people who become depressed?”

Dr. Epel, director of UCSF’s Center on Obesity Assessment, Study, and Treatment (COAST) and a faculty member in the Osher Center for Integrative Medicine, notes that stress-activated hormonal responses both impair decisionmaking and lead to chronic physiological changes. She told an audience at a recent TEDx talk, “We have vastly overestimated our ability to control conscious behavior.” A classic example: Someone slightly depressed and sleep-deprived has less willpower to avoid grabbing that doughnut than he might think.

The psychological and metabolic patterns that result from stress reactions can perpetuate themselves throughout a lifetime—and, in the case of pregnant women, throughout their unborn children’s lives. “The roots of resiliency start in utero,” Dr. Epel explains. “Maternal stress and depression can have long-term metabolic and neural effects on offspring, all the way to adult life.”

These findings shape Dr. Epel’s current research on low-income mothers, who have high levels of stress, particularly food insecurity. People living with food insecurity often have to skip or skimp on meals, but are also prone to binge eating and obesity. Early findings suggest that, when these women are able to reduce stress, they gain less weight, and it looks as if their babies show more stress resiliency. “We can’t easily help them with the food insecurity,” Dr. Epel says, “but we can help these mothers be less self-critical, feel less stress, and make healthier, more creative food choices.”

In another current project, Dr. Epel is studying parents of autistic children. “[Lack of] sleep is a common problem for parents of children with autism,” she observes, as is divorce. This work is leading to a new mindfulness-based program to reduce stress for the parents and for their children, autistic and otherwise. “These parents, sadly, are on a path of accelerated aging,” Dr. Epel says. “We can’t change their caregiving situations, but we can change the caregiver, the way they experience life and react to things that happen.”

Science, she observes, is developing a “humbling” new understanding of the mind. Cognitive neuroscience is revealing that, although our experience feels seamless—we think we see and understand everything—we actually have very limited perceptual abilities. We behave in a certain way that we’re not aware of and make up stories later, post hoc, to explain what we did. Given our limited ability to control our behavior, we need to shape our environment to support us better”—from resisting multitasking to restricting impulsive consumption.

In the face of various controversies about efforts to regulate access to unhealthy behaviors, it is clear that, culturally, Americans still prize the individual right to make bad choices. “It’s a principle that makes sense theoretically,” Dr. Epel says, “but the data and the obesity epidemic point to the failure of personal responsibility. We have to realize that people will still make bad choices because they’re not in full conscious control of their behavior. Stress makes any of us more impulsive. We need more health and food policy based on a deeper understanding of the psychology of human behavior.”

She is encouraged that the public and business leaders are increasingly interested in improving wellness. “I live near Silicon valley,” she says, “and the question for that culture is how to be more creative and innovative, and have greater wellbeing.” Though such initiatives as the recent Wisdom 2.0 conferences, she says, “There’s a movement starting in the heart of the valley to bring more compassion and mindfulness to work. The motivation might start with improving business profits, but in the process they create a healthier, more compassionate culture.”

While technology may improve culture, Dr. Epel notes, it can also create cognitive load by multitasking and reduce important social interactions and relationships. “We’re sickened by tress, and the backlash is good. Our society is going to rediscover the power of the very basics—social connection and self-knowledge—in helping people manage stress and achieve optimal performance. We are realizing how stress affects us in the workplace, making us sleep-deprived, with hostile edges and narrow thinking. We need to promote cultural change toward connection and compassion.”

Look for Dr. Epel’s work on TED.


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