Chronic Stress Is Aging Your Body Faster Than Smoking (Here's How To Reverse It) | Dr Elissa Epel

1. 0:00 – 1:47

   Chronic stress, telomeres, and the “10 years of aging” finding

   1. RCDr. Rangan Chatterjee0:00

      You've done some research suggesting that chronic stress can age the body by as much as 10 years. That's quite a staggering statistic.

   2. EEDr. Elissa Epel0:08

      Yes. So the telomere is this structure made of base pairs. It sits at the ends of chromosomes, and it protects them. So telomeres are one of our many biological clocks, and they do shorten as cells divide over time, but they also shorten based on the level of wear and tear or stress, physiological stress, in a cell. We statistically can say with confidence shorter telomeres predicts more likelihood of early disease, early mortality, slower wound healing. And when we first started studying telomeres, we did this calculation where we know exactly how many base pairs we lose per year, and thus we can quantify how much extra aging or additional base pairs people lose when they're under chronic stress. And that's how we came up with that statistic, that there was 10 additional years of aging in terms of the immune system. But our lifestyle changes actually can boost this protective enzyme that can lengthen telomeres. And so if you study someone over time, you actually see that they're much more dynamic and that nothing is determined or written in stone. And any time in life, any day, we can start to reverse damage and boost all of the restorative enzymes and processes in the cell and lengthen our telomeres.

2. 1:47 – 3:16

   Why “deep rest” is repair time (and what grind culture is costing us)

   1. RCDr. Rangan Chatterjee1:47

      Does that therefore mean that if we focus more on relaxation in our lives, and we can of course, uh, elaborate as to what we mean by that, are we therefore then able to slow down the aging process in the same way?

   2. EEDr. Elissa Epel2:04

      Absolutely. And it's not just that we're not experiencing stress, but when we put ourselves into a state of rest, and even more so deep rest, now it's time to restore and repair. And so that happens at night when we sleep, and that needs to happen more in the day. I think we've lost the siesta. We've lost a culture where it's okay to lie down in the middle of the day or have leisure time be a regular part of the day. And so we're in a, in a sense, this grind culture is grinding down our telomeres more quickly as well. When we rest, we turn on telomerase, the enzyme that repairs telomeres. We also turn on other restorative mechanisms such as DNA repair mechanisms and the cleanup crew in the cell that cleans up junk, repairs proteins. And we also turn on the anabolic hormones-

   3. RCDr. Rangan Chatterjee3:07

      Mm

   4. EEDr. Elissa Epel3:07

      ... the, the sex hormones, the, the steroids that actually create growth and maintenance.

3. 3:16 – 8:07

   Recognizing chronic stress as the new default (and why we stop noticing)

   1. RCDr. Rangan Chatterjee3:16

      Yeah. If I reflect on my career as a medical doctor, I don't think that stress per se was really on my radar at the start of my career. But I soon started to realize that, wow, unmanaged stress that goes on for a prolonged period of time can have quite devastating effects on human biology. And I guess when I really saw this was with my father, my dad. And to cut a long story short, for 30 years, my dad only slept three nights a week. He was a consultant physician in Manchester Royal Infirmary, but also when he got home in the evening, he would get picked up in a car and be doing a family doctor house calls all night-

   2. EEDr. Elissa Epel4:14

      Wow

   3. RCDr. Rangan Chatterjee4:14

      ... four nights a week. And I didn't know, you know, Dad got lupus. He had kidney failure. He ultimately died in 2013. I've learnt so much about the impacts of chronic stress since my dad died. I know that his lifestyle ultimately is one of the reasons why he's not here today.

   4. EEDr. Elissa Epel4:34

      Mm. Mm-hmm. That's heartbreaking, and, uh, that was his normal default mode. You know, it became what he was used to. If we are living a lifestyle of chronic stress, we tend to become numb to the feelings and thoughts of stress and to the body signals. We don't read them anymore because it's our default mode. And so I think we're, at, as a society in general, living with an epidemic of chronic stress. The baseline level of arousal for people is not, let's say, normal. It's not a resting state. It is a subtle state of chronic stress. And some people, of course, many people feel the thoughts of str- the feelings, the subjective stress, feeling overwhelmed, feeling worried, but other people don't, and yet their body is still under the state of chronic stress, but they're not, uh, they're not denying it. They just don't notice it anymore.

   5. RCDr. Rangan Chatterjee5:43

      Yeah.

   6. EEDr. Elissa Epel5:43

      They're, they're so used to it. So I think there, there's a, uh, question about, like, what is our true baseline? Are we under chronic stress? We can ask ourselves how stressed we feel, and this is how we measure it in studies, you know, rate on a one through 10 scale. Whether you feel moderately stressed in the middle of five or extremely stressed at 10. But when w- it's day after day, you know, we just adjust our baseline.

   7. RCDr. Rangan Chatterjee6:13

      Yeah. One of the things I loved in your book, The Stress Prescription, was the way you describe these different states that we can be in as it relates to stress, red mind, yellow mind, green mind, and blue mind. So perhaps now would be a good time for you to explain, first of all, w- what is stress? What's, what's the point of the stress response, you know? Because it clearly serves a role in our bodies or we wouldn't have it. And then from there, it would be really fun to explore these different mind states because I think it helps us understand where we might be living. And as you say, do many of us even know what it's like to really feel deep relaxation anymore? I think many people just don't, right? So perhaps we can just start with, you know, what is stress, and then move on to these different mind states.

   8. EEDr. Elissa Epel7:07

      Yes, that sounds great. I really like the mind states because it opens the door to us having a labeling system, pretty simple label system of four mind states, and checking in with our body and seeing where we're at, and that's step one. If we can turn on the light of awareness, we can then measure, manage, monitor, and reduce stress, and that sounds like a lot of work, but we can do that within minutes. So the beauty of feelings of stress is that they are absolutely malleable, and we can change our physiological stress as well as our emotional stress within five minutes. So these subtle, s- small changes every day that you talk about a lot and, and many of your speakers are really the medicine. They are critical for us to bringing down our elevated, excessively elevated,

4. 8:07 – 9:40

   What stress is for: acute stress vs chronic stress physiology

   1. EEDr. Elissa Epel8:07

      unnecessary feelings of stress so that we can actually really tap into deeper living. So that's where the mind states come in. The first mind state is... Well, sorry, you asked me what is stress. W- we are all experts on stress because we live with so much stress. We know what we do to manage it. We all wanna manage it better. You can't get rid of it. It is the fundamental survival neurobiological and body wiring that keeps us able to adapt to the ever-changing environment. So we n- we need to be flexible and responsive, and that is beautiful and healthy. So the stress response in a young, healthy organism is a low baseline, a really high peak response, and a quick shutoff. That dynamic, flexible, let's mobilize energy when we need it, and then let's recover when we don't need it, and that shutoff, of course, is hard when we carry mental stress. Um, so the acute stress response is beautiful and necessary, and that's how we adapt so beautifully to demands. And, uh, shifting up and down is so important, but we lose that ability to, to quickly downshift. And when we're under chronic stress, we can't even upregulate the stress response normally. We get a blunted stress response. So acute stress is a different animal.

5. 9:40 – 12:37

   The four mind states: Red, Yellow, Green, Blue (a simple stress map)

   1. EEDr. Elissa Epel9:40

      And let's talk about normal daily acute stress. It is our friend. It is our body being excited and responsive and enabling us to really a- adapt flexibly to demands and perform well. So that's the red mind state, is that acute stress, um, that's healthy, and we have it every day. Now, when we, of course, are having that too much or we're in these situations where we just can't let down, um, we are under chronic stress. And of course, that's, as you've described in your book, where the wear and tear on biology, on telomeres and every other regulatory system happens. When we can downshift from this acute stress response, we get into yellow mind state, and that's where the majority of time is spent for most of us living in an urban, stressful environment. The yellow mind state is pervasive, moderate, sometimes invisible cognitive load. So this is a subtle chronic stress state that we're used to. That's the one we don't notice. And so shifting out of yellow mind state to a healthy, acute stressor like exercise or down to relaxation is really important, thinking about moving our stress response system. I call that stress fitness. We wanna move flexibly through the day. We don't wanna stay in yellow mind. Of course, we don't wanna stay in an acute stress response either. The stress response is extremely expensive energetically. It uses up so much ATP or en- energy, and so it's exhausting. By the end of the day, if we've had a lot of these w- peak red mind states, we will inevitably feel exhausted and depleted, and that's why it's so important to have these, these breaks during the day and getting out of red and yellow mind. Green mind is a state of relaxation. We love to call it green mind to remind us that nature attunes us toward, uh, automatic or, or let's say, passive relaxation, that we don't have to work hard to have our body let down the stress response and release when we are in a natural environment, and we feel safe. And then the blue mind state is the state of deep rest, and I really think that there's magic to blue mind states. Biologically, this is when we release the most powerful healing mechanisms in our cells, and this is also the state that we get the least. So if you look at your typical week, Rangan, how much do you spend in blue mind states during the day?

6. 12:37 – 17:38

   Morning/evening ‘bookends’: priming the nervous system and improving night recovery

   1. RCDr. Rangan Chatterjee12:37

      Well, I'll tell you the sort of things I do each day. You can tell me if any of these are blue mind. I have a little morning routine, and the first thing I do in that morning routine is I meditate for usually 10 minutes, sometimes 15 minutes. I will usually have two to three walks throughout the day. Sometimes they're only 15 minutes, but it's just my way of, you know, managing my blood sugar and managing my stress load and that kind of stuff. And I will not work in the evenings barring exceptional circumstances. So that's maybe given you a flavor of the kind-

   2. EEDr. Elissa Epel13:08

      Yeah

   3. RCDr. Rangan Chatterjee13:08

      ... of things I do, but I don't know how much of that would be blue mind versus green mind.

   4. EEDr. Elissa Epel13:13

      Right. It's a beautiful, um, rhythm of the day, and you're integrating so many of the, the critical microinterventions in that day. What I really do think of the window right after we wake up and before we go to bed as these critical periods where we really impact our stress response system. In the morning, we prime it for the day. We're either building in a resilient, a cushion of resilience for the day with some practices that set our nervous system up for lower reactivity and more stability and equanimity. And at the end of the day, we're priming our nervous system for allowing us to release and restore, releasing unconscious stress during the night. So it's amazing with these wearables how we can see how we hold onto stress during the night in our nervous system. We've been looking at that in some of our studies. How much does our, our vagal tone, our heart rate variability respond to the deepest stage of sleep? How low can it get, and what practices promote that? So well, daily slow breathing, for example, we have found is, is very important for allowing us to reach more deep rest states during the night. So very short periods of slow breathing during the day when we respond with more vagal tone during the night, this is incredibly helpful for relieving depressive symptoms and boosting our mood. Um, we- that's one of the, the analyses we're currently working on. But to back to your question, what, what are these mind states, and how do they map onto your day? So in the, uh, starting off with these practices that allow us to look into the mind with awareness, mindfulness, mindful movement. So body practices are just as effective as, um, let's say, psychological or cognitive practices. They, um... I would say g- green mind states when we're attuned and in flow would be the common theme in your practices. And the deep rest that, that we were trying to define, I really reserve that for lying down practices that are passive when we literally allow ourselves to release and let go and not exert effort. So that would be something like yoga nidra, visualization, listen to music, lying and resting. Resting, not ruminating. Um, something that allows, uh, our body to truly have a break. And of course, there are flow states when we're engaged in hobbies or being in nature that are, that are, let's say, light blue mind states, where we're not necess- We're still active, but we are, our body's getting signals we're safe right now.

   5. RCDr. Rangan Chatterjee16:17

      Yeah.

   6. EEDr. Elissa Epel16:17

      It's, uh, t- time to relax. It's okay to relax right now. And our cells are getting physiological signals that we don't need to be creating proteins to, uh, fight viruses, you know, to keep our immunity up and to keep our stress response up, and that's the exact profile of what our cell's doing or the, the proteins that we make that we see during a meditation retreat. So in meditation retreats, when we look at gene expression, we see that the body shifts toward, uh, during a multi-day meditation retreat, so a week or less, the body shifts into creating more proteins for cell restoration like telomerase and mitochondrial function and less of the proteins that are toward building up immunity and mounting the stress response. So we get that shift toward what we call growth maintenance and repair genes or the healing process when we rest. And if we're ripping ourselves off of relaxation and we're not getting deep rest, we are aging faster.

7. 17:38 – 23:48

   Why you can sleep 8 hours and still feel tired: pre-sleep arousal and deep sleep quality

   1. RCDr. Rangan Chatterjee17:38

      Yeah. So one thing, Elissa, I'd noticed over the years is sometimes patients would say, "I slept for seven or eight hours last night," but if they didn't switch off before bed, they woke up feeling exhausted. So that could have been that they were keeping their mind active in some way, stimulated. It could be they were doing some work emails before bed, or it could be a variety of different things. First of all, I'd love your comments on that, and secondly, would you say that just before we go to bed, it would be a good idea for us to try and get to that deep restorative blue mind state a, a, almost like a daily habit?

   2. EEDr. Elissa Epel18:28

      I think it's a brilliant place to intervene. It's, as you said, it's the bookend that we control right before bed. It is the ability to allow our nervous system to descend into a relaxed state before sleep will directly affect our sleep physiology to be more restorative.

   3. RCDr. Rangan Chatterjee18:53

      Hmm.

   4. EEDr. Elissa Epel18:54

      So some people think, "You know, my, my head hits the pillow, I fall asleep right away. I don't need to relax before sleep." The bottom line is a lot of that's your homeostatic drive for sleep because you have a sleep debt, right? So you don't have trouble getting into sleep, you probably underslept. But what is your nervous system saying to you while you sleep? It may be saying, "Well, I need to stay vigilant, and I need to continue problem-solving, and there's still, um, a lot of work to be done, and so we need energy. We need to be burning ATP instead of, of restoring and creating it." So we can measure that now with these wearables. It's quite remarkable. When we can l- create a decrease in our arousal from, from our more yellow mind state before sleep, we are allowing our parasympathetic nervous system to get a head start on reaching its nadir, its lowest level of arousal. That happens during deep sleep. And so during sleep in general, we wanna have this release of stress. This is when we reset our metabolism. We, we develop more insulin sensitivity. We get out of that insulin-resistant or pre-diabetic state that we might have been in from stress. We reset. Um, it's also when growth hormone and anabolic hormones that restore and promote growth-

   5. RCDr. Rangan Chatterjee20:33

      Mm-hmm

   6. EEDr. Elissa Epel20:33

      ... depending on what stage of our life. When we're younger, promoting growth; when we're older, repairing and restoring. So these, only, uh, some of them, like growth hormone as adults, mostly appear during the night and not during the day. So we just wanna protect that restorative period. It's precious. I think some of us are just worse sleepers in general, and so we need to work a little bit harder. But I guess my point is chronic stress can, as, as we were talking about at the beginning, reset baselines. It can rewire things so that our body is now, even in its rest state, still in a somewhat chronically stressed state, and that will... We'll see that in our sleep. We'll see that in our food choices-

   7. RCDr. Rangan Chatterjee21:16

      Yeah

   8. EEDr. Elissa Epel21:17

      ... um, even in our ability to, like, really connect and relax when we're in social-

   9. RCDr. Rangan Chatterjee21:22

      Yeah

   10. EEDr. Elissa Epel21:22

       ... situations and relating to other people.

   11. RCDr. Rangan Chatterjee21:24

       You mentioned the term parasympathetic before. For, for people who are not familiar with these terms, w- we're, we're talking largely about the two main branches of the autonomic nervous system, the sympathetic, which is the sort of stress, fight or flight arm of our nervous system, as opposed to parasympathetic, which is the rest and relaxation part. Is one way to think about red and yellow that they're sort of different gears of the, the activated stress state? So gear one is yellow mind, where you're slightly activated, and, and red mind is sort of when you're full-on activation. And, and can we say the reverse for green mind and blue mind? So green mind is a little bit of relaxation, w- you know, I think what you've called relaxed engagement. But then if you really wanna go to gear two of relaxation, you need to hit blue mind, which is, I think you wrote in your book that this is where you have a profound sense of safety around you as well. In fact, did you say that safety signals around you are prerequisites even to enter blue mind state?

   12. EEDr. Elissa Epel22:33

       Right, and that was a big emphasis in our r- research paper led by Alexander Croswell on blue mind states. This idea of really being able to turn on restorative physiology partly depends on our perception of safety. For us to really be able to let down our guard, we need to feel that sense of physical and social safety. Once we feel that, we can actually really shift gears into that state that we call, um, better than relaxation, that deep rest state. The parasympathetic nervous system inhibits the sympathetic nervous system or the stress response, and so when we feel stressed, we release the parasympathetic nervous system. We have lower vagal tone. That's how we get this big boost in sympathetic activity. But back to your question. Yes, the parasympathetic and the sympathetic nervous system mostly map onto these mind states in the way you described.

8. 23:48 – 29:07

   Safety signals, neighborhoods, and inequality in deep rest and cellular aging

   1. RCDr. Rangan Chatterjee23:48

      As you were speaking there, Elissa, three thoughts came to mind which, um, I hope you don't mind me sharing. The first one was about the socioeconomic discrepancy we see with health outcomes. So depending on where you live, certainly here in the UK, and I'm sure it's the same in America, your life expectancy can be as much as 10 years different depending on where you live, and there are all kinds of factors that play into that, right? No question. But one of the factors I was thinking about as you were talking there was to do with safety signals. If we're saying- That a prerequisite to get into deep restful sleep which will restore us is to try and get into blue mind. But in order to get into blue mind, we need to have safety signals around us first. That it stands to reason that there will be populations living in dangerous areas, noisy areas, police sirens going on around them. That's gonna be very, very hard for these people to achieve, right? Second point was this idea that I believe that there may well be many people now, because of our busy modern lives and because technology has basically obliterated the boundaries between work life and home life, I reckon there are some people out there, or many people out there, who may go weeks without ever experiencing blue mind, okay? Which is really quite remarkable. What's your take on that?

   2. EEDr. Elissa Epel25:31

      I think it's the hidden epidemic, the, the disappearance of true relaxation. It's cultural. I mean, there are definitely societies that still keep the siesta and have a healthier relationship with time and with, um, how much they value social and leisure time. But in general, we tend to commoditize time. We view time as money. We pack in as much as we can of, of doing and achievement into our, you know, our minutes and our day. And so physiologically, we are really, uh, deficient in the natural and normal flow of the diurnal rhythm's need for rest, right? We should, in the afternoon be, when we're low energy, be allowing ourselves to have that, uh, nadir of activity in the day.

   3. RCDr. Rangan Chatterjee26:32

      Mm-hmm.

   4. EEDr. Elissa Epel26:32

      And w- many people, of course, h- don't have the degrees of freedom to have that. But like you said, controlling the weekends more, controlling the bookends of the day more can make a tremendous difference.

   5. RCDr. Rangan Chatterjee26:48

      Yeah.

   6. EEDr. Elissa Epel26:48

      So the socioeconomic status absolutely patterns the amount of not just chronic stressors, but danger signals in n- in, in neighborhoods, noise, crime, uh, the lower levels of kind of trust of neighbors, knowing neighbors and social capital, those all matter so much for individual health. So knowing someone's zip code helps you predict things like their weight, their body mass index, so level of obesity, but also telomere length. We know that neighborhoods actually are a predictor of how short our telomeres become in, in adulthood and mid-adulthood. So these studies are fascinating on neighborhoods. Things that matter that come to the top are feelings of safety, um, the, what we call deprivation, neighborhood deprivation. So these measures of how much a neighborhood has things like, uh, grocery stores and community resources versus not having these, these resources. Aesthetics is another aspect, or the, uh, level of green, n- parks and trees is another thing we measure in neighborhoods.

   7. RCDr. Rangan Chatterjee28:17

      Mm-hmm.

   8. EEDr. Elissa Epel28:17

      And, uh, in some studies that's starting to be measured and being related to cellular aging. So this study that I love in Hong Kong, um, they compared the suburbs of Hong Kong, which were, like, literally, um, green hills and a tremendous amount of natural land versus this very dense urban area, and they looked at city dwellers, and they controlled for socioeconomic status, like at indivi- at the individual level, like education and income, and found that there were significantly longer telomeres in the people that lived in the green area versus the urban area. And of course, there's many studies on urbanization in the brain, the, the stress response, showing that the amygdala is more hyperresponsive in people who live in urban areas.

9. 29:07 – 34:04

   Practical pre-bed blue-mind routine: reduce screens, condition the body, slow the breath

   1. RCDr. Rangan Chatterjee29:07

      Yeah. In terms of practical interventions then, if we just laser focus in on that window before bed. Okay? So sleep, of course, is a great time for the body to restore itself and to, uh, rejuvenate itself. But of course, one of the things that we're talking about that is gonna determine what your sleep physiology becomes is what state are you in just before going to bed. In terms of trying to recommend things to the listener who might be thinking, "Well, I don't sleep particularly well. Normally I'm sort of in bed just scrolling Instagram, and, um, I feel that's relaxing before I go to bed," but let's say that that person's thinking, you know, "Should I be doing something else?" What kind of recommendations do you have for people to try and get themselves into blue mind before they go to bed? I've been using Bon Charge wellness products for over five years, from red light therapy to infrared sauna blankets to blue light glasses, Bon Charge make it really easy to get healthy while staying at home. Now, one of my favorites is their infrared PEMF mat. It uses pulsed electromagnetic field technology to send gentle magnetic energy into the body and helps me feel more grounded and relaxed, quite similar, I would say, to spending time in nature Now, I personally like using this mat in the evenings whilst reading or relaxing to help switch me off before bed. So if you're looking to take charge of your health at home, I highly recommend you consider adding the infrared PEMF mat into your daily routine. Bon Charge are giving my audience 20% off all of their products. All you have to do is click the QR code on screen or go to boncharge.com and use the code LIVEMORE to save 20%.

   2. EEDr. Elissa Epel31:15

      I really admire people who leave their phone in a different room or even a different floor, you know, floor. Um, most people are looking at their phone, and it-- we use the screen for so many things that it's very easy to have excuses and then to flip right to social media and to scrolling. And there's no question that even if it's rewarding in the short term, and it feels good, and it fills time, it's activating threat responses. We're just bombarded by so much information, uh, exponentially more information than our brains are used to even ten years ago-

   3. RCDr. Rangan Chatterjee31:59

      Mm-hmm

   4. EEDr. Elissa Epel31:59

      ... just the amount of stimulus. So clearly, uh, having this protected period, as you describe, two hours is wonderful when you can do that, where you are shutting down the doing mode from work. You know, may-maybe making a to-do list of what you need to do the next day, not talking about work with people at home, um, having less blue light, so less, less screens. And then what you do with that time, that, that ritual is so individual and personal. And so I can list off ideas and some of the things I do, but really just having one or two things that your body is conditioned to do is the trick. Because when our body gets the signals, sensory signals, lighting signals, where we are in our house, it starts that wind-down process. Like the nervous system-

   5. RCDr. Rangan Chatterjee33:02

      Mm-hmm

   6. EEDr. Elissa Epel33:02

      ... is absolutely sensitive to, um, routine order and conditioning. So for example, I will come into our bedroom and set it up by creating a, um, a change in lighting. I will put on a, um, aromatherapy diffuser, lavender or, you know, different mixes, but lavender is, is clearly one of the more relaxing aromatherapy, um, interventions, and, and music. And so right there, that's a completely different sensory environment. Adding some, some yoga poses that are restorative or stretches might be part of someone's routine if they-- especially if they haven't moved much that day. You can even do it in bed if you're that tired. You can do forward bends, um, while, while sitting. So wh--

10. 34:04 – 42:20

    Awareness tools: subjective stress, emotional granularity, and when tech helps (or hurts)

    1. EEDr. Elissa Epel34:04

       some of the big guns that I'd use, I, I, I love to be technology-free, but the truth is these biosensors, when we benefit from them, are a whole new source of information. They promote a whole new level of awareness of where our nervous system is at, which is otherwise invisible to us. We may, uh, think we know how stressed we are, but unless we're measuring it, we don't know. Our feelings of stress are not tightly correlated to our nervous system physiology. So that's kind of a foundation of stress science that we need to measure both. And you first asked me, "What is stress?" So s- so at a, at the subjective level, we all know that what stress feels like. We may be feeling overwhelmed, worried, alarmed, threatened, anxious, tense. All of those subjective feelings are very important. We need to check in with ourselves and say how, um-- what is my level of stress right now? So that's just a tool we don't use enough. That's an immediate check-in. But even more advanced and powerful is getting a layer below, below those feelings of stress. You know, that first sense of is my alarm on or off to various extents. The second layer that's much more powerful is emotional granularity. What, what are the different emotions that I'm feeling right now, and why? So that's a, that's a deeper s- uh, dive into data collection about our mind-body state, 'cause emotions really inform us about how we're feeling and why, and by naming it, we tame it. As Dan Siegel says, "We name it to tame it." So when we can actually do a quick mindful check-in, what am I feeling in my body? What are the, uh, different emotions I-- that might be predominant right now? That check-in is very powerful. That can get us from red or yellow mind closer down to green. Just knowing, just awareness. We're not necessarily going to de-stress ourselves with emotional labeling, but we are going to turn off that alarm, that, that diffuse, uh, let's say nondescript alarm that keeps us stressed.

    2. RCDr. Rangan Chatterjee36:32

       Yeah.

    3. EEDr. Elissa Epel36:33

       Um, so the gadgets. So I use the-- Right now I've got something, um, on my arm that is something I've recently been trying, which I actually really like. Uh, this is called the Apollo Neuro, and it does give very subtle- Um, gentle vibrations to the body that feel calming to some people. So, so I'm particularly responsive to this, and you can wear it at night as well. I like to, uh, also, during tough periods, use a biofeedback monitor right before bed. So it's... I have it right next to my bed. HeartMath is a really easy one where you, you unfortunately do have to use your phone, but you can look at how your nervous system is responding to your slower breathing, and you can do visualizations. You can imagine warmness or kindness in your heart or other visualizations that allow you to feel release.

    4. RCDr. Rangan Chatterjee37:44

       Mm-hmm.

    5. EEDr. Elissa Epel37:45

       And more of a loving tone, like bringing in kindness, kind thoughts, and love, and that just softens everything. And you can actually watch this little monitor and see if your vagal tone is increasing. Now, there's some proprietary formula for HeartMath in particular, but in general, what we're trying to do is increase our heart rate variability. You know, the bottom line, Rangan, is just slowing our breathing. Like, if there's just one thing that we all tend to do right before bed that works for most people, it's just slowing the breathing.

    6. RCDr. Rangan Chatterjee38:24

       Yeah. It's crazy, isn't it, to think that something so simple, which is just a body scan, which has been shown, I think from your research and other people's research, to have a profound impact on our stress response and therefore our ability to fall asleep. But I, I think the key thing is, is that many of us are so disconnected from our bodies now and our ability to sit with it and, and, and sort of understand ourselves. I do think for many people, some kind of external monitor that gives you that feedback so that you go, "Hey, you know, I know I feel better when I've slowed my breathing down, but, oh, I can also see that my nervous system state is different." I really do feel for so many people who struggle to relax and switch off. This could be a game changer, and I personally have not tried this stuff before, but you're saying you have tried it and you find it very useful.

    7. EEDr. Elissa Epel39:24

       I use it on and off. So there's this tension between the, the reality that if we can be more tuned into our body, increase our t- interoceptive awareness, our, our reading of the body sensations, our awareness of the feelings and signals from our body, that is so powerful, and we don't need technology to do that if we're being mindful-

    8. RCDr. Rangan Chatterjee39:50

       Mm

    9. EEDr. Elissa Epel39:50

       ... and doing these check-ins. So where are we placing our tension? Right now, if, if you just l- tune into your body and notice sensations, tension, that just automatically slows our breathing, right? We just all of a sudden are getting into our sensory world. Very, very powerful. It's almost impossible to be really worried and cognitively stressed and problem-solving while at the same time focusing on our breathing or releasing our muscle tension.

    10. RCDr. Rangan Chatterjee40:28

        Mm.

    11. EEDr. Elissa Epel40:28

        So shifting to the se- something sensory, could be nature, petting our dog, tuning into our body, giving ourself a hug. Big shift. We can do that for free. It's cheap. No technology needed. That's the tool we want. But boy, we need extra help. It's really hard these days. We are so bombarded by stressful things in the world and in our personal lives. I t- I'll accept all the help I can get. So I, you know, I use things like HeartMath Monitor on and off. I recently had a conversation with Jon Kabat-Zinn, who has been, of course, practicing and teaching meditation most of his... all of his adult life, and I'm a big proponent of Aura. I'm also one of their science advisors, so that's my disclosure, um, for measuring stress in the body. And so I was telling him how exciting it is [laughs] to be able to, on a daily basis, I look forward to looking at what did my nervous system do during sleep, and, you know, what was my stress response when this or that happened. And at the end of the conversation, he said, "You know, that's, that's wonderful, but I would never need that because look at this. This is what I've been doing my whole life, this reading my body."

    12. RCDr. Rangan Chatterjee41:48

        Yeah.

    13. EEDr. Elissa Epel41:48

        You know? And so that enhanced dedication to, uh, paying attention to the whole of us and interoceptive awareness is, uh, supersedes and overrides our need for technology, but most of us are not being that mindful, and we need that.

    14. RCDr. Rangan Chatterjee42:06

        Yeah.

    15. EEDr. Elissa Epel42:06

        Could benefit from that help. Although I do wanna say, Rangan, that about 30% of people, that's probably a high estimate, do not benefit from monitoring their sleep. It makes them more neurotic and anxious.

    16. RCDr. Rangan Chatterjee42:17

        Yeah.

    17. EEDr. Elissa Epel42:17

        So this is definitely not for everyone.

11. 42:20 – 47:33

    What to track with wearables: trends, recovery, and cumulative stress (not daily ‘scores’)

    1. RCDr. Rangan Chatterjee42:20

       What would you say, Elissa, for people who do have wearables, w- you know, whatever brand they've chosen to get, what are the key things that you would like them to look at to help them understand the impact of stress on their bodies?

    2. EEDr. Elissa Epel42:35

       Hmm. It's a great question. I think wearables are great for increasing our awareness for limited periods, where we can actually become aware of how our exercise habits, our sleep times, all of these are things are affecting our nervous system. And for people who love to wear it all the time, I rarely take off my Oura Ring, that's fine. But the real goal is to increase the synchrony, the, the, the attunement that we have with our body, and know what intervens- daily interventions, nudges, micropractices help us. And then stop monitoring, right?

    3. RCDr. Rangan Chatterjee43:23

       Mm-hmm.

    4. EEDr. Elissa Epel43:23

       So once we know, we know. I mean, it's beautiful that you can gi- give yourself this holistic, "Here's where my mind-body complex is at today. So maybe I wanna be more gentle, maybe I need to do more self-care, or maybe I'm ready to, like, seize the day." Um, that's, that's the goal-

    5. RCDr. Rangan Chatterjee43:42

       Yeah

    6. EEDr. Elissa Epel43:42

       ... really, right? Not to depend on wearables. I really feel more strongly about that when we think about glucose monitoring. Glucose monitoring can drive you absolutely crazy. When you, when you put in a continuous glucose monitor and you can see how your glucose responds to everything you do, [laughs] to your sleep, to every meal, um, to stress eating. I fi- I've been so amused by how dramatic my glucose, uh, responds to when I haven't had enough sleep and I'm stressed about something, and if I eat the wrong thing, boom, I'm, like, in a pre-diabetic state. So I study that. But seeing that, oh, that happens to me, too. It doesn't matter that I'm skinny and that I think I do the right things, we are all vulnerable to these laws of stress physiology. And especially as we, as we age, we're, we're more vulnerable. We all tend to get a bit more insulin resistant-

    7. RCDr. Rangan Chatterjee44:40

       Yeah

    8. EEDr. Elissa Epel44:41

       ... as we age. So the glucose monitoring, I think, is an invaluable tool for looking inside. Of course, getting a fasting glucose, uh, a- as, um, as you could describe much better than I can, um, the knowledge about whether we're pre-diabetic when we wake up after fasting is the most important knowledge, the levels of fasting insulin glucose. And so that's step one. Everyone should know their fasting insulin glucose. But even if you're not pre-diabetic, knowing when you are having huge insulin and glucose spikes because of your dietary patterns or timing of eating is also invaluable. That's kind of a, an optimized way of thinking about really promoting metabolic sensitivity and enhanced functioning in our older years.

    9. RCDr. Rangan Chatterjee45:41

       Yeah.

    10. EEDr. Elissa Epel45:42

        Now, I'm just gonna answer the rest of your question about what to monitor.

    11. RCDr. Rangan Chatterjee45:46

        Okay, sure.

    12. EEDr. Elissa Epel45:46

        When we look at a, a biosensor for stress, we're just measuring physiological stress. This has, uh, some relationship to our emotional stress, but that correlation is usually pretty weak. So when we look at daily stress, we're looking at arousal from positive things like socializing and activity and, uh, engaging in challenging activities even more than it's reflecting emotional stress. So daily stress I don't take too seriously when I look at a biosensor. I do like to make sure that I'm not staying in the high arousal zone all day. You wanna see a lot of up and down. You wanna see that, uh, green mind state be present and manifest at different times throughout the day. The nice thing about these wearables is that they're moving more toward longer-term monitoring so that we're really focused on what's our trajectory. Are we in a high-risk zone with, with the way we've been sleeping and with the way our nervous system has been working over the last weeks or months? So for example, Oura has a measure called cumulative stress that is, has been trained on, uh, the measure of burnout and chronic stress by people's lived experience. So they've trained this metric of cumulative stress based on, uh, people who are experiencing high levels of chronic stress and burnout. So that's a very valuable and meaningful metric, and we want to try to monitor that in a monthly fashion to make sure that we're staying in a lower-risk zone.

12. 47:33 – 59:07

    Mindful eating in pregnancy: improving maternal glucose, mood, and child stress resilience

    1. RCDr. Rangan Chatterjee47:33

       One thing I did wanna talk to you about is your study on mindful eating in pregnancy. I thought it was quite profound because from recollection, there was an impact on blood glucose and also things like cortisol and moods. Could you just walk us through it? What, what it was and what the, what it found?

    2. EEDr. Elissa Epel47:51

       We've been very interested in using mindfulness and mindful eating to help people right before they're eating, when they're starting to feel cravings and hungry, to bring in the ability to determine, is this real hunger? Is this craving about boredom or sadness, or is it that I really need calories right now and I should have a meal? So just that check-in, interoceptive awareness really, about true hunger versus emotions disguised with hunger. We can easily feel cravings and feelings of hunger when we're stressed, and even sadness can increase cravings and hunger. So we really get mixed signals. They're very tied up together, stress and eating. For many people, especially if we have excess weight, stress triggers feelings of Desire to eat, but it's not true physiological hunger. And so how do we get below that? How do we really fine-tune our ability to determine if we, if it's a good time to eat and to restrain and inhibit overeating? That's not easy. We all struggle with that. We know that it's normal for stress to trigger our, um, strong drive to get dense calories. Um, sweets and fats definitely are our biological signal for dense calories. So how do we get beyond that? So for years, we've been training people in mindful eating and these mini meditations right before they eat to really discern whether they are going to choose to eat and what they're gonna choose to eat and how much. So really helping people, in a sense, develop some metacognition and control. It helps. Mindful eating helps. It tends to help reduce dysregulated eating and insulin and glucose spikes, and it doesn't necessarily help with weight loss, but it helps with inner health and metabolic health. That's what we care most about. That's what is, matters most for health, not necessarily what the scale says, but rather how stable our glucose is. We wanted to test if mindful eating could help women during pregnancy, a time when there are very strong cravings and a time when it's very easy to gain excess weight, more weight than is healthy and needed. So we, we enrolled some volunteers, women who were already overweight and were early in their pregnancy. We found 200 pregnant women and randomized them at, in different ways, different groups of 10, to a mindful eating and stress reduction group or to treatment as usual, uh, a control group, which is, um, just their, their usual medical care. And we found that within that first two-month period when women were getting weekly training together in mindful eating and mindful stress reduction, that their glucose became much more normalized. They had reductions in impaired glucose tolerance during pregnancy than women in the control group. And then we followed these women out through their pregnancy, and my colleague Nikki Bush followed the babies for another eight years. And that was quite remarkable because we found that not only did the women benefit in stress and depression and m- metabolic health, but that every year later, all the way up to eight years later, they remained lower in depression and stress. And their babies came out with more stress resilience in their own nervous systems. When they were stressed out in the lab, they recovered more quickly.

    3. RCDr. Rangan Chatterjee52:22

       And this is incredible hearing that. I mean, so you're essentially taking a cohort of pregnant women, teaching them about mindful eating and, you know, more awareness before they eat. Is this physical hunger or is this emotional hunger? And that's having an impact on their glucose control, their stress levels, their mood, which you can see even seven or eight years later, but it's also having an impact on the fetus. And so when the fetus is born and is a baby, the stress resilience of that child is improved. I mean, this is quite profound, Elissa, what you're saying. What, what, what do you think was going on in that study? I mean, what was the change that occurred that led to all of these quite phenomenal results?

    4. EEDr. Elissa Epel53:18

       Yes, that's the big question, and we absolutely n- need to study this further to really understand the mechanisms, but we're so excited. We know that the benefit is high of this, uh, group training, and the risks of it are low or nonexistent.

    5. RCDr. Rangan Chatterjee53:37

       Yeah.

    6. EEDr. Elissa Epel53:37

       And so it's so important for hospitals and healthcare systems to know about not just offering mindfulness for stress reduction, but for this very critical period for pregnant women, that this is potentially creating tremendous neuroplasticity in the mom's brain and e- eventually, it looks like in the developing fetus, as you said. We just don't know exactly what led to all these benefits. So the mom is creating an intrauterine environment that's healthier, less metabolic stress, less, um, physiological stress in terms of the, of her perceived stress being lower. Her physiological-

    7. RCDr. Rangan Chatterjee54:24

       Yeah

    8. EEDr. Elissa Epel54:25

       ... stress is then presumably lower. Her glucose is at a much more healthier level during those months of development. So there was that prenatal priming or, um, p- you know, period of critical development that may have contributed to some of the offspring benefits. They also came out with less, um, really early excess weight in the babies too. It could be that the moms were then using these stress resilience skills as they're parenting in those early months-

    9. RCDr. Rangan Chatterjee55:02

       Yeah

    10. EEDr. Elissa Epel55:02

        ... when things are so stressful.

    11. RCDr. Rangan Chatterjee55:04

        Yeah. I mean, one thing we do know from other pieces of research is that how stressed a parent is around, you know, d- well, during pregnancy can impact the child's stress resilience and have a long-term impact on that. And I don't say that to make anyone feel bad. You know, everyone's doing the best that they can. Sometimes we do have stressful lives when we're pregnant, but there are some cultures out there who do prioritize rest. Okay, we know, for example, in Denmark, which is regarded as one of the happiest nations in the world, I've spoken to quite a few Danish people before who say in a lot of the offices, you leave at 4:00. That is alien in the UK. It's even more alien, I would say, in the US. My perception of America is that there is a real go-get-them work culture, don't stop, don't get much maternity. You know, as soon as you can, let's get back to work. And again, I'm not here to, to criticize or judge. It's just an observation that different cultures clearly prioritize different things and, and the, the different things they prioritize lead to different consequences.

    12. EEDr. Elissa Epel56:20

        Absolutely. And really, the culture, the beliefs, the common values, that is the, the most important lever in determining are we a healthy country or-

    13. RCDr. Rangan Chatterjee56:34

        Mm

    14. EEDr. Elissa Epel56:34

        ... a sick country.

    15. RCDr. Rangan Chatterjee56:35

        Yeah.

    16. EEDr. Elissa Epel56:36

        And there is good data now that the shorter workday, the shorter work week can be just as profitable, and everyone's happier-

    17. RCDr. Rangan Chatterjee56:47

        Yeah

    18. EEDr. Elissa Epel56:48

        ... and healthier. And so the more those studies come out, I think the more businesses will stop this thinking of time as so linear with profit, and understanding that, that human potential and wellbeing is the real resource to invest in.

    19. RCDr. Rangan Chatterjee57:06

        Yeah. Have you tried to meditate before? Perhaps you've heard about some of the benefits, like reducing stress and increased focus, and you've given it a go and thought it's not the practice for you. Well, I believe that may well be because you have not tried the right approach. THE WAY is the only meditation app with a single long-term pathway. You're not forced to make loads of choices each day. Instead, you're guided on an enjoyable and progressive journey that deepens your practice step by step. Since I partnered with THE WAY, I have had so much positive feedback. One listener said, "Dr. Chatterjee, I came to THE WAY through your podcast. I have tried other meditation apps in the past with limited success, and like the idea of following a single guided path. I'm nearly two months in now and loving it. Henry's gentle and concise approach is very calming, and THE WAY is now a part of my morning routine." You see, that's the sentiment that so many people report when they start meditating with THE WAY. For listeners of my podcast, THE WAY is offering 30 free days to establish your own meditation practice. All you have to do is click on the QR code on screen or go to thewayapp.com/livemore to get started. I guess if I zoom out, you've made it clear that acute stress is not inherently bad. We need acute stress to function at our best. At the same time, that chronic, nonstop, unrelenting stress is what ages us faster and increases our risk of all kinds of chronic diseases, including dementia, cancer, autoimmune disease, heart disease, and, and the like. But with that backdrop, we're thinking about what are the practices that we can do to help reduce that? So you mentioned that critical window

13. 59:07 – 1:05:04

    Joy, connection, and culture: micro-acts of joy as a shortcut to lower stress

    1. RCDr. Rangan Chatterjee59:07

       before bed and how breathwork, for example, or slowing your breathing down, doing a body scan can be very helpful. What have you found in terms of the relationship between joy and the stress response?

    2. EEDr. Elissa Epel59:23

       There's a large literature on positive psychology showing that there are many things we can do to boost our positive emotion, and that, that actually is a shortcut to reducing stress. Boosting positive affect in healthy ways makes us feel stress less. It makes us perceive things as less stressful. And so this is this huge opportunity to boost our wellbeing without focusing on symptoms of stress and depression. In one study, we decided to test whether these short behaviors that produce bursts of positive affect would produce additive effects over the week, and would they really increase deep wellbeing, the purpose and meaning and greater intimacy in relationships that people can feel? We call that emotional wellbeing, and that's almost independent of feelings of stress and depression. We can have flourishing even when we're suffering and struggling with stressful situations or chronic illness or intermittent depression.

    3. RCDr. Rangan Chatterjee1:00:40

       Yeah.

    4. EEDr. Elissa Epel1:00:40

       So we want to boost and focus on these positive aspects of life, and we can increase positive affect within minutes, just like we can reduce stress within minutes. So we tested out a handful of these micro acts of joy, being kind to a stranger, um, talking with someone about something they're, they experienced recently that they're proud or happy about-

    5. RCDr. Rangan Chatterjee1:01:04

       Mm

    6. EEDr. Elissa Epel1:01:05

       ... and really experiencing their joy with them. We had other ways of inducing joy, like gratitude, making a short gratitude list. And we studied this in about 20,000 people over a week, and anyone can try this platform of micro-acts of joy. We still are collecting data for our studies, so you could just type in The Big Joy Project if you want to try this. What we found were several things. Number one, even in this remote massive study, when people read about how to try out this micro-act of joy, it boosted their positive affect to various extents, but that positive affect often lasted through the evening. When we again measured their feelings of positive and negative emotions, we see lasting effects. And over the week, we see a buildup of joy, this positive cycle where the next day when they woke up, they actually felt a bit more positive-

    7. RCDr. Rangan Chatterjee1:02:13

       Mm-hmm

    8. EEDr. Elissa Epel1:02:13

       ... than the previous day. So that was a beautiful shift, really, in their baseline emotional tone.

    9. RCDr. Rangan Chatterjee1:02:21

       Yeah.

    10. EEDr. Elissa Epel1:02:21

        And at the end of the week, we found improvements in feelings of altruism and prosociality. So this social aspect of joy, helping others, being kind, uh, sending love and kindness, these are very powerful, and they increased how much people felt like they wanted to make sacrifices so that others could live a better life.

    11. RCDr. Rangan Chatterjee1:02:53

        Yeah.

    12. EEDr. Elissa Epel1:02:54

        So that's remarkable, that love, that, um, kind of attitude of altruism, that we could change that just with these small boosts in positive emotion.

    13. RCDr. Rangan Chatterjee1:03:02

        Yeah. And what a wonderful prescription from a stress researcher or a doctor to say, "Do things that you enjoy," [laughs] right? You know, a lot of the time people think about health as being things that, "Oh, I've gotta not have this and not eat that." And actually, I, like you, for many years have been trying to promote joy. I remember maybe 10 years ago reading a research paper showing us that people who regularly do things that they love are more resilient to stress, and it kind of echoes very nicely with what you just said and what your study is showing. And of course, what I find joyful may be different from what you find joyful. And in terms of that prosociality and our desire to be kind and considerate to the world around us, it, it just seems to be such an important thing for us all to focus on at a time when the world can sometimes seem quite divided. If we can have fun more and do things that we enjoy more, it's probably gonna then magnify out into a more cohesive society because we're going to be nicer to the people around us.

    14. EEDr. Elissa Epel1:04:16

        Absolutely. I couldn't agree more. I think that the in- the focus on individual health and individual mental health is really limiting us from seeing the potential of-

    15. RCDr. Rangan Chatterjee1:04:34

        Yeah

    16. EEDr. Elissa Epel1:04:34

        ... actually how the big levers, the big effects are about how we help each other-

    17. RCDr. Rangan Chatterjee1:04:41

        Yeah

    18. EEDr. Elissa Epel1:04:41

        ... how we connect with each other. That feeling of safety we're talking about, like we can't fully relax unless we feel at least a bit safer, is all about social safety. Do we feel someone has our back? Do we feel connected? Is there someone that we can talk to when we feel really in need?

14. 1:05:04 – 1:19:17

    Perception changes physiology: threat vs challenge responses and learning reappraisal

    1. RCDr. Rangan Chatterjee1:05:04

       The final thing I wanted to talk to you about, Elissa, is probably my favorite topic when it comes to stress, which is our perception of stress. And one of the reasons I, I'm so passionate about this is because I feel that some of the quantum leaps in my own wellbeing and happiness and contentedness have come from my deep realization that most situations in life can be considered neutral. Most. And it's really the perception that we choose to take on that neutral event that determines its outcome on us. I know you've done some interesting work showing that our perception of stress quite literally changes the, the physiology of the stress response, which is, which is truly quite remarkable. And I think you talk about it in terms of a survival response versus a challenge response. So can you just speak to this area? Because I think there is a, a feeling out there that an event is either stressful or it's not stressful, but of course, the same event is not stressful to, in the same degree to every single person. So there is an interaction, isn't there, between the stressor and our internal state that ultimately [laughs] determines a huge part of whether this is stressful or not.

    2. EEDr. Elissa Epel1:06:31

       You just described it so well. It is about our perception of, of whatever is happening out there in our body. It's the story we are telling ourselves. What is our narrative? If we are seeing and embedding a situation with more threat and more danger than, than is really there, we are driving an excessive and unnecessary stress response, and that tendency to, to overattribute danger, threat- Is biologically conserved. It is our safety response. So we've got to have a lot of compassion and kindness and humor about the stories we tell because we're just, m-m you know, let's say the majority of us are just over-exaggerating threat, and even unconsciously all the time. So just asking ourselves, what is the story right now? And is that true? What are alternative stories? Is there... You know, what is the, the w- the likely outcome here? What is the worst outcome? Just that inquiry, just that curiosity is going to deflate our ability to catastrophize and exaggerate. And so just stepping back and, like you said, asking ourselves to take a, you know, realistic assessment of the situation is very powerful. But do you, um, Rangan, do you have any examples of when you had this realization that things were actually much more neutral than you were seeing? What was like a situation that you were able to reframe, or what we, what we say with our jargon, cognitively reappraise?

    3. RCDr. Rangan Chatterjee1:08:37

       Yeah. I mean, you know, if, if we had two hours left, I could, I could literally go through a whole series of them because that, there were just so many. And, and what I realized at the start, Elissa, is that initially it can be difficult to do in the moment. So often it would be in the evening where I'd reflect on my day and go... The question I would ask myself actually was, "Where today did you get triggered, Rangan, by the actions of someone else that were completely outside your control?" That was one of the questions I would ask myself.

    4. EEDr. Elissa Epel1:09:12

       Good. Ooh, that's brilliant.

    5. RCDr. Rangan Chatterjee1:09:14

       And once you start asking yourself this question regularly, it is amazing how many things you start to find. You go, "Oh, well, that email bothered me," and, "Oh, the person in the supermarket who did that started to bother me, and that driver." This is many years ago, right? And then you are- you go... And what I would do is I would go, "Okay, what's a different story you could put onto this situation?" Okay, the driver, what else might be going on with that driver? Were they really trying to irritate you? Or maybe it was a busy parent who was up last night with their sick child. Maybe it's, uh, you know, someone who's been late for work three times in the last six months, and if they're late again today, they're gonna be fired, so all they're trying to do is, you know, keep their job, which then pays for their bills and their house. So there's a whole number of things. But what, why that exercise was so powerful is because I learnt cognitively but also viscerally that there are multiple interpretations of every single situation, and I can train myself to choose a more empowering interpretation. And initially, you can't do it in the moment. You have to do it at night. This is my experience. But over time, you realize, "Oh wow, I'm doing it in the moment now." So the driver who cuts me up now, uh, while I'm driving on the motorway, generally speaking, I just smile. And so this goes to a question I had for you actually, which is this idea that our perception changes our physiology, right? 'Cause I've heard you talk before, Elissa, about this idea that in both situations your cortisol might be going up, but if you deem it as a threat to your survival, you're gonna have your blood pressure go up from vasoconstriction, and the recovery period is gonna be very slow from that. Whereas if you interpret it more as an opportunity to learn something or a challenge that you can overcome, yes, your blood pressure goes up, but it goes up from more cardiac output, which is a much healthier way for your blood pressure to go up. There's more oxygenation to your brain. You're better at problem-solving, and you recover quicker. And I thought this is incredible because the stressor is the same.

    6. EEDr. Elissa Epel1:11:35

       Yes, exactly as you've described. It's really quite phenomenal. And the story we tell ourselves directly determines our physiological response. If we are telling ourselves that we've got this under control, this is something that we will survive regardless of how it turns out, that we have what it takes, that people have our back, we have the resources we need, any one of these positive or empowering statements will tilt us toward a positive challenge response. We will feel hopeful, excited, enthusiastic, empowered, and more confident, and that means that we are going to be having a more oxygenated response, high cardiac output, high oxygen to our brain-

    7. RCDr. Rangan Chatterjee1:12:39

       Mm

    8. EEDr. Elissa Epel1:12:39

       ... better problem-solving, more positive emotion. Wendy Mendes is the researcher who's studied this the most in a granular way. If we are feeling these catastrophic thoughts that lead us to mount more of that survival response, we are having the opposite happen. And yes, our blood pressure's going up, but it's going up through the vasoconstriction. We're having less oxygenation. Our, our perception is literally changing. Our attention is narrowed- Toward threat, we're seeing threat more-

    9. RCDr. Rangan Chatterjee1:13:16

       Mm-hmm

    10. EEDr. Elissa Epel1:13:16

        ... and we're not able to problem solve and bring the higher powers of our intellect to bear on the problem. And so it changes how we think. It changes our hemodynamics. It changes our neuroendocrine response. The threat response is characterized by that quicker response that's energizing and the faster recovery. The threat response is characterized by a greater cortisol response, that sluggish recovery, and more inflammation. And so think about that. Every day if we're triggering more of that threat response, that is going to turn into chronic stress and have more of a wear and tear-

    11. RCDr. Rangan Chatterjee1:14:04

        Yeah

    12. EEDr. Elissa Epel1:14:04

        ... response. It's often, um, helpful for people to think of the lion and the gazelle, right? This is the in-nature stress response. The lion's chasing gazelle. Gazelle is having this full-on threat response, thinking, "My life is in danger," and getting ready to be wounded and have that inflammatory and vasoconstriction response to help with that. That lion is having that thrilling challenge response of, "This is gonna be dinner for a week. I'm going to, you know, get so much benefit for the whole pride for this," and so all of these positive emotions and-

    13. RCDr. Rangan Chatterjee1:14:45

        Mm-hmm

    14. EEDr. Elissa Epel1:14:45

        ... excitement as well. So completely different responses. So the way that we can control that is, number one, those empowering thoughts, as you said, bringing on the, uh, reminders of why we will survive and how we could do well, but then also framing the body's response as another positive resource. My body is excited.

    15. RCDr. Rangan Chatterjee1:15:11

        Mm-hmm.

    16. EEDr. Elissa Epel1:15:11

        My body is mounting this stress response to help me. My body knows exactly how to cope with this moment. That can reinforce that positive challenge response.

    17. RCDr. Rangan Chatterjee1:15:23

        So can we say this? The body activates the stress response because there was a threat there, but through training, your perception of that stressor changes, and therefore, the physiology of how that stress response plays out also changes.

    18. EEDr. Elissa Epel1:15:44

        Exactly.

    19. RCDr. Rangan Chatterjee1:15:45

        I mean, that, that is so, so empowering because I know that this can be trained 'cause I've done it myself. I've, you know, I've helped people train this in them. I also acknowledge that, yes, for some people, it can be harder than others. If you've had childhood trauma, or you've had real challenges in your life, of course it can be more difficult. But I don't know if you would agree with this, Elissa, or not, but I would say, in my experience, whatever your starting point is, it is a skill that you can get better at. So you can, you can learn how to change it from whatever your current baseline is.

    20. EEDr. Elissa Epel1:16:24

        Right. Right. Exactly. I, I just love your example also of reappraising at night and being able to then more likely to reappraise in the moment, but we try to load up and go into stressful situations with the resources and the empowering thoughts, but more often than not, our body's gonna respond, especially if we've been, um, exposed to a lot of trauma. And so then we're gonna be exquisitely sensitive to threat. So it's not so much about controlling that immediate reaction. It's about what happens next.

    21. RCDr. Rangan Chatterjee1:16:59

        Yeah. I love that.

    22. EEDr. Elissa Epel1:17:00

        When can we recover? When we change our story and when we focus on changing our attention, right? Focusing on releasing stress in the body, getting into sensory experiences, uh, getting into nature, focusing on gratitude or joy. But this power of reappraisal that you've brought up, it's never too late to change our s- narrative, to look at things in a different way, to bring the light of curiosity to the situation-

    23. RCDr. Rangan Chatterjee1:17:35

        Yeah

    24. EEDr. Elissa Epel1:17:36

        ... to look at what good could have come from this as well, what good can still come. So all of those beautiful open thoughts that we can bring to a stressful situation can happen years later as well, right? Because we hold onto stories, and we hold onto stress.

    25. RCDr. Rangan Chatterjee1:17:56

        Mm-hmm.

    26. EEDr. Elissa Epel1:17:56

        So this reappraisal, yes, try to do it before the stressor, definitely try to do it right after, but also be willing to look at the big stories that we carry around-

    27. RCDr. Rangan Chatterjee1:18:08

        Yeah

    28. EEDr. Elissa Epel1:18:08

        ... about those difficult life situations that we have that take up a lot of mental real estate and that cause us a lot of rumination and, in a sense, extra stress.

    29. RCDr. Rangan Chatterjee1:18:21

        What an empowering message to leave people with at the end of this conversation. Um, Elissa, I just wanna acknowledge you for all the work and research you've carried out over the years. Your contribution to this field has been absolutely profound.

    30. EEDr. Elissa Epel1:18:36

        Thank you.

Episode duration: 1:19:18