6 Practices for Preventing Depression with Dr. Elissa Epel

Elissa Epel, PhD. is the Director of the Aging, Metabolism, and Emotions Center at UCSF & Scientific Advisor to Meru Health.

Emily Hine is a Certified teacher of Compassion Cultivation Training and Mindfulness and an inspirational writer and speaker. She served as Vice President on the founding team of Meru Health.

This blog post originally appeared in The 2-Minute Mind Check Blog. The 2-Minute Mind Check campaign aims to help employees in the San Francisco Bay determine where they stand on the depression scale and share helpful resources with those in need.

Woman sitting on a wooden bench looks at a sunset going down over mountainous area in the distance

Depression affects 16 million Americans and 75% of adults report experiencing moderate to high levels of stress on an ongoing basis. Both stress and depression can take a great toll on our minds and bodies. Dr. Elissa Epel is a health psychologist focusing on stress pathways and stress resilience. She shared that we’re more likely to get depressed after a period of certain kinds of stress, especially social stress. To that end, it’s important to weed out relationships that make us feel bad about ourselves, and instead, surround ourselves with supportive allies. Since we can’t control stressful events that happen to us, we want to focus instead on our response to life’s inevitable curveballs. Bring on stress resilience! Building stress resilience requires a few things:

a) understanding the mind

b) understanding how we respond to stress mentally and biologically

c) learning how to work with our minds so that we respond to stress in ways that enhance our mental and physical health

What is stress exactly and why does it go on and on and on? Stress is a natural response to a life event. Biologically, we actually need the cortisol and body responses that naturally occur in order to help us respond appropriately to given situations. However, as humans, we tend to prolong the stress response with our thinking (see #1 above — understanding the mind.) We project things before they happen, and we worry about things that never happen. Often, after a peak stress event, we’re still thinking about it ala rumination causing stress to live on in the body longer than it needs to. With rumination, these sneaky thoughts disguise themselves as addictive “problem solving”, when in actuality they are simply keeping the stress alive in our minds and bodies. Clearly, this rumination takes us out of the present moment in our lives, making it hard to meaningfully connect with others. And prolonged stress simply isn’t good for us. In fact, it can lead to disease — such as depression — not to mention premature aging and lower quality of life.

So, how can we foster a healthier stress response? Instead of chronic unease and vigilance, imagine feeling low anxiety. Then, only when we need to deal with an active challenge, we activate a burst of a stress response to give us the energy to cope with the challenge, followed by a quick recovery to a more relaxed baseline! According to Dr. Epel, that is the picture of a resilient emotional and physiological stress response. And, because we’re smart human beings, we can learn to build that!

Luckily, Dr. Epel gave us a helpful Stress Resilient Toolkit with six specific practices that support both the body AND mind.

Body Up Bolsters! Depression and chronic stress wear on our circadian rhythm (energy and sleep patterns), setting us up for further depression and illness. We can build our “reserve capacity” with these protective practices:

1. Establish Daily Rhythms

Go to bed and wake up at the same times every day budgeting for at least 7 hours of sleep.

Wind down gently: Develop a bedtime wind down ritual to support maximum rest and restoration. If applicable, have your partner do this with you. We need this more than ever now that we have stimulation from screens (and blue light) during the time we need melatonin.

Wind up with joy: The first thing you do in the morning really matters! Waking up anticipating negative things gives a jolt to our cortisol. Therefore, instead of reaching for your phone, or watching the news, take a few minutes to set yourself up for a positive mindset and trajectory for the day. Use the first precious waking moments to think of positive things — things you are grateful for, or something you are looking forward to. Elissa’s research has found that positive waking states relate to healthier cortisol and anti-aging profiles.

2. Build a Mind-Body Habit

Adopt a mind-body ritual to give the body a restorative break. This is missing from most people’s routines and it is especially important for those of us prone to depression. Try Yoga, Tai-Chi, Qi Gong, Mantra or Mindfulness Meditation, breathing exercises, or really any body-mind practice that suits you. They are different, so try some on, but they have the same fundamental effects on our breathing, physiology, and mind. Even if it’s just for 5–10 minutes a day, it will help.

3. Regular Exercise

Sometimes called nature’s antidepressant, depression can both prevent and treat depression. If you’re at risk of depression, any type of exercise will help, it just requires that you do it. So find something you enjoy, and if it helps you stay consistent, find an accountability exercise partner!

The second essential item in the Stress Resilient Toolkit is practices for the mind.

Mind the Gap! There are valuable moments that occur between the stressor, any negative event, or even negative thought, and our response to that event or thought. That moment — the GAP — is where we can be empowered to respond in a way that supports our best mental health. We must be paying attention to our mind to notice and use the gap.

4. Label the Stressful Emotion

Simply noticing and naming emotions as they pass reduces their negative impact.

5. Cultivate Distance and Perspective

There are many ways to gain distance from painful thoughts and emotions. For example, when you are in the thick of it, take a few breaths and ask yourself, realistically, will this situation really impact your life in one year? In one month? Usually, the answer is no!

6. Take a Mindful Minute

When we are prone to depression, our negative thoughts and feelings stick together, spiraling us into sadness or anxiety. We can break this network up with an attentional exercise. Dr. Epel offered a short practice to support our effort in minding the gap, the three-minute breathing break.

Since we’re talking specifically about depression prevention, it might help to keep an eye out for stressors that can specifically lead to depression. There are many intense stressors that can lead to depression, for example, loss — such as the loss of resources, jobs, relationships, etc. As it turns out, social and interpersonal stress affect us even more than work-related stress. The toughest issues are those that cause us to feel rejection, social shame, humiliation, or embarrassment. These are the stressors we really need to monitor carefully. And, they can run rampant during the holidays when we’re put into many social situations, especially with family members who can unconsciously trigger high (and often historic) stress in our nervous systems. I remember hearing famous Buddhist Meditation Teacher, Jack Kornfield remark that there’s a reason it’s called the “Nuclear Family!” Holidays can create the conditions for a nuclear emotional event. But, now that you know you have agency in your response to those events, you can use Dr. Epel’s Stress Resilient Toolkit to cultivate a successful, nurturing, and even joyful Holiday Season.

Elissa Epel is a professor at the department of psychiatry and behavioral sciences at University of California, San Francisco. She is the Director of the Aging, Metabolism, and Emotions Center at the UCSF and has published groundbreaking research in the field of stress, aging, and obesity for over two decades. She has published the book “The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer.” She also serves as a scientific advisor to Meru Health.

Emily Hine is a Mental Health executive, mindfulness & compassion teacher, and an inspirational writer and speaker. She served as Vice President on the founding team of Meru Health.

Still have questions? Ask away.