Manage Stress and Build Resilience: Tools From Dr. Elissa Epel

Stress is not inherently bad. A stress response that mobilizes us to meet a challenge and then subsides is essential to survival. The problem arises when that response stays active long after the immediate demand has passed, or when our thoughts repeatedly reactivate it.

That distinction changes the goal of stress management. We are not trying to eliminate every difficult situation. We are trying to respond effectively, recover fully, and recognize when more effort will help versus when it will simply exhaust us.

Dr. Elissa Epel’s research on stress, cellular aging, and caregiving offers a useful framework for doing that. It brings together the mind, the body, and the environment, while addressing a particularly important question: How can we live well when some of our biggest stressors cannot be removed?

Table of Contents

• Stress Is Both a Demand and a Response
• Three Ways to Interrupt Rumination
• Recognize the Different Timescales of Stress
• Why Some Stress Can Support Healthy Aging
• Threat Versus Challenge: Two Ways to Meet the Same Demand
• Mitochondrial Health, Caregiving, and Daily Mood
• Radical Acceptance for Stressors You Cannot Change
• Build Tolerance for Uncertainty
• Know When to Act and When to Release
• Use Narrative and Purpose to Make Sense of Experience

Stress Is Both a Demand and a Response

One way to define stress is the feeling that the demands placed on us exceed the resources we have available. But the event and our response to it are not the same thing.

A difficult conversation, a work deadline, or an ongoing caregiving responsibility can all create demands. What happens next depends partly on how we interpret those demands, how our body responds, and whether we have opportunities to recover.

Activation followed by recovery is very different from activation that continues all day. We need the ability to mobilize energy. We do not need to keep mobilizing it while mentally replaying something that happened hours ago.

This is where rumination becomes important. Thinking can help us solve a problem, but it can also keep a stressor alive without moving us any closer to a solution. We may believe we are being productive when we are actually rehearsing threat.

For broader background on recognizing stress, the National Institute of Mental Health provides a useful guide to stress and anxiety.

Three Ways to Interrupt Rumination

There is no single tool that reliably stops every form of overthinking. Epel organizes the options into three broad categories: change the way you relate to your thoughts, change your bodily state, or change your surroundings.

Before choosing a tool, notice what is happening. Daily tension can become so familiar that we stop recognizing it as stress. Check your hands. Are they clenched? Are you holding your body as if you need to be ready for something, even though nothing requires action right now?

The body can reveal a stress response that has not yet registered consciously.

1. Use the mind to influence the body

These are top-down strategies: awareness, beliefs, and the statements we make to ourselves about a situation.

The first step is recognizing that a thought is not necessarily a fact, and that continued thinking is not necessarily useful problem-solving. From there, we can ask whether our interpretation is helping us meet the demand or making the demand feel even larger.

Reframing does not require pretending that something difficult is easy. It means finding an interpretation that is both believable and more useful.

2. Use the body to influence the mind

Sometimes trying to reason your way out of stress is not the best entry point. Movement and other body-based approaches can help work through the physiological activation.

Epel describes this as shifting away from threat-focused processing and toward a more immediate, sensory experience. Rather than continuing to analyze the stressor, we change the state from which we are analyzing it.

Exercise is a particularly clear example. It creates physical activation, but it can also help reduce rumination and improve mood. The important distinction is between using the body deliberately and remaining stuck in prolonged, unproductive vigilance.

3. Change the scene

Our surroundings can repeatedly cue stress. An office, a crowded city environment, or a particular workspace may keep reminding us of demands.

Changing the scene does not have to mean taking a trip. It can mean moving to a quiet corner of the home and surrounding yourself with signals of safety: a comforting pet, meaningful photographs, familiar smells, or calming music.

The question is not only, “How do I stop these thoughts?” It is also, “What would help my body register that I am safe right now?”

Recognize the Different Timescales of Stress

Feeling stressed and being physiologically activated do not always line up perfectly. You may report feeling reasonably calm while your nervous system remains vigilant, scanning for what could happen next.

That vigilance is energetically expensive. The stress response relies on ATP, the energy supplied by mitochondria. If the body keeps preparing for action throughout the day, exhaustion can follow even without a dramatic crisis or a large cortisol response.

It helps to distinguish several timescales:

• Acute stress: An immediate demand calls for activation, followed by recovery.
• Stress lasting days or months: An ongoing difficulty requires coping, but there may still be periods when restoration is possible.
• Chronic stress lasting years: A persistent situation, such as caregiving, may not be something you can resolve or remove.

For demands that extend over time, a useful question is: Am I actively coping with something right now, or is this a moment when I could restore?

We can become so accustomed to carrying a problem that we stay mobilized even when no useful action is available. Recognizing a window for recovery is itself a skill.

Chronic stress also does not produce identical outcomes in everyone. In Epel’s research, some caregivers show biological aging measures comparable to, or more favorable than, those of people without an identifiable major ongoing stressor. That variability matters. A difficult life circumstance is not a fixed biological destiny.

Why Some Stress Can Support Healthy Aging

A life with no stress would not necessarily be a healthier life. It could also be a life without engagement, growth, or meaningful challenge.

Epel points to a study in which older adults participated in a school-based tutoring program for at-risk children. Instead of being treated as people whose meaningful contributions were behind them, participants took on demanding, caring roles.

They experienced purpose, growth, and relationships with the students. Brain imaging showed hippocampal growth among participants, particularly the men. The broader point is not that every demanding activity will produce that result. It is that meaningful challenge can remain valuable well into later life.

Exercise helps illustrate the same principle. During a hard workout, heart rate, blood pressure, and stress hormones rise. Yet repeated bouts, with recovery, can produce beneficial adaptations.

Short, repeated physical challenges such as high-intensity interval training can support what Epel calls stress fitness, alongside aerobic fitness. People can experience less rumination, anxiety, and depression.

Psychological challenges can also become less threatening with experience. The key is that they are manageable and do not leave us carrying an unresolved stress response indefinitely.

Threat Versus Challenge: Two Ways to Meet the Same Demand

Two people can encounter the same situation and have very different stress responses. One experiences it as a threat to survival, competence, or social standing. The other experiences it as a difficult but manageable challenge.

Both may have elevated blood pressure. That does not mean the underlying physiology is identical.

• A threat response involves more vascular constriction and can include a pronounced cortisol response, feelings of impending failure, and slower recovery.
• A challenge response involves greater cardiac output and more effective delivery of oxygenated blood, supporting engagement and problem-solving.

In laboratory studies, a stronger challenge response has also been associated with less inflammatory activation afterward. Epel describes associations between challenge-oriented responding and longer telomeres, one measure relevant to cellular aging.

These findings do not mean that a positive thought instantly changes biological age. They suggest that the way we repeatedly meet demands may matter for both immediate performance and longer-term health.

The goal is not to be unaroused. It is to use arousal effectively.

Build believable “stress shields”

Epel uses the term “stress shields” for statements that help orient us toward challenge rather than threat. They must fit the person using them. A phrase that feels false or forced is unlikely to be especially useful.

Examples include:

• I have the resources to handle this.
• I can work through the next step.
• This is difficult, but I can meet it.
• My body is mobilizing energy to help me cope.

The last example addresses a common problem: becoming stressed about the sensations of stress. A racing heart can lead to another layer of alarm if we interpret it as evidence that something is going wrong.

Reappraisal offers another interpretation. The body may be doing what it needs to do to help us perform. In studies Epel discusses, people trained to interpret stress activation more positively performed better, experienced more positive emotion, solved problems more effectively, and recovered more quickly.

Her memorable analogy is the lion and the gazelle. Both are highly activated during a chase. The gazelle is trying to survive; the lion is pursuing an opportunity. The analogy is not a complete account of stress physiology, but it captures an important shift: activation can signal engagement, not just danger.

Mitochondrial Health, Caregiving, and Daily Mood

Epel and her collaborator Martin Picard have examined how chronic stress relates to mitochondrial function. Their research includes mothers caring for children with autism and mothers of neurotypical children.

The researchers used a blood-based index incorporating mitochondrial enzyme activity and accounting for mitochondrial quantity. In the study Epel describes, mothers in the caregiving group had lower mitochondrial activity on average, suggesting reduced energy-producing capacity in the sampled cells.

That finding offers a possible biological window into the exhaustion associated with chronic stress. But there was also substantial variation within the caregiving group.

Caregivers with more favorable mitochondrial measures reported more positive emotions, both in the morning and in the evening, with a particularly notable relationship in the evening. Mood measured close to the blood sampling was more strongly related to mitochondrial function than mood measured farther away in time.

This was an early finding, and it does not establish that positive feelings directly improve mitochondrial function. It does suggest that daily emotional experience and cellular energy regulation may be closely connected.

Why the end of the day matters

Across the daily diary research Epel discusses, emotional recovery after a stressful day is associated with longer-term health. Can a difficult day still contain some contentment, ease, confidence, or joy? Or does the stress erase access to those experiences?

People with lower negative emotion or greater positive emotion in these patterns tend to have more favorable health trajectories, including lower risks of later depression, heart disease, and early death.

The useful takeaway is not to force yourself into a good mood. It is to recognize that a stressful day does not have to remain emotionally stressful until bedtime. Restoration and engagement still matter, even when the larger problem is unresolved.

Radical Acceptance for Stressors You Cannot Change

Some situations cannot be solved by better planning or more effort. A loved one may have a lifelong condition. A caregiving responsibility may continue for years. Other people may not change in the ways we wish they would.

In these situations, repeatedly asking why life is not different can add an ongoing internal struggle to an already difficult circumstance.

Radical acceptance means acknowledging the reality that exists now. It does not mean liking that reality, approving of it, or abandoning the actions that remain available.

A useful starting practice is to identify the situations that stress you and distinguish which parts you can change from which parts you cannot. Simply recognizing that a particular fact is not going to disappear can create room to stop fighting it continuously.

This is not a decision made once. Epel describes it as a practice she returns to in her own experience as a caregiver: noticing the wish for a different reality, then reorienting toward the life and choices available now.

Put down the rope

Imagine pulling on a rope attached to a brick wall. You pull because you care deeply. You want life to improve for yourself, someone you love, or a group of people.

But the wall does not move. The effort only injures your hands.

Putting down the rope does not make the wall disappear. It frees your hands.

That is the distinction between letting go of an unwinnable struggle and giving up on living well. The energy spent trying to change an unchangeable fact can become available for something you can influence.

Epel’s research also examines this at the level of everyday attention. Participants were asked whether they had recently been engaged in what they were doing or wishing things were different. Regardless of caregiving status, more of that disengaged, wishful state was associated with greater unhappiness and shorter telomeres.

Those associations do not mean that an occasional painful thought is damaging your cells. They point toward the potential importance of recurring patterns of attention over time.

Build Tolerance for Uncertainty

We often want control because predictability allows us to relax. If we know what happens next, we can stop scanning for possibilities.

But much of life does not offer that certainty. Epel describes comfort with uncertainty as an important resilience factor, associated with less anxiety and depression and quicker recovery after stressful events.

One approach is to notice when you are physically bracing against the future. Are you leaning forward, tense, trying to anticipate the next demand?

Then try a different posture:

1. Lean back from that forward, anticipatory stance.
2. Take a few slow breaths.
3. Allow yourself to receive the present moment rather than mentally rushing ahead.
4. Approach what comes next with curiosity rather than trying to predict every detail.

This is not a way to make uncertainty disappear. It is a way to practice meeting uncertainty without maintaining constant vigilance.

There is a meaningful difference between preparing for something you can influence and trying to control tomorrow so completely that you can finally feel safe.

Know When to Act and When to Release

Stress advice can sound contradictory. One message tells us to lean into difficulty, take action, and push through. Another tells us to soften, accept, and let go.

Both are useful. Neither is appropriate for every situation.

When effort can be productive, apply effort. When you are pulling against a wall that cannot move, release the struggle.

Taking action offers agency, but it also costs energy. Acceptance conserves energy, but it should not become a reason to avoid a solvable problem. Resilience involves discerning which response fits the moment.

Epel compares life to an ocean with waves of different sizes. We cannot prevent the next wave from arriving. We can become more skillful at knowing when to paddle, how to navigate, and when it is possible to feel safe and at ease.

Use Narrative and Purpose to Make Sense of Experience

Journaling or speaking about an experience can help us create a coherent narrative: what happened, what it means, and how it fits into our lives.

That is different from repeatedly replaying the same upsetting details. A useful narrative supports understanding, meaning, and resolution rather than simply extending the stress response.

Epel emphasizes the value of a narrative organized around purpose. What matters to you? What role do you want to play? How do you want to live within the circumstances you have?

Our ability to reflect on the future, recognize that life is finite, and choose what we want to contribute gives us a powerful resource. Purpose does not remove hardship, but it can change our relationship to the effort hardship requires.

The central skill is flexibility: mobilizing when action matters, recovering when the demand has passed, and releasing the struggles that cannot be solved by pulling harder. Building resilience is not about becoming impervious to stress. It is about learning how to engage with life without keeping the stress response switched on all the time.