This is what happy looks like: clear blue skies and a week off of work and kids who laugh so hard they clutch their tummies. It looks like crisp apples picked from the tree, a reassuring hug, and knowing you’ve done exactly what you set out to do. And this, too, is what happy looks like: health.
It’s easy to think health breeds happiness. After all, someone without diabetes must feel more joy than those who have to prick their fingers, take medication, and count every last carb they eat—right?
Not necessarily. Researchers are learning that the connection between mental and physical health is more complex. Good health doesn’t guarantee you a pair of rose-colored glasses. And while people with chronic illnesses such as diabetes are more likely to become depressed, they don’t all become Debbie Downers. But there’s more to how disease and illness affect your outlook on life. Your mental state can help or harm your health. In fact, it may be that happiness breeds health.
Down in the Dumps
Scientists and psychologists have known for some time that negative emotions harm health.
Biology also plays a role. Negative emotions such as depression, fear, anger, and anxiety lead to a stress response in the body and release of hormones such as adrenaline and cortisol. “The fight-or-flight stress hormones, they’re good for the short term,” says Stephen Post, PhD, professor of bioethics and director of the Center for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University in New York. “Over time, they’re like acid on metal, and they have real serious consequences.”
According to Laura Kubzansky, PhD, a professor in the Department of Social and Behavioral Sciences at the Harvard School of Public Health, negative emotions can increase cholesterol, inflammation, and the risk of heart disease. Studies have shown that negativity can weaken the immune system, increase the risk of disease, and shorten your life span.
Biology and behaviors sometimes overlap. A 2010 study in the journal Diabetes Care found that depressed people with type 2 diabetes had a greater risk for complications over five years than those without depression. Much of that may be a result of worsening diabetes management. A 2004 study published in the same journal determined that depressed people with type 2 diabetes were less likely to exercise, eat healthfully, and take their medicine.
On the Bright Side
If there’s any reason for grouches to give up their pessimistic ways, it’s this: Optimism can improve health independently. “It’s great not to initiate the stress response,” Kubzansky says. “But what if there’s something else that gets set into motion [when you think positively]?” That is, steering clear of negative emotions can help you avoid chronic stress’s detrimental effect on the body. But there may be more required to improve your health. For that, you need to focus on positive emotions.
A 2011 study published in the journal Proceedings of the National Academy of Sciences found that optimistic older adults lived longer than their pessimistic peers. Some data show that “people who are more optimistic have faster recovery from surgery and wound healing,” says Kubzansky. Other studies have shown a link between positive emotions and reduced inflammation as well as better protection against heart disease, and even the common cold.
There’s a specific link between well-being and diabetes. In a study still in the works, Julia Boehm, PhD, assistant professor of psychology at Chapman University, looked at the connection between participants’ satisfaction in life and their diabetes risk years later. “Those people who were initially more satisfied with life had a reduced risk of having a doctor’s diagnosis of diabetes,” Boehm says.
There are two main ways optimism affects health: through the behaviors it promotes and biologically. “We think people who are in a healthier psychological state are more likely to engage in healthy behaviors,” says Kubzansky. They tend to exercise, eat healthfully, drink less alcohol, and are less likely to smoke.
Scientists are just starting to learn that the link goes above and beyond behaviors. Something happens in your body when you’re cheerful, although researchers aren’t entirely sure what. “There hasn’t been a lot of research on that right now,” says Boehm. “It is possible that being happy buffers against the stress response.”
It’s more than a suppression of stress hormones, though. Kubzansky has found an association between optimism and greater antioxidant levels and longer telomeres, the parts of chromosomes related to aging (telomere shortening is linked to aging). Other biological effects may be at play. “One thing people are interested in: gut bacteria,” says Kubzansky. “Do positive states alter the balance of healthy bacteria?”
Of course, all of the research raises the question: What is happiness? Well, that’s hard to say scientifically because studies focus on different aspects of what makes us happy. Some look at optimism. Others examine satisfaction with life and still others emotional vitality—being engaged with the world.
Some forms of happiness may be more beneficial to the body than others. In fact, happiness that comes from a life with meaning affects us to our core. A 2013 study published in the Proceedings of the National Academy of Sciences explored how different types of well-being affected gene expression, a process through which genes encode proteins that determine a cell’s function. People with a purpose in life had a decrease in inflammatory gene expression and better expression of antiviral genes than those who were simply happy and satisfied with their lives.
Altruism at Its Best
It may not consciously fill you with as much joy as an all-inclusive trip to the Happiest Place on Earth, but if you want to improve your health, start with others. “If you could package [the effect of volunteering] in a pill and sell it, you’d be a billionaire instantly,” says Post, whose book The Hidden Gifts of Helping: How the Power of Giving, Compassion, and Hope Can Get Us Through Hard Times tackles the health benefits of volunteering.
Studies have found that people who volunteer report higher self-esteem and greater satisfaction with their lives, are happier, and have lower levels of depression. In a 2011 study, Post surveyed nearly 5,000 Americans about their volunteering. Nearly all of them said volunteering made them happier, 92 percent reported it increased their purpose in life, and 73 percent said it lowered their stress levels.
Helping others won’t just make you happier—it’ll improve your health, too. Volunteering can relieve stress, lower blood pressure, improve heart health, and may ease depression. Helping others can also improve your chances of recovering after a serious trauma, such as amputation, for which people with diabetic neuropathy are at an increased risk.
Research has linked volunteering to a lower risk of early death and, in people with chronic pain, decreased disability and less pain. “[Volunteers] tend to be healthier in respect to many things, but they also seem to be living longer,” Post says.
So how does it work? “Possibly because when you do face-to-face helping activities, you have an almost ubiquitous release of [the happy-making hormone] oxytocin,” Post says.
There may be more to the “helper’s high” than that, though. “A lot of studies show that when your brain circuitry for empathy and compassion is turned on, it pushes out destructive emotions that are bad for stress, like bitterness and hostility,” Post says. “If you’re engaged in helping activities, it tends to shift your emotions.”
While what’s behind volunteering’s effect on health is still being determined, two things are clear: First, you’ll need to spend enough time helping others to see a benefit. According to Post, a couple of hours a week is a good start, though putting in additional hours is fine—as long as you don’t wear yourself out. Volunteer too much and you could add additional stress to your life.
Second, you have to want to do it. “[Researchers] tend to see more pronounced benefits … if people are really doing this because they’re so fabulously engaged at every level,” Post says.
The type of volunteering doesn’t matter, though finding something you’re passionate about is better than a cause you regard with ambivalence. Helping others with the same health conditions as yours may be especially beneficial. In a study, people with multiple sclerosis who made calls to others with MS fared better with their disease. People addicted to alcohol who refrain from drinking are more likely to stay on the wagon if they consistently help others stay dry—and the same goes for eating disorders, which Post is beginning to study in a group of overeaters. “It gives you the sense that you’ve been there, done that,” Post says. “It encourages you because you realize the seriousness of the condition. But mostly it encourages you to be a good role model.”
C’mon, Get Happy
Here’s what it takes to get happy, chemically speaking: endorphins, dopamine, serotonin, and oxytocin. These brain chemicals are responsible for that warm-and-fuzzy feeling, but how exactly they work within the body to cheer you is up for debate. “It doesn’t mean [that] if I start taking a capsule of dopamine, I’ll be happy,” says Amit Sood, MD, MSc, FACP, professor of medicine at the Mayo Clinic College of Medicine, chair of the Mayo Clinic’s Mind-Body Initiative, and author of The Mayo Clinic Guide to Stress-Free Living. “We have not created a pill to make you happier.”
That said, there is a way to turn your frown upside down—even if you’re a naturally pessimistic person. And it’s never too late to start. “I don’t think you’re doomed if at some point later in life you have a reversal in your psychological outlook,” Boehm says. “There are opportunities for people to change. This may translate into direct effects on a person’s health.” The key is to banish your naturally negative way of thinking.
Have you ever driven home only to find you don’t remember the trip once you arrive? We all have moments like that throughout the day—even if we’re not conscious of them. Wandering minds aren’t necessarily bad, but they can be. “Research has shown us when we’re doing that, we’re thinking a lot of neutral or negative thoughts,” Sood says. “So when you’re not trying to think, your brain naturally thinks negatively.”
That’s why it’s so important to force positive thinking, such as by keeping a mental tally of all you have to be grateful for or by doing kind deeds for others. “It is the pursuit of gratitude and compassion that will make you happier,” Sood says. “Not the pursuit of happiness.”
1. Express Gratitude.
Counting your blessings can take your mind out of the default negative-thinking mode and help you practice positivity. Before he gets out of bed each morning, Sood thinks of five people he’s grateful for.
You can also mentally tally other things in life you’re grateful for, such as the insulin that keeps you alive or the dietitian who explains carb counting in a way you can understand. Do this when you wake up, before you go to bed, while washing your hands, in traffic, and any other time during the day.
2. Wish Others Well.
Just like making a mental list of all you’re grateful for, mentally wishing others well during the day helps you avoid a wandering mind and the pessimistic thinking that follows. “Reality is, for every person you see, that person is silently struggling with something in their head,” Sood says. “Wish that person well.”
It’s a lot simpler than you think. If you overhear a stranger talking about an upcoming job interview, mentally say, “I hope he does well. I hope he gets the job.”
3. Show Kindness.
While there’s a strong link between volunteering and health, don’t overlook small acts of kindness. Even something as apparently insignificant as holding the door for the person behind you can improve your mood. “When I hold the door for somebody, it means I was not stuck in my head at the moment,” Sood says. “Little things are big things.” Such small kindnesses may include taking time from your busy schedule to go to a friend’s musical performance or calling a family member you haven’t spoken to in a while.
“Your whole self-esteem, your sense of who you are rises a bit,” Sood says of acts of everyday kindness. “You also feel like if you help someone else, you can help yourself.”
4. Cultivate Relationships.
In today’s society, busy life and a reliance on technology can leave us in a bubble of solitude. Consciously surround yourself with friends and family, and grow those relationships—even if it seems like work.
It’s easy to take the people in our lives for granted, but paying attention to the important people in your life can improve your mental health. “The person who is most important at any time is the person who is right in front of you,” says Sood. So, for instance, turn off the TV and talk to your spouse and kids during dinner. “We’re really missing out on life,” Sood says. “Technology is useful, but it’s disconnecting us from what’s important.”
5. Go Outdoors.
For a quick pick-me-up, step outside. Nature is a mood enhancer, researchers found when they tracked people’s daily happiness and connected it to their location. The study, published in 2013 in the journal Global Environment Change, found that while all natural habitats promoted positivity, being by the sea had the biggest impact.
6. Forgive Others.
The mind’s natural inclination is toward negative thinking, so you have little head space for positive emotions. Hanging on to old hurts leaves you even less room for optimism.
Your health will thank you: Holding on to anger lets negative emotions fester, resulting in a stress reaction that can worsen your health. Forgiveness can reduce stress, improve your blood pressure, help you sleep better, and lower your heart rate. That’s why it’s so important to forgive others—and then use the freed-up energy for gratitude, kindness, and other positive thoughts.
What makes you grateful?
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