Happiness - The Highest Form of Health

Thomas Jefferson once said, “Our greatest happiness does not depend on the condition of life in which chance has placed us, but is always the result of a good conscience, good health, occupation, and freedom in all just pursuits”. More recently, the Dalai Lama has described happiness as “the highest form of health”, and Leigh Hunt has stated, “The ground work for all happiness is health”. Throughout history, health and happiness have been intrinsically linked in popular wisdom and common values, but is there more to the connection than that? A branch of science that studies the effects of happiness on health, and vice versa, has been dubbed “Positive Psychology”, defined by one of its originators, Martin Seligman, like this: “The aim of Positive Psychology is to catalyze a change in psychology from a preoccupation only with repairing the worst things in life to also building the best qualities in life.”^[1]

Psychological resilience is the ability to use positive emotions to cope with and recover from negative events.^[2] Positive Psychology looks at the effects of psychological resilience on health and considers whether resilience can be cultivated. Resilience was first identified as a factor in health by Norman Garmezy in 1973.^[3] He looked at those who become ill contrasted with those who do not to understand why there is a difference. This revealed the factors that increase risk or are protective and allowed him, with Sandra Streitman, to develop tools to promote the development of resilience.^[4] During the 1980s, the study of resilience blossomed into a major topic for theory development and investigation. Researchers have looked at what factors make people resilient ^[5] in the face of such adverse conditions as neglect and abuse,^[6] disastrous life events,^[7] or poverty.^[5] Recent studies explore the relevance of resilience to conditions as diverse as workplace stress ^[8] and surviving tsunamis.^[9] Ongoing research in the area of Positive Psychology seems to prove old Tom Jefferson was right: your happiness and your health affect each other and do not depend solely on the conditions of your life.

Resilience

We explored the idea that health and happiness are connected, and looked at how research has revealed the nature of this connection through studies in the field of Positive Psychology. Positive Psychology looks at the effects of psychological resilience, the ability to use positive emotions to cope with and recover from negative events ^[2] on health, and the means by which it can be cultivated. People are considered to be resilient when they demonstrate one or more of the following:

• a better-than-predicted outcome despite high-risk status,^[10]
• the capacity to function well under stress,^[11]
• recovery from trauma,^[12] and
• the ability to use the experiences gained when facing challenges to improve their handling of future hardships.^[13]

It also seems that people who are resilient are more likely to be happy. “Happiness” in this context is defined as the regular experience of positive emotions such as joy, contentment, engagement, and pride.^[14] Although variations may exist among age groups, happiness has been found to be correlated with resilience.^[15] What seems to be emerging from the research is the notion that happiness and health influence each other through the quality of resilience. This suggests that an unhealthy but happy person could improve their health by using positive emotions to develop resilience to illness (imagine someone with a great attitude successfully fighting cancer), and that an unhappy, but otherwise healthy, person could do likewise by using their health to foster the psychological skills that promote happiness (imagine an athlete overcoming the trauma of childhood sexual assault). Studies have found that resilient people will have at least some of these attributes:^[16-18]

• effective and healthy coping behaviors in response to stress;
• good problem-solving skills;
• ability and willingness to seek help;
• belief that you are able to manage your feelings and cope;
• social support and feelings of being connected with others, such as family or friends;
• willingness to self-disclose the trauma or problem to others;
• spirituality;
• identifying as a survivor not a victim;
• willingness to help others; and
• capacity to find positive meaning in the trauma.

Mind-Body Medicine

Studies on the nature of resiliency in the field of Positive Psychology have held great relevance for application in the area of mind-body medicine, as well as for specific conditions. Using mind-body interventions such as triggering the relaxation response has been shown to help build resiliency and positively impact conditions such as depression,^[19] anxiety,^[19] chronic temperomandibular joint dysfunction,^[20] arthritis,^[21] asthma,^[22] and general health.^[23] In a 2012 review of research on mind-body practices in American public schools, the mind-body interventions were found to increase resilience as well as a number of other indicators of psychological hardiness.^[24] Even without the tools of formal intervention, having a positive affect on its own appears to generate a significant impact on one’s health. In other words, a happy disposition can contribute to good health. This finding has been substantiated through research on people with conditions as diverse as heart disease,^[25] lung disease,^[26] Parkinson’s,^[27] AIDS,^[28] and multiple sclerosis.^[29]

It’s clear that the “happiness factor” has a real effect on health, but how does it work? In 2009, Andrew Steptoe and his team found that the health-building effects of a positive affect and psychological resilience are the result of their ability to act as antidotes for stress, thereby minimizing the impact of the stress hormone, cortisol.^[30] More recently, it’s been suggested that having a happy, resilient disposition counters the negative effects of cortisol by increasing the activity of several neurotransmitters, such as DHEA, growth hormone, insulin-like growth factor, and oxytocin, among others.^[31] While a simplistic summary of the research to date could look like: “Being happy reduces stress by changing body chemistry” and seem obvious, it’s important to remember that an understanding the minutiae of these chemical activities is what will underpin the development of successful treatments for many illnesses, beyond a prescription of “Don’t worry, be happy”.

Conclusion

The World Health Organization accepts that happiness has a demonstrable effect on health,^[32] and I hope you are likewise becoming convinced that being happy offers substantial health-related benefits. For those among us who have sunny-side-up dispositions, it’s great to know that our mental attitudes are health-supporting, but what happens if you have a naturally dour disposition? It turns out you can learn to be happy. We can “catch” emotions from others,^[33] or learn emotional regulation for ourselves.^[34] If we revisit the list of attributes that support resilience, it’s clear that a number of these involve behaviors that can be taught or developed:^[16–18]

• Effective and healthy coping behaviors in response to stress.
• Good problem-solving skills.
• Ability and willingness to seek help.
• Willingness to self-disclose the trauma or problem to others.
• Identifying as a survivor, not a victim.
• Willingness to help others.

If you think your happiness skills could use some honing, here are a few suggestions:

• An easy way to begin would be to become more open with your loved ones.
• Cognitive Behavior Therapy (CBT) is a research-substantiated set of tools you can use to modify distorted (negative) thinking and generate more positive emotions — learn more about it here: http://www.heretohelp.bc.ca/visions/cognitivebehavioural-therapy-vol6/mond-traps.
• Check out some online resources such as Happify (http://www.happify.com/), Action for Happiness (http://www.actionforhappiness.org/resources), or Authentic Happiness (http://www.authentichappiness.sas.upenn.edu).

Abraham Lincoln said, “Most folks are as happy as they make up their minds to be.” For the good of your health, decide to be happy.