Happiness for Health

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

In Anatomy of an Illness, his bestselling book in the early 1980s, Norman Cousins describes how a positive attitude and laughter can assist the body in overcoming disease. Cousins’ own personal experience involved a seriously debilitating condition called ankylosing spondilytis, a disease of the body’s connective tissue. At the low point of the illness, he could hardly move his limbs. His jaw was nearly locked shut and doctors gave him one chance in 500 of recovering.

Cousins, who was the celebrated editor of the literary journal Saturday Review at the time, did more than beat the odds. Moving from hospital to hotel room, and putting himself on megadoses of Laurel & Hardy, the Marx Brothers, and vitamin C, he cured himself of the horrible disease.He later became an adjunct professor in the school of medicine at UCLA, and, until his death in 1990, he used that platform to inspire research and hospital programs on psychosocial healing.

Laughter and optimism remained one of Cousins favorite healing ingredients. In his book, he recalls the Biblical advice that a merry heart works like a doctor. He quotes Immanuel Kant, the great 18th century German philosopher, who said that laughter produces a healthful and gratifying influence on bodily processes enabling us to “reach the body through the soul and use the latter as the physician of the former.”

Just as exercise is regarded pivotal to health, Cousins saw laughter as a form of “internal jogging” that puts glands and biochemistry into healing gear. Perhaps the most important effect of laughter and positive emotion, he felt, is that they “replace the apprehension and helplessness that tend to lead to depression and thus a deepening of a disease.”

Happy, Optimistic Thoughts Indeed Prolong Life

Norman Cousins was a pioneer who brought the element of happiness, mirth, and optimism into the medical mainstream. As a cardiologist who repeatedly saw how stress and depression could ravage hearts and health, I found Cousins to be a beacon of insight.  After his book came out, I often prescribed watching comedies to patients along with other more conventional remedies.

In 2001, a landmark study (Danner) was published in the Journal of Personality and Social Psychology that gave strong confirmation to Cousins’ ideas. The study analyzed the medical histories and length of life of nearly 200 Catholic nuns who had completed handwritten autobiographies during the 1930s when they were in their early 20s.

“Positive emotional content in early-life autobiographies was strongly associated with longevity six decades later” after the nuns had retired from years of teaching school, the authors reported.

A careful examination of the writings for such key words such as “happy,” “joy,” “love,” “hopeful,” and “content” found that the nuns expressing more positive emotions lived as much as ten years longer than those expressing fewer positive emotions. The findings concurred with other studies showing that people who rated more positive on personality tests seemed to live longer than those who are more pessimistic. The researchers also discovered that early mental function could predict which individuals would show brain damage typical of Alzheimer’s disease some sixty years later.

In this and many other studies, science is increasingly connecting the dots between emotions and physical health, mental health, and longevity. Ancient cultures were aware of the connection but didn’t know the mechanisms involved. The Greeks, for instance, erected healing temples next to their amphitheaters so that infirm individuals could view the entertainment, knowing that exposure to mirth and pleasantries made them feel better and heal faster.

Awesomely Optimistic Seniors

I was reminded of Cousins’ message and personality research during a talk I gave to about 200 health-conscious senior citizens in 2005.  As I looked out at them from the podium, they radiated health, vigor, and an absolutely contagious optimism.

Many had significant medical problems, yet what a difference between them and most people their age. Here were individuals eager for knowledge, even down to the nitty-gritty of how many milligrams of vitamin X to take…and when. Here were people learning how to be healthier so they could grab more of life, and not just passively waiting for the next prescription from their doctors.

One gentleman got up to the microphone and said he was 86, had aortic dysfunction, shortness of breath, arrhythmia, and was somewhat hard of hearing. He had had a quadruple bypass and a knee replacement.

“I want to make plans for the next thirty years,” he said. “My cup is half full and I want to make it fuller.”

Wow! I thought. That’s a healing attitude. Somebody else in his shoes would think their cup was half-empty and draining. But not him, and not the others in that exceptional room of people.

Optimism Optimizes Your HDL!

In 2013, Harvard researchers published a fascinating study (Boehm) showing the “trickle-down effect” of optimism on blood fats. In their study, they looked at the results of a life orientation questionnaire filled out by almost a thousand men and women (average age 55) and then analyzed the cholesterol levels of the group. The findings: greater optimism was associated with higher HDL cholesterol and lower triglycerides, as well as healthier behavior and more ideal weight.

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For me, the findings are a big deal. The study offered superb evidence of a positive impact for a positive attitude on biochemistry and the mind/body connection. If you carry your excess fat around your middle, have a low level of HDL cholesterol and high triglycerides, you very likely have some degree of insulin resistance (also known as the metabolic syndrome), and widely considered to be a forerunner of diabetes. Moreover, the HDl/triglyceride ratio has shown over time to be a serious indicator of coronary artery disease risk.

When misfortune or disease strike we make a conscious reaction. Some people develop a “poor me” attitude and turn into victims. Others see illness in terms of spiritual or emotional growth. Referring to their illnesses, patients have told me, “God placed it in my path to be more humble,” or “to get out of job I disliked,” or “to stop me in my too busy tracks and mend a relationship.” My most successful patients have always been people like the 86-year-old man with that resounding positive attitude. I can assure you, from observing thousands of patients, that attitude counts. You can choose to be depressed and live with the biochemistry that depression creates in your body, or choose to be optimistic, find purpose in life, and live with the molecules that optimism creates. Which set of molecules do you think makes you healthier?

More Happiness with Age

For whatever it’s worth, it might be comforting to know that as you age you have a natural tendency to be happier. That’s the conclusion of a 2008 study by a University of Chicago sociologist named Yang Yang who summarized 30 years of face-to-face interviews with 28,000 Americans aged 18 to 88.

“The good news is that with age comes happiness,” he said.  “Life gets better in one’s perception as one ages.”

Even though aches and pains, and deaths of loved ones and friends mount with the years, older people have learned to be more content with what they have than younger adults, he said.

I have found this to be very true. Older people have lesser expectations. I am not sure about the Baby Boomer generation though. Tomorrow’s seniors tend to want more and resist aging. We’ll see how that shakes out on the happiness scale.

From a cardiology standpoint, I have taken care of many people near death who managed to escape cardiac care units and hospitals on their own steam. They were usually extremely happy to be above ground. The experience changed their outlook on life, emphasizing relationships over material things. I’ve learned that happier and more optimistic people, and people who laugh more, have less cardiovascular disease.

The Yang study found that although there were ups and downs in the happiness level generally corresponding to good and bad economic times, older Americans were consistently the happiest. The odds of being happy increased 5 percent with every decade of life. About one-third of the 88 year olds reported being very happy as compared to about a quarter of those from 18 into the early twenties.

The Sinatra Solution

I can’t emphasize enough the importance of finding ways to defuse your stress, develop a positive attitude, and infuse your life with happiness and laughter.

There are many options open to you. Tai-chi. Yoga. Meditation. Prayer. Volunteering your services. Listening to your favorite music or stand-up comedy. Watching comedy movies or sit-coms. Unstructured play with children or pets.

Do whatever it takes to stay optimistic, happy, and engaged in life. You’ll create the molecules of longevity within you. Express love and gratitude every single day of your life. Follow your own personal passion.

Even if you become seriously ill, try to stay positive. Positive intention is vital for healing. Negative thoughts are toxic to the body.


© Stephen Sinatra, MD. All rights reserved.

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