Happiness Read online

  Dr. Cohen's research team was not only able to control a participant's diet, activity, and social contact, but also plotted the course of the illness as it slowly worked its way through their bodies. In the end - you guessed it - Cohen and his colleagues found that the people who were happier prior to the experiment reported fewer runny noses, as well as less congestion and sneezing. They also showed fewer objective medical signs of illness, such as excess mucus. Thus, not only did the happier people think they were healthier, the objective medical tests also demonstrated that they were healthier.

  But it makes sense to wonder whether this is an instance of negative moods detracting from health or of positive moods actually contributing to protect health. Cohen found that the people higher in positive emotions were less likely to catch colds; those who did experienced fewer and less severe symptoms. Professor Cohen's studies provide clear evidence of a link between mood and health in which happier people seem to benefit from a natural, emotional inoculation against sickness. The stunning finding is that not only do happy people complain less when they get sick, but they are less likely to succumb to infections in the first place because they tend to have stronger immune systems!

  It is difficult to emphasize enough how important Professor Cohen's findings are. Before this particular research, the evidence that happy people are healthier and less likely to succumb to infectious diseases frequently amounted to stories like, "Well, my cousin Megan was happy and she never got sick," or "This fellow I read about watched humorous movies and got over cancer." The problem with this type of anecdotal evidence is that there is always a counterstory. A person can always respond by saying, "But my Uncle George was an incessant complainer, and he never got sick," or "Aunt Matilda was a worrywart and she lived to be 103." Examples and counterexamples such as these can always be found because happiness is only one of many factors important to health, and other influences can override the impact of emotions in specific instances. Thus, the stories of people we know do not provide strong evidence either for or against a link between health and happiness. What is so important about studies such as those conducted at the Vacation Inn is that they demonstrate an objective link between happiness, immune system strength, and the probability of getting an infection. Uncle George and Aunt Matilda, move aside; Professor Cohen is about to take your place.

  Three Types of Health

  Health has become a modern obsession. There are everincreasing numbers of gyms, diet fads, and television talk shows catering to a new generation of health-conscious customers. Even fast food restaurants are turning their attention to delivering healthier meals. Just about everybody wants health, and many people are willing to invest a fair amount of time, money, sweat, and self-control in the pursuit of it. But what, exactly, is health? Is it bouncing back quickly from a bout of the flu? Or is it something possessed only by those athletic individuals who successfully complete the Boston marathon? Most people have a rough notion of health that includes strength, endurance, flexibility, and resistance to illness. Researchers define and measure health in several concrete ways: the likelihood a person will contract specific illnesses, how long a person lives after contracting a lifethreatening illness, and how long a person's lifespan is. We discuss how happiness is related to each of these three types of health - called morbidity, survival, and longevity - and show that positive moods improve all of them.

  Morbidity

  Simply put, morbidity is whether or not an individual develops or contracts a specific illness, such as pneumonia or breast cancer. We all know that genetics and environmental factors influence who contracts such illnesses, but what role might our moods play in contracting a serious illness? In one long-term study conducted over three decades, research participants were found to have lower rates of many health problems if they were high in positive emotions. These included lower death rates from cardiovascular disease, suicide, accidents, homicides, mental disorders, drug dependency, and liver disease related to alcoholism. The beneficial effects of positive moods persisted even when the researchers took gender, age, and education into consideration. In fact, the only health problem happiness did not predict was whether the subjects were obese. Of course, many of the illnesses examined in the study, such as alcohol and drug dependency, were related in obvious ways to lifestyle and behavior, but there were also surprising instances of illnesses being influenced by happiness. For example, depressed individuals were more likely to have heart attacks and recurrences of heart attacks than happy people. Thus, it appears that happiness can help fend off infectious diseases, guard against lifestylerelated illnesses, and protect against heart disease as well. Unhappiness and depression, by contrast, can actually harm health.

  Survival

  It is a fact that, ultimately, we all die. None of us will survive indefinitely. When researchers talk about survival, however, they mean something a little more modest. "Survival," or what happens to people once they have already developed a serious illness, is a second definition of health. Health researchers are interested in how people fare once they have developed serious and life-threatening illnesses. Why do some people succumb quickly while others live on and on? Where emotions are concerned, it is interesting to consider whether people living with the burden of diabetes, HIV, or cancer might do better if they are happy. If you have been paying attention to the take-home message of this chapter, you would probably guess that happiness helps people survive longer. Unfortunately - and surprisingly - just the opposite is true. Reviews of studies linking health and emotions show that survival rates for those people who have serious diseases might be an exception to the health benefits of happiness. Although happiness appears to be generally helpful in promoting health, survival is the one area where happiness is sometimes actually detrimental.

  Why might this be the case? If happiness is good for you, and is an emotional tonic that promotes health, how can it, in this instance, be bad for you? There are several possible reasons. First, it is possible that highly positive people may fail to report symptoms of illness, a dangerous tendency that can lead to inadequate treatment. A blotch on the skin or small lump might go ignored or overlooked when it should be examined by a medical professional. Happy people tend to be optimistic, and this might lead them to take their symptoms too lightly, seek treatment too slowly, or follow their physician's orders in a half-hearted way. It is also possible that highly positive people who are seriously ill are more likely to choose to live out the remainder of their lives without the pain and invasiveness of some treatment regimens that might result in their living longer.

  Regardless of the reason, being very happy in the face of a serious illness can be detrimental to your health. This reinforces the major theme of this book: happiness, as psychological wealth, is good and good for you, but - just as financial wealth can lead to some undesirable outcomes - being in a giddy mood regardless of circumstances is not necessarily a good thing. One of the most important lessons about happiness is that there is an optimal level, beyond which additional positivity is detrimental. Despite the popular idea that we might be able to wish our way out of cancer with humor and positive thoughts, the scientific evidence for this is tenuous. Our advice is that gethappy techniques probably don't hurt and might even help, as long as they don't interfere with available medical treatments. Happiness is a good thing, but we can't let it cloud our judgment when it comes to our health - a conscientious approach to symptoms and diseases should be combined with an optimistic, positive attitude.

  Longevity

  If you are anything at all like most people, you probably want to live a long time. In fact, you probably want those golden years to be good ones, in which your mind and body are fit enough to allow you a good quality of life. Longevity, measured by the age at death, is the final method of quantifying health. Age at death, regardless of quality of life, offers an objective number for researchers to use as an outcome in their statistics. From a research standpoint, death is a good variable. There is
rarely confusion about when a person is dead, and death is a health outcome about which most of us care a great deal. Although a long life does not always mean a good life, by and large, people prefer to live longer than shorter. Given this, we should ask whether chronically happy people actually live longer than their depressed counterparts. The short answer to this question is yes.

  In a fascinating and now-classic study, researchers examined an unusual group to pinpoint the happiness-longevity relationship: Catholic nuns. Like the participants in Sheldon Cohen's hotel studies, religious sisters residing together in a convent live in very similar conditions, and this consistency offers something akin to a controlled laboratory. Among nuns, for instance, there are few differences in illicit drug use, alcohol consumption, diet, sexual risk taking, and other circumstances that could confound other studies that compare happy and unhappy people. In what is now referred to as "the nun study," the University of Kentucky researcher Deborah Danner and her colleagues trained their sights on 180 nuns of the School Sisters of Notre Dame to better understand problems associated with aging, such as Alzheimer's disease. The nuns who participated in Danner's study originally entered convents as young adults in Milwaukee and Baltimore between 1931 and 1943. When they entered, they wrote an autobiography describing their lives and their reasons for joining a religious order. Years later, it was these autobiographies that captured the attention of the researchers.

  Danner and her colleagues were interested in the nuns' emotions, and how these might influence their overall health. The research team sifted through the personal stories for indications of positivity and negativity. In particular, they were interested in the presence of language that might reflect positive and negative emotions. They kept an eye out for positive words like "happy," "interested," "love," "hope," and "gratitude." For example, one nun wrote: "I was born in 1909, the eldest of seven children ... My candidate year was spent in the Motherhouse, teaching chemistry. With God's grace, I intend to do my best for our Order, for the spread of religion, and for my personal sanctification." This autobiography is very practical, very nuts and bolts. Although we have no doubt that the author of these words was a woman of good character, her writing contained little positive emotional content. Contrast her autobiography with that of a sister with high positive emotions, who wrote: "God started my life off well by bestowing upon me a grace of inestimable value ... The past year which I have spent as a candidate studying at Notre Dame College has been a very happy one. Now I look forward with eager joy to receiving the Holy habit of Our Lady and to a life of union with Love Divine." See the difference? With words like "bestowed upon me grace," "a very happy one," and "I look forward with eager joy," it is easy to picture how upbeat and vital this nun must have been.

  Using tallies of the emotional content of the autobiographies as their measure of happiness, the Danner research team divided the study group into happiness quartiles, ranging from the happiest 25 percent to the least happy 25 percent, and examined how long the nuns in each of the four groups lived. At the time of the study, of course, some of the nuns were still alive, while many had passed away. In table 3.1, we show the longevity of the happiest and least happy groups at the time of the study.

  The risk of mortality - being dead at the time of the study - was two and a half times higher among the least happy compared to the happiest nuns. Indeed, nuns who used a number of different positive emotion words in their autobiographies - happy, interested, love, hope, grateful, eager, contented, amusement - lived, on average, over ten years longer than those who used few such words. It is enough to make you take a look at how you speak and write! What is especially compelling about this study, apart from the dramatic health findings, is that the researchers were able to find a group of people who were similar in terms of their social activities, reproductive histories, medical care, occupations, socioeconomic status, and diet. In this case, happiness could be separated from these potentially confounding factors, and in the end, amounted to an influence larger than many of those factors about which your doctor inquires.

  Source: Danner, Snowden, and Friesen (2001)

  Most folks like hearing about the nun study because it includes interesting results and a fascinating sample. Just the same, some people raise the issue that the results of a single study with an unusual group might not translate to the rest of us. Fortunately, the women in the nun study are not isolated examples of a link between positive emotions and health. Using the nun study as her model, the health researcher Sarah Pressman analyzed the autobiographies of 96 famous psychologists. She found that, just as in the nun study, psychologists writing happier life stories were likely to live longer. If the psychologists used more humor or positive feeling words such as "vigor" and "energy" in their autobiographies, they lived about six years longer. In contrast, when they used words such as "nervous" and "tense" in their life stories, they lived about five years less. Interestingly, Pressman also found that when the famous psychologists described their relationships with family members, friends, and colleagues, this also predicted greater longevity. Take heed - when you pen your own autobiography, make sure to write a happy one!

  Still not convinced that happiness generally leads to longer life? Perhaps you think that famous psychologists are as unusual a group as nuns. Fortunately, there is even more evidence. In yet another study of longevity, researchers examined the emotions of MexicanAmericans, and followed up two years later to determine who was still alive. They found that people reporting high positivity and an abundance of emotions such as joy and love were half as likely to die during the follow-up period as those who suffered from high amounts of fear, anger, and anxiety! What's more, happiness was associated with a lower risk of dying during the period of the study even after researchers applied fancy statistical controls to account for pre-existing medical conditions and smoking addiction. In other words, comparing people who were initially of similar health led to the conclusion that happiness increased longevity. Happy people of different cultural and ethnic origins seem to experience greater longevity than their unhappy peers. None of the research to date is definitive, but don't bet your life against it by being unhappy for long!

  The Pathways from Happiness to Health

  We have read many research findings that point to the same conclusion - happiness is usually beneficial to your health and longevity. There ought to be concrete reasons why this is so. We found at least eight ways in which happiness leads to less illness.

  Moaners and Groaners

  Many doctors believe that chronically unhappy people (those folks psychologists describe as "high in neuroticism") just howl louder about symptoms, aches, and pains. Indeed, they do. We all know critical folks who never seem to be able to see the good in anything. These are the types of people who are constantly on the lookout for something to go wrong or something to complain about. People classified as high in neuroticism, or low in positive emotions, notice small physical symptoms more than other folks, and they complain more about their aches given the same levels of pain or illness. However, studies in which negative moods are experimentally induced in people show that angry, sad, and fearful moods can actually reduce pain tolerance. Thus, unhappy people might actually feel pain more acutely than upbeat people. Your curmudgeonly Aunt Matilda might invoke some eye-rolling and displeasure among the relatives when she complains about the pain in her hip, but she might truly feel more pain.

  Good and Bad Habits

  Nobody is perfect. We all have small vices, whether it is a love of rich desserts, or occasionally skipping a workout due to sheer laziness. But it is the unhappy folks, on average, who have more bad habits. People who often feel down are far more likely to smoke, take drugs, and drink in excess. Unhappiness may lead people to these bad habits in an attempt to "repair" their negative moods. For example, smokers tend to smoke more when they are distressed, and people who are trying to quit smoking are more likely to relapse when they experience a stressful life event such as to
ugh work at the office or a fight with their spouse.

  Many health behaviors are related to happiness, hope, and optimism on the one hand, and to unhappiness and depression on the other. For example, happy people are more likely to exercise, eat well, and take vitamins. By contrast, unhappy people are more likely to die from suicide, homicide, and accidents. When rehabilitation therapy is needed, unhappy people are less likely to stay involved. Because of smoking and alcoholism, unhappy people are also more likely to die from lung cancer and liver disease. Thus, your neighbor Billie Bob might not just complain more about his health; some of his behaviors might have led to health problems in the first place.

  Immune Power

  As demonstrated by Sheldon Cohen's studies, the immune systems of happy people tend to be more effective than those of depressed people, and therefore they are better able to fight infections. In happy people, the immune system is stronger because of higher levels of infection fighters, such as natural killer cells. In contrast, depressed and distressed people tend to have lower immune reactions. With a weaker immune system, unhappy people are more likely to succumb to the infectious viruses and bacteria to which they are exposed.

  Cardiovascular Problems

  What is the number-one cause of death in most industrialized nations? Is it cancer? Accidents? It turns out that cardiovascular problems, such as stroke and heart disease, are the leading causes of death in the United States and other industrialized countries. Interestingly, emotions - especially anger and depression - are directly related to these maladies. Depressed people are several times more likely than nondepressed folks to have heart attacks and hypertension. Individuals who work under stress or who have troubled marriages are also more likely to suffer from a heart attack and arterial thickening. In one fascinating study, however, a good marriage helped buffer against the ill effects of a bad work environment in terms of such cardiovascular problems. In another study, researchers found that people in happier nations have fewer problems with high blood pressure. On the positive side, people receiving counseling aimed at reducing hostility and impatience for their "Type A" personalities are less likely to have a second heart attack.