Creating a Sustainable Future
The Pursuit of Health
Does Mind Matter?
The Pursuit of Health and Happiness
The focus of modern, Western medicine has been largely on intervening in the body machine with drugs and surgery. Nonetheless, psychosocial factors play a major role in who gets sick, the course of their illness, as well as the recovery from illness.
Chest pain, back pain, dizziness, headache, difficulty breathing, inability to sleep, abdominal pain and lack of energy. Sound familiar? These are the most common reasons people consult a physician.
But despite how common these ailments are, less than half of all people displaying these symptoms are appropriately diagnosed by their doctors – even after a thorough patient history, physical exam and medical testing. Doctors either don’t diagnose or do so inaccurately because they’ve failed to consider a very common root cause of human suffering and the source of many physical symptoms- namely, psychological stress.
While some patients – about 10 to 20 percent – exhibit extreme anxiety and depression indicative of a major psychiatric disorder, most people have what is best termed “everyday psychological distress.” This more common type of psychological distress has a major impact on daily physical and social functions. It even produces disabilities equivalent to diabetes, hypertension or arthritis.
The majority of Americans report unhealthy stress levels. And 1 in 5 people quantify their stress level as “extremely high.” What’s perhaps even more worrisome is that only 37 percent of Americans feel they’re able to adequately manage their stress. Most commonly, stress originates from work, financial pressures, family responsibilities, relationships and personal health concerns.
Ironically, stress negatively impacts the aspects of people’s lives that cause it in the first place. For instance, 70 percent of individuals who are stressed experience physical symptoms, lower productivity at work, and disruptions in their family and social lives.
Furthermore, adults with high stress levels are less likely to eat healthily, engage in physical activity, get enough sleep or moderate their alcohol consumption. These behaviors – often caused by stress – lead to additional health problems like depression, cardiovascular disease and even a greater susceptibility to colds. Stress can even affect our genes and speed up the aging process. Women with high stress levels experience a shortening in portions of their DNA with results equivalent to nearly a decade of accelerated aging compared to women with less stress.
We know stress-related symptoms take a toll on individual health. But studies also show the dire impact stress has on our nation’s work productivity and overall health care system. A third of U.S. workers report feeling extremely stressed at work. And this job-related stress is costing American industry an estimated $300 billion a year in absenteeism, turnover, diminished productivity and on-the-job accidents. Meanwhile, health care expenditures are nearly 50 percent greater for workers who report high levels of stress.
Early childhood stress seems to exert an exceptionally powerful influence throughout life. A long-term study of 17,000 people, found that Adverse Childhood Experiences (ACEs) are:
The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States is approximately $124 billion in 2010 dollars. This economic burden rivals the cost of other high profile public health problems, such as stroke and Type 2 diabetes.
Fortunately, there is evidence that some of this child maltreatment and its health, social and economic consequences can be prevented.
The Other Side Of Stress: Why Positive Moods and Mindset Matters
Some stress can actually be positive, particularly when it motivates necessary lifestyle changes and builds resilience. Interestingly, the effect of stress on health and well-being, seems to be moderated by your view or “mindset” regarding the impact of stress. People who view stress as potentially helpful, something to be used and embraced (“stress-is-enhancing mindset”), fare much better than those who see stress as something that makes you sick and to be avoided and reduced (stress-is-debilitating mindset”). The good news is that these stress mindsets can be altered. In one experiment, when “stress-is-enhancing” videos were shown to people, their symptoms of anxiety and depression, as well as work performance improved. (Crum, Alia J., Peter Salovey, and Shawn Achor. "Rethinking stress: The role of mindsets in determining the stress response." Journal of Personality and Social Psychology 104.4 (2013): 716.)
In a study of over 28,000 people those who reported both a lot of stress and the perception that stress affects their health had a 43% increased risk of death. In fact, believing that stress is harmful to health may have caused over 20,000 premature deaths per year, making this the 15th leading cause of death in America. (Does the perception that stress affects health matter? The association with health and mortality. Keller, Abiola; Litzelman, Kristin; Wisk, Lauren E.; Maddox, Torsheika; Cheng, Erika Rose; Creswell, Paul D.; Witt, Whitney P.Health Psychology, Vol 31(5), Sep 2012, 677-684) Seeing the upside of stress is not about deciding whether stress is either all good or all bad. It’s about how choosing to see the good in stress can help you meet the challenges in your life. (McGonigal, Kelly The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It (pp. xxiii-xxiv). Penguin Publishing Group. 2015)
Studies show that positive and negative moods influence physical health and longevity independently. Mounting evidence demonstrates that happiness, pleasure, joy, optimism, excitement and sense of humor each have positive biological and physiological effects. So, while counteracting chronic stress and reducing negativity is important, another key to better health is finding happiness.
People who report that they are very happy (with less negative and more positive emotion and optimism) live 4 to 10 years longer than unhappy individuals. More so, those extra years are also lived healthier. Further, people who express positive emotions like joy, cheerfulness, and enthusiasm are 22 percent less likely to develop heart disease than those who don’t. In fact, in a study of nearly 100,000 women, optimists were 30 percent less likely to die from coronary heart disease than pessimists. Happiness, even expressed in a given day, is a statistical predictor of health. In one study, those who reported a more positive mood in one 24-hour period experienced a 50 percent lower death rate over the next five years compared to those who were less happy that day.
Since happiness – and its many forms – can improve one’s health raises an important question: Can we choose to be happy? If we’re generally unhappy, can we reset this emotion or are some people too influenced by genetics, upbringing, and environment to modify their emotional state?
Of course, separating cause and effect is difficult here. Does one’s negativity cause stress that causes negative health outcomes? Likewise, can day-to-day happiness alone reverse negative health trends? Evaluating the impact of stress levels on lifestyle change is complex.
Factors like genetics and the environment can impact both disease prevalence and mood. But regardless of etiology, when faced with such adversity, happy people optimize their health and cope better than those who are unhappy.
Happily, there is mounting evidence that our moods and happiness can be modified by some simple activities and interventions that reshape our thoughts and moods each day.
Healthy Pleasures: The Health Benefits of Sensuality, Optimism and Altruism
Imagine a medical treatment that can help lower your blood pressure, decrease your risk for heart disease and cancer, boost your immune function and block pain. It’s safe, inexpensive and readily available. The main side effects include feeling good, an increased sense of well-being and greater self-confidence.
Would you take it?
Many of us couldn’t begin to imagine such a treatment. But it turns out this remedy is readily available and inexpensive. And best of all, this “miracle drug” is produced by our brains in response to pleasure, happiness, optimism and positive mood.
“Mind-body” medicine – increasing our positive thoughts and emotions to influence physical health – is safer than medications sold through pharmacies, produces fewer negative side effects and provides longer-lasting results. But unlike swallowing a pill, such medicines require people to contribute time, energy and practice.1. Savor Your Senses
Our senses – touch, taste, sight, smell and hearing – allow us to learn about and enjoy the world around us. Human beings evolved to seek out experiences that are pleasurable because they either increased individual or group survival. For example, our ancestors who sought out a variety of taste sensations and foods, were more likely to get a healthier mix of nutrients, survive, and pass on this propensity to later generations. We rely on our senses to protect ourselves from danger, but our sensory nervous system also has the power to reduce stress. To enjoy the positive health outcomes of our senses, try some of these mind-body medicines on for size.
2. Practice Happiness
Much of our distress comes not from the stress triggers themselves but from our own interpretations about our situation. These mental stories can be altered with positive results.
3. Indulge In Altruism
People who volunteer and care about something other than themselves (think: people, pets, plants and the planet) tend to be both happier and healthier. In fact, helping others can buffer stress and reduce a person’s risk of death.
Embracing Happiness And Health
Many people worry that to promote health they have to adopt extremely restrictive diets, engage in punishing exercise, avoid all salt and shun cholesterol. Although each of these in moderation can contribute to improved health, participating in pleasurable activities also adds to happiness and health.
Scientific evidence now suggests that for most people, doing what is pleasurable actually pays off in both immediate enjoyment and better long-term health. The healthiest, most robust people seem to indulge in many small daily pleasures and cultivate a positive, optimistic view of their lives.
So taking a siesta, playing with a pet, talking to a friend, looking at nature, smelling a sweet scent, laughing at a funny movie and scores of other healthy pleasures may measurably improve your life, your health – and your happiness.
At the same time, neither commercially produced drugs nor “mind-body” prescriptions are cure-alls. Both have their usefulness and their limitations. Mental imagery, relaxation or other mind-body techniques are ineffective in treating medical problems such as infections, cancers and advanced heart disease.
But before concluding that there is a pill for every problem, remember that traditional treatment with drugs and surgery are also not effective for a variety of medical problems, particularly those that result from stress and mild mood disorders. For these patients, a combination of mind-body techniques and traditional medical care produces the best outcomes.
The Way Forward
While it might seem at first from reading this article that I am somehow against medical care. Not so. I have practiced medicine for 35 years and many of my patients have benefited greatly from the care that I and my colleagues have provided. And the future is bright for medical care. With advances in biotechnology and medical science we will certainly develop better preventive medicines and interventions tailored to individuals based on their genetics and risks. This emerging development is sometimes referred to as Precision Medicine or Personalized Medicine.
At the same time, the arguments made above suggest some prudent and realistic approaches to optimizing health and minimizing harm as well as costs.