5 evidence-based paths to happiness

Balancing life and work is overwhelming enough for most physicians, but the pandemic is amping up stress levels. Even with optimism about the vaccine rollout, the beginning of 2021 feels much like 2020. With still-skyrocketing COVID-19 rates, the world’s in for more sick and dying patients, dashed plans and celebrations, canceled medical appointments, social isolation, and face masks.

But there are a number of simple actions that physicians can take to improve their well-being and embark on a path to happiness. Among those well-versed in happiness strategies is Laurie Santos, PhD, a professor of psychology at Yale University and host of The Happiness Lab podcast. In 2018, Santos came across a survey of college students that suggested that more than 40% were so depressed they had a hard time functioning. This prompted Santos to create a class that provided students with practical, evidence-based tips on how to boost their happiness levels. The class was so popular that Santos put it online—and as of January 2021, more than 3 million individuals have signed up for it. 

If you don’t have the time or patience to take an entire course, we’ve got you covered. Below is a snapshot of the tips that Santos based her class on, along with supporting research and evidence. So, keep reading to learn five science-based methods to boost your happiness and well-being in your practice and at home. 

Try to be social

While this can be tough during a pandemic, studies show that social people tend to be happier. Santos cites psychologists Ed Diener and Marty Seligman, who found that people who scored in the highest 10th percentile on happiness surveys were more social. In fact, researchers concluded that our happiness tends to somewhat rely on interactions with other people.

Santos is far from alone on this. This past December, a literature review published in Proceedings of The National Academy of Sciences of the United State of America, noted that among the fundamental tenets of well-being is “connection,” which the authors defined as “caring relationships and positive social interactions.” These, according to the review, can buffer against psychological disorders like depression and anxiety.

Why? Well, the parts of our brains that we use to form and maintain relationships contain many of the same neural systems involved in experiences of physical threat and safety. As an example, the authors of the review cited an earlier study that showed holding the hand of a spouse while being exposed to electric shock resulted in reduced activation in parts of the brain that create pain sensations.

So, don’t let lockdown stop you: Get on the phone with a friend or relative, or find time to take a socially distant stroll with a loved one. Even if you’re feeling down beforehand, you might just get a happiness boost.

Go for gratitude

Socializing is tricky right now, but one happiness-enhancing activity that doesn’t require you to go anywhere is practicing gratitude. Santos notes that those who express more gratitude and actively think about what they’re grateful for tend to show lower levels of stress hormones like cortisol. Similarly, grateful people experience less depression and tend to sleep better.

Indeed, there is a growing body of evidence that suggests that feelings of gratitude are related to various positive physical health outcomes, like reductions in chronic pain, lower blood pressure, and improved immune systems. A 2018 study published in Psychology, Health & Medicine looked at over 600 healthy adults, finding that the positive effect of gratitude on physical health was significantly mediated by lower reported levels of perceived loneliness and stress. 

Aim to be present

Yet another tip that feels particularly apt during a pandemic is: Live in the moment. According to Santos, a study conducted by a team of psychologists from Harvard University indicated that we spend about 40% of our time letting our minds wander—not being in the present. And there is increasingly more evidence to suggest that this is detrimental to our mental health. 

The aforementioned 2020 review includes “awareness” as one of its four principles for well-being. The authors define this as “heightened and flexible attentiveness to perceptual impressions in one’s environment,” which essentially amounts to paying attention to the here and now. The review cites a number of studies that suggest being present is important for healthy psychological functioning. The authors conclude that high levels of distraction are associated with stress, anxiety, depression, and ADHD symptoms. The problem is also related to biomarkers of poor physical health, like increased levels of cortisol and α-amylase and reduced telomere length.

This is because awareness is associated with lateral regions of the prefrontal cortex that form part of the brain’s central-executive network, whereas distraction is linked to diminished activation of this network, and specifically to decreased activity in the dorsolateral PFC. Abnormal functioning of the central executive network is a transdiagnostic marker for schizophrenia, anxiety, depression, and other mental health disorders.

So, stop dwelling on that nebulous moment in the future when lockdown might be lifted or vaccines might come to your clinic. Take a breath and try to engage with whatever or whomever is around you right now.

Get rest and stay active

This may sound like a contradiction, but Santos talks about two specific elements for good mental health: getting enough sleep and some physical exercise.

A proper night’s sleep provides more health benefits than many understand. There are multiple different stages of the 90-minute sleep cycle. During what’s known as “quiet sleep,” muscles relax, heart and breathing slow, and certain physiological changes occur that help boost the functions of our immune system. During rapid eye movement sleep, or the stage when we dream, our learning and memory capabilities grow stronger. 

While research into how these mechanisms work is ongoing, various studies have found that sleep problems, like insomnia, increase the likelihood of developing depression. One recent study, published in Environmental Research and Public Health, analyzed the role of sleep in the well-being of over 250 undergraduate students in China. Researchers found a strong association between having normal sleep quality and lower levels of psychological well-being.

Exercise is also a great way to boost happiness levels. Santos cites a study that found even just 30 minutes of cardio on a stationary bike reduced feelings of tension, anger, depression, and fatigue over a period of up to 12 hours. 

Practice kindness

Finally, research shows that being nice—to others and yourself—is a great way to bolster mental health. According to Santos, the best way to promote self-care is to provide other-care. She cites research that indicates those who self-report being the happiest are those who focus on others, donate more time and money to charity, and engage in random acts of kindness.

One study, published in the Journal of Social Psychology in 2018, sought to investigate the effects of a 7-day kindness activities intervention on the levels of happiness in more than 600 individuals. Not only did acts of kindness increase levels of happiness, but researchers saw a positive correlation between the number of kind acts and increases in happiness.