Beyond Depression: Promoting Heart Health by Flourishing in Life
by Arthur Luz, Ph.D.


It is true depression is a risk factor equal to high blood pressure or high cholesterol for cardiovascular disease. So let us say you wisely decide to talk to a psychologist and get help for your depression. You get rid of this dreadful condition with good treatment just like you do when you have a difficult medical illness and are treated successfully by a physician. Are you healthy now? Does the absence of your depression signify a state of health?

Well not really. It does appear that psychological health is not just the absence of disease but includes the promotion of positive ways of thinking, feeling and behaving. And it appears that positive thinking, positive emotions and supporting behaviors promote lower rates of physical disease, fewer physician visits, and a longer and more satisfying life. This has been recently documented specifically for cardiovascular disease. In a large study conducted by Corey Keyes at Emory University, individuals “flourishing in life” had an 8% rate for cardiovascular disease compared to a 19% rate for those “languishing in life” and experiencing depression. In fact, those not even depressed but “languishing in life” had a 13% rate for cardiovascular disease.

So, what positive psychological factors promote health and minimize disease?

Optimism, for example, has been clearly identified as a pattern of thinking contributing to less illness, better health and a longer life. In a landmark study, Harvard University graduates from the 1930’s and 1940’s were given a number of physical and psychological tests and followed through life for evidence of illness, psychological well-being and longevity. Psychologists call this a prospective study because it looks at a group of individuals for a long period of time. Almost all of the participants were males who were World War II vets. Upon returning from their war experiences they each answered a questionnaire about their “difficult war experiences”. These questionnaires were kept and analyzed during the 1980’s for the content of optimism versus pessimistic expressions. Sure enough, thinking optimistically as a young man was strongly related to the absence of physical illness 35 years later.

But what is optimism? We all seem to know something about Dale Carnegie and the “power of positive thinking.” Think positive and good things will happen! Right? I’ll win the lottery if I just believe I will. Not exactly.

Optimism is far more complex than the clichés seem to suggest. It appears that there may be two kinds of optimism.

The “little optimism” is demonstrated when you think you will be successful in reaching a goal and there is a good chance of success. Believing you can get the high quality food products at your favorite grocery store with a trip to the store later in the day is an example of “little optimism. “Little optimism” is tempered by chance. That is to say, there is little risk or chance that you won’t get there or that the store won’t carry what you are looking for. Not so with winning the lottery. Your chances are slim no matter how strongly optimistic you are.

Then there’s “big optimism.” It is reflected in a broader belief system of the individual, particularly when anticipating or facing a crisis. For example, it is the expressed belief that despite economic setbacks, I will recover and, despite the struggle, life is still good. With the “big optimism” there is not just a positive thinking style but a strong positive emotional and motivational basis of faith, strength and perseverance. The “big optimism” is probably associated with the psychological well-being, good health and well being of the Harvard men.

Secondly, love has a clearly established relationship with good physical health. This could be love for a spouse, child or parent. Love for the Earth or God. All love involves some kind of caring and an extension of oneself to another. The experience of giving is a joyful experience. A study by psychologists of nuns who wrote biographical essays in the 1930’s about their childhood, the schools they attended, their religious experience and reasons for taking vows demonstrated the difference between the joyful experience of the “happy” nuns and the more duty bound experience of the others. The researchers were interested in determining if the more “happy” nuns were less prone to illness and lived longer lives. But if one considers the statements of the “happy” nuns their expressions are full of joyful love and purpose. For example, joyful love is expressed by one nun with the statement, “Now I look forward with eager joy to receiving the Holy Habit of Our Lady and to a life of union with the Love Divine,” compared to the neutral statement of another nun “With God’s grace, I intend to do my best for our Order, for the spread of religion and for my personal sanctification.” The results clearly suggested that positive loving content had a clear relationship with survival. The joyful nuns lived on average 10 years more than their counterparts. This difference in longevity is quite significant. Consider the fact that the 7 year difference in longevity for non-smokers compared to smokers has been one of the most dramatic health findings to date.

 Also, study after study has demonstrated that being “happily married” is far better than being single or divorced from a health perspective. Happily married couples experience less illness than single or divorced individuals. Of course, unhappily married couples experience more illness than those who have divorced or remained single. These relationships are stronger for men than women. This may be due to the caring relationships women have with each other outside of marriage in comparison to men who are more socially and emotionally isolated from each other. Love protects against illness and supports the competence of the immune system.

Positive psychology is young and is sure to add other health promoting factors to its list. For example, another factor closely related to optimism and love as a contributor to life satisfaction is gratitude. Are those who are also “thankful” healthier? Some psychologists are betting on it (personal communication with Chris Peterson at the University of Michigan) but only further research will tell. The good news is that optimism and love are within the reach of all of us.


To learn more consider these references:

Keyes, C.L.M., (2007). Promoting and Protecting Mental Health as Flourishing; A Complementary Strategy for Improving National Mental Health. American Psychologist, Vol. 62, 95-108.

Peterson, C., Seligman, M.E.P., & Vaillant, G. E. (1988). Pessimistic explanatory style is a risk factor for physical illness: A thirty-five year longitudinal study. Journal of Personality and Social Psychology, 55, 23-27.

Danner, D. D., Snowdon, D., & Friesen, W. V. (2001). Positive emotions in early life and longevity: Findings from the nun study. Journal of Personality and Social Psychology, 80, 804-813.

Peterson, C. (2006). A primer in positive psychology. Oxford: Oxford University Press.