Does a positive outlook give you an extra edge against illness? Or does pressuring yourself to stay perpetually cheerful just create more stress?
People – and researchers for that matter – are curious.
Maintaining a positive outlook during stress offers protection against inflammatory reactions and future depressive symptoms, one study found. And people who stay optimistic during stressful events are 22 percent less likely to have a heart attack, according to another.
Despite the hopeful evidence, the jury is still out.
“There seems to be a connection. However, the associations between positive attitude and health are complex but promising, and merit further investigation,” says Firdaus Dhabhar, Ph.D., a psychiatry and behavioral sciences expert at the University of Miami Health System.
The mind-body connection
"The connection between mind and body in health and healing has been appreciated since ancient times," Dr. Dhabhar says. "Science is beginning to elucidate [or explain] mechanisms mediating this connection. For example, in my laboratory, we investigate biological connections and mechanisms through which stress, including psychological stress, induces changes in our bodies that can negatively or positively affect health outcomes.”
Chronic vs. short-term stress
Dr. Dhabhar’s research concurs with data found in other labs.
"We have shown that chronic or long-term stress significantly suppresses and/or disrupts immune function," he says. "It creates conditions that inhibit wound healing and vaccine responses, and contributes to the development or exacerbation of diseases such as cancer."
On the other hand, short-term stressors, such as the fight-or-flight response, actually boost our immune response and can enhance healing and recovery. Patients who launched an adaptive short-term stress response during surgery had a significantly better recovery than those who did not, says Dr. Dhabar. The adaptive short-term stress response occurs when immune cells move rapidly from organs through the blood vessels to reach other parts of the body to heal a wound, including wounds resulting from surgery.
Overall, short-term stress lasting minutes or a few hours isn’t harmful, says Dr. Dhabhar. “Even if you’re dealing with a series of short-term stressors, they aren’t likely to harm you as long as there is sufficient time between ‘hits’ when you return to a low- or no-stress state.” Chronic stress lasting months or years is another matter. Researchers have long blamed chronic stress for health problems of the heart, brain, and gastrointestinal system. In a study published in early 2019, they identified a mechanism that promotes cancer stem cell growth, which leads to tumors. The mechanism is triggered by chronic stress.
When positivity isn’t practical
Even the sunniest people experience situations when no amount of platitudes, positive thinking, or well wishes improve their outlook. The upside of this hard truth? It’s perfectly normal to feel crummy. “If you are in a really difficult situation, acknowledge to yourself that it’s natural to experience negative emotions and feel overwhelmed. Do your best to accept things you may not be able to change. It’s good if you can maintain positivity, but if you can’t, it’s not a sign of failure,” Dr. Dhabhar says. A study supports his comment; in it, researchers found little evidence that “psychological coping styles” affect the likelihood of cancer recurring or the ability to survive cancer.
If you’re trying to comfort someone coping with a serious illness, Dr. Dhabhar urges sensitivity. “Well-intentioned messages such as ‘Be positive, because that will help you fight your disease,’ can have unintended negative consequences. They could make the person feel that it may be their fault that they got the disease and their fault if they can’t fight it.”
Ask for support
No man (or woman) is an island. Having a support system is one way to bolster your outlook and perhaps also your biology: Dr. Dhabhar and his colleagues have shown that social support can be a buffer against the biological effects of negative emotions. Reaching out to family and close friends is important. Speaking to a mental health professional, or a religious or spiritual counselor may also help. If family and friends don’t live nearby, focus on building a support system. “Most people are intrinsically helpful and caring," says Dr. Dhabhar, “Find the ones who you get along with.” Take time to forge friendships at the gym, church, in support groups, in your neighborhood, at work, or at outings where you will meet others with similar interests.
“You don’t need 1,000 friends on Facebook, just one or two people who care about you and who you can truly count on when you’re dealing with chronic stress.”
He also recommends finding activities you enjoy that prevent stress from accumulating. Who knows? An hour’s walk on the beach might just be the attitude adjustment you need to improve your health.
Nancy Moreland is a contributing writer for UMiami Health News. She has written for several major health care systems and the Centers for Disease Control and Prevention. You can also find her writings in the Chicago Tribune.