THE BLOG
10/28/2010 02:08 pm ET | Updated May 25, 2011

Heart Health: Being Mindful of a Happy Heart

A recent study from Columbia University examined whether good heart health over a 10 year period relies on feeling good (Davidson, 2010). While it has been known for awhile now that depressed mood is associated with worse heart health (Nabi, 2010), the actual effects of positive mood on long term heart health had not been rigorously studied until David and colleagues took a look at whether positive affect protects the heart.

To determine whether mood and heart heath were related, they studied outwardly displayed positive affect. They found that over a period of 10 years, increased positive affect was protective against the 10-year incidence of coronary heart disease. The implications of this finding are interesting.

Affect refers to the experience of feeling or emotion, so positive affect refers to how happy a person appears to feel to the extent that they express this. Thus, this study really was not about internal bliss or satisfaction but about the actual expression of felt happy feelings. This is an interesting distinction as simply feeling happy but not expressing this was not accounted for in the study. In order to "express" happiness, the way one feels has to be aligned with the brain's ability to outwardly manifest this feeling. This "alignment" or feeling of continuity is something that is so often impaired in adults.

Children, for example, often burst into a giggle or a fit of laughter if something makes them happy, but adults are always internally watching how they express their happiness. Not feeling happy is one problem -- or so this study implies. But not expressing happiness is another problem that it would be important to contemplate. What causes this misalignment of disinclination to express good feelings?

Social awkwardness is one factor that plays in. Children generally do not care if you can see their tonsils when they are laughing -- in fact, if you are sufficiently close to them, you might actually get a glimpse. Adults, however, often watch their laughter to make sure that there is not too much mouth showing. Also, adults are excruciatingly aware that life is full of ups and downs and so they prevent themselves from being "too happy" by laughing just enough but not too much. They don't want to feel like fools. The problem is, this outward restriction of expression often leads to no expression. It is part of what I call the "why bother" syndrome that often infects the 'adult" temperament. As a result, the outward expression of happiness is limited.

At a deeper level, this study of "expression" also highlights the fact that we are sensory and motor creatures. That is, we receive and give in all matters of life. Whether it is love, money, sex or gifts, this ability to give and receive is an innate part of our social behavior. However, when it comes to our own feelings, we do not always give what we get. We often choose to replace actual expressions with words and if you examine closely how people respond, there is what I sometimes refer to as social pornography -- sounds of pleasure that simply do not ring true but appear to represent the truth. Words have become the exhibition boxes for our feelings and our faces and throats have been spared the effort. This clearly also deprives our arteries that appear to depend on whatever expression does to their walls and blood flow.

More literally, this study implies that it is not just treating depression, but enhancing positive affect that can protect our hearts. It is at once alarming but also necessary to note that we may have to learn how to express happiness more effectively as well. The way I am examining this matter of "expression" was probably not how the authors conceived of affect as the assumption is that if you are not expressing happiness in your face you are not happy. I would say that it is not only sad people who are at greater risk for coronary heart disease, but also non-expressers who burden their brains with self consciousness about lip movement, mouth openness or social propriety about the "extent" to which one expresses happiness.

Asking words to carry this burden also simply does not cut it, as the actual expression of happy affect requires the brain to make contact with the heart through its expressive functions that are silent but fluid. In my opinion, there is an epidemic of fluid expression avoidance in adults that we would be wise to pay attention to. Simply put: it's not too late to start showing what you feel -- or teaching yourself to do this -- particularly when what you feel is good and happy. Lose the words and show the world the full range of possibilities of simple, pure happy expression if you want to protect your heart.

References
1. Davidson K.W. Mostofsky, E. Whang, W. Don't worry, be happy: positive affect and reduced 10-year incident coronary heart disease: the Canadian Nova Scotia Health Survey. Eur Heart J. 31 (9) 2010
2. Nabi, H., Kivimaki, M., Suominen, S., Koskenvuo, M., Singh-Manoux, A., Vahtera, J. Does depression predict coronary heart disease and cerebrovascular disease equally well? The Health and Social Support Prospective Cohort Study. Int J Epidemiol. 39 (4) 2010