Many of those who’ve suffered from illness or disease would have received the advice to “stay positive.” Is this sage advice that can truly have a positive effect on health, or an added burden for someone who is already suffering — the need to also feel good about it?
We asked five experts in various fields whether a positive mindset can affect outcomes for those suffering from illness and disease.
Five out of five experts said yes
However, they had some important caveats. It depends on the disease —for example, one expert said studies in cancer have not found positive thinking affects disease progression or the likelihood of early death.
And while our mental health can have powerful effects on our physical health, the perceived need to “stay positive” can be an added burden during a difficult time. So it’s also important to remember grief is normal.
Here are the experts’ detailed responses:
Erica Sloan, stress and cancer research
There is increasing evidence mental states such as feeling stressed or anxious can have negative effects on our health. We are beginning to understand the anatomical basis for this. The sympathetic nervous system extends from our brain through our body and controls the fight-or-flight response to stress. While this response can be adaptive, it impairs the immune system, severely limiting how well protective T cells and innate immune cells can do their jobs. Alarmingly, viruses and cancer also hear the fight-or-flight response, which helps them grow and evade the immune system.
But it’s not all bad news. We are discovering how positive mental states bolster immunity by activating the brain’s reward center. As a diagnosis of a chronic disease can be stressful, this research points to the importance of treating the whole patient, not only the disease.
Jayashri Kulkarni, psychiatry professor
Mental health affects physical health in many ways. Adverse events in early life have a mental impact, affecting hormones (the “stress hormone” especially), the immune system, and our mood (including anxiety). These can all cause physical illness and delay recovery from existing physical health issues. For far too long, the split between mind, body, and environment held back medical treatments. Now that we know more about the interactions, we can consider how mental disease affects physical disease.
Our work in borderline personality disorder, for example, reveals early life abuse in girls is correlated with adult obesity (and consequent diabetes and heart disease), increased infertility, premenstrual depression, high levels of anxiety, and increased autoimmune conditions. The external world affects the brain circuitry, chemistry, and results in causing or exacerbating physical and mental illnesses.
Michael Roche, mental health nurse
Recovery from acute illness, and our capacity to live with and effectively manage chronic illness, can be powerfully influenced by the way we view ourselves and the illness with which we are confronted. Making this more complex, one of our responses to physical illness can be mental ill health such as depression, which can further compromise our well-being and ability to recover.
Factors such as intrinsic optimism and pessimism, or mental health disorders, have been linked to the speed and degree of recovery in many studies, but importantly so is our resilience, something we can develop and strengthen, particularly with appropriate support from our social networks and health care professionals. To recover well, we will do best when we have hope, and that means we need to address all facets of our being when confronted with ill health.
Michael Vagg, pain specialist
Pain is a sociopsychobiological phenomenon, and the conscious experience of pain is always shaped by the current state of the brain’s threat perception, beliefs about pain based on prior experiences, social context, and expectations about pain in given situations. Little of this can be consciously influenced, however. Just “thinking positively” does not really equate to better outcomes in chronic diseases, though being optimistic by nature before you get sick might actually help.
Interventions such as learning a mindful approach to life, sound stress management techniques, having supportive (but not overly protective) loved ones, and being given accurate information about what to expect during surgery have been shown to reduce the need for painkillers after surgery. So, as far as pain goes (whether acute or long-term), mental state really does matter for outcomes, but it’s hard to manipulate to improve your outcome once the problem starts.
Sarah Mansfield, GP
Yes it may, but evidence is conflicting. Some studies show an association between optimism and better outcomes in chronic diseases, particularly heart disease, and potentially reduced mortality. Explanatory hypotheses include a greater likelihood of engaging in treatments and beneficial health behaviors, development of stronger relationships and supports, and possibly protective immune-related changes.
However, other studies, especially regarding cancer, have found positive thinking does not alter progression or mortality. Moreover, many patients experience added emotional burden due to the social pressure to adopt a positive attitude all the time, and guilt if they cannot achieve this. It’s normal to experience grief and negative emotions associated with illness, and many conditions actually alter our mood and personality. It’s important we recognize this and support patients’ mental well-being with a view to improving their quality of life rather than it being primarily about changing the course of a disease.