Seattle Times
Astrid Pujari, MD
Column: May 30, 2006
You’ve probably heard the quote, “An ounce of prevention is worth a pound of cure.” And when it comes to physical health, I think most doctors would agree. That is why primary care providers spend so much time talking about things like exercising and quitting smoking.
On the other hand, prevention is a radical new idea when it comes to our emotional and mental health. In conventional medicine, we seem to focus on “mental health” only when there is a problem – depression, anxiety, and addiction, for example. But we spend precious little time talking to people about emotional wellness.
The irony is that, in the end, most of us want to be happy. And I think medicine has made the assumption that if you aren’t depressed, you must be happy – or at least “fine,” whatever that is.
But the road to happiness, in my experience, is very different than the road to “not depressed.” On the road to “not depressed” you can afford to coast – perhaps – as long as you don’t hit a major crisis or change in terrain. But the road to happiness takes hard work. Contrary to what many people would tell you, people don’t just randomly “become happy.” They work at it. They practice. They take care of their emotional health with the same attention others would give to their cholesterol or weight.
That’s not to say that depression, or other issues, are necessarily the result of poor emotional care. I believe that they are real illnesses, with real biology, and that even the best laid plans can go awry. On the other hand, I also think that if we are really interested in comprehensive and holistic prevention, it is essential that we include emotional and mental health in the package – and not just physical health. Too often we focus on the outside, only to realize that when the tire hits the road, it’s our insides that make the difference.
That being said, the good news is that medicine is changing. One proof of that is the emerging field of “positive psychology,” the study of what brings us happiness, satisfaction, and meaning in life. I read a wonderful article some time ago by Dr. Paul Hershberger, in which he describes a few simple techniques which have been shown to promote positive emotions, including happiness. Let me share a few of them with you here. For more information, I recommend you go to this link to read the full article. www.stfm.org/fmhub/fm2005/October/Paul630.pdf
- Every night, take the time to write down three good things that happened during the day, and then write why you think it happened. Gratitude is a powerful way to help people move from focusing on the negative to the positive. In one small study, doing this daily for one week helped people to feel less depressed up to 3 months later.
- Share good news as often as possible. Encourage others when they tell you good news. One researcher found that every time we share good news, we reinforce those feelings in ourselves and in others. Our relationships also tend to be stronger and more positive.
- Focus on cultivating one of the five following qualities – love, hope, gratitude, curiosity, or vitality. The field of positive psychology has a list of 24 different qualities that they describe as character strengths. These five were found in one study to have the closest link to life satisfaction.
- Don’t go for best. Go for satisfactory. Instead thinking that we need to get the latest and greatest new dishwasher – or whatever the item is – the goal here is to decide what the basic criteria are that you want to meet, and get the first option that meets those criteria. This approach saves emotional energy, time, and “buyer’s remorse.”

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