Dr. Aliasgar Lokhandwala - M.D. Medicine, delivered a Talk at SKMC - Abu Dhabi on Tuesday 13th May 2014 to the Medical Fraternity at the Hospital. The Oxford Happiness Questioner was the Cherry on the Cake and evoked a good response.

1. PURSUIT OF HAPPINESS
From Philosophy to Medical Science
ALIASGAR LOKHANDWALA
INSTITUTE OF MEDICINE
SKMC

2. CONTENT
• STORY OF PURSUIT
• DEFINITION OF HAPPINESS
• MEASUREMENT Of HAPPINESS
• FACTORS INFLUENCING HAPPINESS
• MEDICAL BENEFITS Of HAPPINESS
• ROLE OF MEDICINE-LOOKING FORWARD
• CONCLUSION

3. Story of Pursuit
• Socrates-Happiness can be attained
• Aristotle- Eudemonia /Virtue and rationality a necessity
for Happiness
• America’s Declaration of independence,1785(Thomas
Jefferson)-Life, liberty and Pursuit of Happiness
• Modern Times-The goal should be the greatest happiness
of all

4. Story of Pursuit
• All medical science attention to Depression
• From 2000 onwards-Perception changed
• 10 billion dollar Industry/5000 motivation speakers in US
alone
• International day of happiness-March 20
• Science of Happiness

7. Definition
•Happiness is a mental or emotional state
of well-being characterized by positive or
pleasant emotions ranging from
contentment to intense joy.

8. Measurement of Happiness
• The Subjective Happiness Scale(SHS).
• The Positive and Negative Affect Schedule(PANAS).
• The Satisfaction with Life Scale(SWLS).
• The Oxford Happiness Questionnaire.

9. The Oxford Happiness Questionnaire was developed by
psychologists Michael Argyle and Peter Hills at Oxford University.
• Below are a number of statements about happiness. Please indicate how much you agree or
disagree
• with each by entering a number in the blank after each statement, according to the following scale:
• 1 = strongly disagree
• 2 = moderately disagree
• 3 = slightly disagree
• 4 = slightly agree
• 5 = moderately agree
• 6 = strongly agree
• Please read the statements carefully, some of the questions are phrased positively and others
• Negatively. There are no “right” or “wrong” answers (and no trick questions)
• The first answer that comes into your head is probably the right one for you.

10. 1. I don’t feel particularly pleased with the way I am. ( R) ______
2. I am intensely interested in other people. _____
3. I feel that life is very rewarding. _____
4. I have very warm feelings towards almost everyone. _____
5. I rarely wake up feeling rested. (R) _____
6. I am not particularly optimistic about the future. (R) _____
7. I find most things amusing. _____
8. I am always committed and involved. _____
9. Life is good. _____
10. I do not think that the world is a good place. (R) _____
11. I laugh a lot. _____
12. I am well satisfied about everything in my life. _____
13. I don’t think I look attractive. (R) _____
14. There is a gap between what I would like to do and what I have
done. (R) _____

11. 15. I am very happy. _____
16. I find beauty in some things. _____
17. I always have a cheerful effect on others. _____
18. I can fit in (find time for) everything I want to. _____
19. I feel that I am not especially in control of my life. (R) _____
20. I feel able to take anything on. _____
21. I feel fully mentally alert. _____
22. I often experience joy and elation. _____
23. I don’t find it easy to make decisions. (R) _____
24. I don’t have a particular sense of meaning and purpose in my life.(R)_
25. I feel I have a great deal of energy. _____
26. I usually have a good influence on events. _____
27. I don’t have fun with other people. (R) _____
28. I don’t feel particularly healthy. (R) _____
29. I don’t have particularly happy memories of the past. (R) _____

12. Calculate your score
Step 1. Items marked (R) should be scored in reverse:
For example, if you gave yourself a “1,” cross it out and change it
to a “6.”
Change “2″ to a “5″
Change “3″ to a “4″
Change “4″ to a “3″
Change “5″ to a “2″
Change “6″ to a “1″
Step 2. Add the numbers for all 29 questions. (Use the converted
numbers for the 12 items that are
reverse scored.)
Step 3. Divide by 29. So your happiness score = the total (from
step 2) divided by 29.
Your Happiness Score: ____(Unhappiest score 1/Happiest score 6)

13. World Happiness Report-2013
• Happiest Countries in the world- Denmark, Norway,
Switzerland, Canada, Sweden. USA 11th,and UAE 28th.
• Happiest profession in the world-Clergyman, Actor,
Architect , Firefighter, Executive managers. Physician comes 7th.
• UK and Bhutan are the only countries which
measures GNH(Gross National Happiness).

14. Happiest Person in the world- Mathieu Ricard (French Scientist)
Neuroscientist Richard
Davidson wired up his skull
with 256 sensors at the
University of Wisconsin .
The scans showed that when
meditating,Ricard's brain
produces a level of gamma
waves - 'never reported before
in the neuroscience
literature’.
The scans also showed
excessive activity in his brain's
left prefrontal cortex
compared to its right
counterpart, giving him an
abnormally large capacity for
happiness and a reduced
propensity towards negativity.

15. World Happiest Photograph-Alfred Eisenstaedt(1950)

16. Factors Influencing Happiness
• Genes-Genetics
• Social interaction-Society
• Money-Wealth
• Religion-Faith
• Disease-Health
• Food- Diet
• Life style

17. Chemicals and Centre- Happiness
• The Neurochemicals of Happiness-
Serotonin---Mood Molecule
Oxytocin ---Bonding Molecule
Dopamine---Reward molecule
Endorphins---Pleasure molecule
• The Neurocentre’s for Happiness-Left Orbitofrontal cortex/
Anterior cingulate gyrus /Hippocampus.

18. Factors Influencing Happiness
• Genes-Genetics
• Social interaction-Society
• Money-Wealth
• Religion-Faith
• Disease-Health
• Food- Diet
• Life style

19. Genes and Happiness
• Just like height, our happiness set point is also genetically
predetermined.
• The Genetic contribution is 50% (Tellegen, A.et. el, 1988, p.1035)
• Multiple Genes involved.(Molecular Genetics and Subjective wellbeing,Meike Bartels et,al April
2013,VU University Amsterdam).
• One of the gene, known as 5-HTTLPR(serotonin transporter gene),
and it seems like length is the key variant.(E. fox, et. Biol Psychiatry. Dec 1, 2011;
70(11): 1049–1054).
• Longer the length of Gene—more reported life satisfaction.(Journal of
Neuroscience, Psychology, and Economics 2012, Vol. 5, No. 4, 193–211)

22. Social relationship and Happiness
• Low social interaction can be as bad as smoking 15 cigarettes a
day, and is twice as bad for health as obesity.
Stillmann et al 2009
• Happiness is contagious-many emotions can pulse through social
networks.
• And unlike the flu, happiness! we can spread and enjoy.
• Having a happy friend who lives within a mile of you,appears to
increase the probability that you will be happy as well by 25%.

23. Social relationship and Happiness-Contd
• Prof James and Prof Christakis Studied the data of 5,000 people
over 20 years and found that happiness benefits other people
through three degrees of connection.
• Similar effects were seen for the spread of happiness between
next–door neighbors, siblings that live nearby, and spouses—so that
good feelings continue to move from person to person, even when
there’s no longer a direct connection to the primary happy person.
Dynamic spread of happiness in a large social network:longitudinal analysis over 20 years in
the Framingham Heart Study,UCLA & Harward medical school.BMJ 2008,James H
Fowler,Nicholas A Christakis.

25. Social relationship and Happiness-Contd
• The Harvard Grant study followed 268 men from there
college life in the 1930s up to there old age(follow up of
around 75 years), and it found that social relationships
with family and friends mattered more than anything
else, for health, success and happiness in life.

27. Money and Happiness
• Benchmark annual income for happiness---$75,000.
Study from Princeton University's 2006(Woodrow Wilson School-New Jersey/USA)
• The lower a person's annual income falls below the
benchmark, the unhappier he or she feels. But no matter
how much more than $75,000 annually people make,
they don't report any greater degree of happiness.

29. Money and Happiness-Contd
• Happiness is also related to financial relativity. Depends
on the income of colleagues and neighbors.
• Spend money on experiences instead of things. Studies
shows people report feeling happier when they spend their money
on experiences rather than objects.
Howell, Ryan T., Pchelin, Paulina. The Hidden Cost of Value-seeking: People do not Accurately Forecast the
Economic Benefits of Experiential Purchases. Journal of Positive Psychology. 2014.San Francisco State
University).

31. Religion and Happiness
• Religious people are happier than non-religious people.
Okulicz-Kozaryn, A. (2010). Religiosity and life satisfaction across nations. Mental Health, Religion & Culture, 13, 155-169.
• Religion promote happiness as it gives people a sense of purpose and
order and serves as a resource for coping with negative life
experiences and fear of death.
• Number of studies seem to suggest that one of the ingredient in
religion that provides happiness is social connectedness.
Salsman, J. M., Brown, T. L., Brechting, E. H., & Carlson, C. R. (2005). The link between religion and spirituality and
psychological adjustment: The mediating role of optimism and social support. Personality and Social Psychology Bulletin,
31, 522–535.

33. Diseases and Happiness
• The association between health status and happiness depends
greatly on the degree to which disease disrupts daily functioning.
• The Study surveyed 383 older adults recruited from the practices
of primary care doctors in Alabama.
• After taking into consideration other factors associated with
happiness, such as economic status, poor health was closely linked
to unhappiness only in people who reported that their health
status interfered with their daily lives activity.
Daily Functioning, Health Status, and Happiness in Older Adults. Dr Erik Angner’ J
Happiness Studies, October 2012,Virginia, USA.

34. Diseases and Happiness-Contd
• Studies suggest that even people with life-threatening diseases,
such as cancer, or life-altering disabilities ---- are often just as
happy as those in good health.
• Resetting the set point study-People who suffered paralysis following
Spinal cord injury, though Initially suffered depression, but within 6 months of
accident, returned to there original state of happiness.
Adaptation and the Set-Point Model of Subjective Well-Being: Does Happiness Change After
Major Life Events? by Richard E. Lucas in 2007.

36. Food and Happiness
• The personal pursuit of happiness begins on your dining table.
• Food may interfere with brain neurotransmitters. Serotonin cannot
cross blood brain barrier but Tryptophan does.
• The happiness diet-General rules.
-Minimize Processed foods(Contains excess sugars)
-Grass fed meat/Milk/Butter instead of Grain fed.
-Fruits, Green vegetables and whole grains.
-Strive for variety

38. Food and Happiness-Contd
• 5 most happiness food—
1)Eggs-Complete Brain food(B12/Folate/Iodine/Vit d)
2)Fish(salmons)-Essential Fatty acid(DHA)-Brick of brain.
3)Coffee-Increase Dopamine/Antioxidants.
4)Walnuts-Nature’s Multivitamin.
5) Chili and Ginger –Stimulates Endorphins.
Source-The Franklin Institute(Resource for Science learning)
Foods that increase happiness levels-Clements,Ed et al June 2009.

40. Life style and Happiness
• Exercise-20 minutes/day. Preferably Aerobic exercise. Increases
endorphins/serotonin and Brain Tryptophan.
Meeusen R, Piacentini MF, Kempenaers F, et al. Brain neurotransmitter levels during exercise. Dtsch Z
Sportmed2001;52:361-8.
• Sunlight-Increase serotonin and Vitamin D levels.
Rot M, Moskowitz DS, Young SN. Exposure to bright light is associated with positive social interaction and
good mood over short time periods: a naturalistic study in mildly seasonal people.J Psychiatry.2006.11.010.
• Yoga-Meditation-20 minutes/day-MRI brain showed increase
activity-and Helps grow your Lt Prefrontal cortex.
D.Cresswell,2007 UCLA study.

41. Life style and Happiness-Contd
• Optimism-A study of the journals of 180 Catholic nuns written when
they were about 22 years old (1930’s) found a correlation between
optimism and longevity. Positive emotional content in early-life
autobiographies was strongly associated with longevity six decades later.
The nuns who expressed joy in their journals when they were young
lived almost 10 years longer than the other nuns whose journal writing
was negative or neutral.
The Nun Study, Snowdon etal,1999.
• Sleep-Average 8 hours/day-Improves positive outlook of life.
Basner, M., Rao, H., Goel, N., and Dinges, D.F. (2013). Sleep deprivation and neurobehavioral dynamics.
Current Opinion in Neurobiology, 23, 854-863.

43. MEDICAL BENEFITS Of HAPPINESS
• There is a benefit of positive mental health that goes beyond
the fact that you’re not depressed. What that is still a
mystery !!
• A Meta analysis of more than 160 studies of human and
animal subjects has found "clear and compelling evidence"
that -- all else being equal -- happy people tend to live longer
and experience better health than their unhappy peers.
The journal Of Applied Psychology: Health and Well-Being, March 2011,By Professor Ed Deiner at
University of Illinois at Urbana-Champaign.

44. MEDICAL BENEFITS Of HAPPINESS-Contd
• Happy People live 14% longer.
Ed Diener, Micaela Y. Chan. Happy People Live Longer: Subjective Well-Being Contributes to Health and Longevity.
Applied Psychology: Health and Well-Being, 2011.
• Life expectancy increases by 7.5 to 10 years.
Happy people live longer, Bruno frey, Feb 2011:Science 4:542-544.
• Happiness correlates closely with biological markers-
Study by Steptoe and Marmot at University college london,2009-
216 participants,116 male and 100 females between age of 45 to
59.Showed that Basal heart rate, cortisol level and fibrinogen level was
around 40% higher in people who were least happy compared to those
participants rated as most happy.

45. MEDICAL BENEFITS Of HAPPINESS-Q O L
• Being happy leads to more healthy and preserved physical function as
people age
• The study included more than 3,000 people age 60 and older living in
England, and followed them for eight years.
• The results showed that happier people maintained better physical
function as they aged, even when the researchers accounted for
confounding factors such as age, healthier lifestyle and economic
situation.
• The unhappiest people in the study were about 80 percent more likely to
develop impairments in daily functions, compared with the happiest.
Study published Jan.2013 in the Canadian Medical Association Journal, Andrew
Steptoe and et al.

46. MEDICAL BENEFITS Of HAPPINESS-CVD
• Emotional vitality study-a 2007 study (Prof Laura Kubzansky,
HSPH,Boston,USA)
• Followed more than 6,000 men and women aged 25 to 74 for 20
years, and it found that emotionally happy people—appears to
reduce the risk of coronary heart disease by 25 to 30%.
•
• The protective effect was distinct and measurable, even when
taking into account such wholesome behaviors as not smoking and
regular exercise.

48. Laughter is the best Medicine
• Laughing or even anticipation of laughter (smile) has tremendous
positive effects on health.
• The physical benefits similar to Aerobic exercise.
• Laughter correlates with improvement of natural killer (NK) cell
activity—the immune cells that kill cancerous cells and prevent
viral illnesses.
Humor and Laughter May Influence Health” (Evidence-based Complementary and Alternative
Medicine, December 2007), Mary Payne Bennett and Cecile.
• The anticipation of “mirthful laughter” increases two hormones:
beta-endorphins, which alleviate depression, and human growth
hormone, which helps with immunity. The results were significant,
increasing the hormone levels from 27 to 87 percent. And it also
reduced the levels of stress hormones — such as cortisol and
epinephrine.
Lee Berk,et,al 2010,Loma Linda University, California,USA.

50. Medicines for Happiness
• Happiness Pills-Monday, July 28, 1947-TIMES
Happiness is now within the reach of everyone—everyone, that is, who wants to
be a dope. In the British Medical Journal, a distinguished British psychiatrist
named G. Tayleur Stockings announced that one capsule of pyrahexyl, a synthetic
marijuana-like drug, taken each morning, would make the saddest sack happy.
• Antidepressants like SSRI were tried in Normal subjects-Though the
serotonin level raised but there was no subjective increase in happiness state.
• Happy pills-Cocktail of Vitamin D3,Vit B5,B6,B12, Caffeine, Arginine,
Trptophan,Tyrosine and St John’s Wort.
• Tryptophan supplements-In US labelled as dietary supplement while in
Canada and Europe being sold as Drug.

51. Looking Forward
• Development of new field of Medicine— PNI (PsychoNeuroImmunology).
It incorporates psychology, neuroscience, immunology, physiology, pharmacology,
molecular biology, psychiatry, behavioral medicine, infectious diseases, endocrinology,
and rheumatology.
• New brain chemical called hypocretin-1: it is linked to increases in
happiness, social interactions, pleasure, reward and also anger. Hypocretin-1 might help
researchers in developing new treatment.
• Happy Gene Therapy.

52. Conclusion

56. Thank You

57. Calculate your score
Step 1. Items marked (R) should be scored in reverse:
For example, if you gave yourself a “1,” cross it out and change it
to a “6.”
Change “2″ to a “5″
Change “3″ to a “4″
Change “4″ to a “3″
Change “5″ to a “2″
Change “6″ to a “1″
Step 2. Add the numbers for all 29 questions. (Use the converted
numbers for the 12 items that are
reverse scored.)
Step 3. Divide by 29. So your happiness score = the total (from
step 2) divided by 29.
Your Happiness Score: ____(Unhappiest score 1/Happiest score 6)

64. • According to a study done by Jeremy Siegel, a professor at the University
of California in Los Angeles, the chemical hypocretin, which has two
types in the brain, is responsible for pleasure and reward. Hypocretin-1
levels rise simultaneously with increases in positive emotions, social
interactions, and strangely, also anger. The researchers looked at the
levels of hypocretin-1 and the hormone MCH in eight epileptic patients
that received brain implants that would help them with tracking their
seizures and possibly prevent them. The researchers monitored the
levels of hypocretin-1 and MCH in these patients who were told that
they qualified for the brain implants. Siegel and his colleagues found
that patients who received good news had higher levels of hypocretin-1.
The researchers also found that hypocretin-1 levels rose when the
patients talked to their family members and friends and when they
laughed.