How to maintain good mental health and happiness in a pandemic

1. Happy?
Aging in a Pandemic, is
everybody happy?
Robert Miller MD
ASPEC 10-12-20

3. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19
Pandemic — United States, June 24–30, 2020
Weekly / August 14, 2020 / 69(32);1049–1057

4. COVID-19 and Psychological Distress—Changes in Internet Searches for
Mental Health Issues in New York During the Pandemic
JAMA Intern Med. Published online October 5, 2020
During the lockdown, significant increase ins Google
Search:
Anxiety (18%) Panic Attack (56%) Insomnia (21%)
Suicide and Depression were not significantly higher

6. Aging and the U-Shaped Happiness Curve

7. GUIDE TO HAPPINESS
Background on happiness
Aging and happiness
Basic facts of life (things you can’t change)
One ‘simple’ attitude adjustment
Some of the models to consider
Diversity and flexibility

8. Doctor Miller’s Recommended Happiness Guru’s
Ed Diener, Ph.D., is Professor
of Psychology at the
University of Illinois,

9. 1.Google these people (Sonja Lyubomirsky, Martin
Seligman, Tal Ben-Shahar, Dan Gilbert, Raj
Raghunathan, Ed Diener)
2.Go to their web sites
3.Watch their videos and TED talks (? Apps)
4.If they resonate then buy or download their books
(then recommend them to others)

11. Meta-analysis of Benefits of Happiness
(225 studies)
• More productive and creative at work
• Superior jobs and income
• Better leaders and negotiators
• More likely to marry and have better marriages
• More friends and social support
• Stronger immune systems, physically healthier and
live longer
• More helpful and philanthropic
Lyubomirsky, Psych Bull 131:803

12. Benefits of Happiness on Health
• Lower incidence of stroke and cardiovascular
disease
• If have CHD more likely to survive at 11 years
• If lung cancer more likely to be alive at 3 years
• Less likely to be on disability at 11 years
• Less likely to die in a car accident at 8 years
• Less likely to die of all causes at 28 years
Lyubomirsky

13. Cold Virus Study
• Healthy volunteer complete happiness
measurement
• Then received nasal drops of a rhinovirus
• Then quarantines for 5 days and monitored
for 1 month
• Happier volunteers were less likely to
develop a cold
Cohen. Psych Med 65:652

14. A Duchenne smile involves contraction of both the
zygomatic major muscle (which raises the corners of the
mouth) and the orbicularis oculi muscle (which raises the
cheeks and forms crow's feet around the eyes).
Hillary… real smile or
fake smile?
Smile… Live Longer?

15. Positive Emotion and Health
Study of 1952-1953 MLB baseball cards…players with a smile on their face
lived 11 years longer
Mills College Yearbook Photos – genuine smile, 30 years later happier
marriage and lower divorce rates
Nun study – 1930’s / essay with positive emotion, 60 Years later the survival
was much longer

16. Using pessimistic
lexicon will predict
cardiovascular
mortality
(harm is equal to
smoking 2.5 packs
of cigarettes per
day)
The Hope Circuit - Dr. Martin Seligman

17. Eudaimonia
Term for the highest human good, takes virtue and its
exercise to be the most important constituent in
eudaimonia but acknowledges also the importance of
external goods such as health, wealth, and beauty.

18. Hedonism
Hedonism is a school of thought that argues
that pleasure and happiness are the primary or
most important intrinsic goods and the proper
aim of human life.

19. “All I wanna do is have some
fun, I got a feeling I’m not the
only one”
Sheryl Crow
Hedonic Pleasure
Wastin’ away again in
Margaritaville, Searchin’ for my
lost shaker of salt
Jimmy Buffett

20. Subjective Well Being
High positive mood + Low negative
mood + High Life-satisfaction
According to a participant’s own
self-ratings

22. The aging paradox: The older
we get, the happier we are
In a recent survey (2016) of more than 1,500 San Diego residents aged 21 to 99,
researchers report that people in their 20s were the most stressed out and
depressed, while those in their 90s were the most content.
There were no dips in well-being in midlife, and no tapering off of well-being at
the end of life.
Scientists found a clear, linear relationship between age and mental health: The
older people were, the happier they felt.
J Clin Psychiatry 2016;77(8):e1019–e1025

23. Is it better
to keep
working
than
retire?

25. Most studies show U Curve for Age and Happiness

27. Percent of Americans with Fair or Poor
Self-Rated Health in 2010
Obviously, health gets
worse with age
People have more health problems as they age, so
how can they be happier?

30. Most studies show U Curve for Age and Happiness

31. Doesn’t Have to Start Declining in Old Age

32. Life Satisfaction by Age
Age (years) Age (years)
Western Countries
Former Soviet Union
Sub-Saharan Africa
Latin America and
Caribbean
Women
Men

33. Proportion of respondents who reported that they experienced a lot of worry yesterday,
based on data in Gallup-Healthways Wellbeing Index Poll
Age and Worry

34. 12-9-2017

35. One of the many ways we make ourselves unhappy

36. We probably obsess too much about life circumstances

37. Siddhartha Gautama (the
Buddha) c480BCE – c400 BCE
Was he the first great
cognitive therapist?
we make ourselves unhappy

38. One ‘simple’ character adjustment…stop comparing yourself to
everyone else.

39. stop
comparing
yourself to
other people
Sophia Loren and Jayne
Mansfield

40. Maslow's
hierarchy of
needs

42. Generativity vs. Stagnation (Care)—Generativity involves finding your life’s work and
contributing to the development of others through activities such as volunteering, mentoring, and
raising children. During this stage, middle-aged adults begin contributing to the next generation,
often through caring for others; they also engage in meaningful and productive work which
contributes positively to society. Those who do not master this task may experience stagnation and
feel as though they are not leaving a mark on the world in a meaningful way; they may have little
connection with others and little interest in productivity and self-improvement.
Integrity vs. Despair (Wisdom)—He said that people in late adulthood reflect on their
lives and feel either a sense of satisfaction or a sense of failure. People who feel proud of their
accomplishments feel a sense of integrity, and they can look back on their lives with few regrets.
However, people who are not successful at this stage may feel as if their life has been wasted.
They focus on what “would have,” “should have,” and “could have” been. They may face the end of
their lives with feelings of bitterness, depression, and despair.

43. There is a pre-wired normal midlife transition found
in a few other primates and may be evolutionarily
adaptive trait (benefits grandchildren)
1. devalue ambition (hedonic treadmill)
2. switch from status and achievement to community,
concern for others and interpersonal connections
(grandmother hypothesis) become wired to give
back to society
3. Brain reacts more to positive things than negative
(paradox of aging, out values change faster than our
bodies)
Shift in values makes us more receptive to learning
the values of wisdom

44. The Grandmother Hypothesis Could
Explain Why Women Live So Long
From an evolutionary perspective, the
point of life is to procreate and pass on
genes, hypothesis states that women
live well past menopause so that they
can help raise successive generations
of children

45. #1 Recommendation: “Don’t retire, keep going or
make sure have something equally compelling that will
engage you”
Because neurochemical shifts there is a “positivity bias”
and “grandparents syndrome” large data set found
that the peak age of happiness was age = 82

46. The new era of positive psychology
Martin Seligman is the founder of positive psychology, a field of study that examines
healthy states, such as happiness, strength of character and optimism.
http://go.ted.com/Jm2b9A

48. Flourish or Well Being is all About PERMA
P = positive emotion
E = engagement (flow)
R = good relationships
M = meaning and purpose (future oriented)
A = achievement or accomplishment
We value these 5 elements differently (each is measurable and
teachable)

49. Positive Emotion: This route to well-being is hedonic
– increasing positive emotion. Within limits, we can
increase our positive emotion about
the past (e.g., by cultivating gratitude and
forgiveness), our positive emotion about
the present (e.g., by savoring physical pleasures and
mindfulness) and our positive emotion about
the future (e.g., by building hope and optimism).

50. Engagement: Engagement is an experience in which someone
fully deploys their skills, strengths, and attention for a
challenging task.
This produces an experience called “flow” that is so gratifying
that people are willing to do it for its own sake, rather than for
what they will get out of it. The activity is its own reward. Flow is
experienced when one’s skills are just sufficient for a challenging
activity, in the pursuit of a clear goal, with immediate feedback
on progress toward the goal.

51. Relationships: Relationships are fundamental to well-being.
The experiences that contribute to well-being are often amplified
through our relationships.
Connections to others can give life purpose and meaning.
Support from and connection with others is one of the best
antidotes to “the downs” of life and a reliable way to feel up.
Research shows that doing acts of kindness for others produces
an increase in well-being.

52. Meaning: A sense of meaning and purpose can be derived from
belonging to and serving something bigger than the self.
There are various societal institutions that enable a sense of
meaning, such as religion, family, science, politics, work
organizations, justice, the community, social causes (e.g., being
green), among others.

53. Accomplishment: People pursue achievement, competence,
success, and mastery for its own sake, in a variety of domains,
including the workplace, sports, games, hobbies, etc.
People pursue accomplishment even when it does not
necessarily lead to positive emotion, meaning, or relationships.

54. Positive Psychology During
COVID
Sheldon Cohen a researcher, who injected rhinovirus into his
participants to see if a positive emotional style (PES) affected how
they would respond. He found out that those who were cheerful and having more fun
had less severe colds.
Martin Seligman decided during COVID to have as much fun as he could! He bought
a puppy, danced, made love, drank wine, and listened to music a lot!
Emotional state of happiness (smiley face) worked but not the cognitive state of
optimism The people who report positive emotions are less likely to catch colds and
also less likely to report symptoms when they do get sick. This held true regardless of
their levels of optimism, extraversion, purpose and self-esteem,

55. SELF DETERMINATION THEORY
All human beings have three basic
psychological needs
- Autonomy-doing what you choose
- Competence-doing it well
- Relatedness- connecting with others

57. If You’re So Smart, Why Aren’t You Happy? Raj Raghunathan
M: Progression towards Mastery
(really good at something)
A: Autonomy, a sense of control over
your own life
The Three Big Goals to pursue after meeting your basic
necessities (MBA)
B: Belonging, sense of deep
connectivity with at least one other
person

58. There are Two Routes to the Big Three
“Abundance”: Approach “Scarcity” Approach
Mastery
Pursuing Passion Chasing Superiority
(flow, focus on the present)
Belonging
Need to Love (and Give) Need to be Loved
Autonomy
Internal Control External Control

59. How to Grow Old: Bertrand Russell on What Makes a Fulfilling Life
“Make your interests gradually wider and more
impersonal, until bit by bit the walls of the ego
recede, and your life becomes increasingly
merged in the universal life.”

60. Strategies to Try to Boost Happiness
• Expressing gratitude and appreciation
• Practicing acts of kindness
• Coping well with adversity
• Nurturing optimist thinking
• Learning to forgive
• Savoring the moment
• Investing in relationships
• Committing to significant life goals
• Practicing your religion
• Meditating regularly
• Engaging in physical activity or exercise
From Lyubomirsky and Diener

61. Happy Boosting Exercises
1. Savoring the moment (focus on something beautiful or meaningful)
2. Remembering happy days (try to replay the positive emotions)
3. Acts of kindness journal
4. Strengthening social relationships (calling or writing an old friend)
5. Goal evaluation and tracking (strive for realistic goals and move foreword)
6. Gratitude journal
7. Expressing gratitude personally
8. Thinking optimistically (think about your best possible future scenario)
From Lyubomirsky and Diener

62. Top 5 Evidence-based coping
techniques when times are
tough
(10-2-20)
1. Exercise
2. Gratitude (write down a few things everyday)
3. Sleep (focus on positive sleep habits)
4. Get Social
5. Be with emotions (meditation techniques)

63. Control your exposure to the
news.

64. Miller Guide to Happiness
1. Accept responsibility to make yourself happy (and accept the
facts of life about yourself)
2. Try to have diversity in things that make you happy
3. Be flexible in changing and adjusting priorities as circumstances
change
4. Accept the fact that everyone is different and its not necessarily your
responsibility to ‘correct’ other people's problems. (watch The moral
roots of liberals and conservatives - Jonathan Haidt)
5. Take advantage of ‘low lying fruit’ (e.g. humor, art, nature, children,
pets)

65. Humor is mankind's greatest blessing.
Mark Twain
Importance of Developing a Sense of Humor
Total absence of humor renders life impossible. – Colette
If I had no sense of humor, I would long ago have committed suicide. Mahatma Gandhi
Imagination was given to man to compensate him for what he is not;
a sense of humor to console him for what he is. Francis Bacon
You don't stop laughing because you grow older. You grow older
because you stop laughing. Maurice Chevalier
Everything is funny, as long as it's happening to somebody else.
Will Rogers