By Mark Gold, MD
Everyone knows someone who always seems positive, even in challenging situations. To them, the glass is always half full. For example, Microsoft founder Bill Gates is one fabulously successful optimist:1
“In my own life I’ve been extremely lucky. But even subtracting out my personal experience, I think the big picture is that it’s better to be born today than ever, and it will be better to be born 20 years from now than today….So, yes, I am optimistic. It does bother me that most people aren’t.”2
When viewing an image of a glass containing an equal amount of liquid and empty space, 58 percent of Americans felt that the glass was half-full, according to a survey conducted by One Poll on behalf of Borden milk.3 People who view a glass as half-full think more optimistically, decisively, and with more creativity.
It’s common for many individuals to seek out self-help or turn to “positive thinking” after a crisis or particularly stressful point in their lives, and common for others to mock such efforts as misguided or naive. Individuals with depression have problems finding positive aspects of life and may even believe that the proverbial "dark cloud" hovers over their heads. Behavior and motivation-oriented substance use disorder treatment programs often encourage patients to cultivate positive beliefs and to try to focus on positive developments, and some patients approach these practices with skepticism. These programs may advise: fake it till you make it, or shoot for the stars and settle for a moon landing.
Research, however, consistently demonstrates the benefits of optimism across a number of key health functions. Studies show that optimism can decrease mortality,4 reduce the risk of stroke,5 reduce the risk of heart disease,6 present fewer progressions of carotid disease,7 and improve pulmonary function,8 among other health benefits. So why might an optimistic disposition and positive attitudes lead to better health outcomes, and just how beneficial are these approaches to life?
What did this study find?
This study, by Lee et al., in the prestigious National Academy of Sciences journal, found that optimism is associated with a longer life span and an increased chance of “exceptional longevity.” The study defines optimism as, “a psychological attribute characterized as the general expectation that good things will happen, or the belief that the future will be favorable because one can control important outcomes.” By focusing on optimism’s relation to living an extra long life, this study also confirmed and extended other findings that link optimism to protection against premature death and chronic diseases. Uniquely, it not only looked at optimism and total years lived, but also at “exceptional longevity”—in effect, a very long life span, understood as reaching age 85 or older. For individuals born in the early 20th century, the study notes, 85 is past the average life expectancy, but not unheard of, and has become a standard reference point for “exceptional longevity” as a result.
This very large and important study reviewed data on women collected from the Nurses’ Health Study (NHS), and data from men collected from the Veterans Affairs Normative Aging Study (NAS). The NHS yielded data on 69,744 women starting in 1976, and the NAS on 1,429 men starting in 1961. Women in the NHS did an optimism assessment in 2004 and were measured on mortality to 2014. Men in the NAS did an optimism assessment in 1986 and were measured on mortality until 2016. Most of these tracked men and women were married and white, middle-aged or older, and had higher socioeconomic statuses relative to the population as a whole. This study applied time models to tease out relationships between longevity and optimism in the reviewed cohorts. It found a 14.9% longer life span for women in the highest optimism quartile compared to women in the lowest quartile. For men, the figure was 10.9%. The study also observed that the optimistic among both sexes had greater chances of living to 85 or older.
These results were independent of a number of potentially offsetting factors, such as health, socioeconomic status, depression, and demographics, though they were partially affected by “health behaviors,” like alcohol use, smoking, diet, and physical activity. This is interesting in part because choices about health behaviors may be influenced by optimism, and possibly one reason why optimism contributes to longer lives. At any rate, the association between optimism and longevity still persisted, albeit at somewhat lower rates, after adjusting for health behaviors. This study may be limited by the higher socioeconomic status of its subjects, since higher status is usually linked to higher optimism, and by subjects’ middle and older ages, which preclude examination of how earlier life developments may affect optimism.
Why is this important?
Attitude matters. We often say, "adopt an attitude of gratitude." As the study points out, research also suggests that longer lives are linked to less morbidity. From a public health perspective, this means that factors involved in increasing life span, especially to “exceptional” ages, may help us learn more about and apply better strategies to help individuals lead healthier lives. The more research we have that indicates optimism is one of these vitality-enhancing factors, the more we should encourage it, and the study calls for interventions that promote individual construction of positive attitudes or dispositions. Notably, this approach would be distinct from initiatives that emphasize or prioritize managing or “fixing” particular psychological problems—it may be the case that positivity itself can help patients and those seeking assistance more than any attempt to tackle select concerns.
An optimistic temperament, as the study notes, is about a quarter heritable, but can also be learned, and influenced by structural forces, so more optimism-focused interventions are consistent with what we know about the development of this disposition. There is also a question about related social mechanisms, such as attachments to friends and family, and how they relate to a positive life outlook. Researchers have suggested that optimism may “work” so well across many studies because it’s a conceptual tool, turning aspirations or motivations into actual behavior. Another perspective is that the sunnier among us are more resistant to stress and adversity.
There is no one secret to optimism, but there is a science supporting optimism and happiness. Professor Randy Larsen of Washington University in St. Louis (WUSTL) identified two personal behaviors as the keys to someone’s relative happiness over the long haul.9 “Being extroverted—that’s a strong predictor of happiness,” Professor Larsen asserts. Conversely, he says that neuroticism, “a tendency to worry, complain, and be pessimistic, is a strong predictor of unhappiness." He also suggested that fearful, pessimistic, and anxious people are drawn to the internet, which may exacerbate their dispositional challenges.10 Tim Bono, a WUSTL Assistant Dean in Arts & Sciences, also teaches courses on happiness. In his recent book, When Likes Aren't Enough: A Crash Course in the Science of Happiness, Bono examines how simple parts of life can contribute significantly to happiness.11 Bono offers the following tips for faking it until you make it, or getting and staying happier, in an interview with WUSTL's The Source related to the release of his book:12
"Get outside, move around, take a walk. Research confirms that a few minutes of exercise in nature can boost both mood and energy levels. Exercise is key to our psychological health because it releases the brain’s “feel good” chemicals.
Get more happiness for your money. Studies show little connection between wealth and happiness, but there are two ways to get more bang for your happiness buck — buy experiences instead of things and spend your money on others. The enjoyment one gets from an experience like a vacation or concert will far outweigh and outlast the happiness from acquiring another material possession. Doing good things for other people strengthens our social connections, which is foundational to our well-being.
Carve out time to be happy, then give it away. People dream of finding an extra 30 minutes to do something nice for themselves, but using that time to help someone else is more rewarding and actually leaves us feeling empowered to tackle the next project, helping us feel more in control of our lives and even less pressed for time. This translates to higher levels of happiness and satisfaction.
Delay the positive, dispatch the negative. Anticipation itself is pleasurable, and looking forward to an enjoyable experience can make it all that much sweeter. Wait a couple of days before seeing a new movie that just came out, plan your big vacation for later in the summer and try to take time to savor each bite of dessert. On the flip side, get negative tasks out of the way as quickly as possible — anticipation will only make them seem worse.
Enjoy the ride. People who focus more on process than outcome tend to remain motivated in the face of setbacks. They’re better at sticking with major challenges and prefer them over the easy route. This “growth mindset” helps people stay energized because it celebrates rewards that come from the work itself.