Mental well-being: A gateway to happiness

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MUMBAI: A middle-aged man walked into my clinic in his designer outfit. “I have everything doctor. God has given me a wonderful, loving family, great friends and a flourishing business. But I am not happy,” he said.

Happiness: a subjective state of contentment and well-being; an aspiration of every The United Nation’s World Happiness Report (2013) found the world’s happiest countries to be Denmark, Norway, Switzerland, Netherlands and Sweden. India unfortunately ranked at 111th, behind most of its neighbouring countries. The study also found mental health to be the single most important determinant of individual happiness globally. It emphasized that depressive and anxiety disorders are the single biggest cause of disability, absenteeism, misery and economic waste worldwide (United Nations, 2013).

So what factors determine happiness? Studies suggest that over 33% is accounted for by genetics (De Neve et al., 2013). Brain circuits such as the nucleus accumbens (the brain’s pleasure centre) are involved, which when stimulated, make people smile, laugh, feel pleasure and happiness. Several neurochemicals play a role. For instance, dopamine, associated with positive emotion, activates the reward system. Serotonin helps maintain a positive mood. Endorphins lower pain perception and increase a sense of calm and well-being. Happy people enjoy greater immunity, better health, better relationships and increased longevity. The reverse is true for unhappy people. Reason enough to make pursuing Of course, everyone is unhappy from time to time; this is normal. Unhappiness becomes a problem when it persists, turning into recurrent depressed moods, with symptoms such as sleep and appetite disturbances, low self-esteem, decreased interest and energy, diminished concentration, etc.

After a detailed assessment, it emerged that our patient (reporting persistent unhappiness) in fact had recurrent clinical major depression. After a detailed discussion, treatment was initiated with a combination of medication, counseling, and later, with rTMS (Repetitive Transcranial Magnetic Stimulation); he responded well to How can one enhance one’s Happiness Quotient (HQ)? People are good at synthesizing happiness, says Daniel Gilbert, a Harvard Psychology professor. Psychologist Ed Diener found the frequency of positive experiences is a much better predictor of happiness than the intensity of positive experiences. The UN study for instance, found people in happy nations (Denmark and Netherlands) ride bicycles by choice. What an eco-friendly, and fun way to enhance happiness.

Do figure out your personal happiness mantra. As for me, I am getting myself a bicycle (and a helmet!). Hopefully, the bicycling will stimulate my nucleus accumbens and happy neurochemicals, steering me along the road to happiness. What about you?

(Dr Shamsah B Sonawalla is a consultant psychiatrist at Jaslok Hospital and a former faculty of Harvard Medical School, US