Healthy Thoughts

You might think being healthy puts you in a good state of mind, but it’s the good state of mind that will keep you healthy in the long-term.

Chris Stewart-Patterson
1 January 2003
Photo by Matthew Kane.

You might think being healthy puts you in a good state of mind, but Dr. Chris Stewart-Patterson argues that it’s the good state of mind that will keep you healthy in the long-term.

When it comes to health, it may be our minds that matter most. Usually the message that wellness gurus and public health authorities give ad nauseam is that longevity and wellness are largely about good lifestyle habits: if we regularly do the right things, such as exercise, eat right and avoid smoking, we will likely live longer and better. While that message is true, it’s also an oversimplification of a deeper process. If we probe a bit further we see that the things that allow us to start and maintain healthy habits at any given time are our thoughts and feelings. It’s a minor epiphany for most people to realize that in order to change our lifestyles, ultimately we must change our minds first.

Let’s work backward to see the connections. We all know that major chronic medical conditions such as heart disease, stroke and cancers are affected by health habits such as smoking, diet and exercise. And we can see from our own daily experiences that our health habits are influenced by moment-to-moment feelings such as sadness, anxiety or joy. When feeling sad or down, for instance, we are less likely to motivate ourselves to be active or eat nutritiously. We may also be able to see that feelings are affected by thoughts; negative thoughts, for instance, can instantly give rise to feelings of anxiety or depression. In addition, thoughts stemming from our personal and cultural beliefs, attitudes and values will influence our health choices. So while acknowledging that there are other health factors such as genetics, life events and environment, let’s further examine this cascade of connections between our thoughts today and chronic disease later in life.

Our thoughts can affect our feelings at any given time. Social scientists investigating cognitive behavioral therapy, a highly effective form of psychotherapy used for many psychological conditions including depression and anxiety disorders, repeatedly demonstrate how negative thought patterns or “self talk” can precipitate or prolong bouts of anxiety or depression. For instance, if you habitually turn trivial events into catastrophes, or repeatedly focus selectively on the unpleasant aspects of your experiences, you are more likely to find yourself in a dark mood. Cognitive behavioral therapy teaches how to substitute negative thoughts for more realistic ones. This is not new: 2500 years ago the Buddha extolled us to abandon negative thoughts. In the Vitakkasanthana Sutra he taught about avoiding unskillful thoughts by picturing how a carpenter would remove a rotten wooden peg from a piece of lumber by hammering it out with a strong, finer peg. This is essentially a timeless endorsement for modern cognitive therapy and its emphasis on negative thought substitution.

Then, just as our thoughts can affect our feelings, our feelings can affect our physical health. Prior clinical depression is a risk factor for heart attacks and osteoporosis. Depression, with its symptoms of sadness, apathy, fatigue and negative thought patterns, can adversely affect healthy lifestyle habits and even medical treatment compliance. Seemingly a purely psychological disorder, depression also directly affects physiology. Depression alters levels of cortisol, a hormone in the body that affects many body systems. Altered cortisol levels may reduce bone density, which may partially explain the link between depression and osteoporosis. Heart disease risk may be related to abnormal adrenaline levels found in depressed people.

This mind-body process works in reverse as well. Many medical conditions affect our thoughts and feelings. The onset of diabetes, migraines and some cancers are all associated with later risk of clinical depression. If the thyroid gland is revved too high, as it is in hyperthyroidism, the individual may experience symptoms of anxiety and panic. In addition, clogging the arteries to the brain with cholesterol can cause small, unnoticed strokes that impair concentration and memory.

My favorite bumper sticker is “Subvert the local paradigm!” Having examined some of the ways that mind indirectly affects health and vice versa, let’s leap further and consider the radical question of whether or not mind directly affects health. Are lifestyle changes such as exercising, improving diet, and quitting smoking merely a function of a particular state of mind? There are two tantalizing clues that suggest this could be so. First, all the factors that help us constructively handle stress and improve our mental health—exercise, relaxation, good nutrition and so on—are the exact same things that are associated with longevity and reduced risk for common chronic physical diseases.

Second, researchers have enrolled people into lifestyle modification programs to see if helping them improve their diet and physical activity will protect them from future disease. Even though people do make changes, surprisingly these intervention studies often show less or even none of the health protection predicted from previous studies looking at people who reported changing to healthy habits by themselves. Self-changers showed a very strong protective association. What is that about? One possible explanation is that being suddenly and prematurely coached to change aspects of your lifestyle involves a different cognitive process than doing so under your own steam. The research subjects may not have a chance to generate the natural mind shift that may ultimately be needed to engender good health.

The idea that mind may have direct as well as indirect effects on health is good news. As practitioners we know that we can slowly but surely have some influence on our minds if we persevere—that’s what meditation and practice are all about. For those unconvinced or wary of Eastern traditions, there are the effective alternatives of cognitive therapy and relaxation techniques.

The message to patients and doctors alike is ultimately one of empowerment. Encouraging healthy habits and healing is about facilitating an opportunity for a person’s mindset to shift. The starting point for any change, either physical, mental, emotional or spiritual, is our present state of consciousness. Ultimately that’s all we have at any given moment. So mind your mind.

Chris Stewart-Patterson

Chris Stewart-Patterson, M.D. is assistant professor of medicine at the University of British Columbia and works as an emergency department physician at an inner city hospital in Vancouver.