Towards A Healthier View of Happiness: Human Fulfillment

By Roberto A. Blanco, M.D. 

I believe that mistaking what one would call pleasure or joy with happiness is causing people a lot of unnecessary pain.  In popular culture and the media, “happiness” is the feeling when you open a brand new bottle of soda, when you have a party with your friends, or when you get a new car.  Consumer culture has subtle but noticeable effects on people’s beliefs to the point where most people buy into these images or ideals consciously or unconsciously to some extent.  

But, this is not the meaning of happiness for which we should be striving.  This is because pleasure, while it may be fun, is superficial and impossible to sustain.  Even for people who live a “charmed life," it is impossible to find pleasure or joy in all events in life.  In fact, unless there is some larger or longer-lasting definition of happiness such as human satisfaction that fills our lives, it is likely that we won’t be able to find joy in anything.  Events that should provide joy will lose their effect eventually without some deeper meaning.

This may be why many people become depressed.  A lot of us put pressure on ourselves to be “happy” all of the time.  Because we confuse pleasure for happiness at times, the fact that we are not “happy” all of the time can lead to more dissatisfaction with life or lack of fulfillment.  If happiness equates with pleasure or joy, how can we be happy and happy with ourselves when we are going through difficult but worthwhile transitions?  What about during periods of grief? 

It is often very difficult to sustain superficial happiness especially when the inevitable thoughts of ‘why am I feeling bad?’ or ‘why am I not happy?’ creep into the mind.  These thoughts often cause people to feel guilt and then as if they are failures.  To be joyful and smiling all of the time is just an unrealistic goal and we should not feel bad about ourselves if we happen to be in a difficult stage of life.  We need to keep in mind that it is all part of a larger plan or goal of development, human fulfillment or self-actualization.

The search for a good definition of happiness is not a new idea and certainly not one that I thought of.  Over 300 years before Christ and in his book entitled NicomacheanEthics, Aristotle proposed his definition of happiness to the ancient Greek people and laid out his arguments for the meaning of happiness.  He argued that having true happiness is the best and final aim for human activity.  Aristotle called true happiness “eudaimonia” which was a type of long-lasting happiness more consistent with human fulfillment or satisfaction.  Aristotle also believed that happiness should be human fulfillment and not confused with joy or pleasure when he wrote:

For one swallow does not make a spring, nor does one sunny day;
similarly, one day or a short time does not make a man blessed and happy.

I agree that human fulfillment is a loftier goal than joy because when someone is having a difficult time or fallen on hard times, they can still be working towards human fulfillment. During these formative or growing experiences, we can still feel as we are fulfilled or fulfilling our own self-actualization even if we aren’t joyous.  When we take into consideration human fulfillment, we no longer need to feel guilty or as failures during difficult times, transitional periods, or episodes of grief.  We begin to see life from the wide angle of human fulfillment rather than from the small picture of pleasure.

Kahlil Gibran, the famous Christian mystic poet from the early 20th century, also believed in eudomainia.  When Almustafa, the all-knowing visitor in the poem The Prophet, answers a woman’s question on pain, he exemplifies this belief in the beauty of human fulfillment and long-lasting satisfaction despite these painful episodes:

And could you keep your heart in wonder at the daily miracles of your life, your pain would not seem less wondrous than your joy;
And you would accept the seasons of your heart, even as you have always accepted the seasons that pass over your fields.
And you would watch with serenity through the winters of your grief.

As people living in a society where mental illness is so common, we must seek to understand happiness and human fulfillment.  In the hopes of making happiness something more meaningful and sustainable, what we should be striving for is an eternal, longer-lasting form of happiness which is known as human fulfillment or as the Greeks called it eudaimonia.  This is because human fulfillment rather than joy or pleasure allows for the different stages of our lives and growth without having to feel guilt or as if something is wrong.  If we make human fulfillment the goal, we will live happier and more satisfying lives.  Now the obvious question becomes, how do we achieve it?

1.  Aristotle (1999).  Nicomachean Ethics. (Martin Ostwald Trans.)  Upper Saddle River, New Jersey: Prentice Hall, Inc.
2. Gibran, Kahlil (1964).  The Prophet .  New York: Alfred A. Knopf.
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Make Mental Health Your Priority Every Month

By Felicia Wong, M.D

As the month of May comes to an end, make a promise to yourself that personal mental wellness will remain a daily priority.  Mental Health America has been working for 100 years to promote well-being for all Americans and recently developed a resource called 10 Tools to Live Your Life Well based on extensive scientific evidence.

Each day, we face all sorts of demands and drama which can lead to insomnia, lack of concentration, problems in our relationships, and other mental health issues. 

These "10 Tools" provide proven, healthy ways to cope with stress and boost your overall well-being.  Make a commitment to follow this list and feel more relaxed, fulfilled, and focused long after Mental Heath Month is over. . .  

1) Connect with Others. People who feel connected are happier and healthier--and may even live longer.

2) Stay Positive. People who regularly focus on the positive in their lives are less upset by painful memories.

3) Get Physically Active. Exercise can help relieve insomnia and reduce depression.

4) Help Others. People who consistently help others experience less depression, greater calm, and fewer pains.

5) Get Enough Sleep. Not getting enough rest increases risks of weight gain, accidents, reduced memory, and heart problems.

6) Create Joy and Satisfaction. Positive emotions can boost your ability to bounce back from stress.

7) Eat Well. Eating healthy food and regular meals can increase your energy, lower the risk of developing certain diseases, and influence your mood.

8) Take Care of Your Spirit. People who have strong spiritual lives may be healthier and live longer. Spirituality seems to cut the stress that can contribute to disease.

9) Deal Better with Hard Times. People who can tackle problems or get support in a tough situation tend to feel less depressed.

10) Get Professional Help if You Need It. More than 80 percent of people who are treated for depression improve.

So now you know the tools. . . Today is the perfect time to start incorporating this list into your day-to-day routine.  For more information, go to http://www.liveyourlifewell.org/ . 
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Yes, Food Addiction is Real. Do You Know Someone Suffering?

By Sarah Johnson, M.D.
The obesity epidemic is a huge problem (no pun intended) due to associated medical problems and their burden on the healthcare system. In 2009, an estimated 25% of Americans met criteria for obesity. This figure has steadily increased since the 1970’s.

Obesity leads to heart disease, strokes, high blood pressure, diabetes, and may be associated with increased risk for depression. It has been suggested that over-eating and other eating behaviors associated with obesity may share features with drug and alcohol addiction. This would certainly explain why this epidemic is so difficult to combat.  

The DSM IV-TR defines substance dependence as three or more of the following symptoms occurring within one year: tolerance, withdrawal symptoms, substance taken in larger amounts or for a longer duration than intended, attempts to cut back, excessive time spent pursuing, using, or recovering from use, reduction or discontinuation of important activities because of use, and continued use despite adverse consequences. 

Food cravings associated with binge eating can trigger the same area of the brain that is activated in drug craving. Although research is preliminary and limited at this time, specific foods such as carbohydrates may actually have a direct effect on mood in those who crave them.

Certain eating behaviors, such as restriction combined with overeating or binge-purge cycles may emulate addictive behaviors. Personality traits such as impulsivity have been found in samples of addicts and obese individuals. Children with behavior disorders such as ADHD and Conduct Disorder may be at increased risk for both addictions and obesity.  

Prevention is the best way to reduce the impact of behaviors associated with obesity. While eating may have similarities with addiction, we live in a toxic food environment, and awareness is key in prevention. Family members can seek help from medical professionals for loved ones who may be exhibiting pathological eating behaviors. 

For more information: Corsica JA, Pelchat ML. Food addiction: true or false? Curr Opin Gastroenterol. 2010 Mar;26(2):165-9.
Wilson GT. Eating disorders, obesity, and addiction. Eur Eat Disord Rev. 2010 Sep-Oct; 18(5):341-51.

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The Insanity Defense: Fact or Fiction?

By Molly McVoy, M.D. 

When you hear about a defendant pleading insane at the time he or she committed a crime, what thoughts cross your mind?  You may be thinking of those infamous court cases: John Hinckley, Andrea Yates, Brian David Mitchell (Elizabeth Smart's kidnapper), and most recently, Jared Laughner.  It's common to feel conflicting emotions - anger, confusion, even sympathy - as you remember these high-profile defendants and traumatic court cases.

The word “sanity” is a legal term, not a mental health or clinical term.  Generally, a determination of “sanity” in a court of law refers to whether a “mental disease or defect” (also a legal, not clinical term) causes a person to be unable to know the wrongfulness of his or her action.

Over time, the court clarified what qualifies as a “mental disease or defect,” and it's not always directly related to clinical diagnosis as used by practicing psychiatrists.  Typically, severe mood and psychotic disorders do classify as a “mental disease or defect,” but many other psychiatric illnesses and personality disorders do not.  Courts ultimately determine what illnesses do and do not qualify as a “mental disease or defect” under the “not guilty by reason of insanity” defense. 

The application of this defense has also changed in scope.  Early in American law, only if someone had total loss of memory or understanding would this defense apply.  But in time, that became more liberal -- applying if someone was unable to know the wrongfulness of his or her actions or, because of illness, was unable to resist the urge to commit the crime.

After the attempted assassination of Ronald Reagan by John Hinckley, the standard became narrower once again, returning to apply only to those whose “mental disease or defect” prevented him or her from knowing the wrongfulness of the crime.

Finally, some states have an additional “guilty but mentally ill” statute that affects eventual sentencing but not strict guilt or innocence.  You will probably hear more debate about the insanity defense in media's coverage of Jared Laughner.  There may always be misunderstanding and controversy for this complicated, highly sensitive issue.
 

For more information:

http://www.aapl.org/

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Why Women Must Exercise for Mental Health

By Claudia Reardon, M.D.

Exercise has mental health benefits for men and women of all ages.  However, there are unique factors to consider in thinking about the mental health benefits of exercise for women in particular.  Compared to men, women have a two-fold increased prevalence of major depression throughout their reproductive life cycle.  Exercise can be a very useful treatment for depression in women at any of a number of different times in their lives:   

• During pregnancy and breastfeeding:  Depression is highly prevalent in women of childbearing age.  Medications are often necessary to treat moderate to severe depression.  However, many women wish to avoid treatment with medications during pregnancy and while breastfeeding.  At least one study has shown that women who exercised regularly reported less depression in the first and second trimesters compared with women who did not exercise.  The American College of Obstetricians and Gynecologists has recommended 30 minutes of moderate exercise on most days.

• During the postpartum period:  Exercise can also help to treat and prevent postpartum depression.  One study has shown that postpartum women who exercised three times per week had less depression than postpartum women who did not exercise. 

• During the premenstrual period:  Exercise can be useful to treat physical and emotional premenstrual symptoms.  It is less clear if exercise by itself can treat the most severe of premenstrual syndromes (called “premenstrual dysphoric disorder”), but it is still a first-line treatment strategy that most physicians would recommend. 

• During menopause:  Several studies have shown that aerobic exercise can improve both depression and insomnia occurring during menopause.  Additionally, lower intensity exercise such as yoga has been shown to improve psychological well-being in menopausal women.

Importantly, women may experience barriers to exercise.  Here are some examples of these barriers, and strategies to help address them:

• Childcare issues:  Women are often responsible for childcare, which makes it difficult for them to find opportunities to exercise.  Gyms that offer childcare services can be helpful.  Also, partners can share the workload. 

• Intimidation:  Some women may feel uncomfortable working out in the coed environment of a gym.  Consider taking women-only exercise classes, or walking or doing other exercise with women exercise buddies.

• Self-consciousness about appearance:  If a woman is already uncomfortable about her appearance, then she might worry that she’s drawing even more attention to her body by exercising, especially if wearing skimpy sports clothes.  One strategy is to try walking, which can be done almost anywhere and in almost any type of clothing.

• Guilt:  Women, especially those who are family caretakers, sometimes describe feeling guilty about taking time for themselves to exercise.  Remember, it is not a selfish thing to exercise.  You are taking time to improve your physical and emotional health, which will allow you to more effectively be there for others.  Besides, you deserve to experience the benefits of exercise!   

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