Victoroff also provided some insight on a study that assessed the mental health of 2 groups of people with spinal cord injuries and a group of able–bodied people.1 Although the patients with high spinal cord injuries (damage above the T6 vertebra) had the worst level of physical functioning, their outlook toward life was not only very positive but better than that of less impaired patients and of able–bodied people. The authors suggested that successful coping after spinal cord injuries may be influenced by not only psychological adaptive reactions but by neurophysiological changes induced by the injury itself.
Having worked in a rehabilitation hospital, Victoroff said many paraplegic or quadriplegic patients he saw exhibited less distress than you might expect among patients with spinal cord injuries. Nonetheless, he emphasized that a substantial body of research has shown that disability more typically has a negative impact on well–being.
Victoroff stated that some evidence supports the benefits of:
• Going out of doors
• Helping and spending money on others
• Being sociable within one’s own comfort zone
• Expressing gratitude
• Recording positive events or personal strengths
He cited the work of Seligman and others16 who looked at the effectiveness of psychological interventions to increase individual happiness. In a randomized placebo–controlled study, researchers compared the results of 5 happiness exercises. For example, 1 exercise focused on expressing gratitude by writing and delivering a letter of thanks to a person who had been especially kind but had never been properly thanked. That exercise led to large positive changes among study participants that lasted for a month.
Victoroff pointed to the evidence of the benefits of regular exercise for lasting eudaimonic happiness. “There are relatively few interventions that we can do that are absolutely known to work, and one of them is getting patients to exercise, particularly aerobic exercise.” He went on to say, “Certainly, positive affect and personality correlate with exercise motivation and participation. But also, if you oblige people to exercise, encourage them and reward them for exercising, it increases their positive affect.”
Other potential factors affecting eudaimonic happiness, Victoroff said, may include hormone replacement therapy in women; marriage/affiliative security; breast feeding; using SSRIs in a subgroup of patients; cognitive–behavioral therapies; working toward a valued goal; and (possibly) mindfulness meditation or even repetitive transcranial magnetic stimulation (TMS).
The FDA last October approved TMS to treat depressed adults in whom 1 antidepressant medication has failed to work. Victoroff added that, “although the evidence of efficacy at present is rather weak, at least in some cases, it seems to lead to lasting benefits.”