Positive Thinking?  It's Positively Healthy

There are many different factors that may determine the course of medical illnesses. Access to appropriate medical care, time of diagnosis, illness severity and individual immune response all have a measurable impact on illness progression. In recent years, the importance of a positive attitude has been identified in many scientific studies on medical illnesses. Without doubt, it is very difficult to remain optimistic when confronted with the diagnosis of a serious illness or                                    disability.  Many  people  feel  understandably  frightened  and insecure they                            experience illness. Serious illness provokes fear. Symptoms can be                                        distressing. Treatment may also cause unwanted side effects. Certainly,                                  there  are  many  negative  aspects  of  medical  illnesses.  Despite  all  the                            negative consequences of illness, it is becoming increasingly apparent that                              maintaining a positive mental attitude improves the prospects for recovery                                from illness. Several well-constructed and reputable scientific articles published in respected medical journals have demonstrated measurable benefits from a positive attitude. Remaining optimistic in the face of illness is often difficult. It may however but be important for healing and recovery.

There are numerous anecdotal reports of the benefits associated with an optimistic attitude in illness. Most people have some personal knowledge or experience of people who are ill or disabled and maintain a positive attitude. We often marvel at their extreme resilience! Sometimes they amaze or inspire us or even make us laugh. How can they remain so incredibly upbeat when they are ill? In many cases it's just their personality. In other cases however these individuals have unintentionally discovered genuine practical benefits from maintaining a positive attitude. They have realised that a positive attitude allows them to participate in enjoyable activities and build relationships. Frequently, their symptoms have improved. They have learned by trial and error that a positive attitude has real benefits.

What about those scientific reports? A so called 'placebo' effect has been recognised in the medical field for a long time. Put simply, patients who expect to improve on certain medical treatments often do report an improvement. Even patients who receive specially designed fake treatments will report a measurable improvement in their symptoms. The phenomenon is so well accepted that all reputable medical studies must automatically apply a correction factor for this 'placebo' effect. The impact on our state of mind may be even more significant than the placebo effect alone. A study in  the  Canadian Medical  Association Journal                            in  August  2001 is  quite  enlightening.  The  authors  reviewed  a  total of 16                           studies  based  primarily  on  the  possible  effect that patient's expectations
had on their recovery. In short, these studies demonstrated that patients who
had  an  expectation  of  a  positive  outcome  in  their  recovery consistently
reported  better  treatment  outcomes. There  were  faster  recoveries  and  a
decrease  in  severity  of  symptoms  such  as  pain.  The  effect  of  positive
expectations upon a wide range of conditions from heart surgery to chronic pain was reviewed in this Canadian study. Other studies have also produced interesting results. A recent study demonstrated that an optimistic attitude predicted increased survival in patients with cancer of the head and neck. The concept that many cancer patients who remain positive suffer fewer distressing symptoms and are better adjusted emotionally is now more widely accepted by health professions.

What are the possible benefits of an optimistic attitude when we are ill? Actually there are many possible advantages of remaining positive. Not all of these relate to symptoms and results of our treatments. There are also practical benefits with respect to maintaining a happy and functional life. A positive attitude can help us in numerous ways when we are unwell.and can promote:

It is not easy to remain consistently positive when we feel uncertain and anxious about the future. Even the strongest, bravest and most courageous individuals experience bad days when confronted by the reality of a serious illness or disability. Inspirational stories from illness survivors have however shown that a positive outlook really does make a difference. Now it appears that science has proved the benefits of an open minded and optimistic attitude to medical illness.

There is a flip side to this whole issue. Does an improvement in our overall physical health lead us towards a happier life? The answer would appear to be that it does. That issue will however have to wait till another column.

Wishing you improved health and a happier life!

By Andrew Rylatt (Medical Doctor)
24th February 2004 

Further Reading:

Mondloch, M.V., Cole, D.C. and Frank, J.W., Does how you do depend on how you think you'll do? A systematic review of the evidence for a relation between patients' recovery expectations and health outcomes. Canadian Medical Association Journal,
July 24, 2001; 165 (2)

Allison, P.J., Guichard, C., Fung, K. and Gilian, L., Dispositional Optimism Predicts Survival Status 1 Year After Diagnosis in Head and Neck Cancer Patients. Journal of Clinical Oncology, Vol 21, Issue 3 (February), 2003: 543-548

Turner, J., McEvoy, B., Luxford, K. and Fletcher, J., Clinical practice guidelines for the psychosocial care of adults with cancer. Australian Family Physician, Vol 33, No. 1 / 2, January / February 2004: 63-65 
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