which comes first, health or happiness?

Health & Happiness, The Chicken and the Egg

As a Health Professional, I have spent the best part of 20 years trying to help people ignite the fire within to recover, protect and improve their health and performance. This quest has taken me on an exciting and enlightening journey from hospitals to movie sets and many places in between.

Having worked with such a diverse array of clients- from cardiovascular rehab patients to elite athletes, I have, for the most part, been convinced that the key to overcoming health challenges is motivation; a deep-seated motivation that is fuelled by inspiration so powerful that it compels the beholder to change, to grow, be better, and strive for a greater experience of themselves and the world around them. I believe this inspiration can be derived from both positive and negative circumstances. Unfortunately, in the realm of healthcare it seems to negative circumstances that inspire people to change, often in the form of pain or sickness.

What is Good Health?

The concept of ‘good health’ is a kind of vague and inexact entity with a variety of definitions depending on which source you are deriving it from. If we take the World Health Organization’s definition of health- ‘A state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity’, how do we know when we’ve actually achieved this?  We may know how it feels to be free of disease and infirmity, but a state of complete physical, mental and social well-being seems far less of an obvious experience or goal.

With such ambiguity around what good health actually means and feels like, how do we summon and sustain the motivation to shoot for such a vague ideal?  Is it worth dedicating effort and sacrifice to a goal that we may never actually know that we have achieved?

If good health is our objective then maybe we need to focus on something that is more identifiable, unmistakable and even more fundamental than good health. A goal that provides the solid platform for health to flourish, and also makes it easier and more enjoyable to achieve…..Happiness!

The pursuit of happiness is described by the Greek philosopher Aristotle and the Dalai Lama as the very purpose of life. It is a state that makes us more likely to engage in healthy behaviours and can in turn be reinforced by being healthy.

So, if happiness inspires good health and is also a product of good health, shouldn’t our focus be on cultivating our happiness as a pre requisite for achieving good health?

representation of the biopsychosocial model of care, reflecting the importance of a persons happiness

In healthcare, we are now increasingly embracing the importance of the person behind the pain or disease. This includes understanding a person’s life experiences, emotions, perceptions, feelings and beliefs, all of which affect our ability to overcome poor health and thrive. This is portrayed in the ‘Biopsychosocial Model of Healthcare’, which really reflects the importance of happiness by emphasizing the need to consider a persons, beliefs, relationships emotional and mental health, as well as just looking at the biological and physiological aspects of disease.

Why Focus on Happiness before Health

Research suggest that happier people tend to engage in healthy behaviours more than unhappy people and actually live longer. In addition, being happier is associated with greater resilience, reduced levels of chronic pain and a stronger immune system! Something as simple as watching a funny film for an hour can improve the protective function of our immune cells for up to 12 hours afterwards.

So maybe universities should include clowning modules in their medical training programmes, or hospitals could host comedy nights as a therapeutic intervention for their patients. After all, if it didn’t help the patients, maybe it would lighten up the whole medical profession a little, who knows, I’m just thinking out loud!

I must admit, I became overly serious during my 4 years of training as an Osteopath. Don’t get me wrong, healthcare is laden with pitfalls and we have a duty to take people’s health seriously. However, the irony is that some of the most therapeutic healing modalities available to us are the very antithesis of seriousness, such as laughter, fun, joy and playfulness.

 Healthcare training is often laden with fear, a fear of misdiagnosis, not gaining proper consent, fear of harming a patient, fear of being sued etc. As a result, all of this apprehension, fear and precaution can detract from our interactions with those we serve, and disable some of the most healing and therapeutic tools available- humour and fun! In addition, ever increasing rates of burnout and dissatisfaction amongst medical professionals is not exactly fertile ground for cultivating better health!

I think we may be missing a trick in our delivery of healthcare. A trick that Dr Patch Adams (above) cottoned onto a long time ago- Administering and prescribing fun and happiness!

Get your giggle on

As medical professionals, we would surely benefit patients by infusing more humour and fun into our interactions, and maybe prescribing a good old giggle! If we are suffering from aches and pains, we should employ the healing power of happiness on a daily basis. Cultivating more fun, play, laughter and joy into our daily doings will bolster our resilience, stimulate our immune system, and promote the release of our endogenous pain relieving endorphins.  Something as simple as a hearty belly laugh with friends reduces pain sensitivity, improves the function of our immune system, reduces stress hormones and brings us closer together by enhancing our social bonds.

Now what’s not to like about that? 👍

Laughter shares many of the physiological benefits of exercise including those mentioned above. The physical act of a hearty hysterical hoot has even been compared to aerobic interval training! However, if we want to get more bang for our buck when it comes to the myriad of health benefits both happiness and exercise can provide, why not combine our fun and laughter with some exercise. I think a good title for this would be something we’ve all done, but have maybe forgotten and supressed under the heavy trench coat of adulthood- Play!

Even without the fun element, group activity/exercise can stimulate a significantly greater analgesic endorphin release than exercising by ourselves. This is attributed, in part, to the primal instinct of strengthening our social bonds.

Exercise programmes that focus on participants having fun by including laughter interventions have been shown to improve mental health, aerobic endurance and self-efficacy amongst a population of elderly and mostly sedentary people. It may seem obvious but this combination of fun and activity may be the key to motivating some of those least likely to exercise amongst us, into adopting and maintaining health enhancing behaviours.

I guess the take home from this is that you don’t need to be reluctantly dragging yourself through arduous workouts to get some of the most important health protective benefits that exercise can offer. For improved mood, immune function, stress resilience, pain relief and consistency, having a good laugh with a bunch of mates in a Zumba class will be far more effective for many people.

One of the inspirations behind this blog, as well as Dr Patch Adams, is the TED Talk below by Darryl Edwards, creator of the ‘Primal Play’ method. This concept focuses on making physical activity fun, while helping people get healthier and fitter in the process.

When describing his inspiration for ‘Primal Play’, Darryl takes me back to my childhood with games like British bulldog, leapfrog, tag and breakdancing. All great examples of fun filled play, worthy of also being categorized as intense exercise. His TED Talk has reminded me of just how simple it is to combine health, happiness and better parenting!  We only need to observe children at play to see how our primal instincts of creativity, imagination and fun cultivate and reinforce authentic happiness, togetherness and health.

So whether it’s adherence to a healthy diet, adherence to medication, or adherence to exercise, happiness seems to be a predictor of both adopting and sustaining healthy behaviours.

At the opposite end of the spectrum, it is well established that unhappiness, more specifically depression, can be a precursor to physical symptoms such as chronic joint pain, back pain, digestive issues, poor sleep etc. People with a coexisting physical condition such as chronic pain, and psychological condition such as depression, represent a large proportion of those suffering from multimorbidity (2 or more coexisting long-term medical conditions). The majority of GP consultations, prescriptions and hospital admissions involve people with multimorbidities, which is unfortunately an increasing trend that is placing a disproportionately large demand on the UK’s overburdened healthcare system.

So if happiness begets health and health reinforces happiness, where should we start? Well here are a few simple tips to get some horse power behind your health goals.

1.    Practice Gratitude

Gratitude is defined as an appreciation of what is valuable and meaningful to you. It represents a state of appreciation and thankfulness. Research shows a strong association between gratitude and a sense of happiness and wellbeing.

Anecdotally I have witnessed the power of gratitude through the 31 Day Health Transformation Programme which invites participants to keep a gratitude journal and reflect on aspects of their day to day lives that they are grateful for.  Journaling and expressing gratitude to others on a daily basis enhances positive emotions and resilience. Gratitude interventions have even contributed to improving healthy eating behaviours!

There are many different ways of raising our awareness and affirming what we have to be grateful for such as:

-Writing about things you are grateful for before bed or on waking

-Writing a letter to someone you are grateful for

-Meditating on what you are grateful for

Many people derive a sense of gratitude by considering their lives in contrast to some of the hardships suffered by humanity around the world. If you run out of things to express gratitude for, flip it and write a few things that you’re grateful not to have or be, for example:

I am grateful that I am not starving.

I am grateful that I am not living in a war zone.

I am grateful that I am not terminally ill.

2- Find your Flow

When was the last time you were completely absorbed in an activity or task? So much so that you were oblivious to the outside world, felt completely focused, present and in the zone, unaware of time, and less aware of any worries or problems? During that time you were probably experiencing flow!

The concept of flow definitely deserves a stage of its own, however, I’m going to do it no justice by summarising some of the key points about this important super food for happiness!

In simple terms flow can be described as the holistic sensation that people feel when they act with total involvement. The following description from a Flow research participant really encapsulates the experience.

My mind isn’t wandering. I am not thinking of something else. I am totally involved in what I am doing. My body feels good. I don’t seem to hear anything. The world seems to be cut off from me. I am less aware of myself and my problems.”

The distinguished professor of psychology and happiness researcher Mihaly Csikzentmihalyi (don’t even try to pronounce his last name!😂), recognized and named the concept of flow, which describes a state that is created when people tackle activities and tasks that are perceived to be at just the right level of challenge or ‘stretch’ for their individual skill sets. These challenges have clear short-term goals and provide instant feedback. As a result, these activities are pleasant, enjoyable and naturally motivating.

8 Characteristics of flow (taken from http://bit.ly/fatherofflow)

-Complete concentration on the task;

-Clarity of goals and reward in mind and immediate feedback;

-Transformation of time (speeding up/slowing down);

-The experience is intrinsically rewarding;

-Effortlessness and ease;

-There is a balance between challenge and skills;

-Actions and awareness are merged, losing self-conscious rumination;

-There is a feeling of control over the task.

Common activities when people experience flow include


Tai Chi






Playing and listening to music

Playing Computer games (although I wouldn’t advocate too much of this!)

The concept of flow merges the principles of being both completely present and purposeful in our day to day tasks and activities. That said, we have the opportunity to develop flow in many of our day to day experiences. In addition, the reduction of self-consciousness, positive feedback, sense of reward, effortless and ease induced by flow states provide all the ingredients for greater happiness.

3- Laugh and Smile more

We know that laughter has a multitude of health benefits, so watch your favourite comedians on youtube, or a few funny films now and again, and If you’re feeling really experimental you should definitely try a class of laughter yoga!

As part of our 31 Day Health transformation programme, we introduced people to laughter yoga which was an absolute winner! Any apprehension is dissolved within minutes as simulated laughter soon transforms into genuine hysterical fits of laughter. Participants leave on a unique high that I have personally never experienced before. I can only describe it as an uplifting euphoria that stays with you for hours beyond the experience.

Also, why not try to be the instigator of a good laugh? Learn a few simple jokes and tell them to friends. Laughing is highly infectious and when we make others giggle it often leaves us in fits of laughter also.

The science of smiling is also very interesting and just like simulated laughter can help us feel happy, so can a simulated smile. Apparently, even a forced smile helps to release the feel good nuero-transmitters endorphin, serotonin, and dopamine. An interesting study on the effect of facial expressions on depression found that a botox injection that prevented people from frowning helped to reduce depressive symptoms in a significantly higher amount of participants than a control group! Not only does smiling make us feel happy, it also makes us look, younger, more attractive, and contributes to the wellbeing of others.

Again, what’s not to love about that? I could definitely do with a few less years and a lot more attractiveness! 😂😂

Oh and by the way, it’s free!!

There are so many simple things that we can do to boost our happiness, but as with everything, action is the biggest cure all! We can know all of this stuff but the magic is in the doing.

Some research also suggests that 50% of our happiness is explained by genetics, 10% by circumstances and 40% is accounted for by our intentional activity.

 Below is a fantastic happiness guide book taken from the Action for Happiness website. This inspirational guide provides 10  keys to happier living and is well worth a read just to remind yourself how easy it is to experience your god given right of happiness!


So in summary…

I believe that happiness is a more identifiable goal than good health. and also a prerequisite to successfully achieving and sustaining good health. Happiness fuels the motivation to engage in the behaviours and habits that bring about better health.

In contrast to this, stoically engaging in healthy behaviours without a genuine sense of enjoyment or an identifiable goal may reduce the therapeutic potential of our endevours and the likelihood of sustaining them.

So as users of healthcare, we can lay the foundations for our own recovery and vitality by simply doing more of the things we enjoy, playing more, laughing more, rediscovering and losing ourselves in the tasks and activities we love.

Just as importantly, as healthcare providers, we can enhance our interactions with patients by lightening up a little, telling a few jokes and having a giggle. We should also be prescribing happiness, and using it to build a therapeutic alliance that, despite all our medical knowledge, may well be the most effective skill we have!

Laughter is the shortest distance between two people.

Victor Borge

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This Post Has 4 Comments

  1. Lou Hudson

    Excellent article, well written and thought provoking. It can be hard to maintain happiness in the current political and social climate in the UK but this was positive food for thought.

    1. Ricky Brown

      Hi Lou, Thanks for the positive feedback. I think that a lot of the fear-based discord and turmoil in UK society at present is made more challenging because most of it is based on speculation! A mass exodus of attention onto an uncertain future as opposed to present day living is the perfect storm for unhappiness, discontentment and anxiety! It’s times like this that a daily reinforcement of gratitude and mindfulness of what we have in the now could be really helpful. The doom always seems to be coming but life is happening in the meantime! 😊

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