Good health and happiness are closely connected, but did you know that you may be able to improve your health by increasing your positivity and happiness? (26) Research has shown that positive psychological well-being is associated with various benefits, such as improved cardiovascular and immune health, (6) as well as a reduced risk of mortality. (2)

Defining positive psychology

Positivity encompasses several related concepts, including positive mood, positive attitude, happiness, and gratitude. Positive psychology, the study of a flourishing and healthy life, includes examining positive relationships, institutions, psychological states such as happiness, and psychological traits such as interests and talents. (21)

family all together playing in living room

In psychology, the term “affect” refers to the extent to which you experience positive or negative mood states.

What is a positive mood?

The term mood is understood as a predominant emotion or conscious state of mind. (16) In psychology, the term “positive affect” is used to describe how often an individual experiences positive moods, including happiness, alertness, interest, and joy. (2)(15)(18)

What is a positive attitude?

Attitude is considered a mental position, feeling, or emotion toward a fact or state. (1) According to the American Psychological Association, a positive attitude is an individual’s feelings of approval and acceptance of themselves or others. (22)

Attitude towards a behavior, such as a healthy habit, can be categorized as cognitive or affective. A positive cognitive attitude involves interpreting behavior as beneficial, and a positive affective attitude involves associating the behavior with an emotion, such as a positive mood state. (25)

The difference between the two categories of attitudes (cognitive and affective) is important because affective attitudes that characterize a particular behavior as enjoyable have been found to better predict individual engagement with that behavior. (25) This would suggest that associating enjoyment with a healthy habit, such as the activity of walking, may result in increased engagement with that healthy habit, compared to those who only consider it a beneficial activity.

What is happiness?

There are many different historical and philosophical interpretations of happiness. One study examined dictionary definitions of happiness from over 30 countries compared to historical definitions of happiness in the United States. It found that in the present-day U.S., happiness refers to a wide range of positive inner feelings, whereas in several other countries, it may be used more selectively in reference to rare positive events or conditions, such as having good luck and success. (17) Happiness is one example of positive moods under the umbrella of positive affect. (15)

Did you know?
A global survey known as the World Happiness Report ranks countries by perceptions of their citizens’ happiness. In the 2017 to 2019 ranking of happiness, Canada ranked as 11th on the list and the U.S. ranked as 18th. (9)

What is gratitude?

Gratitude is a concept that includes the recognition of a positive event that impacts you, and the recognition that another individual or entity such as nature was responsible for that event. (4) Having a sense of gratitude is said to promote happiness and well-being. (14)

In psychology, the term “affect” refers to the extent to which you experience positive or negative mood states.

The health impact of happiness and positivity

There are several ways in which positive psychological well-being may improve health. Researchers propose that genetics may influence both affect (mood states), health behaviors, and health in general. Positive affect may reduce the activation of certain pathways that directly impact health, such as nervous system, immune, and inflammatory pathways. Additionally, having a positive effect has been associated with a greater likelihood of maintaining a healthy lifestyle. (6) This process has been called the “upward spiral theory of lifestyle change.” (25)

A systematic review of prospective studies investigated the effect of psychological well-being on health. The study found that positive psychological well-being is associated with a decreased risk of mortality in both healthy and diseased individuals. (2) Various studies have shown that positive affect may improve cardiovascular function, cognition, cortisol levels, immune health, mental health, and medical treatment outcomes. (4)(6)(13)(20)(23)

woman looking at her smart watch as she is beginning to run outside

Positive mood states increase adherence to healthy behaviors, such as exercising, which may, in part, explain their impact on health. (6)

Cardiovascular function

When your body is exposed to challenges (stress), the sympathetic nervous system responds and initiates changes in cardiovascular activity, such as blood pressure and heart rate. Having a positive mood may decrease cardiovascular recovery time from a stressful state or negative emotions. This may occur because positive emotions can activate the parasympathetic nervous system, which reduces the sympathetic nervous system’s action on the cardiovascular system. (6)

Emotional vitality, a positive emotional state characterized by positive well-being, energy, and effective regulation of emotions, may protect cardiovascular health. A study including over six thousand men and women measured emotional vitality and incidents of coronary heart disease (CHD) over 15 years. Individuals who reported high emotional vitality had a reduced risk of CHD. (13) Additionally, positive affect may reduce the risk of stroke in older adults, while having depressive symptoms may increase the risk. (18)


Having a positive mood may benefit cognition by improving the ability to process information. Research has shown that having a positive mood can help broaden attention, allowing individuals to be more perceptive of their surroundings. A positive mood can also modify the interpretation of negative events, such as unwanted behavioral responses, by decreasing their negative impact on ones’ outlook. (23)

Cortisol levels

The hypothalamic pituitary adrenal (HPA) axis responds to emotional states by releasing adrenal and pituitary hormones, including cortisol. Cortisol is commonly referred to as the stress hormone, and experiencing chronic stress has been associated with excess cortisol output. (10) Chronically elevated cortisol can impact health and has been linked to cognitive impairment, (19) impaired injury healing, (8) and a higher body mass index (BMI), or obesity. (24)

Studies have found lower overall cortisol levels in those who have increased positive affect. However, there are some discrepancies in these findings depending on age, and the time of day cortisol is measured. (6)

Immune health

Positive affect has been associated with multiple changes in immune function. For example, positive well-being has been linked to an increased number of helper T cells. Positive affect may also improve antibody levels, antibody response, and natural killer (NK) cell response. (6)

One study of 334 healthy adults demonstrated the implications of these immune changes for upper respiratory infections. Individuals measured their positive affect over three weeks to establish their emotional style and were then subjected to a rhinovirus, which typically causes the common cold. The study found that individuals with a positive emotional style demonstrated a reduced risk of developing cold symptoms by up to three times. (6)

Mental health

A randomized clinical trial examined the effect of a gratitude intervention on the mental health and well-being of 1,337 adults. For 14 days, the gratitude group composed a gratitude list, which included moments they were grateful for during the day. The two control groups recorded either daily hassles or neutral events. The study found that the gratitude group experienced increased subjective happiness, life satisfaction, and positive affect, as well as decreased negative affect and symptoms of depression. (4)

Medical treatment outcomes

As a positive mood increases beliefs in positive outcomes, and a negative mood can increase doubts, mood can indirectly affect health outcomes. Research suggests that both positive and negative beliefs play a role in the success of medical treatments. (20) Similarly, studies have found that promoting a positive mood can improve how an individual processes and responds to information that threatens their health, such as a warning message about the impacts of smoking. (5)

How to improve your psychological state

Certain factors that impair psychological well-being may be out of your control. Examples include poor socio-economic standing, adverse environmental exposures in early life, abuse, or caregiver separation. (11)

On the other hand, activities you have control over are referred to as intentional activities. If intentional activities are positive, they can lead to an improvement in positive psychological well-being. These activities can include:

  • Behaviors (e.g., being kind to others, exercising)
  • Thought patterns (e.g., having gratitude, having a positive interpretation of events)
  • Motivations (e.g., setting and working towards goals that reflect your values) (11)

Other factors that may improve psychological well-being include:

  • Flexible thinking and creativity (11)
  • Good physical health (11)(26)
  • Social engagement (11)

The following tips are ways you can improve your psychological well-being.

woman reading a journal and smiling

Practices such as mindfulness and gratitude can improve your mood and well-being.

Use mindfulness approaches

Studies that have assessed the connection between mindfulness interventions and indicators of psychological health. One review concluded that practicing mindfulness is associated with increased self-reported well-being, reduced emotional reactivity, and improved behavioral regulation. Interventions included in the review were mindfulness-oriented, such as mindfulness-based cognitive therapy (MBCT) and meditation-oriented, such as Acceptance and Commitment Therapy (ACT). (12)

To learn more about incorporating mindfulness, view Fullscript’s mindfulness handout.

Practice positive thinking

Using positive thinking may help reduce negative thoughts, such as worry about possible negative outcomes. A study in individuals with generalized anxiety disorder had the treatment group replace thoughts of worry with images or words of possible positive outcomes, while the control group envisioned positive images unrelated to their worries. Both groups experienced similar effects, with decreased levels of anxiety and worry. (7)

Try smiling to increase happiness

A recent meta-analysis found that facial expressions have a small impact on emotional experience, including general feelings of positivity or negativity, and individual emotions, such as happiness or anger. This suggests that smiling may lead to an increase in happiness; however, the effects may be small. (3) Notice what makes you smile, whether it’s spending time with loved ones or looking at pictures of animals, and incorporate more of it in your life.

Create an attitude of gratitude

There are various ways to cultivate gratitude, such as keeping a gratitude journal and practicing gratitude meditation. A daily gratitude journal involves writing a list of things in your life for which you are grateful or thankful. (4) Starting with a list of five items is common, but you can decide on a number that works for you.

Researchers have also examined the effects of gratitude meditation and suggest that it may help improve self-motivation and emotional regulation. One study of gratitude meditation had individuals focus on taking slow, deep breaths for one minute, followed by focusing on a mental image of their mother and mentally expressing appreciation to her for the next four minutes. This meditation was associated with changes in the brain seen in magnetic resonance imaging (MRI) that could be responsible for changes to motivation and emotion. (14)

Work on improving your general health

Research shows that mood states and health have a bi-directional relationship, meaning they influence each other. One study investigated this relationship in adults by measuring effect and health status three times over 20 years. It found that positive and negative affect can influence self-reported health and functional limitations. (26) Work with your integrative healthcare provider to establish and/or maintain good physical and mental health.

The bottom line

Improving your psychological well-being can reduce the risk of certain health conditions and mortality while improving well-being. Fortunately, several voluntary activities, such as practicing mindfulness, using positive thinking, smiling, practicing gratitude, and improving general health are associated with positive mental well-being. Follow the tips in this article to help increase happiness and improve your mood.

If you are a practitioner, consider signing up to Fullscript. If you are a patient, talk to your healthcare practitioner about Fullscript!

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