What nurses can do to ease this journey
A patient comes to see a psychiatric nurse practitioner complaining of depression. Using solution-based counseling, the NP asks a theoretical question.
“If you woke up tomorrow and your depression was magically gone, how would your life be different?”
He replies “I would be happy” but the NP responds, “I can help you become less depressed but I can’t make you happy – only you can do that.”
Traditionally psychiatrists, psychiatric nurse clinicians and other mental health providers have focused on psychopathology and what is wrong with people. There is no billable DSM-5 code to aid people in the pursuit of happiness. Mental health treatments such as medication and cognitive-based therapy may aid in reducing depressive symptoms, but happiness is not just the absence of depression.
Happiness is defined in many ways. In general, it refers to having more positive emotions than negative ones, feeling a sense of contentment, wellbeing, life satisfaction, and joy in daily living. Positive Psychology is the branch of psychology that focuses on the strengths of human beings and why some people are resilient and flourish. It has scientifically aided our understanding of happiness. What have we learned about happiness, and what are some of the techniques we can teach patients to help them in their pursuit of happiness?
Many people dream of hitting the lottery, believing that money will buy happiness. Rich people are generally happier than poor people, but only to a point. Once a person reaches a certain level of comfort, additional money will not improve happiness. More money can lead to wanting more possessions, placing us in competition to improve our perceived social standing. This pursuit can lead to unhappiness, as having too many choices can be problematic. People who simplify their choices tend to be happier than those who keep looking for the perfect product.
While some people have a genetically determined temperament geared toward unhappiness, there are environmental considerations that can improve our happiness.
Research indicates that those who attend religious services tend to have higher levels of happiness. It might be because of the social support and the positives of group membership rather than the faith-based beliefs. People who work in meaningful jobs, with a sense of purpose who have pride in their product or task are often happier than those who work only to “get a paycheck.”
What have we learned that might be valuable to teach patients in their quest to seek a happier life?
We know more money doesn’t increase happiness, but there are ways in which money can aid happiness. We know that people often feel joy when they spend money on others. We get joy when we buy the new toy the child opens, or buy a friend lunch. It doesn’t have to be a big amount – it can be as cheap as a cup of coffee or a candy bar. We know that people are generally more happy when they spend money on experiences rather than possessions. Trying something new and meeting new people may produce lifelong memories, while that new possession will soon lose its glow and something new will be needed to replace it. We feel joy when we spend money on things that go along with our values such as church offerings or political donations.
People who are depressed often spend a great amount of time thinking about what is going wrong and the things they don’t have. People who are happy tend to feel and show gratitude with what they do have. Encourage people to find three reasons to give thanks each day. They don’t have to be big things. Focusing on positives in our life is the first step in changing our negative thoughts.
Thank those who have been kind or helpful during the day. As a nurse, thank your coworker for aiding
with that dressing change or for covering your unit so you could go to lunch. One unit uses a three compliments per hour rule. People are happier when others notice and praise them. “Nice job doing your PT today, Bob” will make him feel accomplished and moving toward recovery.
Using mindfulness can be helpful. We often worry endlessly even while doing daily tasks. While brushing our teeth, we are thinking about all the work we have to do today or an important meeting we must have. If we are using that time to prepare, it can be worthwhile, but usually it is time to be flooded with negative thoughts.
“What if I ‘m not prepared? How am I going to get everything done?
Focus on feeling the experience of brushing your teeth. Focus on each stroke of the toothbrush, and feel the freshness of a clean mouth. Live in the moment.
Focus and live in the present. Life can be short and good things can be fleeting. When you find yourself in the flow of positive feelings and events, cherish and enjoy. Things will change fast enough. Have a goal or purpose. I meet young patients who when asked ‘what are you going to do today?’ they have no response or plan. They often report being unhappy or feeling empty. People need a daily focus. If you can’t work, perhaps you can find happiness in volunteering. It can be as little as an hour or two each day. Or perhaps you can adopt a pet and experience the joy of caring for another living being. Pet owners often report increased happiness, as do people who spend time outdoors and appreciate nature’s wonders.
Since we are social beings, having friends is important. Loneliness is one of the biggest causes of unhappiness. Social support is a factor in living longer and having a higher quality of life. It can be hard to meet people, but there are ways. Say “yes’ when invited. Join clubs of groups with similar interests as yours.
Practice putting yourself out there by doing things you might not ordinarily do. Instead of looking at your phone on your subway ride home, strike up a conversation with the person next to you. Studies show that people who act assertively or extroverted even when usually reserved get a shot of happiness. Surround yourself with positive people. Happiness can be contagious.
Some studies suggest that simply smiling with good intent can increase happiness. Smiling might induce muscle changes in the face that trigger the ‘happiness’-related neurons in the brain.
In summary, to be happy, start each day with the idea that you will be happy. Take the steps needed to achieve happiness. Have a daily goal or purpose. Live in the present. Be social and hang around with people who are positive in thought and behavior. Try smiling more. Have a healthy lifestyle, including a healthy diet, exercise and practice mindfulness. Compliment and thank others. Do something for someone else altruistically. And at the end of the day, recount the positives of the day and be grateful .
Happiness is usually found in our daily living experience, being in the flow at work and home. Even if things don’t go great that day, by practicing the tools listed you will have the resilience needed to face these challenges and continue your pursuit of happiness the next day!
Michael C. LaFerney is a psychiatric clinical nurse specialist at Arbour Senior Care; Haverhill, MA and an adjunct professor of Psychology at Quincy College; Quincy, MA.