Notes

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Introduction

The Harvard psychologist Daniel Gilbert has spent more than a decade studying just how abysmal human beings are at predicting which future events will make them happy: “The Science of Happiness: A Talk with Daniel Gilbert,” introduction by John Brockman, www.edge.org/3rd_culture/gilbert06/gilbert06_index.html.

Cardiologists now know that loss of heart-rate variability is an early sign of disease: E. Kristal et al., “Heart Rate Variability in Health and Disease,” Scand J Environ Health 2 (April 21, 1995): 85–95. See also editorial by J. M. Karemaker and K. I. Lie, “Heart Rate Variability: A Telltale of Health or Disease,” European Heart J 21 (March 2000): 435–37, www.heartmath.org.

Ramakrishna Paramahansa (1836–1886), a famous Indian saint: Walther G. Neevel Jr., “The Transformation of Sri Ramakrishna,” in Hinduism: New Essays in the History of Religions, edited by Bardwell L. Smith (The Netherlands: E. J. Brill, 1976), 53–97. See also Peter Holleran, “Ramakrishna Paramahansa—God-Intoxicated Saint,” www.mountainrunnerdoc.com/articles/article/2291157/31005.htm.

CHAPTER 1. What Is Emotional Well-Being?

Yet enforced, almost bullying cheerfulness dominates our culture: Barbara Ehrenreich, Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America (New York: Metropolitan Books, 2009).

“The president almost demanded optimism,” noted Bush’s secretary of state Condoleezza Rice: Ehrenreich, Bright-Sided, 10. See also Richard Pine, “Bush’s Toxic Optimism,” Huffington Post, September 16, 2007, www.huffingtonpost.com/richard-pine/bushs-toxic-optimism_b_64616.html.

One [study], from 2004, notes: Yukiko Uchida et al., “Cultural Constructions of Happiness: Theory and Empirical Evidence,” J Happiness Studies 5 (2004): 223–39.

Other scholarly articles report significant differences from country to country in rates of reported happiness: Roya Rohani Rad, “Happiness: A Literature Review of Cross Cultural Implications,” November 2010, www.selfknowledgebase.com/files/happinessliteraturereview.pdf.

CHAPTER 2. An Epidemic of Depression

The World Health Organization predicts that by 2030 more people worldwide will be affected by depression than by any other health condition: “Depression Looms as Global Crisis,” BBC News, September 2, 2009, http://news.bbc.co.uk/2/hi/health/8230549.stm.

The number of Americans taking antidepressant drugs doubled in the decade from 1996 to 2005: Amanda Gardner, “Antidepressant Use in U.S. Has Almost Doubled,” Healthday, August 3, 2009, http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2009/08/03/antidepressant-use-in-us-has-almost-doubled.

Today an astonishing one in ten people in the United States, including millions of children, is on one or more of these medications: Katharine Kam, “Can Antidepressants Work for Me?” WebMD, February 20, 2011, www.webmd.com/depression/features/are-antidepressants-effective.

the Diagnostic and Statistical Manual of Mental Disorders (DSM): Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), published by the American Psychiatric Association, 2000. DSM-V will appear in 2012.

The current edition of the DSM gives specific criteria for the diagnosis of this most severe form of depression: DSM-IV-TR.

The novelist William Styron, author of Sophie’s Choice, provides: William Styron, Darkness Visible: A Memoir of Madness (New York: Vintage, 1992), 50.

The English writer Aldous Huxley wrote of it: Aldous Huxley, Beyond the Mexique Bay: A Traveler’s Guide (New York: Harper and Brothers, 1934).

According to the DSM’s classification, I would have been diagnosed with dysthymic disorder, the commonest form of mild to moderate depression: DSM-IV-TR.

A prominent health website notes that in one group surveyed: “The Relationship Between Depression and Anxiety,” HealthyPlace.com, January 13, 2009, www.healthyplace.com/depression/main/relationship-between-depression-and-anxiety/menu-id-68/.

Women are twice as likely as men to experience depression: Stephanie A. Riolo et al., “Findings from the National Health and Nutrition Examination Survey III,” Am J Pub Health 65, no. 6 (June 2005): 998–1000.

We know also that depression commonly coexists with physical illness: National Institute of Mental Health, 2002, www.nimh.nih.gov/health/publications/depression/complete-index.shtml.

Nevertheless, experts on aging agree that depression is not a normal consequence of growing older: National Institute of Mental Health.

The National Institute of Mental Health reports that in any given year, 4 percent of adolescents in our society suffer severe depression: National Institute of Mental Health.

Depression is also being diagnosed much more frequently in preteens than ever before: Harvard University study reported in Harvard Mental Health Newsletter, February 2002, www.health.harvard.edu/newsweek/Depression_in_Children_Part_I.htm. See also: www.about-teen-depression.com/teen-depression.html; “Depression Facts and Stats,” www.upliftprogram.com/depression_stats.html#4; “Depression in Children and Adolescents Fact Sheet,” National Alliance on Mental Illness, July 2010, www.nami.org/Template.cfm?Section=by_illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=17623; E. R. Cox et al., “Trends in the Prevalence of Chronic Medication Use in Children: 2002–2005,” Pediatrics 122, no. 5 (November 2008): e1053–61, pediatrics.aappublications.org/cgi/content/abstract/122/5/e1053.

Along with attention deficit hyperactivity disorder (ADHD) and the autistic disorders, depression accounts for the unprecedented, widespread use of prescribed psychiatric drugs by our young people: Harvard University study reported in Harvard Mental Health Newsletter, February 2002, www.health.harvard.edu/newsweek/Depression_in_Children_Part_I.htm. See also: www.about-teen-depression.com/teen-depression.html; “Depression Facts and Stats,” www.upliftprogram.com/depression_stats.html#4; and Cox et al., “Trends,” e1053–61.

In 1996, the pharmaceutical industry spent $32 million on DTC antidepressant ads; by 2005, that had nearly quadrupled, to $122 million: Liz Szabo, “Number of Americans Taking Antidepressants Doubles,” USA Today, August 4, 2009, www.usatoday.com/news/health/2009-08-03-antidepressants_N.htm.

More than 164 million antidepressant prescriptions were written in 2008, totaling $9.6 billion in US sales: “Study: Antidepressant Lift May Be All in Your Head,” USAToday.com, January 5, 2010, www.usatoday.com/news/health/2010-01-06-antidepressants06_ST_N.htm.

Crazy Like Us: Ethan Watters, Crazy Like Us: The Globalization of the American Psyche (New York: Free Press, 2010).

A Nigerian man… “something akin to loneliness”: Watters, Crazy, 195.

Over the past decade, however, a massive marketing campaign launched in Japan: Watters, Crazy, 225.

The fact that DTC advertising is illegal in Japan was little impediment: Watters, Crazy, 187–248.

A study published in the April 2007 issue of the Archives of General Psychiatry: Jerome C. Wakefield et al., “Extending the Bereavement Exclusion for Major Depression to Other Losses: Evidence from the National Comorbidity Survey,” Arch Gen Psychiat 64, no. 4 (April 2007): 433–40.

the rate [of depression] has more than doubled…. It is also going up in the rest of the developed world: W. M. Compton et al., “Changes in the Prevalence of Major Depression and Comorbid Substance Use Disorders in the United States Between 1991–1992 and 2001–2002,” Am J Psychiat 163, no. 12 (December 2006): 2141–47.

the same study reports that the day-to-day sense of how happy one feels (“positive feelings”) is almost entirely unconnected to income level: Ed Diener et al., “Wealth and Happiness Across the World: Material Prosperity Predicts Life Evaluation, Whereas Psychosocial Prosperity Predicts Positive Feeling,” J Pers Soc Psychol 99, no. 1 (2010): 52–61.

The risk of developing major depression has increased tenfold since World War II: Martin E. P. Seligman and In J. Buie, “ ‘Me’ Decades Generate Depression: Individualism Erodes Commitment to Others,” APA Monitor 19, no. 18 (October 1988): 18.

People who live in poorer countries have a lower risk of depression than those in industrialized nations: “Unipolar Depressive Disorders World Map,” http://en.wikipedia.org/wiki/File:Unipolar_depressive_disorders_world_map_-_DALY_-_WHO2004.svg.

In modernized countries, depression rates are higher for city dwellers than for rural residents: JiamLi Wang, “Rural–Urban Differences in the Prevalence of Major Depression and Associated Impairment,” Soc Psychiat and Psychiat Epidemiol 39, no. 1 (2004): 19–25.

In general, countries with lifestyles that are farthest removed from modern standards have the lowest rates of depression: “Unipolar Depressive Disorders World Map.”

Within the United States, the rate of depression among members of the Old Order Amish: J. A. Egeland and A. M. Hostetter, “Amish Study, I: Affective Disorders Among the Amish, 1976–1980,” Am J Psychiat 140, no. 1 (January 1983): 56–61.

Hunter-gatherer societies in the modern world have extremely low rates of depression: Chantal D. Young, “Therapeutic Lifestyle Change: A Brief Psychoeducational Intervention for the Prevention of Depression,” submitted to the graduate degree program in Psychology and the Graduate Faculty of the University of Kansas in partial fulfillment of the requirements for the degree of Doctor of Philosophy, August 27, 2009, 31, http://kuscholarworks.ku.edu/dspace/bitstream/1808/5946/1/Young_ku_0099D_10545_DATA_1.pdf.

“neither of these pre-modern cultures has depression at anything like the prevalence we do”: Martin E. P. Seligman and R. E. Ingram, eds., “Why Is There So Much Depression Today? The Waxing of the Individual and the Waning of the Commons,” Contemporary Psychological Approaches to Depression: Theory, Research, and Treatment (New York: Plenum Publishing, 1989–1990), 1–9.

“The more ‘modern’ a society’s way of life, the higher its rate of depression…. The human body was never designed for the modern post-industrial environment”: Stephen Ilardi, The Depression Cure (Cambridge, Mass.: Da Capo Press, 2009), 6.

Agriculture began ten thousand years ago, and as recently as 1801, 95 percent of Americans still lived on farms: www.landinstitute.org/vnews/display.v/ART/2004/04/08/4076b2169776a.

And before the advent of industrial agriculture, farmers lived far healthier lives than most of us today: Ilardi, Depression Cure, 122.

The term nature deficit disorder has recently entered the popular vocabulary: Richard Louv, Lost Child in the Woods: Saving Our Children from Nature-Deficit Disorder (Chapel Hill, N.C.: Algonquin Books, 2005).

Hunter-gatherers and other “primitive” peoples do not develop the deficits of vision: www.physorg.com/news168157251.html.

More than twenty studies support a link between depression and creativity: www.cnn.com/2008/HEALTH/conditions/10/07/creativity.depression/index.html.

Clinical psychologists see rumination as a “way of responding to distress that involves repetitively focusing on the symptoms of distress, and on its possible causes and consequences”: S. Nolen-Hoeksema et al., “Rethinking Rumination,” Persp Psychol Sci 3 (2000): 400–424.

a 2010 New York Times Magazine article titled “Depression’s Upside”: Jonah Lehrer, New York Times Magazine, February 28, 2010, 41, www.nytimes.com/2010/02/28/magazine/28depression-t.html.

“Do you not see how necessary a World of Pains and troubles is to school an Intelligence and make it a soul?”: John Keats, Selected Letters, Robert Gittings, ed. (New York: Oxford University Press USA, 2009), xiii.

CHAPTER 3. The Need for a New Approach to Mental Health

In 1977, the journal Science published a provocative article: George L. Engel, “The Need for a New Medical Model: A Challenge for Biomedicine,” Science 196, no. 4286 (April 8, 1977): 129–35.

In 1980, the American Psychiatric Association radically revised the Diagnostic and Statistical Manual-III (DSM-III) to be in accord with the biomedical model: www.allacademic.com/meta/p_mla_apa_research_citation/1/7/5/4/0/p175408_index.html.

In 1921, Otto Loewi (1873–1961), a German pharmacologist, demonstrated that nerve cells (neurons) communicate by releasing chemicals: Renato M. E. Sabbatini, “Neurons and Synapses: The History of Their Discovery,” chapter 5, “Chemical Transmission,” Brain & Mind 17 (2003), www.cerebromente.org.br/n17/history/neurons5_i.htm.

The first antidepressant drug was discovered serendipitously in 1952: Joseph A. Lieberman, “History of the Use of Antidepressants in Primary Care,” “Primary Care Companion,” J Clin Psychiat 5, S.7 (2003): 6–10.

Amazon sells nearly three thousand books with the word [serotonin] in the title: Keyword search in August 2010 by author for serotonin in Books section of Amazon.com.

In fact, a new pharmaceutical known as tianeptine—sold in France and other European countries under the trade name Coaxil—has been shown to be as effective as Prozac: Sharon Begley, “The Depressing News About Antidepressants,” Newsweek Online (January 29, 2010), www.newsweek.com/2010/01/28/the-depressing-news-about-antidepressants.html.

As psychology professor Irving Kirsch of the University of Hull in England told Newsweek: Begley, “Depressing News.”

The first such analysis, published in 1998: Begley, “Depressing News.”

In April 2002, the Journal of the American Medical Association (JAMA) published the results of a large randomized controlled study: Wayne Jonas et al., “St. John’s Wort and Depression,” JAMA 288, no. 4 (April 2002): 446–49. See also: http://nccam.nih.gov/news/2002/stjohnswort/q-and-a.htm.

Zoloft also worked no better than the placebo: Begley, “Depressing News.”

Irving Kirsch summarized the growing body of evidence against SSRIs in his 2010 book: The Emperor’s New Drugs: Exploding the Antidepressant Myth (New York: Basic Books, 2010).

the most recent analysis, published in the January 6, 2010, issue of JAMA: Jay C. Fournier et al., “Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-analysis,” JAMA 303, no. 1 (January 5, 2010): 47–53.

About 13 percent of people with depression have very severe symptoms: Begley, “Depressing News.”

One of the authors of the JAMA paper, Steven D. Hollon, PhD, of Vanderbilt University, has said: Begley, “Depressing News.”

Loneliness, for example, is a powerful predictor of depression: R. A. Schoevers et al., “Risk Factors for Depression in Later Life: Results of a Prospective Community Based Study (AMSTEL),” J Affect Disord 59, no. 2 (August 2000): 127–37.

I quoted Albert Einstein on the subject of conceptual models: The quote is from Einstein and Infeld, Evolution of Physics (Cambridge, UK: Cambridge University Press, 1938), 152.

individuals trained in meditation have different brain activity from those without such training: Britta K. Hölzel et al., “Mindfulness Practice Leads to Increases in Regional Brain Matter Density,” Psychiat Res Neuroimaging 191, no. 1 (January 30, 2011): 36–43.

CHAPTER 4. Integrating Eastern and Western Psychology

Lewis Mehl-Madrona: Coyote Medicine (New York: Simon and Schuster, 1997).

“The Lakota language does not have a concept of strictly mental health”: Lewis Mehl-Madrona, personal communication and lecture content, March 2010.

“In these ways of thinking of the mind and mental health, the community is the basic unit of study, not the individual”: Mehl-Madrona communication.

Mind and Life XV, held in 2007 at Emory University in Atlanta: “Mind and Life XV,” www.mindandlife.org/dialogues/past-conferences/ml15/.

“mindfulness-based therapies, along with techniques to enhance compassion, may prove especially useful in the treatment of depression”: “Mind and Life XV,” www.mindandlife.org/dialogues/past-conferences/ml15/.

Davidson’s studies, along with those of others, demonstrate that neuroplasticity is a fundamental characteristic of our brains: Richard Davidson and Antoine Lutz, “Buddha’s Brain: Neuroplasticity and Meditation,” IEEE Signal Processing Magazine 25, no. 1 (January, 2008): 174–76.

In a January 2007 interview, Ricard told the British newspaper The Independent: www.independent.co.uk/news/uk/this-britain/the-happiest-man-in-the-world-433063.html.

The Dalai Lama, who believes that “the purpose of life is happiness,” also teaches that “happiness can be achieved through training the mind”: His Holiness the Dalai Lama and Howard Cutler, MD, The Art of Happiness: A Handbook for Living (New York: Putnam Books, 1998), 13–14: See also: www.1000ventures.com/business_guide/crosscuttings/cultures_buddhism_dalai_lama.html.

Studies show it [MBSR] to be effective at improving outcomes and quality of life in patients with chronic pain and a variety of diseases: Margaret Plews-Ogan et al., “A Pilot Study Evaluating Mindfulness-Based Stress Reduction and Massage for the Management of Chronic Pain,” Gen Intern Med 20, no. 12 (December 2005): 1136–38. See also: E. Bohlmeijer et al., “The Effects of Mindfulness-Based Stress Reduction Therapy on Mental Health of Adults with a Chronic Medical Disease: A Meta-Analysis,” J Psychosom Res 68, no. 6 (June 2010): 539–44; and www.mindfullivingprograms.com/whatMBSR.php.

In a study reported in January 2011 in Psychiatry Research: Britta K. Hölzel et al., “Mindfulness Practice Leads to Increases in Regional Brain Gray Matter Density,” Psychiat Res Neuroimaging 191, no. 1 (January 30, 2011): 36–43.

Another application, mindfulness-based cognitive therapy (MBCT): www.mindfullivingprograms.com/whatMBSR.php. See also: “Mindfulness-Based Cognitive Therapy,” www.mbct.com and Zindel V. Segal et al., “Antidepressant Monotherapy vs. Sequential Pharmacotherapy and Mindfulness-Based Cognitive Therapy, or Placebo, for Relapse Prophylaxis in Recurrent Depression,” Arch Gen Psychiat 67, no. 12 (December 2010): 1256–64, http://archpsyc.ama-assn.org/cgi/content/short/67/12/1256.

Daniel Siegel, MD, clinical professor of psychiatry at UCLA… calls this ability “mindsight”: Daniel J. Siegel, Mindsight: The New Science of Personal Transformation (New York: Bantam Books, 2010), xi–xiii.

CHAPTER 5. Optimizing Emotional Well-Being by Caring for the Body

Up to 20 percent of people suffering from depression are deficient in thyroid hormones: I. Hickle et al., “Clinical and Subclinical Hypothyroidism in Patients with Chronic and Treatment-Resistant Depression,” Austral NZ J Psychiat 30 (April 1996): 246–52. See also: “Depression Explored, with Dr. Barry Durrant-Peatfield,” November 19, 2003, http://thyroid.about.com/b/2003/11/19/depression-explored-with-dr-barry-durrant-peatfield.htm.

Dysfunction of the pituitary and adrenal glands also commonly affects emotional health, as do the drugs used to treat it: W. F. Kelly, “Psychiatric Aspects of Cushing’s Syndrome,” QJM 89 (1996): 543–51, http://qjmed.oxfordjournals.org/content/89/7/543.full.pdf+html?sid=1ce50d74-b3f4-4d2a-b7b0-8d367d3133ee.

Depression in some older men can be relieved by boosting low testosterone levels: M. Amore et al., “Partial Androgen Deficiency, Depression and Testosterone Treatment in Aging Men,” Aging Clin Exper Res 21, no. 1 (February 2009): 1–8.

People with diabetes are more likely to be depressed than people without it: Pan An et al., “Bidirectional Association Between Depression and Type 2 Diabetes Mellitus in Women,” Arch Int Med 170, no. 21 (November 22, 2010): 1884–91. See also: S. H. Golden et al., “Examining a Bidirectional Association Between Depressive Symptoms and Diabetes,” JAMA 299, no. 23 (2008): 2751–59.

A recent study in animals with type-1 diabetes demonstrated a previously unknown effect of insulin: “Insulin’s Brain Impact Links Drugs and Diabetes,” Vanderbilt University Medical Center, ScienceDaily, October 17, 2007, www.sciencedaily.com/releases/2007/10/071017090131.htm.

(footnote): Concern about this possibility in one Addison’s sufferer, John F. Kennedy: Thomas H. Maugh, “John F. Kennedy’s Addison’s Disease Was Probably Caused by Rare Autoimmune Disease,” Los Angeles Times, September 5, 2009, http://articles.latimes.com/print/2009/sep/05/science/sci-jfk-addisons5.

One in three heart attack survivors experiences depression, as does one in four people who have strokes and one in three patients with HIV: “Co-Occurrence of Depression with Other Illnesses,” from National Institute of Mental Health publication “Men and Depression,” NIMH (2005): www.nimh.nih.gov/health/publications/men-and-depression/co-occurrence-of-depression-with-other-illnesses.shtml.

An even higher percentage—50 percent—of people with Parkinson’s disease suffer from depression: Miranda Hitti, “Depression Common with Parkinson’s Disease,” WebMD Health News, September 29, 2004, www.webmd.com/parkinsons-disease/news/20040929/depression-common-with-parkinsons-disease.

“The depression is part of the illness, not simply a reaction to the disease”: Hitti, “Depression Common.”

As many as 25 percent of persons with cancer experience depression: Dana Jennings, “After Cancer, Ambushed by Depression,” New York Times, Health Section, September 29, 2009.

With some kinds of cancer—notably pancreatic—the percentage is much higher: Frank J. Brescia, “Palliative Care in Pancreatic Cancer,” Cancer Control 11, no. 1 (January/February 2004): 39–45.

A commonly reported side effect of interferon therapy is severe depression; some patients have even killed themselves: Molly McElroy, “Scientists Build on Case Connecting Inflammatory Disease and Depression,” Illinois News Bureau, July 27, 2004, http://news.illinois.edu/news/04/0727depression.html.

In addition to severe physical side effects, it can cause paranoia and hallucinations: Timothy DiChiara, “What You Need to Know About Interleukin-2 for Metastatic Melanoma” About.com, March 31, 2009, http://skincancer.about.com/od/treatmentoptions/a/interleukin.htm.

when proinflammatory cytokines are administered to animals, they elicit “sickness behavior”: K. W. Kelley et al., “Cytokine-Induced Sickness Behavior,” Brain Behav Immun 17, 1 (February, 2003): 112–18.

in the 1960s, research revealed a blood-borne factor to be responsible: J. E. Holmes and N. E. Miller, “Effects of Bacterial Endotoxin on Water Intake, Food Intake, and Body Temperature in the Albino Rat,” J Exp Med 118 (1963): 649–58. See also: N. Miller, “Some Psychophysiological Studies of Motivation and of the Behavioral Effects of Illness,” Bull Br Psychol Soc 17 (1964): 1–20.

These are classified as high-glycemic-load foods because they raise blood sugar quickly: Jennie Brand-Miller et al., The Glucose Revolution: The Authoritative Guide to the Glycemic Index (Emeryville, Calif.: Marlowe & Company, 1999).

People who are fit and who exercise regularly have less inflammation than others: E. S. Ford, “Does Exercise Reduce Inflammation? Physical Activity and C-reactive Protein Among U.S. Adults,” Epidemiol 15, no. 5 (September 2002): 561–68: See also: Rainer Rauramaa et al., “Effects of Aerobic Physical Exercise on Inflammation and Atherosclerosis in Men: The DNASCO Study: A Six-Year Randomized, Controlled Trial,” Ann Int Med 140, no. 12 (June 15, 2004): 1007–14.

The quantity and quality of your sleep also influence inflammation, as does stress: “Poor Sleep Quality Increases Inflammation, Community Study Finds,” Science Blog, November 14, 2010, http://scienceblog.com/40178/poor-sleep-quality-increases-inflammation-community-study-finds/. See also: Robert A. Anderson, “Inflammation and Stress,” Townsend Letter for Doctors and Patients, May 2005, http://findarticles.com/p/articles/mi_m0ISW/is_262/ai_n13675741/; and N. Simpson and D. F. Dinges, “Sleep and Inflammation,” Nutr Rev 65, no. 12, part 2, supplement (December 2007): 244–52.

Many studies link specific nutrient deficiencies to suboptimal brain function and mental/emotional health: David F. Horrobin, “Food, Micronutrients, and Psychiatry,” Int Psychogeriat 14, no. 4 (January, 2005): 331–34.

omega-3 fatty acids. These special fats are critically important for both physical and mental health: “Fish Oils and Mental Health/Depression,” posted on oilofpisces.com database, 2010, www.oilofpisces.com/depression.html.

Dietary supplementation with these fats, usually in the form of fish oil, has proved to be an effective, natural, and nontoxic therapy: “Fish Oils and Mental Health/Depression.”

Very high doses of fish oil—20 grams a day or more—have been used as treatments without any ill effects: “Fish Oils and Mental Health/Depression.”

A gorilla, eating mostly leaves and other raw vegetable matter that is very low in fats, has a brain that is about 0.2 percent of overall body weight: Imonikhe Ahimie, “The Difference Between Human Primates and Ape Primates,” posted on Helium.com, September 1, 2009, www.helium.com/items/1572554-differences-between-human-primates-and-ape-primates.

vitamin D, and it is almost impossible to get enough of it from diet alone: “Vitamin D Important in Brain Development and Function,” Science News, April 23, 2008, www.sciencedaily.com/releases/2008/04/080421072159.htm.

not just for bone health but for protection against many kinds of cancer, multiple sclerosis, influenza, and other diseases: “Vitamin D Important.”

more doctors now routinely check blood levels of vitamin D in their patients and are documenting a deficiency in many of them: “Vitamin D Important.”

High vitamin D levels may protect against age-related cognitive decline: D. M. Lee et al., “Association Between 25-hydroxyvitamin D Levels and Cognitive Performance in Middle-Aged and Older European Men,” J Neurol Neurosurg Psychiat 80, no. 7 (Epub May 21, 2009): 722–29.

(The last correlation is posed as a possible explanation for the surprisingly high incidence of schizophrenia in dark-skinned immigrants who move to northern European countries): M. J. Dealberto, “Why Are Immigrants at Increased Risk for Psychosis? Vitamin D Insufficiency, Epigenetic Mechanisms, or Both?” Med Hypotheses 70, no. 1 (2008): 211.

Deficiencies of other vitamins and trace minerals have been reported in people with mood disorders: David F. Horrobin, “Food, Micronutrients, and Psychiatry,” Int Psychogeriat 14, no. 4 (January 2005): 331–34.

A national news story from June 2010 described an “unorthodox treatment for anxiety and mood disorders”: Laura Blue, “Is Exercise the Best Drug for Depression?” Time Magazine Online, June 19, 2010, www.time.com/time/health/article/0,8599,1998021,00.html.

“In order for man to succeed in life, god provided him with two means”: Plato, 4th century BCE, quoted in Andreas Struohle, “Physical Activity, Exercise, Depression and Anxiety Disorders,” J Neural Transm 116 (2009): 777–84.

Many studies show that depressed patients who stick to a regimen of aerobic exercise improve as much as those treated with medication and are less likely to relapse: Struohle, “Physical Activity, Exercise, Depression and Anxiety Disorders.”

The data also suggest that exercise prevents depression and boosts mood in healthy people: Struohle, “Physical Activity, Exercise, Depression and Anxiety Disorders.”

Most prospective studies have used walking or jogging programs: Struohle, “Physical Activity, Exercise, Depression and Anxiety Disorders.”

some research finds nonaerobic exercise such as strength and flexibility training as well as yoga to be effective, too: Struohle, “Physical Activity, Exercise, Depression and Anxiety Disorders.” See also: B. G. Bergen and D. R. Owen, “Mood Alteration with Yoga and Swimming: Aerobic Exercise May Not Be Necessary,” Percept Mot Skills 75, no. 3, part 2 (December 1992): 1331–43.

clinical psychologist and yoga therapist Bo Forbes explains: Quote following is from Bo Forbes, Yoga for Emotional Balance, (Boulder, Colo.: Shambhala Publications, 2010), 39.

The most important conclusions of research to date are that regular physical activity: Struohle, “Physical Activity, Exercise, Depression and Anxiety Disorders.”

Most experts agree that sleep and mood are closely related: Lawrence J. Epstein, MD, “Sleep and Mood,” December 15, 2008, http://healthysleep.med.harvard.edu/need-sleep/whats-in-it-for-you/mood.

Studies report that about 90 percent of patients with major depression have difficulty initiating and maintaining sleep: Epstein, “Sleep and Mood.”

chronic insomnia—on and off for the better part of a year—is a strong clinical predictor of depression: Epstein, “Sleep and Mood.”

Five to 10 percent of the adult population in Western industrialized countries suffer from chronic insomnia: Epstein, “Sleep and Mood.”

Most of it involves sleep deprivation: human subjects are observed in laboratories over days or weeks when they are allowed to sleep less than normal amounts: Ruth M. Benca, “How Does Sleep Loss Affect Mood?” Medscape Family Medicine 7, no. 2 (2005), cme.medscape.com/viewarticle/515564. See also: Monica Haack and Janet M. Mullington, “Sustained Sleep Restriction Reduces Emotional and Physical Well-Being,” Pain 119, no. 1 (December 15, 2005): 56–64.

One study at the University of Pennsylvania: David Dinges et al., “Cumulative Sleepiness, Mood Disturbance, and Psychomotor Vigilance Decrements During a Week of Sleep Restricted to 4–5 Hours Per Night,” Sleep 20, no. 4 (April 1997): 267–77.

Another study, by investigators at Harvard Medical School and the University of California, Berkeley, used functional MRI to assess changes in brain function with sleep deprivation: Seung-Schik Yoo et al., “The Human Emotional Brain Without Sleep—A Prefrontal Amygdala Disconnect,” Curr Biol 17, no. 20 (October 23, 2007): R877–78.

because sleep deprivation also increases inflammation in the body: Deborah Simpson and David F. Dinges, “Sleep and Inflammation,” Nutr Rev 65 (December 2007): S244–52.

Mood disorders are also strongly linked to… REM (rapid eye movement) sleep: Rosalind Cartwright, The Twenty-four Hour Mind: The Role of Sleep and Dreaming in Our Emotional Lives (New York: Oxford University Press, 2010), 7.

“REM/dream loss is the most critical overlooked socio-cultural force in the etiology of depression”: Rubin Naiman, “Circadian Rhythm and Blues: The Interface of Depression with Sleep and Dreams,” Psychology Today Blog by Rubin Naiman, PhD, February 28, 2011, www.psychologytoday.com/blog/bloggers/rubin-naiman-phd.

Of significance is the fact that most medications used to help people sleep suppress REM sleep and dreaming: Naiman, “Circadian Rhythm and Blues.”

Research suggests that the emotional content of many dreams is negative: Naiman, “Circadian Rhythm and Blues.”

With long-term use, steroids cause emotional instability, mania, and, most often, depression: S. B. Patten, “Exogenous Corticosteroids and Major Depression in the General Population,” J Psychosom Res 49, no. 6 (December 2000): 447–49: See also: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), published by the American Psychiatric Association, 2000.

(Interestingly, Iceland is an exception, probably because its inhabitants have unusually high tissue levels of omega-3 fatty acids from a diet rich in oily fish, as well as high dietary intake of vitamin D): Daphne Miller, The Jungle Effect: Healthiest Diets from Around the World: Why They Work and How to Make Them Work for You (New York: Harper, 2009), 137–39.

In 1984, Norman E. Rosenthal, MD, and colleagues at the National Institute of Mental Health described a form of depression that recurred seasonally: N. E. Rosenthal et al., “Seasonal Affective Disorder: A Description of the Syndrome and Preliminary Findings with Light Therapy,” Arch Gen Psychiat 41, no. 1 (1984): 72–80.

his 1993 book, Winter Blues, is the classic treatise on the subject: Norman E. Rosenthal, Winter Blues (New York: Guilford Press, 1993).

An estimated 6.1 percent of the US population suffers from SAD, and more than twice as many people are prone to a milder form called subsyndromal seasonal affective disorder, or SSAD: D. H. Avery et al., “Bright Light Therapy of Subsyndromal Seasonal Affective Disorder in the Workplace: Morning vs. Afternoon Exposure,” Acta Psychiatrica Scandinavica 103, no. 4 (2001): 267–74: See also: M. Said, “Seasonal Affective Disorders,” Priory (January 2001), priory.com/psych/SAD.htm.

Whatever its cause, treatment with full-spectrum light—not the same as ordinary indoor light—works to relieve SAD as effectively as antidepressant drugs and faster: Robert N. Golden et al., “The Effect of Light Therapy in the Treatment of Mood Disorders: A Review and Meta-Analysis of the Evidence,” Am J Psychiat 162 (April 2005): 656–62.

but analysis of data so far suggests that it can be effective for treating nonseasonal depression, again working as well as medication: Golden, “Effect of Light Therapy.”

Many devices include wavelengths of blue light that are hazardous to the eye, increasing the risk of age-related macular degeneration (AMD): “The Dark Side of Light: Rhodopsin and the Silent Death of Vision. The Proctor Lecture,” Investig Ophthalmol Vis Sci 46 (2005): 2672–82: See also: “The Risk of Eye Damage from Bright Light and Blue Light Therapy,” www.sunnexbiotech.com, www.sunnexbiotech.com/therapist/main.htm.

(Herbert Kern, the engineer who first tried it, reported in an article in Science in 2007): Y. Bhattacharjee, “Psychiatric Research. Is Internal Timing Key to Mental Health?” Science 317, no. 5844 (September 14, 2007): 1488–90.

Long-term use of antidepressant drugs may actually prolong depression: Rif S. El-Mallakh et al., “Tardive Dysphoria: The Role of Long-term Antidepressant Use in Inducing Chronic Depression,” Med Hypotheses 76, no. 6 (June 2011): 769–73.

Recent research suggests that antidepressant medications may increase the risk: Steven Rosenberg, “Study Hints at Link Between Antidepressants and Heart Trouble,” report on presentation by Dr. Amit Shah at the 2011 annual meeting of the American College of Cardiology, HealthDay News, April 2, 2011; L. Cosgrove, Ling Shi et al., “Antidepressants and Breast and Ovarian Cancer Risk: A Review of the Literature and Researchers’ Financial Associations with Industry,” PlosOne, www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0018210.

This European plant (Hypericum perforatum) has a long history of medicinal use, including as an herbal mood booster: Paul Hammernes et al., “St. John’s Wort: A Systematic Review of Adverse Effects and Drug Interactions for the Consultation Psychiatrist,” Psychosomatics 44 (August 2003): 271–82.

most experimental results with mild to moderate depression have been positive, with St. John’s wort performing better than a placebo, often doing as well as prescription antidepressants, and sometimes proving more effective than the drugs: Hammernes et al., “St. John’s Wort.”

SAMe has been extensively studied as an antidepressant and treatment for the pain of osteoarthritis: “SAMe for Treatment of Depression,” The National Center for Complementary and Alternative Medicine at the National Institutes of Health, December 22, 2008, www.healthyplace.com/depression/alternative-treatments/same-for-treatment-of-depression/menu-id-68/.

In recent research… investigators from Harvard Medical School and Massachusetts General Hospital gave SAMe or a placebo to seventy-three depressed adults: George I. Papakostas et al., “S-Adenosyl Methionine (SAMe) Augmentation of Serotonin Reuptake Inhibitors for Antidepressant Nonresponders with Major Depressive Disorder: A Double-Blind, Randomized Clinical Trial,” Am J Psychiat 167 (August 2010): 942–48.

Rhodiola rosea: Richard P. Brown et al., “Rhodiola rosea: A Phytomedicinal Overview,” American Botanical Council, HerbalGram 56 (2002): 40–52.

[Rhodiola rosea] has been extensively studied by scientists in Russia and Sweden: Brown et al., “Rhodiola rosea.”

Rhodiola root contains rosavins, compounds that appear to enhance activity of neurotransmitters in the brain and may be responsible for the herb’s beneficial effects on mood and memory: Brown et al., “Rhodiola rosea.”

In a 2007 double-blind, placebo-controlled human study from Sweden: V. Darbinyan et al., “Clinical Trial of Rhodiola rosea L. Extract SHR-5 in the Treatment of Mild to Moderate Depression,” by Nordic J Psychiat 61, no. 5 (2007): 343–48.

Valerian comes from the root of a European plant (Valeriana officinalis) used safely for centuries to promote relaxation and sleep: American Botanical Council, The ABC Clinical Guide to Herbs (New York: Thieme Publishers, 2003), 351–64.

Kava is another root with a sedative effect: ABC Clinical Guide to Herbs, 259–71.

Kava is an excellent anti-anxiety remedy, shown in controlled human trials to be as effective as benzodiazepine drugs: ABC Clinical Guide to Herbs, 259–71.

Animal research shows ashwagandha to be equivalent to true Panax ginseng in stress protection, without ginseng’s stimulating effect: “Materia Medica: Withania somnifera,” Europ J Herbal Med 4, no. 2 (1998): 17–22. See also: S. K. Bhattacharya and A. V. Muruganandam, “Adaptogenic Activity of Withania Somnifera: An Experimental Study Using a Rat Model of Chronic Stress,” Pharmacol Biochem Behav 75, no. 3 (June 2003): 545–55.

Human studies in India demonstrate ashwagandha’s anti-anxiety and mood-elevating properties and confirm its lack of toxicity: S. K. Kulkarni and A. Dhir, “Withania Somnifera: An Indian Ginseng,” Prog Neuropsychopharmacol Biol Psychiat 32, no. 5 (July 1, 2008): 1093–1105.

Holy basil, or tulsi (Ocimum sanctum), is a sacred plant in India…. Modern research in both animals and humans demonstrates a lack of toxicity and a variety of benefits: S. Singh et al., “Evaluation of Anti-inflammatory Potential of Fixed Oil of Ocimum sanctum (Holy Basil) and Its Possible Mechanism of Action,” J Ethnopharmacol 54 (1996): 19–26. See also: David Winston and Steven Maimes, Adaptogens: Herbs for Strength, Stamina, and Stress Relief (Rochester, Vt.: Inner Traditions—Bear & Co., 2007), and Dr. Narendra Singh and Dr. Yamuna Hoette, Tulsi—Mother Medicine of Nature, International Institute of Herbal Medicine (Lucknow, India), 2002, www.holy-basil.com/6685.html and www.pharmainfo.net/reviews/ocimum-sanctum-and-its-therapeutic-applications.

My colleague Jim Nicolai, MD, medical director of the Integrative Wellness Program at Miraval Resort and Spa in Tucson, tells me he has had great success with holy basil in his patients: Personal communication, 2010.

Turmeric, the yellow spice that colors curry and American yellow mustard, is a potent natural anti-inflammatory agent: American Botanical Council, HerbalGram 84 (2009): 1–3, http://cms.herbalgram.org/herbalgram/issue84/article3450.html.

Its active constituent, curcumin, has shown promise as an antidepressant: S. Kulkarni et al., “Antidepressant Activity of Curcumin: Involvement of Serotonin and Dopamine System,” Psychopharmacol 201, no. 3 (September 3, 2008): 435–42.

Indian researchers suggest doing clinical trials to explore its efficacy as a novel antidepressant: S. Kulkarni et al., “Potentials of Curcumin as an Antidepressant,” Scientific World J 9 (November 2009): 1233–41.

absorption is greatly increased by the presence of piperine, a compound in black pepper: G. Shoba et al., “Influence of Piperine on the Pharmacokinetics of Curcumin in Animals and Human Volunteers,” Planta Med 64, no. 4 (May 1998): 353–56.

in a controlled trial from China in 1994, depressed patients treated six times a week with acupuncture for six weeks improved as much as those treated with amitriptylene (Elavil): X. Yang et al., “Clinical Observation on Needling Extrachannel Points in Treating Mental Depression,” J Tradit Chin Med 14, no. 1 (March 1994): 14–18. See also: Pavel Jalynytchev and Valentina Jalynytchev, “Role of Acupuncture in the Treatment of Depression, Benefits and Limitations of Adjunctive Treatment and Monotherapy,” Psychiat Times 26, no. 6 (May 12, 2009), www.psychiatrictimes.com/depression/content/article/10168/1413274.

Some studies use electroacupuncture: G. A. Ulett et al., “Electroacupuncture: Mechanisms and Clinical Application,” Biol Psychiat 44, no. 2 (July 15, 1998): 129–38.

We know that animal and human infants deprived of physical contact do not develop normally; some actually sicken and die: Katherine Harmon, “How Important Is Physical Contact with Your Infant?” Scientific American Newsletters (May 6, 2010): www.scientificamerican.com/article.cfm?id=infant-touch.

Some new, intriguing studies are documenting the biochemical benefits of touch: Mark Hyman Rapaport et al., “A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic-Pituitary-Adrenal and Immune Function in Normal Individuals,” J Compl Alt Med 16, no. 10 (October 18, 2010): 1079–88.

Touch promotes the release of oxytocin, which in turn causes the release of dopamine in the brain’s reward center: Paul J. Zak et al., “The Neurobiology of Trust,” Ann New York Acad Sci 1032 (2004): 224–27.

Paul J. Zak, PhD, a founder of the contemporary field of neuroeconomics: Paul Zak with Susan Kuchinskas, “The Power of a Handshake: How Touch Sustains Personal and Business Relationships,” Huffington Post, September 29, 2008, www.huffingtonpost.com/paul-j-zak/the-power-of-a-handshake_b_129441.html.

The brains of those who got massage released more oxytocin than the brains of those who rested. And the massaged subjects returned 243 percent more money to the strangers who showed them trust: Vera B. Morhenn et al., “Monetary Sacrifice Among Strangers Is Mediated by Endogenous Oxytocin Release After Physical Contact,” Evol Human Behav 29, no. 6 (November 2008): 375–83.

An article with the provocative title “Is Dirt the New Prozac?”: Josie Glausiusz, Discover, July 2007, http://discovermagazine.com/2007/jul/raw-data-is-dirt-the-new-prozac.

CHAPTER 6. Optimizing Emotional Well-Being by Retraining and Caring for the Mind

Mark Twain advised to “drag your thoughts away from your troubles… by the ears, by the heels, or any other way you can manage it”: Popularly attributed to Mark Twain.

the field known as positive psychology is quite recent. Its chief proponent is Martin Seligman: Martin E. P. Seligman, Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment (New York: Free Press, 2004).

“Remember that foul words or blows in themselves are no outrage, but your judgment that they are so”: Quote attributed to Epictetus (55–135 CE), Internet Encyclopedia of Philosophy, 2011, www.iep.utm.edu/epictetu.

Seligman has tested many interventions to help people enjoy greater pleasure, flow, and meaning in their lives and has found three to be particularly effective: Seligman, Authentic Happiness.

American psychiatrist Aaron T. Beck (1921–), who developed a cognitive theory of depression in the 1960s, is regarded as the father of cognitive therapy: http://en.wikipedia.org/wiki/Aaron_Temkin_Beck.

(In his original treatment manual, Beck wrote, “The philosophical origins of cognitive therapy can be traced back to the Stoic philosophers”): A. T. Beck et al., Cognitive Therapy of Depression (New York: Guilford Press, 1979), 8.

In a 2011 publication, the British Royal College of Psychiatrists concluded that CBT: Bullet points following are from “Cognitive Behavioural Therapy (CBT),” Royal College of Psychiatrists, 2011, http://rcpsych.ac.uk/mentalhealthinformation/therapies/cognitivebehaviouraltherapy.aspx?theme.

Depressive symptoms often improve in this initial stage, and many patients are no longer depressed after only eight to twelve sessions: A. C. Butler and A. T. Beck, “Cognitive Therapy for Depression,” The Clinical Psychologist 48, no. 3 (1995): 3–5.

In a study reported in the December 2010 issue of the Archives of General Psychiatry: Zindel V. Segal et al., “Antidepressant Monotherapy vs. Sequential Pharmacotherapy and Mindfulness-Based Cognitive Therapy, or Placebo, for Relapse Prophylaxis in Recurrent Depression,” Arch Gen Psychiat 67, no. 12 (December 2010): 1256–64.

“The elephant steps right along with his stick held upright in a steady trunk”: Eknath Easwaran, Meditation: A Simple Eight-Point Program for Translating Spiritual Ideals into Daily Life, (Tomales, Calif.: Nilgiri Press, 1991), 58.

Using Easwaran’s The Mantram Handbook, several researchers have documented the efficacy of this method: Eknath Easwaran, The Mantram Handbook: A Practical Guide to Choosing Your Mantram and Calming Your Mind, (Tomales, Calif.: Nilgiri Press, 2008).

One study, published in the Journal of Continuing Education in Nursing in 2006: Jill E. Bormann et al., “Relationship of Frequent Mantram Repetition to Emotional and Spiritual Well-Being in Healthcare Workers,” J Cont Educ Nursing 37, no. 5 (September/October 2006): 218–24.

Other researchers have come to similar conclusions after testing mantram repetition in male veterans and HIV-positive individuals: Jill E. Bormann and Adam W. Carrico, “Increases in Positive Reappraisal Coping During a Group-Based Mantram Intervention Mediate Sustained Reductions in Anger in HIV-Positive Persons,” Int J Behav Med 16, no. 1 (January 2009): 74–80. See also: J. E. Bormann et al., “Mantram Repetition for Stress Management in Veterans and Employees: A Critical Incident Study,” J Adv Nurs 53, no. 5 (March 2006): 502–12.

(C. J. Jung incorporated the use of mandala into his psychoanalytic work with patients): Gerald Schueler, “Chaos Theory: Interface with Jungian Psychology,” 1997, www.schuelers.com/chaos/chaos1.htm.

“A Wandering Mind Is an Unhappy Mind” is the title of a report: Matthew A. Killingsworth and Daniel T. Gilbert, Science 300, no. 6006 (November 12, 2010): 932.

“If you can recognize, even occasionally, the thoughts that go through your mind as simply thoughts”: Quote from Eckhart Tolle, Stillness Speaks (Vancouver, B.C.: Namaste Publishing, 2003), 14–15.

I wrote about the value of meditation in my first book, The Natural Mind, back in 1972: Andrew Weil, The Natural Mind (Boston: Houghton Mifflin Company, 1972).

In his compelling recent book, In Pursuit of Silence: Listening for Meaning in a World of Noise, essayist George Prochnik tells a story of going on patrol with a Washington, DC, police officer named John Spencer: Excerpt that follows is from George Prochnik, In Pursuit of Silence: Listening for Meaning in a World of Noise (New York: Doubleday, 2010), 17–18.

“We get much more information than we desire”: Excerpt is from Francis Heylighen, “Complexity and Information Overload in Society: Why Increasing Efficiency Leads to Decreasing Control,” Free University of Brussels, 2002 (draft for The Information Society), http://pespmc1.vub.ac.be//Papers/Info-Overload.pdf.

In 1900, only 5 percent of US households were single-person households: “Loneliness and Isolation: Modern Health Risks,” The Pfizer Journal 4, no. 4 (2000).

A 2006 study in the American Sociological Review found that Americans on average had only two close friends to confide in, down from an average of three in 1985: Miller McPherson et al., “Social Isolation in America: Changes in Core Discussion Networks Over Two Decades,” Am Soc Rev 71, no. 3 (2006): 353–75.

Social isolation and loneliness are strongly correlated with depression: R. A. Schoevers et al., “Risk Factors for Depression in Later Life; Results of a Prospective Community Based Study (AMSTEL),” J Affect Disord 59, no. 2 (August 2000): 127–37.

In his classic work, Suicide, Émile Durkheim (1858–1917), the father of modern sociology, wrote: Émile Durkheim, Suicide (New York: Free Press, 1997), 210.

Researchers have documented an association between Internet use and social isolation as well as depression among adolescents: Carole Hughes, “The Relationship of Use of the Internet and Loneliness Among College Students,” Boston College Dissertations and Theses, Paper AAI9923427, January 1, 1999, http://escholarship.bc.edu/dissertations/AAI9923427/. See also: Kimberly S. Young and Robert C. Rodgers, “The Relationship Between Depression and Internet Addiction,” Cyber Psychol Behav 1, no. 1 (1998): 25–28; Christopher E. Sanders et al., “The Relationship of Internet Use to Depression and Social Isolation Among Adolescents,” Health Publications, summer 2000, http://findarticles.com/p/articles/mi_m2248/is_138_35/ai_66171001/pg_2/.

CHAPTER 7. Secular Spirituality and Emotional Well-Being

Mind/body medicine is coming into its own, and more scientists are taking placebo responses seriously: Harald Walach and Wayne B. Jonas, “Placebo Research: The Evidence Base for Harnessing Self-Healing Capacities,” J Alt Comp Med 10, no. 1 (2004): S103–12.

A great deal of scientific research confirms the benefits to health in general and emotional health in particular of living with companion animals: J. Nimer and B. Lundahl, “Animal Assisted Therapy: A Meta-Analysis,” Anthrozoo 20, no. 3 (2007): 225–38.

Lynette A. Hart, PhD, a professor of veterinary medicine at the University of California, Davis, writes: Lynette A. Hart, “Companion Animals Enhancing Human Health and Wellbeing (Proceedings),” CVC Proceedings, August 1, 2008, http://veterinarycalendar.dvm360.com/avhc/content/printContentPopup.jsp?id=567242.

“Being around pets appears to feed the soul, promoting a sense of emotional connectedness and overall well-being”: Dennis Thompson Jr., “Pet Therapy and Depression,” Everyday Health, 2011, www.everydayhealth.com/depression/pet-therapy-and-depression.aspx.

“It is important to develop and uplift human consciousness through beauty,” he wrote: Quote attributed to Mokichi Okada (1882–1955), http://ikebanasangetsu.org/.

In his 2001 book, The Healing Power of Doing Good: Allan Luks, The Healing Power of Doing Good (New York: Fawcett Columbine, 1991).

lawyer Allan Luks introduced the term “helper’s high” to describe the rush of good feelings that people get when they help others: Luks, Healing Power of Doing Good, xiii.

Since then, neuroscientists have demonstrated that helping others activates the same centers in the brain involved in dopamine-mediated pleasure responses to food and sex: Shoshana Alexander and James Baraz, “The Helper’s High,” The Greater Good, February 1, 2010, http://greatergood.berkeley.edu/article/item/the_helpers_high/.

In one study, these pleasure centers lit up when participants simply thought about giving money to a charity: Alexander and Baraz, “Helper’s High.”

From a study of more than three thousand volunteers, Luks concluded that regular helpers are ten times more likely to be in good health than people who don’t volunteer: Luks, Healing Power of Doing Good, xi.

“giving help to others protects overall health twice as much as aspirin protects against heart disease”: Quote and excerpt following are from Christine L. Carter, “What We Get When We Give,” Psychology Today, February 18, 2010, www.psychologytoday.com.

One of the findings of the landmark Social Capital Community Benchmark Survey of almost thirty thousand Americans, published in 2000: A. C. Brooks, “Does Giving Make Us Prosperous?” J Econ Finance 31, no. 3 (fall 2007): 403–11.

Is charity “really self-interest masquerading under the form of altruism”: Anthony de Mello, Awareness: A De Mello Spirituality Conference in His Own Words, edited by J. Francis Stroud (New York: Random House, 1992), 19.

The Dalai Lama uses the term selfish altruism without any pejorative sense: Alexander and Baraz, “Helper’s High.”

“compassion and affection help the brain to function more smoothly”: Quote is from the Dalai Lama, “Compassion Is the Source of Happiness,” The Berzin Archives, May 2008, www.berzinarchives.com/web/en/archives/sutra/level2_lamrim/advanced_scope/bodhichitta/compassion_source_happiness.html.

In his brain-imaging studies, Richard Davidson and colleagues have documented changes in the brains of both Tibetan monks and laypersons trained in compassion meditation: Antoine Lutz et al., “Regulation of the Neural Circuitry of Emotion by Compassion Meditation: Effects of Meditative Expertise,” PLoS ONE 3, no. 3 (2008).

In his excellent book The Compassionate Mind, psychologist Paul Gilbert: Quotes that follow are from Paul Gilbert, The Compassionate Mind (London: Constable, 2009).

“always forgive your enemies—nothing annoys them so much”: Quote popularly attributed to Oscar Wilde.

Research shows that those who forgive enjoy better social interactions in general and become more altruistic over time: C. V. Witvliet et al., “Forgiveness and Health: Review and Reflections on a Matter of Faith, Feelings, and Physiology,” J Psychol Theol 29 (2001): 212–24. See also: C. V. Witvliet and K. A. Phipps, “Granting Forgiveness or Harboring Grudges: Implications for Emotion, Physiology, and Health,” Psychol Sci 12 (2001): 117–23.

a 2009 study documents an inverse correlation between forgiveness and depression: J. L. Burnette et al., “Insecure Attachment and Depressive Symptoms: The Mediating Role of Rumination, Empathy, and Forgiveness,” Personality and Individual Differences 46, no. 3 (February 2009): 276–80.

such as a six-hour “empathy-oriented forgiveness seminar”: Stephen J. Sandage and Everett L. Worthington, “Comparison of Two Group Interventions to Promote Forgiveness: Empathy as a Mediator of Change,” J Mental Health Couns 32, no. 1 (January, 2010): 35–57.

“For me it was a limitation that we were so bound from connecting the material, tangible, and measurable world to spiritual questions and pursuits”: Quote is from Frederic Luskin, MD, in Teresa Rose, “Director of the Stanford Forgiveness Project Frederic Luskin Suggests Forgiving to Mediators” (video), Examiner.com, San Francisco, June 4, 2010, www.examiner.com/sf-in-san-francisco/director-of-the-stanford-forgiveness-project-frederic-luskin-suggests-forgiving-to-mediators-video.

“the free expression by outward signs of an emotion intensifies it. On the other hand, the repression, as far as this is possible, of all outward signs softens our emotions…. Even the simulation of an emotion tends to arouse it in our minds”: Quote is attributed to Charles Darwin in his Expression of the Emotions in Man and Animals (London: John Murray, 1872). See also: Charles Darwin, The Expression of the Emotions in Man and Animals, Joe Cain and Sharon Messenger, eds. (New York: Penguin, 2009), xxviii.

A 1988 study by researchers at Universität Mannheim, Federal Republic of Germany, did just that: F. Stack et al., “Inhibiting and Facilitating Conditions of the Human Smile: A Nonobtrusive Test of the Facial Feedback Hypothesis,” J Pers Soc Psychol 54, no. 5 (May 1988): 768-77.

similar studies demonstrate clearly that emotions stimulate physical expressions, and physical expressions stimulate emotions: Studies include: M. Zuckerman et al., “Facial, Autonomic, and Subjective Components of Emotion: the Facial Feedback Hypothesis Versus Externalizer-Internalizer Distinction,” J Pers Soc Psychol 41 (1981): 929–44; R. Tourangeau and P. C. Ellsworth, “The Role of Facial Response in the Experience of Emotion,” J Pers Soc Psychol 37, no. 9 (September 1979): 1519–31; Pamela K. Adelmann and R. B. Zajonc, “Facial Efference and the Experience of Emotion,” Ann Rev Psychol 40 (1989): 249–80.

Begun by Dr. Madan Kataria, a physician from Mumbai, India, the first laughter club convened in March of 1995 with a handful of people: “What Is Laughter Yoga?” www.laughteryoga.org/index.php?option=com_content&view=article&id=180:what-is-laughter-yoga&catid=85:about-laughter-yoga&Itemid=265.

regular participation in laughter clubs has been shown to improve long-term emotional and physical health in a variety of ways: “Laughter Lowers Blood Pressure,” July 21, 2008, www.laughteryoga.org/index.php?option=com_content&view=category&id=125&layout=blog&Itemid=275&limitstart=160.

“Why?… Are we afraid of what we will discover when we come face-to-face with ourselves there?”: Quote from Susan Hill, “Silence, Please,” StandPoint Magazine, June 2009. www.standpointmag.co.uk/silence-please-features-june-09-susan-hill.

“silence is a rich and fertile soil in which many things grow and flourish”: Hill, “Silence, Please.”

We now have scientific evidence for emotional contagion: Alison L. Hill, et al., “Emotions as Infectious Diseases in a Large Social Network: the SISa Model,” Proc Biol Sci 277, no. 1701 (December 22, 2010): 3827–35.

if you have a happy friend who lives within a mile of you, your chance of happiness increases by 25 percent: James H. Fowler and Nicholas A. Christakis, “Dynamic Spread of Happiness in a Large Social Network: Longitudinal Analysis over 20 Years in the Framingham Heart Study,” BMJ 337, no. a2338 (December 4, 2008).

That is one finding of a study published in the British Medical Journal in 2008: Fowler and Christakis, “Dynamic Spread of Happiness.”

Other analyses of the same data show that negative emotions are just as transmissible as positive ones…. The same is true of depression: Michael Yapko, Depression Is Contagious: How the Most Common Mood Disorder Is Spreading Around the World and How to Stop It (New York: Free Press, 2009).

We have strong evidence of the power of gratitude to boost mood: Discussion that follows is from research by Robert Emmons. See: Robert A. Emmons, Thanks! How Practicing Gratitude Can Make You Happier (New York: Houghton Mifflin Harcourt, 2007).

regularly practicing grateful thinking can move your emotional set point for happiness by as much as 25 percent in the right direction: Brad Lemley, “Shiny Happy People: Can You Reach Nirvana with the Aid of Science?” Discover, August 2006, http://discovermagazine.com/2006/aug/shinyhappy.

“First, gratitude is acknowledgment of goodness in one’s own life”: Emmons, Thanks!, 4

The method used most frequently in research on the effects of practicing gratitude is the Gratitude Journal: Alvaro Fernandez, “Enhance Happiness and Health by Cultivating Gratitude: Interview with Robert Emmons,” SharpBrains, November 29, 2007, www.sharpbrains.com/blog/2007/11/29/robert-emmons-on-the-positive-psychology-of-gratitude/.

“The thankful receiver bears a plentiful harvest”: The Complete Poetry & Prose of William Blake, edited by David V. Erdman et al. (New York: Anchor; rev. ed., 1997), 37.