Positive Psychiatry: Its Time Has Come

Executive Summary 

Positive psychiatry is the science and practice of psychiatry that seeks to understand and promote well-being through assessment and interventions aimed at enhancing behavioral and mental wellness.

Positive psychological characteristics such as resilience, optimism, and social engagement have been reported to be associated with better health outcomes; yet, they are rarely addressed in clinical practice, training, journals, or textbooks.

What are the components of Positive mental health? 

Well-being is defined as an absence of disease that leads to positive life satisfaction and happiness. It is associated with greater longevity and healthy life. In modern economics, well-being is considered a measure of national development. 

Low level of the Perceived state: People with good subjective well-being (SWB) have a high tolerance for stress. 

Successful Aging: people with high SWB has better adaptation and coping in the later part of life. 

Post Traumatic Growth: Trauma in life is inevitable. People with resilience deal with trauma much better. 

Positive Psychosocial characteristics that we need to develop

Resilience: it refers to ready recovery from or positive adaptation to illness or other adversities. It is associated with improved physical health, health-related quality of life, self-care, treatment and exercise adherence, pain tolerance, and longer life expectancy. 

Optimism reflects a tendency to expect good outcomes. One large Meta-analysis study showed a significant relationship between optimism and better health outcomes, including cardiovascular outcomes, physiological markers (including immune function), cancer outcomes, and outcomes related to pregnancy, pain, and mortality yes mortality.

Personal mastery and coping self-efficacy: these are the people with high EQ and the ability to deal with stress better. They have an effective and unwavering coping style. 

Social engagement: Health people nourish and nurture good relationships to keep the loneliness away. Meta-analysis of 148 studies (N > 300,000) found a 50% increased likelihood of survival among participants with strong social relationships compared to others with weak social relationships. 

Spirituality: Proposed mechanisms include emotional support and optimism derived from religious communities, but spirituality may remain a significant determinant even when controlling for these factors

Wisdom: common elements of wisdom include prosocial behaviors (compassion, empathy, altruism), social decision-making, insight, decisiveness, acknowledgment of uncertainty, emotional regulation, tolerance of divergent value systems, openness to new experience, spirituality, and a sense of humor. 

How to put this into practice for us and our patients? 

The first step is to cultivate awareness that positive psychology and subjective wellbeing are important components of our health. Just being not sick is not enough. These are our psychosocial immune responses that will come in handy at the subconscious level. I always teach my patients about BASICS which includes taking care of the body, moderating our affects and emotions, improving our social interactions, working on partner intimacy, cultivating intellectual stimulation and hobbies, and finally our spirituality and altruism. 

Thank you for joining the journey of seeking happiness and positive wellbeing with me. Looking forward to your comments and suggestions.

Dilip V. Jeste, MD; Barton W. Palmer, Ph.D.; David C. Rettew, MD; and Samantha Boardman, MD J Clin psychiatry 2015, 76 (6): 675-83

Tarak Vasavada, MD