Good relationships are good for your health

In a previous post, I wrote about an interview with Robert Waldinger, director of the Harvard Study of Adult Development, who has led one of the longest and most comprehensive studies of adult life ever conducted. It has been tracking the lives of two groups of men for over 80 years, and now includes some of their spouses and children, to understand what factors contribute to a healthy and happy life:

“The research project, the longest in-depth study of physical and mental well-being among adults, began in 1938 with 724 participants: 268 Harvard College sophomores and 456 young adults from Boston. It now includes 1,300 descendants of its original participants.”

Dr. Waldinger emphasized that quality loving relationships are the secret to a fulfilling life and that “the biggest predictor of your happiness and fulfillment overall in life is, basically, love."

In a more recent interview, he described how the focus of study has shifted from living a fulfilling life to living a healthy life:

“As part of the study, we followed our first generation of participants through their entire adult lives — from teenage years all the way into old age. When they reached age 80, we realized we had all these data about their physical and mental health, which we had collected year after year after year.”

Interestingly once again he found that "satisfaction in their relationships, particularly in their marriages, that was the best predictor of a happy and healthy life." One might expect that the leading health factor would be a physiological variable such as cholesterol levels and blood pressure, or healthy behaviors such as diet and exercise, but in this study relationships emerged as the most important (Figure 1).

Dr. Waldinger suggests that the salutory effects arise because relationships can help manage and reduce stress. When you encounter a stressful situation (real or perceived), your body activates the "fight-or-flight" response. adrenal glands (atop your kidneys) to produce stress hormones, primarily cortisol but also adrenaline (epinephrine) and noradrenaline (norepinephrine). Chronically high levels of stress hormones can lead to inflammation which damages the body and exacerbates conditions such as atherosclerosis:

"The best hypothesis for which there are good data suggests that it is about stress and the regulation of stress by our relationships.

First, stress is a natural part of life. It happens every day to most of us: Something will come along that will stress us, and when that happens, the body goes into fight-or-flight mode. When that happens, you can feel your heart rate increase, your blood pressure goes up, you might start to sweat, and that’s normal because we want the body to prepare itself to meet a challenge....  if I have something upsetting happen during the day, and I’m churning or ruminating about it, I go home and talk to my wife or a friend, and if that person is a good listener, I can literally feel my body calm down.

But if you don’t have anyone like that, and many people don’t, if you are isolated or you don’t have a confidant, what we think happens is that the body stays in a kind of low-level fight-or-flight mode, and that means that there are higher levels of circulating stress hormones and higher levels of inflammation, and those things can gradually wear away many body systems."

Another possible explanation not mentioned in the article is that relationships provide partners to help you maintain a healthful daily regimen of exercise and diet as well as seeing a doctor regularly and taking care of your body in general. The opposite of having relationships is loneliness which can be a stressor because we are social animals.

Finally, Waldinger closes with the concept of “social fitness” which is analogous to physical fitness. The goal of social fitness is to build the relationships that not only make us happy, but also help us weather the storms and maintain a steady and stable course which is optimal for health.

"Every life is filled with challenge and hard times. This idea about strengthening relationships is a way to increase our happiness, but also to build a safety net that helps us weather those hard times that all of us have in our lives.”

To facilitate these relationships he recommends taking "small actions ... to enliven our social world.... [T]hink about how you could make new connections, and probably one of the easiest ways to do that is to do something you care about or enjoy doing and do it alongside other people."

Figure 1. Good relationships are necessary not only for happiness, but also for health.