What's your sense of purpose? The answer may affect your health

When you fill out a medical form listing your health history, vital statistics and test results, there probably isn't a space for "sense of purpose."

Perhaps there should be. The term may be hard to quantify or define, but it can be a big factor in overall well-being, physical condition and even life expectancy.

"In all phases of life it's good for your health, and particularly your cardiovascular health, to feel a sense of purpose," said Dr. Lawson Wulsin, professor of psychiatry at the University of Cincinnati College of Medicine. "We all need a role in life that's meaningful to us and the people who care about us."

Lacking a sense of purpose, Wulsin said, can be a factor in depression, which is increasingly linked to physical health problems. Mind-body connections are a longtime theme in wellness discussions – from Norman Cousins' 1979 landmark book Anatomy of an Illness, which popularized the idea of using humor to foster healing, to current retirement guides that urge seniors to stay active and engaged mentally to promote health and longevity.

A recent study underscored the point. Researchers analyzed data from a survey of nearly 7,000 Americans over 50 who filled out psychological questionnaires that measured how strong their sense of life purpose was. In the years between 2006 and 2010, people with a stronger life purpose were less likely to die of any cause, and even less likely to die of heart, circulatory and blood conditions.

"We were surprised," said Celeste Leigh Pearce, senior author of the study in the May edition of the journal JAMA Network Open. "There was already a fair amount of literature about life purpose and health outcomes. But this was a big study and these results are so striking."

So how do you define a sense of purpose?

"There's no one-size-fits-all," said Pearce, associate professor of epidemiology at the University of Michigan School of Public Health in Ann Arbor. "I think that what's unique about life's purpose is that the way it manifests for each person is different.

"Some may derive purpose from raising kids or helping with grandkids, some from work, some from volunteer activities," she said. "Anyone can define for themselves what gives them purpose and work toward fulfilling that. It can be achieved and enhanced in so many ways."

Pearce, who is developing more studies on the subject, said physicians should consider discussing the issue with patients as part of their health assessment and wellness strategy.

Wulsin, whose book Treating the Aching Heart examined the links between depression and heart disease, agreed.

"The popular wisdom is that stress is bad for your heart," he said. "But because there is no easy way to measure stress and it's so complicated, it often doesn't get into the treatment plans of people with heart disease or at high risk of heart disease. That's something I think we can do better at."

The physiological connections between purposefulness and longevity are still being studied. But psychological and physical health, Wulsin said, go together.

"I like to say what's good for your heart is good for your brain," he said. "And what's good for your brain is good for your heart."

People under stress or suffering depression, he said, tend to smoke more, exercise less and sleep less well, all of which can adversely affect health. Beyond that chronic stress and the inability to relax can affect everything from inflammation and metabolism to diabetes and high blood pressure.

"That can accelerate the whole process of cardiovascular risk factors turning into cardiovascular disease," Wulsin said. "The stress response system, which is designed to help us cope with adversity and challenge, functions better when we're not anxious about being victims in a meaningless life."

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