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Is happiness a factor in overall health? An interview with Laurie Santos, PhD

Dec. 2, 2019
What a profound and perplexing question! According to Laurie Santos, PhD, a psychology professor at Yale University, there is a connection between the mind, the body, and overall happiness.

For Laurie Santos, PhD, a psychology professor at Yale University, there is a connection between the mind, the body, and overall happiness. Her course on happiness, "Psychology and the Good Life," is the most popular course that Yale University offers. There is a waitlist for the course, and it can take a semester or more to be accepted into the class.

One out of four students at Yale enrolls in this course, which was developed because Dr. Santos recognized the struggles that students were having with anxiety, panic attacks, academic achievement, their social lives, and the pursuit of personal goals. I recently interviewed her to learn more.

Burkhart: Dr. Santos, why did you think that this course for students was needed, and what do you think is missing in our culture that such a course would resonate with so many students?

Dr. Santos: I think lots of students feel like they’re doing all the right things, but something just hasn’t clicked. And that is because many students are putting lots of time and effort into their grades and job prospects at the cost of things like social connection, sleep, and even free time. The fact that young people are prioritizing things that don’t matter for happiness is likely one of the reasons depression has doubled in the last 10 years and anxiety and stress are on the rise.

Dr. Santos hosts a podcast with other like-minded researchers, academics, and faculty.1 Although happiness is subjective, their current research points to the fact that general happiness may improve health, income, lifespan, and creativity. General happiness can be improved through learning some life skills that increase awareness. These life skills appear to have been somewhat lost by society in the last few decades.

The events most individuals believe will make them happier in life have proven to be much less important in overall health and individual happiness. The false narrative that most people have is, “I will be happy when I achieve . . . ” However, Dr. Santos and colleagues have found that wealth does not make people happy, achieving more status at work does not make people happy, and winning the lottery or even a Nobel Prize does not make people happier long term. Beyond an annual income of $75,000 (a comfortable income for most people), happiness is found in other small milestones throughout an individual’s life. 

I asked Dr. Santos about the lack of connection and personal relationships related to the high rate of depression and the feeling of isolation that students and adults often feel in today’s world.

Burkhart: How important is isolation or loneliness, related to happiness?

Dr. Santos: Social connection is perhaps the most important thing for living a happy life. Loneliness is also bad for physical health. Some estimate that loneliness might be as bad for us as smoking 15 cigarettes per day.

Burkhart: What do you believe to be the most destructive components in student life today?

Dr. Santos: I think students are prioritizing the wrong things. They’re worried about their grades and anxious about their futures and trying to fix these things at the cost of friendships and even sleep.

So, what are these small milestones that are reported to have such a profound effect on mental state and general health? It has been reported for decades that people who are dying are never regretful that they did not spend more time at the office. Instead, their biggest regrets are not spending quality time with their families, not working on personal relationships, missing loved ones’ major life events, and not pursuing important personal commitments. 

Robert Waldinger, MD, has studied and followed both a Harvard group and a group from Boston long term since the 1930s.2 The study is called the Harvard Study of Adult Development. The most important life factors, according to the reported results, appear to be 

  • maintaining good relationships,
  • having a healthy social network,
  • raising healthy children, and
  • teaching life skills to children and grandchildren, and seeing the effects of these on loved ones.

Burkhart: Do you think that these life skills have been lost because of the dissolution of the extended family? In previous generations, many extended family members lived together. As children grew up, these life skills may have been taught to them by grandparents or even great-grandparents.

Dr. Santos: I think we had lots of cultural forces that promoted the things that science shows are good for happiness: taking time off, being focused on community, doing nice things for others, even connecting with other people. So, there are lots of cultural shifts that have moved us in the wrong direction.

According to Sonja Lyubomirsky, PhD, who has researched the subject of happiness and participated in Dr. Santos’s podcast, the happiest individuals have positive emotions, and they exhibit pride, joy, and affection.3,4 Happy people appear to smile naturally (Duchenne smiles) more often. The French physician Guillaume Duchenne developed the profile of those who smile and compared smiles with nonsmiles or fake smiles.5 Smiles involve two muscles that we in dentistry are very familiar with: the zygomatic major, which lifts the corners of the mouth, and the orbicularis oculi, which raises the cheeks. Fake smiles (referred to as cheese smiles) raise only the zygomatic muscles. The Duchenne smile is controlled by the emotional part of the brain, which is part of the limbic system. In other words, the emotional aspect is involuntary, and the person cannot control this aspect, but the “cheese” smile is controlled. 

Some long-term studies have given us relevant information on how these smiles affect our personality and life outcomes in general throughout the years. Researchers Dacher, Keltner, and Harker from the University of California, Berkeley analyzed the smiles in 141 photos from the 1960 Mills College yearbook.6 They divided the photos by Duchenne smiles. The women were followed and questioned at ages 27, 43, and 52. Their life satisfaction and status of their marriages were evaluated, and Duchenne smiles predicted positive outcomes in both their marriages and well-being up to 30 years later.

So, someone with an abundance of “crow’s feet” lines may actually be a very happy person because they truly smile a Duchenne smile much of the time. 

Dr. Santos’s team at Yale has surveyed students before and after they took the course. Recently, they accumulated 1,000 subjects, and they are now compiling the results. As participation in this course continues, more information is expected to be very relevant to happiness. However, the results appear to be very positive! In reading the reviews online regarding the course, students appear to be making the life skills they learned in the course a part of daily life with a lifelong commitment.

Dr. Santos points out that gratitude and kindness appear to be important factors in sustained happiness. Much literature and recent books have focused on the importance of “counting your blessings” and also just having a good level of gratitude for the good things you have in your life.7 She points out that happiness takes work (of course, anything worthwhile does take work!). Many individuals find that counting their blessings, limiting their focus on goals, and improving quality relationships are paramount to being happy. Throughout the podcast, reference is made to the need that students have to improve the quality of their lives.1

Burkhart: How is gratitude developed?

Dr. Santos: You can increase your gratitude simply by taking time to be thankful. Make it a habit to jot down three to five things you’re grateful for every day. 

Burkhart: Do you have advice for those who may be going through some traumatic event in their lives? Would you consider your course a way to develop coping skills for life events?

Dr. Santos: Many people come to my class because they’re going through a rough patch. And a lot of people have found that the class is helpful. That said, if you’re feeling acutely suicidal, then you probably need to seek out more urgent resources (e.g., crisistextline.org), rather than a class like this. 

By correcting bad smiles and improving patients’ oral health, the dental community is contributing to patients’ total well-being. When a patient smiles a noncontrived smile using the involuntary muscles, it appears that he or she may be doing more for overall health than we have even realized. Connecting the body, mind, and total health continues to be so relevant.

As always, continue to ask good questions and always listen to your patients!  


1. The Happiness Lab with Dr. Laurie Santos. Apple Podcasts website. https://podcasts.apple.com/us/podcast/the-happiness-lab-with-dr-laurie-santos/id1474245040.

2. Waldinger R. What makes a good life? Lessons from the longest study on happiness. TED website. https://www.ted.com/talks/robert_waldinger_what_makes_a_good_life_lessons_from_the_longest_study_on_happiness?utm_source=tedcomshare&utm_medium=email&utm_campaign=tedspread. Published November 2015.

3. Dr. Lyubomirsky Happiness Scale. Dr. Sonja Lyubomirsky website. http://sonjalyubomirsky.com.

4. Lyubomirsky S, Lepper H. A measure of subjective happiness: Preliminary reliability and construct validation. Soc Ind Res. 1999;46:137-155.

5. Durayappah-Harrison A. What science has to say about genuine vs. fake smiles. Psychology Today website. https://www.psychologytoday.com/blog/thriving101/201001/what-science-has-say-about-genuine-vs-fake-smiles?eml. Published January 5, 2010.

6. Harker LA, Keltner D. Expressions of positive emotion in women’s college yearbook pictures and their relationship to personality and life outcomes across adulthood. J Pers Soc Psychol. 2001;80(1):112-124.

7. LaMotte S. Meet the smoking-free, carbon-negative country that passes no law unless it improves citizens’ well-being. CNN website. https://amp-cnn-com.cdn.ampproject.org/c/s/amp.cnn.com/cnn/2019/09/13/health/bhutan-gross-national-happiness-wellness/index.html. Published September 13, 2019.