The Effects of Social Media on the Mental Health of Children and The Use of Digital Media to Promote Well-Being Introduction: Social media is a double-edged sword when it comes to mental health. Over the past decade, with more technology and platforms coming out, like TikTok, it feels like there is no escaping social media these days. With so much time, availability, and exposure to digital media, there has to be some effect on the users’ mental well-being. This is especially true for children, particularly adolescents, who immerse themselves in social platforms. Too much social media and harmful platform activity have been known to cause depression, anxiety, and even suicide. The suicide rate of adolescents and young adults ages 15-24 is around 25 to 30 per 100,000 persons, increasing 8% from 2020-2021 [1]. This is the demographic with the highest rate of suicide out of any age group. There has also been an increase in emotional and behavioral problems among children 5-18 years old from 2014 to 2017 from 5.4% to 5.7% on average, and 10% of those identifying as being two or more races, nearly doubling the national average [2]. According to Statista, in the US, 16% of children ages 3 and 4 used a cell phone for the first time, with 12% of children first utilizing a cell phone before age 3. By 2020, 97% of children under 8 owned a smartphone [3]. One reason is that parents feel pressured to give their children these devices because they fear their children being isolated if they do not have one. Also, parents want their kids to stay caught up in technology, and many schools are now issuing devices to young students for learning purposes. The subsequent article will explore several social media factors that affect children’s mental health, particularly the negative impact on children’s mental health over the last decade, and decipher how much screen time on these platforms is considered harmful. Also, it will touch on the negative impact of cyberbullying. Lastly, I’ll discuss what interventions are taking place to protect children from the negativity that social media can bring and how social media can be used to promote mental health. The Negative Impact of Social Media on Children’s Mental Health: The omnipresence of social media has taken its toll on the youth’s mental health, especially adolescents. Several studies have shown it leads to depression, body image and eating disorders, sleep deprivation, and behavioral issues. Harmful content is abundant, including media portraying drug use or promoting suicide. One study of over 400 recent youth hospital admits found that almost 15% were viewing suicidal content, and 16% were viewing content promoting self-harm [4]4444. Major depressive disorder (MDD) in adolescents can exacerbate the negative impact of social media. These children can display an increased impulse control issue regarding internet use and more significant sleep deprivation [5]. Those that have depression and have also been diagnosed with autistic traits fair even worse. These children tend to have worse depressive symptoms in general and are more likely to use social media excessively and be addicted to their smartphones [6]. Another paper on the misuse of social media and cell phones found a positive correlation between excessive use and other psychiatric disorders like anxiety, obsessive-compulsive disorder (OCD), and attention deficit disorder (ADHD) [7]. These studies and data are essential, but the question is, why do those that have mental health issues have more of a problem with social media usage than the average youth population? It may be a constant seeking of validation amongst all the negative, but adolescents tend to compare their real-life selves to their online peers and often feel they cannot measure up. This seems to be more apparent in young girls [8]. Further studies need to be made to determine whether there is a correlation between children with social skills difficulties and not only the excessive nature of using social media but how much of that content could be considered negative. This could mean looking up disturbing or harmful content, like promoting suicide or drug use, or the lack of successful interactions with those online either by being intentionally omitted from online social groups or cyberbullying. As of 2019, Facebook is the most widely used social media platform. Those that suffer from depression tend to have fewer friends and fewer connections between friends. Also, emotional dependence on Facebook has been known to negatively impact a child’s sense of self-sufficiency, finding meaning in life, accepting oneself, having meaningful relationships, and ability to cope with everyday life [9]. Even with these negative mental and social states present, the addictive behavior continues, exacerbating symptoms. The brain can physically change with excessive social media activity use, and there is a link between social media use and cortical thinning. There is a volumetric morphological change in the thalamus-prefrontal cortex-brain stem circuit that is similar to other studies that indicate volume changes in those specific regions are indicators of the early onset of alcohol abuse. Furthermore, these individuals tend to exhibit poorer impulse control, display more hostility, and are more distracted, among other externalizing behavioral issues [10]. This is disturbing, especially considering the study was not conducted on adolescents but on nine and 10-year-olds. The link between alcohol abuse and social media is of interest in many studies. Those that binge drink tend to post more about their alcohol use, and posting alcohol-related content has been indicated in alcohol abuse later in life [9, 11]. Considering the change in brain morphology related to social media use, it would be exciting to know if it is related to the predisposition to engage in risky alcohol behaviors. Due to privacy and consent barriers, it is hard to gather data on some of the negative impacts of social media. This is true for the potential for social media to increase self-harming behaviors and suicidal ideation. Many children and adolescents post pictures of self-harm online anonymously on websites like Tumblr or Instagram, changing hashtags to be exclusively viewed
Mindfulness and How the Chair of Joy Can Promote the Mental Well-being of Children Introduction: Mental health exercises like mindfulness have been an effective tool used in hospitals, schools, and at home to promote the mental well-being of children. Even before the pandemic, these strategies have started to gain more attention in the past two decades. According to the American Psychological Association, mindfulness is defined as: “[A]wareness of one’s internal states and surroundings. Mindfulness can help people avoid destructive or automatic habits and responses by learning to observe their thoughts, emotions, and other present-moment experiences without judging or reacting to them.” It is important to note that although mindfulness can be used with meditation, it is different. Meditation aims to clear thoughts and focus on the body’s physical state, generally through breathing and physical exercises like yoga. With mindfulness, thoughts and emotions are not dismissed but indeed observed and focused upon at face value. It is a coping mechanism for mental distress and promotes mental well-being. Utilizing mindfulness for children is a relatively new science that has only been studied extensively within the last twenty years. This article aims to review several studies researching the effectiveness of mindfulness on children’s mental health, focusing on the cognitive benefits that mindfulness can provide for those with attention deficit disorder (ADHD), emotional issues like depression and anxiety, and autism spectrum disorder (ASD). Lastly, this piece will suggest a new mindfulness strategy, the Chair of Joy (COJ), as a potential mindfulness exercise to increase mental well-being and joy in a child’s life. Mindfulness and ADHD in Children: ADHD is a popular topic of discussion regarding children’s mental health. Many think it is overdiagnosed and is just a phase, but ADHD can severely affect a child’s educational and emotional development if it is ignored. It can continue into adulthood and affect relationships and one’s career. The criteria to diagnose ADHD, according to the Internal Classification of Diseases, is constantly showing inattention and/or hyperactivity/impulsivity over six months, usually starting before or around adolescence, and the symptoms cause issues with school, work, or relationships. Today, this mental health concern is generally treated with psychostimulants and some non-stimulants. These treatments are not always helpful, and not many longitudinal studies evaluate the effects of stimulants many years later. Still, many studies conclude that it is a safe and effective treatment for ADHD. Is there an effective alternative, however? Mindfulness exercises may be one answer; the data is somewhat mixed. One study using mindfulness-based intervention (MBI) and a care-as-usual (CAU) control group found that mindfulness increased self-control in children. Still, after a six-week follow-up evaluation, this effect disappeared. This study and a review of several other studies showed that, although the impact of mindfulness on children’s ADHD symptoms was limited, it did help with parental stress related to parenting a child with ADHD [1, 2]. A meta-analysis by Siebelink et al. [3] showed that several studies had positive outcomes with MBIs. The general results were reduced impulsivity and increased impulse control and attention. Mindfulness directly addresses the cognitive issues related to ADHD by emphasizing the connection to thoughts and emotions present at that moment [4]. However, attention seems to be more greatly affected by MBIs than hyperactivity and impulsivity [5]. These studies show promise in effectively treating ADHD in children and their parents, but more long-term studies need to be conducted to establish if these results can be retained over long periods. Mindfulness and Emotional Issues in Children: Mindfulness exercises may be valuable for treating emotional issues like anxiety, depression, and behavioral problems. A superb meta-analysis by Dunning et al. [6] reviewed many studies that used random control trials (RCT) to evaluate the effect of MBIs on children and adolescents. Random control trials are essential for research because they reduce bias in the study and reveal more true results. This meta-analysis reviewed active control groups, which included an active placebo group, and non-active control groups, such as a waitlist or no contact. Analyzing both groups revealed that MBIs significantly positively affect mindfulness, executive function, and attention, with a lesser but evident effect on anxiety, depression, and adverse behaviors. Analyzing active control group studies independently revealed a significance with mindfulness, depression, and anxiety but not with executive function or attention. Also, fewer negative behaviors were observed in a younger demographic [6]. Mindfulness for Bipolar Disorder: Mindfulness may also be a valuable strategy for children at risk for more severe mental illnesses like bipolar disorder. Research points to mindfulness with cognitive behavioral therapy can reduce anxiety associated with bipolar disorder but not the main symptoms of depression and mania [7]. It may be more effective for youth displaying anxiety at risk for bipolar disorder and might also be helpful in other ways [8]. An fMRI study on 35 children ages 10-14 who underwent an eight-week MBI treatment reported having more mindfulness, mood stability, and reduced inhibition of negative thoughts. The two brain regions that showed increased resting state connectivity and are responsible for the self-reported outcomes are the dorsolateral prefrontal cortex (DLPFC) (responsible for executive functions like changing and rearranging tasks, filtering out interfering stimuli, strategizing, and specific aspects of working memory) and the posterior cingulate cortex (PCC) (responsible for self-reflection) [9-11]. This is in line with the primary purpose of mindfulness exercises, which is to focus on the present emotions and thoughts in a non-judgmental fashion. Effects of Mindfulness on Children with Autism Spectrum Disorder (ASD): Autism spectrum disorder (ASD) is a complex neurological disorder that can manifest in many ways and severities. According to the American Psychological Association, ASD is defined as having issues with communicating, socializing, and displaying a pattern of recurring and inhibiting actions, with symptoms generally appearing around pre-school. Many individuals with ASD are high functioning in other areas, such as creativity and memorization, but they are disconnected from the rest of society. More needs to be done to understand the complexities of this disorder and mitigate ASDs social and cognitive issues. Mindfulness could be a
Mental Health Research in Children Introduction: Mental health in children has worsened over the last decade, especially with the recent COVID-19 pandemic. In 2020, a survey of over 1,000 parents by the Ann & Robert H. Lurie Children’s Hospital of Chicago taken around the United States had 71% of parents say that the pandemic had taken a toll on their children’s mental health, and 69% said that it was the worst thing to happen to the mental health of their child. In 2020, there was an increase in mental health hospital-related visits from 24% of children ages 5-11 and 31% ages 12-17. The American Rescue Plan Act passed in March of 2021, addressed this issue by providing 170 billion dollars for schools to train and implement more psychiatrists in the school setting. This is especially helpful in states like Nevada, which was ranked last in providing services for mental health in the US. The allocation of this money is to be utilized to increase the workforce dedicated to the mental well-being of the youth in the US. This is an action that needs to be taken before the issue can be appropriately addressed [1]. The American Rescue Plan Act passed in March of 2021, addressed this issue by providing 170 billion dollars for schools to train and implement more psychiatrists in the school setting. This is especially helpful in states like Nevada, which was ranked last in providing services for mental health in the US. The allocation of this money is to be utilized to increase the workforce dedicated to the mental well-being of the youth in the US. This is an action that needs to be taken before the issue can be appropriately addressed [1]. The next step is more permanent funding. Although this addresses the crises exacerbated by the pandemic, this needs to be sustained long-term. Psychologists are also helping train teachers to deal with emotional and behavioral issues. Teachers are incorporating mental health lessons in the classroom to reduce the burden on school psychologists and increase mental health knowledge and awareness in students [1]. The current article looks at the mental well-being of children and adolescents over the past decade. It will explore the mental health issues related to children that have become a growing problem before and during the pandemic, interventions based at school, in the community, and at home, and using mental health promotion strategies to improve mental health in children. This is by no means an exhaustive review of the literature but a sampling of research to give perspective on the current state of mental health of children and what can be done about the growing mental illness crisis. Hopefully, this provides needed information to many parents with children and the public on mental health research in the US and worldwide. Prevalence of Mental Health Issues of Children Before and During the Pandemic: A study evaluating the National Survey of Children’s Health from 2016 analyzed responses concerning mental health, particularly depression, anxiety disorders, and behavioral problems. During this period, pre-COVID, it was observed that approximately 7.1% (4.4 million) had anxiety issues, 7.4% (4.5 million) had behavioral problems, and 3.2% (1.9 million) suffered from depression. These results are for children in the US ages 3-17 years of age. Therapy was given to almost 80% of children that suffered from depression but only 60% and 50% for anxiety and behavioral problems, respectively [2]. During and after the pandemic, depression and anxiety increased to 9.4% and 4.4%, respectively, in children 3-17 years of age, and 20% of high-school students experienced persistent depression, with 7 in 100,000 committing suicide and only 1 in 4 children in this age group had received mental health services [3, 4]. The pandemic exacerbated the comorbidity of anxiety and depression but not individually [4]. Also, it has been reported that the severity of depression in children increased in a study of an inpatient care unit in an urban community compared to three years prior. In the same study, the intake of black adolescents in the psychiatric hospital doubled, and there was an increase of 17% in attempted suicide through all demographics [5]. A similar study at another urban children’s psychiatric hospital saw an increase over four-fold increase in the use of restraints in the middle of the pandemic compared to pre-pandemic conditions and a notable increase in the use of psychotropic drugs [6]. Children with more severe mental health issues like obsessive-compulsive disorder (OCD) increasingly suffered during the COVID pandemic. A survey study of children ages 6-18 previously diagnosed with OCD reported that over 50% reported an increase in the severity of their symptoms, such as increased cleaning or washing, obsessive checking of previous activities, and fear of contamination during the pandemic as compared to before [7] There is still lack of evidence for the impact of COVID on the mental health of children with more severe psychotic disorders such as post-traumatic stress disorder (PTSD) and schizophrenia. Mental Health Interventions at School, within the Community, and at Home: There have been many approaches to remedy or prevent children’s mental illness and protect their well-being. Which studies prove to be most effective, however? Which setting is most appropriate for providing mental healthcare to children of different age groups? The answer to these and many more questions are complex in nature. Rarely are studies in this field conducted similarly and comparably or analyzed the same. One review by Das et al. [8] attempts to provide some answers on the effectiveness of school, community, and home/family-based interventions that were aimed at providing help for mentally ill children. It rated 38 systemic reviews covering these approaches and that cover several mental illnesses like depression, anxiety, and eating disorders. In one review covering 15 studies, mental health promotion programs, which will be discussed further in the next section, significantly positively impacted younger children and adolescents [9]. Another review analysis found that school-based preventative mental health measures were also influential. Nurture groups in school that focus on the
Cultural Stigma and Mental Health Introduction: The term stigma, especially regarding mental health, is a complex notion. Although most would agree that stigmatization is negative, there is little agreement on what constitutes a stigma. Erving Goffman [1], a very impactful Canadian-American sociologist in the 20th century, defined stigma as ‘[an] attribute that is deeply discrediting.’ But what is a ‘discrediting attribute’ in one culture, ethnic background, and social class may not be so in another. In many cultures, what constitutes a mental illness and how it is manifested can be vastly different. In the modern world, there is an effort to educate those on what mental illness is and the biological factors that contribute to them, but that also has mixed results in the effort to combat stigma. Generally, people with poor mental health are not viewed well around the world. The implications of poor mental health depend on several factors, however. Is the person suffering from poor mental health able to contribute to society? Can that person work? Can they have a family? Different emphasis is put on various aspects of what it means to have a ‘normal’ life in different cultures. The manifestation of the stigma usually follows whether these individuals can be functional, what kind of support group they have, whether the culture is more etic (having a Western perspective) or emic (a more local or tribal mindset and the social class of the stigmatized individual) [2]. This article presents several perspectives on the stigmatization of mental health in several countries, including North America, South America, Europe, Asia, and Africa. This is by no means an exhaustive review but a short snapshot of how several cultures approach the issue of mental health stigma. North America: In certain sections of the United States and Canada, the outlook toward mental health has vastly changed from the start of the 21st century. There has been an active movement through many communities to educate the public on mental health issues and encourage those with mental health concerns to own it and get help. When discussing the etic perspective of mental health, the higher and more urban areas of North America and Western Europe are considered the center for the push on trying to provide a better understanding of mental health and to reduce its stigma. As diverse a population as the United States and Canada have, the outlook on mental health is varied. For example, in rural areas in the United States, the prevalence of mental health issues is similar to that of more urban areas, about 19% in 2016. Still, individuals have to go further to seek help physically, are more often uninsured for mental health, and are less informed about mental illnesses [3]. Rural areas have more traditional values and close communities where privacy may be lacking, which contributes to individuals delaying seeking help and bolsters stigmas toward mental health in the community and self-stigma. Since 2010, the leading cause of death for teens, besides accidents, was suicide. Peers, social pressures, self-stigma, and a lack of knowledge of mental illness contribute to this. Programs like Youth Aware of Mental Health (YAM) have been implemented in several schools around the country to help educate those with mental illness and their peers and help increase help-seeking behavior. Unfortunately, these strategies have had little influence on increasing help-seeking behavior and suicide in youth [4]. This highlights the difficulty in reducing stigma among individuals with mental health issues and getting them help, even in a higher-income Western medicine setting. Education, despite race, age, gender, or stigma, is associated with higher engagement in seeking help [5]. A Canadian study evaluating the stigma of undergraduates, medical students, and psychiatrists and their outlook on mental illness found that having some relationship with an individual with mental health issues and being educated helped reduce stigma [6]. Higher stigma is associated though within racial minority groups in the US, and since these populations tend to be underserved as far as education as well as facilities to treat people with mental illness, the stigma related to mental health issues is high, and help-seeking is low [7] South and Latin America: The Pan American Health Organization has 35 member states that include most countries in the Caribbean, South, and North America and addresses physical and mental health concerns in cooperation with these member states to supply health services to the populous without fear of becoming destitute. Mental illness is a prevalent issue in the Caribbean and Latin American countries, contributing to 22% of the health issues in that region. Unfortunately, the available resources still have a large gap [8]. In Columbia, stigma toward mental illness, particularly for males, arises with the cultural aspect of machismo. Males are supposed to be strong and the breadwinners of the family. Having a mental illness, especially one that can take away the ability to provide, can be seen as a weakness. Therefore, these individuals avoid seeking help and typically succumb to alcohol abuse. DIADA (Detection and Integrated Care for Depression and Alcohol Use in Primary Care) has been implemented to bring mental health into primary care and help healthcare professionals, staff, and patients better understand mental illness and support the treatment of mental illness [9]. This type of integration of mental health into primary care has been done in Brazil through the Centers for Psychosocial Care (CAPS). These have replaced most mental health hospitals in Brazil and act as outpatient care centers for mental health. They interact with other care units like Family Health Units, which are generally the first option in receiving mental health care and are composed of Family Health Teams, a multidisciplinary means to treat mental illnesses locally. This decentralization of mental health care has had a limited effect. Health professionals still need to be trained adequately, and the facilities are underfunded [10]. It is a step in the right direction, however. More information and funding must be provided to increase the system’s effectiveness. Also, the stigma in Brazil is different from Columbia and
Defining Joy – Christopher Lee McElroy M.S. ABSTRACT Joy is important for our well-being and peace of mind, but what is “joy?” Also, how does this concept differ from that of others in positive psychology of happiness or subjective-well-being? The current review aims to answer these questions and better define what “joy” truly is. In short, it is something that lasts longer and is more visceral than happiness. This review contends that happiness is more of an emotion and joy is more a mood. Next, this review will discuss the neuroscience behind both hedonic happiness and eudaimonic joy. The goal is to try to set a precedent for future research in positive psychology to make a concerted effort to separate the two in both behavioral and functional analysis moving forward. Lastly, joy is something that can be practiced. It could be contended that joy is not necessarily learned but more realized. This can be accomplished through meditative practice which will also be discussed. Simpler Definition of Eudaimonia: Joy It seems that most everyone in their lives strives to find some sense of peace, joy, and happiness. With most of the world fixated on the external environment, the hedonic pleasures, to make them happy, it is important to also account for a peace brought about by inner joy. The concept of joy is an entangled one with many other synonyms besides happiness like delight, gaiety, and bliss. The Webster’s dictionary mainly de- scribes joy as a mental state of mind brought about by “. . . success, or good fortune or by the prospect of possessing what one desires” [1]. In that vein, the definition is not very differentiated from happiness, yet most see joy in a different light than happiness. The website diffen.com has a more unique definition which will be the definition uti- lized for this review as well as the term well-being, in terms of life satisfaction, that will be discussed later: “Joy is a stronger, less common feeling than happiness. Witnessing or achieving selflessness to the point of personal sacrifice frequently triggers this emotion. Feeling spiritually connected to a god or to people.” [2] The concept of joy needs to be more well defined, as to allow for accurate study design and assessments for studies about either getting, building, or retaining joy. Aristotle used the concept of eudaimonia, which directly translates to “the state of having a good indwelling spirit.” This eudaimonia is different from hedonic pleasures, which is more in line with the current definition of happiness. Many studies use the concept of positive well-being, or joy and happiness interchangeably. The ancient philosopher Rumi sums up the concept of joy by explaining that “[w]hen you do things for your soul, you feel a river moving in you, a joy” [3]. In other words, actions taken for your internal peace and not necessarily for external gratification can have a profound positive cognitive reaction. But many will also contend that joy is a visceral reaction to a profound event. That could be more properly described as the feeling of elation and that could be considered a level of joy. To achieve this elation there needs to be the positive basis of the mood joy as a basis. The Psychological Definition of Positive Emotions So, what is the official scientific take on joy? Although it is widely agreed that joy is a positive emotion that is an extension of inner peace, that is a broad definition and doesn’t allow for researchers to have a measurable concept of joy. Positive thought can be broken down into three factors: mood, emotion, and sensory pleasure [4]. Smith and Lazarus (1991) attempt to explain emotion as placing a type of meaning to a preceding event and that external events eliciting pleasure, such as satiating hunger or gratifying sexual desires are more sensory pleasure events, or physical sensations. Although, they can be inherently connected to an emotion [5]. Previous models muddle the definition of emotions with “specific action tendencies” which is the narrowing down the physical response to a stimulus, like the urges fight or flight [4, 5]. A theory that emerged in most recent decades is the “Broaden and Build Theory of Positive Emotions.” A personal well-being brought about by positive cognition is a stable state of mind and could be described as a positive mood. While negative emotions diminish the thought to action ratio, positivity increases the range of responses that accompanies a natural or more positive scenario [1]. There are several cognitive behavioral studies that back this theory. One such study used electromyography (EMG) to evaluate the difference between individuals that dis- play more Duchenne, or genuine, smiles and those that display non-Duchene, non- genuine. The researchers evaluated cognition via attentional breadth and flexibility tasks and found that those with a high occurrence of smiles when given positive cues performed better on these tasks [6]. Another research paper by Jager and Russeler (2016) agrees that there is also broadening of cognition, but contends that there is only a significant change in the non-causal relationship in attentional broadening, not an increase in thought action repertoire [7]. So, overall, there is still not a great deal of consensus on a definition for positive emotion or mood from a psychological perspec- tive. There is a study that indirectly defines joy in a more effective manner. Hansenne (2021) attempted to answer the question of whether putting a high value on attaining happiness might mitigate the ability to gain happiness, and by placing importance on overall positivity, an individual can have more “well-being” [8]. This is generally mixed in with subjective well-being that measures positive and negative affect, and the broader question on the overall outlook on life. It could also be further described in a similar manner as “assertion motivation,” which is the lack of wanting and, whether it is consciously decided, or intuitively so, remaining in a positive state of mind where there is no goal-directed action being pursued [9]. The A- “wanting,”
Importance of Joy – Christopher Lee McElroy M.S. and Sheryl Lynn Abstract: The subsequent review over the mental health topic of joy, that can also be defined as well-being or having a positive affect, is aimed to discuss imperative points in positive psychology. It means to define what the benefits of joy is overall and how to obtain joy via several different methods, particularly utilizing positive psychology interventions. Joy is important for every aspect of life and it would be beneficial to have a simple means to practice gaining joy through a variety of meditative processes. Lastly, this review introduces a simple means of exercising and practicing one’s mind to obtain joy called the ‘Chair of Joy.’ Herein, this review will describe joy as type of happiness with meaning or inner well-being [eudaimonic]. Why is Joy Important to Us? It seems obvious that joy is important for almost all of us in many ways. But why is joy important on a biological level? In the subsequent sections, importance of joy in our physical, mental, and social aspects of our lives. Physically: Most would likely agree that positive people are considered healthier individuals. Although individual mental health circumstances vary, it has also been reported that having joy, or well-being, has a positive effect on the recovery of physically adverse events. One such study looked at the “undoing effect” of positivity of individuals that had recently experienced anxiety induced cardiovascular event [1]. Students were asked to do a speech preparation task to induce anxiety and actively increase heart rate. Afterwards, they were shown either a film with waves crashing [contentment], puppies playing [amusement], colored sticks [neutral], or a video of a child watching their father die [sadness]. It was found that the two positive emotion eliciting clips helped to progress cardiovascular recovery faster. Positive emotions are definitely not limited to just temporary induced states in a lab. Several studies have concluded that there was as significant correlation between individuals that have difficult to control asthma and previously untreated psychiatric illness that would include depression and anxiety [2-4]. This would make sense considering that when the onset of asthma occurs it is important to try to stay calm and breath. The healthy counterparts to these studies have a much easier time managing their asthma. Better management of type 1 and type 2 diabetes can also be helped through positive psychology, particularly in adolescence [5, 6]. On the other end of the age spectrum, positive psychology is well known to increase longevity. Those that have a general well-being, or good mental health, that could be describe as having joy in life have a greater will to live and generally, do live longer [7, 8]. Mentally: Fredrickson [9] differentiated positive emotions from pleasure as being a physical response in the absence of satisfying physical desires [i.e., sex]. She also came up with the “Broaden and Build Theory of Positive Emotions.” The basis of which gives credence to why positive emotions have a biological advantage. In one very simple test, they asked individuals to list their thoughts beginning with the phrase ‘I would like to…’ after watching one of four emotionally provoking videos [anger, fear, neutral, content, and joy]. Those that watched the ‘joyous’ clip filled in all twenty slots given to them on the form, whereas the individuals that watched the angry or fearful clip filled out less than half [9, 10]. This same theory suggests that it can also reverse the effects of negative emotions and increase psychological durability. The broadening of attentional scope itself is does not increase the thought action repertoire but positive emotions can, and do, increase this [11]. This brings more credibility to the broaden and build theory, because it specifically attributes positive attention to the increase in thought action repertoire. Just seeing someone smile can have a positive impact on cognition, in the short term at least [12]. Although it is important to note that the positive emotion elicited can be more ascribed to happiness than joy, these states of mind go hand in hand with each other. In other words, it is easier to be happy when one has good mental health, and a sense of well-being, or joy, and even if happiness isn’t a requirement, joyous people are more likely to be happy [13]. Those with a happier outlook on life don’t only live longer, but those individuals that practice mindfulness through meditation have less stress and depression [14, 15]. Work: Positive individuals are more likely to graduate from college [16]. Individuals with an overall positive affect received “better” employment [17], have higher satisfaction with their job, and were objectively more likely to succeed than their less positive counterparts [17-19]. They were also more inclined to have positive performance reviews from their managers [17, 20]. In the end, they were also the ones that received higher pay, according to an Australian study [21]. An extensive meta-analysis done by Lyubomirsky (2005) defined “happy” people as those that have an overall positive affect and were frequently expressing “…pride, joy, and interest” and over a longer period of time and negative emotions infrequently [22]. This review would contend that their definition of happy is more in line with the definition of joy, positive affect, or well-being. The result of that study is that joyous people are generally more successful in life overall. Salas-vallina et al. [23] defines “happiness” as more of an ‘attitude’ that is elicited before an action. In a subsequent study of almost 500 financial it was observed that this “happiness” has a positive correlation with cross-selling outcomes [24]. Another study did more due diligence in separating hedonic and eudaimonic happiness. In which, this review would consider the more eudaimonic happiness [inner well-being] more congruent with the definition of joy. Cluster analysis in this study revealed several outcomes besides low happiness low performance or high happiness high performance [low-hedonic-high performance, low eudaimonic-high performance, high-hedonic-low performance, high-eudaimonic-low performance]. Performance to happiness ratio mainly depended on the demographics of being analyzed. For
