Conversations about heart disease and mental health often dwell on the overlap between cardiovascular problems and negative emotions. It makes sense: People with depression face a heightened risk of heart problems. Also, it’s common — and understandable — to feel moody, distressed, or irritable after a heart attack.

Increasingly, however, mental health experts are focusing on how optimism and other positive emotions can guard against serious heart-related events and death. Optimism is linked to a lower risk of cardiovascular disease, according to a 2022 review in The

American Journal of Medicine

that pooled findings from nearly 182,000 people from six separate studies. People who are happier or more optimistic may be more likely to exercise more, eat more healthfully, and sleep better, which might explain the link. But can people who aren’t naturally cheerful actually improve their physical health by changing their mindset?

“There’s good evidence that some simple exercises designed to enhance positive feelings can improve well-being and reduce depression,” says Emily Feig, a clinical psychologist in the Cardiac Psychiatry Research Program at Harvard-affiliated Massachusetts General Hospital. Some of these interventions have been shown to encourage people — including those with heart-related issues such as heart attacks and heart failure — to exercise more and take their medications more consistently, she says.

Promoting positive feelings

One exercise, expressing gratitude, involves writing a letter to a person who did something in the past for which you feel grateful. “Research shows that actually writing about your experience has a more beneficial effect that just thinking about it,” says Feig.

In another exercise, people identify one of their own personal strengths from a list of different qualities, such as love, curiosity, persistence, or self-control. Then, they plan a new way to apply that strength to deal with a specific situation over the next week.

Performing an act of kindness for someone is another way people can cultivate positive feelings. For example, you might mow a neighbor’s lawn, or bring a meal to friend.

For each of these exercises, people are encouraged to pay attention to how they feel at each stage of the exercise — planning, execution, and response.

The upward spiral

Having a more positive outlook may help reinforce other positive behaviors, or what psychologists refer to as the “upward spiral.” This momentum can help people start healthy habits like exercise, which then becomes self-reinforcing, says Feig. Practicing positive psychology also helps foster resilience, which can help you cope better during difficult times.

“We don’t tell people to ignore or push away negative experiences or pretend they don’t exist,” says Feig. But your mood tends to mirror what you focus on. Even during a week that includes many difficult challenges, there are usually a few positive moments, she says. Focusing on those small, positive things may allow that emotion to broaden and help you feel more balanced.

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