"Those who get sick the most seem to view the world and their lives as unmanageable." Blair Justice, PhD

In last month's Humor Your Tumor column, positive emotion and a hopeful, optimistic outlook were shown to boost your chances of surviving your cancer. It should come as no surprise, then, that negative emotion has the opposite effect.

We all have days where we feel down, but the impact on your health depends on how often you're depressed and how extreme the level of depression is. In one study, a group of middle-aged adults were given a test of depression. Those who died of cancer within the next 17 years were twice as likely to have had high depression scores 17 years earlier than those who developed no cancer at all.

Negative emotion or attitudes have also been found to be related to survival of other diseases. Among patients with heart disease, those with a pessimistic outlook about their ability to recover enough to eventually resume their daily routine were more than twice as likely as optimists to have died one year later, even when severity of the condition was taken into account.

Another follow-up study of patients recovering from heart attacks showed that those who scored high on tests of sadness and depression were eight times as likely as more optimistic patients to die within the next 18 months. Risk of death was tripled both among those who tended to hold in their anger and those judged to be very anxious.

The researcher who conducted the latter study sees the importance of helping heart patients reduce their pessimistic outlooks and negative emotions, but concludes that "We don't know how to change negative emotions." In future articles in this column, we will show you how to learn to use your sense of humor to help substitute a more positive emotional state for these negative emotions.

People who are chronically prone to any kind of negative emotion over the course of their lives, including anger or anxiety, in addition to depression, are at a greater risk for disease. The specific disease that occurs depends on your unique vulnerabilities, health-related habits, and family history.

The fact that a strong negative emotional focus throughout the course of one's life predisposes one to poorer health makes it all the more important to learn effective coping skills early in life. This includes learning to lighten up on the tough days. By learning to improve your sense of humor now, you'll have the rest of your life to continue receiving the wellness-promoting benefits that result from humor and laughter.

There is a growing conviction among researchers that the increased susceptibility to disease that results from negative emotion and attitudes is at least partly a result of the suppressive effects of negative emotion upon the immune system. This is difficult to document conclusively in research, but the herpes simplex virus (responsible for small ulcers, fever blisters, and cold sores around the mouth) provides a good way to demonstrate it. This virus, carried by about 1/3 of the U.S. population, normally remains latent because it's held in check by the immune system, but persistent negative emotions can trigger an outbreak.

So you have every reason to examine your own daily attitude and mood as you learn to live with your cancer. You needn't worry about the fact that you get angry, anxious, or down from time to time. But if you find that you are habitually angry, anxious, depressed, or pessimistic, and feel that things are hopeless, then it is important for you to begin taking steps now to build a more positive focus into your life.

Humor may not be the best approach for you, so make it your goal to find out how you can overcome these persistent negative emotions and spend more of your day in a positive frame of mind. If you are ready for humor, for starters, try spending more time around friends who make you laugh. Or watch a comedy video or your favorite sit com once a day. Get books of your favorite cartoons. Make it your goal to find five things in your own life to laugh at every day. And simply observe the effect this has on your daily mood and attitude toward life.