How joy affects health: is laughter the best medicine?

Professor Marco Saffi from Brazil and his team of researchers have been looking into the link between laughter and heart health.

Their study, presented at the European Society of Cardiology Congress in 2023, showed that people with coronary heart disease who regularly watched comedy shows had benefits to their heart and circulatory system compared to those who watched serious documentaries.

It was the first randomised clinical trial to study the effects of laughter on people with coronary heart disease, the main cause of heart attack. A group of 26 people with an average age of 64 took part in the 12-week trial.

Half were asked to follow a course of laughter therapy, which involved watching comedy shows twice a week; the other half watched ‘neutral’ documentaries on topics like politics.

The health benefits of laughter

The results showed that laughter therapy led to improvements in the heart and circulation: the arteries were able to expand to a greater extent; oxygen flow around the body increased; and inflammation markers in the blood, which can help predict the chance of a heart attack or stroke, reduced.

While this was a relatively small study, other research has shown the positive effects of laughter on the body. Laughter releases endorphins, known as ‘feel-good hormones’. It increases the oxygen-rich air you take in and reduces stress hormones, bringing down your heart rate and blood pressure, and causing your muscles to relax.

Doctors can prescribe laughter

Professor Marco Saffi has suggested that laughter could be used as therapy. “People with heart disease could be invited to comedy evenings, or encouraged to enjoy fun evenings with friends and family,” he says.

Doctors in Bristol and Coventry are offering laughter yoga, a combination of breathing exercises and deliberate laughter, as part of a pilot scheme to improve their patients’ wellbeing.

Laughter therapy led to improvements in the heart and circulation

But we may be some way off this being expanded to help heart patients. BHF Associate Medical Director Professor James Leiper says we don’t yet know whether laughter could be a treatment for coronary heart disease. Commenting on Professor Saffi’s study he says: “While this study reveals the interesting possibility that laughter could in fact be a therapy for coronary artery disease, this small trial will need to be replicated to get a better understanding of how laughter therapy may be helping these patients.

“It’s encouraging to see that something so simple and widespread could benefit our health, but more research is needed to determine whether laughter alone led to the improvements seen, and how long the effects could last.”

Laughter can help you to relax

Dr Carla Croft, Consultant Clinical Psychologist at Barts Health NHS Trust, says while it’s not helpful to try to force laughter if someone is not in the mood for it, just making an effort to smile can bring warm feelings and positivity.

She says: “We know from studies that just the act of smiling for three minutes can help us feel better. Trying to make someone laugh when they feel like crying is not that helpful. But if you are open to it, you can shift your mood in an instant by watching something funny or laughing with somebody. It can be very powerful. It creates a sense of safety and warmth, and it soothes us instantly.

“If you’re in pain or feeling stressed, a friend who makes you laugh, or watching a programme that makes you laugh, could very well be something that helps, since it’s likely to help you feel more relaxed.”

Humour can help you cope with difficult news

Using humour to try to make sense of difficult news or situations is a normal human response. Dr Croft explains: “When we’re in absurdly difficult situations, we might find that our brain uses humour to process what seems incomprehensible. In such situations, laughter creates connection between people and it’s an example of your brain digesting and making sense of something that’s really quite confusing and difficult, through laughter.”

Laughing is a universally positive experience

“We shouldn’t expect people who have had a life-changing diagnosis or who are in pain to be laughing all the time,” cautions Dr Croft. “But it can reduce feelings of anger and frustration. It can reduce pain and induce feelings of hope. Laughter is a universally positive experience. So if it feels right, it is a really healthy thing to do.”

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