How can you find joy (or at least peace) during difficult times?

An older adult patient once told me, "There are good decades and bad decades." I remember the shock at hearing this — the patient was referring to the relationship with his wife. For many of us, 10 years seems like a very long time to struggle. How do we find joy when experiencing difficulties — or how do we at least make our struggles bearable?

Loss of joy may be a sign of a mental health problem — or it may be a normal response

Life has its ups and downs, but sometimes challenging events occur all at once. When our world is turned upside down, it's normal to feel a lack of joy. Health problems, losses, breakups, housing challenges, natural disasters — the list of severe stressors and traumatic events is long. Most adults will experience multiple severe traumas and losses throughout their lives. Loss of joy in these contexts is a natural part of the human experience.

For some people, however, the lack of joy persists or appears out of the blue. This may occur in a mood disorder like depression. The inability to feel pleasure (also known as anhedonia) is even part of the diagnostic criteria for depression, and it's pretty common. Approximately 8% of US adults will experience depression in a given year, and approximately 20% will experience an episode of depression during their lifetime. A loss of joy may also accompany other mental illnesses, including psychotic illnesses and dementia. Certain medications, including (paradoxically) those that treat depression, can also cause emotional blunting and a loss of joy.

What's the difference between joy and happiness?

Joy and happiness are often used interchangeably. However, happiness technically refers to the pleasurable feelings (emotions) that result from a situation, experience, or objects, whereas joy is a state of mind that can be found even in times of grief or uncertainty. Thus, we can work on cultivating joy independent of our circumstances. Winning the lottery may trigger (short-term) happiness; spending time engaging in meaningful activities may result in long-term joy.

Joy and feel-good neurotransmitters

Although the neurobiology of joy is complex, there are a few neurotransmitters that stand out in promoting positive feelings: dopamine, serotonin, oxytocin, and endorphins. The good news is that many changes to our lives can increase these neurotransmitter levels. For example, running may produce a "runner's high;" spending time with a baby releases oxytocin, the "cuddle hormone" that makes you feel connected.

The effects of neurotransmitters on the body are broad, from relaxing your muscles to speeding up your heart rate, but they may result in a final common pathway of promoting positive feelings. Whether it's finding a sense of purpose or enjoying supportive relationships, the benefits on the mind and body are far-reaching.

How do you increase joy?

During difficult times, it becomes twice as important to modify your routine, allowing yourself to experience joy. Here are some ideas, although it may take some trial and error to find what works best for you:

• Perform regular aerobic physical activity. Think of physical activity as releasing a bubble bath of neurotransmitters — and their effects linger long after the exercise is over.
• Dedicate yourself to others. Activities such as volunteering produce greater joy than focusing on oneself.
• Connect with your spiritual side. When we join with something larger than ourselves, we develop feelings of gratitude, compassion, and peace. Meditation is a powerful way to modify brain pathways to increase joy.
• Discover something new. As humans, we are hard-wired to experience joy when experiencing novelty. Developing a new pursuit can help us refocus our energy.
• Give yourself permission to take a few moments of pleasure, especially when you are feeling low. You can try NPR's Joy Generator for a taste.
• Pay attention to the good. A joyous mindset can be developed, but takes practice. The three good things exercise helps you keep an eye out for the positives during the day.
• Conversely, limit negativity. Whether it's gossipy coworkers, a toxic relationship with a family member, or a complaining friend, spending time around a negative mindset influences us directly. It's okay to set limits.
• Focus your efforts on what brings meaning to your life (and don't focus on money).
• Ask your doctor about whether your medications can affect your ability to experience pleasure, especially if you are taking antidepressants.

Surprising benefits of joy

Regardless of the changes you make to your mindset or to your daily routine, increasing your ability to find joy may provide long-lasting health benefits. Your immune system can be strengthened by your mental state (immune cells even have receptors for neurotransmitters). Interventions to increase joy may also decrease stress hormones, improve pain, and relieve depression. Finally, finding joy can help you live longer.