Depression, Pessimism, and Health

Depression is a syndrome involving sadness and doubt, loss of motivation, and the ability to experience enjoyment. Pessimism (the negative pole of the optimism dimension) is a trait consisting of the generalized expectancy of bad outcomes in important life domains; the term hopelessness conveys a similar sense of anticipating bad outcomes. All these characteristics have been implicated as contributors to adverse health outcomes. Pessimism has been related to low persistence at health promotion efforts and to activities that reflect disengagement from life. Pessimism has also been linked to adverse reactions in certain medical events (e.g., coronary artery bypass surgery, heart transplantation) and to cardiovascular disease. Depression has long been related to elevated likelihood of subsequent cardiac death after initial myocardial infarction, and to heart disease more generally. Both pessimism and depression have also been linked to inflammation, which may be a precursor to several health problems. There is evidence that some of these effects are larger among younger than older persons. Future research must focus more on the pathways by which these variables create their influence.