Dr. Jonathan Fisher, a cardiologist with Novant Health Heart & Vascular Institute in Huntersville, doesn’t literally write his patients prescriptions for laughter. But he will extol its benefits.

Laughter therapy, which uses humor to control pain and boost a patient’s sense of well-being, is a real thing, he said. Chuckling and guffawing can have mental health and cardiovascular benefits and lower blood pressure.

Fisher said the formal practice of laughter – which is kind of funny when you think about a formal study of such a light-hearted response – was introduced in the medical field in the 1970s by Norman Cousins. The Washington Post referred to him as the “longtime editor of the Saturday Review – and a legendary perpetrator of April Fools' Day spoofs.”

His piece — which is not a spoof — “Anatomy of an Illness (As Perceived by the Patient),” ran in the prestigious New England Journal of Medicine.

“Cousins’ article chronicled his remarkable recovery from a severe and life-threatening disease of the connective tissue,” according to The Post. “He was hospitalized in 1964 with severe pain, high fever and near-paralysis of the legs, neck and back.”

In a 2009 NPR story, Anne Harrington, a professor of the history of science at Harvard University, said Cousins “checked himself into a hotel (and) had films of Candid Camera and the Marx Brothers brought in. He read … funny books, and he discovered that 10 minutes of a belly laugh gave him 20 minutes of pain-free sleep. And little by little, as it came to be … remembered, he laughed himself back to health."

More recently, there was a study in Japan involving 17,000 cancer patients, some of whom were given laughter therapy. “Over five years, people who laughed more had better survival,” Fisher said. “So, there's a link between people who find more joy, humor and laughter in their day-to-day lives and how long people survive, even after you adjust for the traditional risk factors of smoking, diet and being overweight. There's something about laughter that keeps us healthy, and science is trying to find out exactly how. We’ve got many clues how that happens.”

The science of good humor

Have you ever heard that you can’t make yourself laugh? Untrue, Fisher said.

Dr. Jonathan Fisher

“In 1995, laughter yoga became popular,” he said. “It’s based on the understanding that we do not need other people to make us laugh. There are two types of laughter – spontaneous laughter, where you may have a funny thought and start to laugh or someone else makes you laugh. And there's what I would call voluntary laughter which is right now.” (Note: At this point, Fisher started laughing – a little at first, but it became a bigger, louder, genuine-sounding laugh. And then I started laughing, which Fisher said was not a surprise. Laughter is contagious.)

“Laughter yoga doesn’t require you to have anything funny going on,” Fisher said. “It’s a different approach, and the science is now showing that you get many of the health benefits, even if you practice making yourself laugh, without the external humor (trigger).”

I was skeptical. Would it have been possible for me, during the start of the lockdown in March 2020 – when everything was scary and uncertain and nothing was funny – to make myself laugh? In isolation?

“COVID, obviously, is no laughing matter,” he said. “But neither is the emergency room or the intensive care unit or a lot of situations that doctors, nurses and patients face every day. And yet, we can find the right moments where laughter is appropriate. And in those moments, we can find opportunities to laugh … it can be beneficial.”

Prescription: Laughter

“A few studies have shown that 30 minutes of laughing once a week for about a month can improve your overall well-being, even if you're not experiencing regular joy and happiness,” Fisher said. “It's just the practice; it releases chemicals into your blood – serotonin, which is the happy hormone, and dopamine, which is the excitement hormone.”

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“When you laugh, you activate the parasympathetic nervous system, which has a calming effect,” he said. “And very interestingly, laughter affects our immune system. Even in times when it can be extremely hard to find joy and laughter, if we can even find a few moments to go through the motions, we can reap some of the benefits of laughter.”

That led Fisher to mention the “motion creates emotion” theory. That means that even if you're not in a happy mood and you do a laughter practice, your overall mood may start to shift. Fake it till you make it, in other words.

“Obviously, if you're dealing with some hard emotions and grief and mourning, that's not appropriate,” he said. “But if you're just looking for a way to boost the spirits a little, you can exercise, eat something healthy, go for a walk outside, listen to music, talk with a friend or spend time with your pet. And I hope that in the future, we'll start to encourage people to find more excuses to laugh, because it can be just as good for our health.”

Gratitude, just learning to appreciate what's in front of us, can help. Mindfulness, is another. And you don't have to overhaul your life to practice all three, Fisher said. Little changes over time can make a big difference.

What's so funny?

There’s even an (unfunny) name for the study of laughter – gelotology. “It’s based on this premise that when we find humor in things and laugh out loud, it helps us manage our stress, increases our resilience, decreases our burnout and it improves our psychological well-being and quality of life,” Fisher said.

And the benefits don’t stop there. “Laughter has been shown in studies to reduce our blood pressure, reduce our heart rate, reduce our respiratory rate, reduce anxiety, reduce pain, improve depression,” he said. “It's been shown to be effective in people who've had trauma and is also commonly used in cancer patients.”

Norman Cousins loved playing practical jokes. One April Fools' Day, “several editors had been momentarily dismayed by an authentic-looking notice from the printer that 300,000 copies of the magazine had been accidentally printed upside down,” The Washington Post wrote. “Another time, the publisher ordered a frankfurter from the office vendor, smeared it with mustard and bit into a rubber hot dog. He knew instantly who was behind it.”

“‘Cousins,’ he muttered.”

Be on your guard April 1. But if someone should punk you, laugh it off. It’ll be good for you.