
Does your mental health and emotional health contribute to living a long happy life?
Most of us know some of the elements that contribute to our physical health and potential longevity such as maintaining healthy weight, managing your cholesterol, regular exercise, and preventative checking for cancers.
Emotional health and physical health are closely intertwined in ways that mainstream medicine is starting to recognise. Part of being healthy will require good emotional mental health.
Making positive choices can contribute to greater longevity, and more enjoyment in life. Conversely, some choices, and conditions unfortunately can take time away, and make time harder for us.
In this article we look at those conditions and behaviours that can give us more time, and also take time from us. We don’t control exactly how much time we have on earth, but we can have some power on our time we have, and how enjoyable that time is.
Losing time – conditions that compromise our ability to live long, fruitful lives.
Our emotional health, and threats to our emotional health, can compromise our longevity. Whilst a psychiatric condition such as stress, depression, anxiety, may have developed because of your circumstances, they are not your fault. However dealing with those conditions becomes your responsibility.
Psychiatric disorders
Serious mental illnesses such as psychosis, bipolar disorder, schizophrenia can leave individuals more prone to suicide, and also more likely to being placed in situations where their physical safety may be compromised. Whilst these conditions are usually quite rare, compared to depression and anxiety, illnesses such a bipolar or schizophrenia disorder appear in about 0.5 of most countries populations [3]. In Hong Kong, documentation of these disorders is not current, but reports as recent as 2017, detail that requests for psychiatric services continues to grow from 187,000 requests in 2011-2012 to 220,000 cases in 2015-2016 [2]. And these numbers predate the COVID pandemic. The COVID pandemic may have exacerbated negative mental health situations for many people in Hong Kong,
The presence of a serious psychiatric disorder adds to the individual, and their family’s’ experience of stress and depression. Additionally, it is difficult to medically treat these conditions so people who are hospitalised may possibly be over medicated, and many of these medications can cause harm to the individual (whilst they are also calming them). Balancing the benefit/cost of psychiatric medications is a complicated situation.
Depression
We use the term “depression” so flippantly we often forget that being depressed for some people is a long term, severe illness which robs them of all enjoyment, and sometimes leads individuals to thoughts of death. Depression affects about 3% of the population of Hong Kong [2].

Unfortunately, around 1000 people choose to take their lives in Hong Kong every year (1) . All of these deaths are tragedies. Its worth noting that, on average, 20% of the suicides in Hong Kong are people over the age of 65 years of age, and about 13% are individuals under 24 years of age. We need to take depression in individuals seriously and provide comprehensive treatment, especially for these more vulnerable populations.
Depression can lead to a fast death, but it can also contribute to a slow death. For individuals with persistent and severe depression some of the aspects of their depressive experience will affect their physical health to the extent that this can influence their physical health and possibly length of life, even in the absence of suicidal ideation or tendencies.
Such behaviours include lethargy, especially long periods, in bed, poor eating habits (both too much and too little) and the impact of poor self-care and hygiene. These are common elements of depression and maintain depression, and have negative impact on blood pressure, metabolism, movement and overall physical health.
People who are persistently depressed need help. The condition of depression is corrosive and controlling over the thought patterns of those trapped in this situation. Some depressed people seem think that they will wake up one day and be motivated to feel better. They are simply waiting for motivation to “kick in”. This is not what happens. Recovery from depression takes work under expert guidance.
Treatment of depression can involve medication, talk therapy, and behavioural interventions. If you have been feeling any of the following symptoms for more than a few weeks, I urge you to contact a counsellor or GP to discuss treatment options.
Symptoms of depression:
- Persistent sad, anxious, or “empty” feeling mood
- Irritability
- Feelings of hopelessness or pessimism
- Excessive fatigue
- Loss of interest or pleasure in hobbies and activities
- Difficulty sleeping, early morning awakening, or oversleeping
- Changes in appetite or weight
- Perpetual feelings of guilt, worthlessness, or helplessness
- Difficulty focusing, remembering, and inability to make decisions
- Somatic aches or pains, – headaches, cramps, or digestive problems without a clear physical cause
- Feeling physically heavy and moving more slowly
- Thoughts of death or suicide, or even just wishing to not be alive anymore.
Stress

Being stressed is a emotional mental health challenge that may affect your longevity and the quality of enjoyment you experience. Being stressed can place undue stress on your heart. Stressful events can be sudden stressful life events such as seeing an accident or the death of a loved one. Sometimes stress is more chronic, an accumulation and persistence of stressful events such as relationship split up, moving house, and a stressful job. A common assessment of stress, Holmes-Rahe-Stress-inventory [4] can help you check if your experience of stress is at such a level that it is likely that you will start experiencing challenges to your physical health.
Unfortunately, those under excessive stress can doubling impact on their physical health through associated compromising lifestyle choices, such a avoidance of exercise, poor diet, poor sleep and self-medication through pills or substances. All of these behaviours make the experience of stress worse, and also threaten the physical health of a person.
Substance addictions
Alcohol, nicotine, cocaine, stimulates, beta blockers – all of these can be dangerous to our physical health. Introducing dangerous levels of toxins into our bodies on a regular basis, can affect the way our body processes these toxins. Additionally, addiction itself, to behaviours and substances traps us in a cycle of shame that can lead to depression. Taking a break from alcohol and other addictive substances can be, literally, lifesaving for many people.
Adding time – choices that can extend life, and the enjoyment of it.
Good help.

Individuals can have a propensity to think to muddle through when they are anxious, stressed or depressed. Something about your lifestyle, thinking processes, or stress levels, is quite possibly prohibiting you from seeing stressful situations realistically. An expert, outside of yourself, can help you see that situation in the way that helps you better process what what has happened, and what can be done. Sometimes individuals who feel down, are stressed, or are self-medicating need to vent, sometimes they need to change.
Consider counselling. Ask your counsellor how they see your current life situation and what you, as a team, can do to alter how you have been feeling. If your counsellor can’t answer this question for you, you are completely entitled, even encouraged, to talk to another counsellor. Counsellor – patient chemistry is an important predictor of positive outcomes.
Dial down your reactivity
Some people are like simmering pots of anger. It doesn’t take much for those pots to boil over. Does this describe you?
Emotional health is the consequence of being able to regulate your emotions. Peter Attia in his masterpiece book on longevity, Outlive, writes, “90% of male rage is helplessness masquerading as frustration”. If you are quick to anger, tears or frustration, you may benefit from working on emotional regulation.
Regulating your emotion requires an attention to the triggers, forces and thoughts that drive your reactions to circumstances. In counselling we unpack your reactions to dissect what you really experienced and believed about a situation and explore how the lessons you have learnt from your past, and the fears that you have about your future, intersect at the way you choose to react. If you feel as if your emotions are out of control, or can’t even feel emotions any more, counselling is for you.
Adopt flexible perspectives
We can all get trapped in our thought patterns and many times we do not look at situations as flexibly as we could. Cognitive filters are thinking errors that make us look at situations from certain perspectives. We grow into using cognitive filters as a means to, we believe, efficiently assess situations. However filters can become problematic and can make us less happy.

For example, we often compare the worst of ourselves to the best of others. When people compare themselves to other people often, they are often misguided in their assessment of both how “lucky/successful” the other person is, as well as a “how unlucky/unsuccessful” we are. When we enter a situation from a rigid black vs white perspectives we tend to think that only one party can be correct, whilst the other must be wrong. Actually, many situations are much more nuanced that we first appreciate and sometimes focusing on you vs someone else means everyone loses.
Read our attached blog to read more about cognitive filters. Change your thinking – change your life.
In order to overcome cognitive filters we need to capture, review and re-frame our perspectives. In therapy we use cognitive flexibility exercises in order to help clients re-frame their experience in ways that helps them become less reactive, and calmer.
Working to develop more flexible thoughts around situations can help you build a different set of responses to situations. The next time you find yourself reacting problematically to a situation consider some of the questions outlined below. These are some of the questions I use when working with clients on their cognitive flexibility.


Embracing age as a gift
Positive age beliefs serve as a barrier against stress. Being accepting or positive about growing older can affect how contented you are as you grow older. Fixating on your age, negative self talk that you are “over it” of “old and frumpy” will make you feel bad. Think about your self-dialogue as a meal that you consume. If you only feed yourself negative commentary, how can you expect to feel good?
Connect to protect
The central tenet of Waldinger and Schulz’s 2023 book, The good life: Lessons from the world’s longest scientific study of happiness, is that good relationships, keep us healthier and happier. Good relationships, friendships and romantic relationships, protect us about the impact of negative events in our lives. Negative events are going to happen. No one completely avoids emotional hardships, what gets us through is the quality of our relationships.
Do you have the relationships you want, or infact need in your life? If not, what can you do to build new and better friendships. Our blog on friendships may help you on this matter.
You can take charge of your future. You don’t have to wait for your mood to improve to engage in change. And you can feel differently, exist differently, and live better (and longer)
About the author. Angela Watkins was named Hong Kong’s best therapist. Angela works with adults and teens to help them build better lives – including relationship recovery, building positive self esteem, overcoming depression, quietening anxiety, getting stuff done, and recovery from trauma. To contact Angela for therapy email Angelaw@reddoor.hk
If you want to read more on the topic of longevity consider reading some of these books:
Attia, P (2023). Outlive: The science and art of longevity. Harmony Books. New York
Gratton, L & Scott, A. (2016) The 100-year life: Living and working the in age of longevity. Bloombury. London.
Greger, M. & Stone, G. (2015). How not to die. Flatiron books.
Levy, B. (2022) Breaking the age code: How your beliefs about aging determine how long and well you live. Harper Collins. Sydney.
Ni, M (2006) Secrets of Longevity
Waldinger, R. & Schulz, M. (2023). The good life: Lessons from the world’s longest scientific study of happiness. Simon & Schuster. New York.
- [1]Centre for Suicide Research and prevention. https://csrp.hku.hk/statistics/
- [2] Food and Health Bureau report 2017. Mental Health Review Report. Dr Ko Wing-man. https://www.healthbureau.gov.hk/download/press_and_publications/otherinfo/180500_mhr/e_mhr_full_report.pdf
- [3] World Health Organisation mental Health statistics.
- [4] https://www.stress.org/wp-content/uploads/2024/02/Holmes-Rahe-Stress-inventory.pdf






































Being contented is a matter of perspective. Those whom are content are more likely to be able to respond positively to change when it is required, accept that many negative events are beyond their control, and allow situations to proceed differently than their initial expectations. This is because they can approach life’s challenges with a rational, and cognitively flexible, perspective.
This type of thinking occurs when you look at situations in a polarised way – situations, people, activities are either good or bad, nothing in between. Most situations are neither complete disasters or beyond fantastic, often situation have both good and bad aspects. Most people have some attributes that you find challenging, but this doesn’t make these people totally bad or good.
Whilst everyone has lots of things that they should (or could) be doing, some beliefs are irrational in their detail and in their believed consequences. For example, if everything needs to be perfect, this creates a lot of pressure on a person to perform a task to a (sometimes) unrealistic standard. Believing that you need to be the perfect student, parent, worker, lover, or be in control of all events in your life, be slim and attractive at all times, always be interesting, always have a friction free family – are unrealistic.
We all have the tendency to occasionally jump to negative conclusions. We may assume that someone deliberately performed an activity that hurt our feelings, or event assume and intent to their inaction (e.g. they don’t like me). In these situations, limited information or evidence can be used to support negative conclusions. This may be the case when we fail to get success at work, thinking that others are not supportive, when they are sometimes just too busy or not focused on our priority.
Overgeneralising is a special type of jumping to conclusions – both negative and positive conclusions. Overgeneralising is often reflected in our language choices – we use extreme frequency terms to describe behaviours – “they ALWAYS forget”, “Things NEVER go right for me in love relationships, EVERYBODY is happy except for me”. “Now that I am separated, ALL my married friends won’t want to see me”. Occasionally we may even do this after a single instance – one rejection letter leading to the assumption “I will never get a job”.
Mind-reading is a special type of jumping to negative conclusions. Not only do we make an assumption about people in the absence of complete evidence, but at some level we feel certain we know what they are thinking. Whilst on some occasions we may guess this right, we may also get this wrong. I often talk with clients who assume people talk about them negatively or think a particular way about them. In my experience we greatly overestimate how much people talk about us, and how judgmental of us they may be. Most people are usually worrying about their lives and what they need to do, rather than the role we play.
Catastrophising refers to the faulty filter we apply when exploring the future of situations in regard to negative outcomes. Whilst it is typical to occasionally feel a negative outcome, when we go for medical checks and such, excessive worry is of no help. If you tend to catastrophise regularly you cause yourself immense distress. Imagining that all situations will end in disaster is exhausting. Worrying that people will die or leave you will not make those situations any easier when they do happen, it just makes you experience the situation, virtually, again and again.
When we personalise we feel responsible for events or situations that are not our fault, or we assume that it is our fault. It can lead to us feeling offended when it isn’t necessary. If a friend ignores your text may not mean that you’ve offended them, instead it may mean they are busy. They may not be trying to offend us, or even be having an emotional reaction to something we have done.
Filtering becomes a threat to our self -esteem if you use this faulty thinking style frequently. In the era of the internet where people can feel more willing to troll other people and say horrible things on line, selecting what you choose to believe and reinforce as regards you sense of self, is extremely important. This is especially true for teens who use internet vehicles to test reactions to their world views – and perhaps do not yet have the resilience to rebuff negative feedback.
It is common to consider our own attractiveness, status, success, and personal worth relative to others. Comparing oneself constantly can become quite negative, especially when we assume elements about the other person and ourselves. For example, thinking a person who gets a better pay rise than you is an overall better person than you is not only unrealistic, it is unproductive. Please see our article on the strong relationship between comparing and feeling miserable.
Occasionally people let us down, even hurt us with their actions. Sometimes these actions are intentional. Many times, they are not. It is good to be able to accept disappointment and imperfections in others. If you find that you become stuck and blame others for your position in life, or in a situation you give away some of the power to fix that situation. Accepting someone’s behaviour is not an endorsement of that behaviour, it is simply acknowledging that bad realities exist, and that life can be unfair.
It is also illogical to label others, on the basis of one inference or observation. One fight with a colleague does not make her a “bitch”. When we label others, we not only diminish them, we provide rationalisation for further retaliation, “its okay to do xyz, because she is a bitch”. This is clearly not rational, and can often become prejudicial.

