Duration of Humor-Induced Immunoenhancement

Only one attempt has been made to examine the duration of the immunoenhancement effects of humor. This may be an artificial question, since changes in emotional state are known to cause ongoing fluctuations in the immune system, and your emotional state generally depends on whether or not you're dealing with anything stressful at the moment. If something happens to make you angry or anxious soon after watching a comedy video, this (to different extents for different people) can be expected to counteract the immune benefits resulting from the video. This is where the strength of your own sense of humor comes in. If your patients are able to find a light side of any aspect of their day in your hospital, they stand a better chance of sustaining the immunoenhancing benefits resulting from the humor in any comedy videos you might provide them, a visiting clown, etc.

The very limited research along these lines suggests that a strengthened immune system is sustained for 30 minutes for IgA, IgG, number of B cells, activation and number of T cells, activation and number of natural killer cells, and gamma-interferon. The immunoenhancement effect was still present 12 hours later for IgA, IgG, number of B cells, complement 3 and gamma-interferon.30 This finding is consistent with recent evidence (discussed above) that the increased pain tolerance resulting from humor is still present 20 minutes later.31 No attempt has been made to study durations beyond 12 hours. This issue clearly needs to be studied further before any claims can be made about the duration of any immunoenhancement effects resulting from humor. 

Sense of Humor and Immunity

Given all the evidence that watching a humorous video strengthens different components of the immune system, it makes sense that individuals who have a better-developed sense of humor - meaning that they find more humor in their everyday life, seek out humor more often, laugh more, etc. - should have a stronger immune system, because they get more of the same kinds of benefits resulting from watching a comedy video by exercising their sense of humor more often. Consistent with this expectation, there is evidence that individuals with higher scores on a sense of humor test have higher "baseline levels" of IgA.32 But there are also several studies which failed to find this expected relationship, so the picture for the relationship between sense of humor and the immune system is not as clear as that obtained for the impact of watching a funny video. 

The reason for the inconsistent findings for sense of humor may lie in the finding noted above that one's immune system fluctuates throughout the day as a function of shifts in mood. While a good sense of humor increases the likelihood that you will have more frequent occasions for mood-elevating laughs throughout the day, it is no guarantee. Even people with a great sense of humor may go hours without laughing. And the mere anticipation of having your blood drawn to participate in a study may be enough to generate immunosuppressive stress - clouding the relationship that typically occurs between humor and the strength of one's immune system.

If people with a better sense of humor do have a stronger immune system than their humor-impaired friends, those with a less-developed sense of humor might be expected to show more immunoenhancement from watching a comedy video. The available research, however, suggests that the opposite is true. Individuals with higher sense of humor scores show the greatest increase in IgA after watching a funny video.33 This suggests that those with a better sense of humor may have appreciated the videos more or laughed more. 

____________________________________________________________________ "John was a clerk in a small drugstore, but he wasn't much of a salesman. He could never find the item the customer wanted. Bob, the owner, had had enough and warned John that the next sale he missed would be his last. Just then a man came in coughing and asked John for their best cough syrup. Try as he might, John could not find the cough syrup. Remembering Bob's warning, he sold the man a box of Ex-Lax and told him to take it all at once. The customer did as John said and then walked outside and suddenly stopped and leaned against a lamp post. Bob had seen the whole thing and came over to ask John what had transpired. "He wanted something for his cough but I couldn't find the cough syrup. So I substituted Ex-Lax and told him to take it all at once," John explained. "Ex-Lax won't cure a cough!" Bob shouted angrily. "Sure it will," John said, pointing at the man leaning on the lamp post. "Look at him. He's afraid to cough!" ____________________________________________________________________

Humor's ability to protect you against immunosuppression during stress was evident in a study which compared people with a well-developed sense of humor (they found a lot of humor in their everyday life or frequently used humor to cope with stress) to people with a poor sense of humor. Among those who rarely found humor in their own lives, especially when under stress, a greater number of everyday hassles and negative life events was associated with greater suppression of their immune system (IgA). Among those with a well-developed sense of humor, on the other hand, everyday hassles and problems did not weaken the immune system.34 Their sense of humor helped keep them from becoming more vulnerable to illness when under stress.

The Role of Mood

Your immune system - as noted earlier - is very sensitive to your mood, being stronger on your "up" days, and weaker on "down" days. This has been shown for both IgA and natural killer cell activity.35 It appears to be the negative emotion or mood that accompanies stress that is responsible for the reduced level of antibody response that occurs when the immune system is asked to fight a virus or other antigen. This has been documented with reduced levels of NK cell activity,36 lymphocyte proliferation,37 serum antibody response to Hepatitis B vaccine,38 and salivary IgA response to a novel antigen, 39 to name a few. 

Part of the health-promoting power of humor and laughter, then, lies in the fact that they help keep the negative events that occur in your (and your patients') life from disturbing your mood.40 They make it easier to keep an upbeat, optimistic outlook, even in the face of the ordeal of being hospitalized. Dr. Bernie Siegel has long emphasized the importance of a positive, optimistic mood in fighting cancer and sustaining wellness,41 and your sense of humor is one of the best ways you have to maintain this mood on high-stress days.

_______________________________ "The simple truth is that happy people generally don't get sick." Bernie Siegel, M.D. _______________________________

Which is More Important, Laughter or the Experience of Humor?

A key question with all of the immune system research concerns the relative importance of laughter versus the mental/emotional experience of humor. Only two studies have addressed this issue. In one, half the participants were encouraged to laugh while watching a comedy video, while the other half were asked to suppress laughter while watching. Comparable levels of increased salivary IgA were found for the two groups.42 Since laughter did not boost the amount of IgA increase, this suggests that the experience of humor may be more important than how much you laugh. This is consistent with other evidence that the act of laughter itself is less important in accounting for observed increases in the threshold for experiencing pain (see below) than the level of enjoyment (as indicated by facial expression) of the humor presented.43

Another study, however, showed that the funniness of the video is not related to the amount of IgA increase shown.44 The precise way in which one's own sense of humor provides immunoenhancement benefits is clearly complicated and not yet well understood. So we cannot answer the question of which is more important for health. As long as you're someone who is comfortable having a good belly laugh when you find something funny, it makes no difference which is really responsible for the immune strengthening benefit (or any other health benefit) you receive in your daily life. Your body gets the benefit, even if your mind doesn't know why. 

The same applies to your patients. Although all nurses have less time than they used to (and than they would like to) have with patients, if you are able to adopt a lighter style of relating to patients (once you've established your competence in their eyes, and a good relationship in general), you'll help assure that they get these immunoenhancement benefits on a daily basis.

Immunotherapy

A very new approach to treating cancer involves activation of the patient's own immune system to get it to battle the cancer more effectively. It is called immunotherapy and uses a drug to bolster the immune system. For example, at the time of preparation of this course, researchers at the Roswell Park Cancer Institute in Buffalo, New York were giving certain cancer patients high doses of a drug called Interleukin2 to stimulate the immune system. Unfortunately, the high doses of this drug are often difficult to tolerate, and the drug only seems to work with certain patients. But when it does work, the effect is dramatic. According to one of the researchers testing the drug, "In those patients where we really get a response out of IL2 therapy, it is nothing short of extraordinary. You can have a situation where a patient with metastatic disease will have their tumors melt away."45 

The investigators studying the impact of immunotherapy are very excited about its potential, but there is no definitive research documenting its effectiveness at this point. It is brought into the discussion here to emphasize that immunotherapy does the very same thing that humor does. That is, it provides a significant boost to the immune system, helping the body to fight disease on its own. Presumably (if it does prove to be effective in battling cancer), Interleukin2 would provide a much more potent immune system boost than that provided by humor, but this in no way devalues the importance of humor as an important ally in the battle.

 

     

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