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Are relationships good for your health? Choose your partner carefully!

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Love is a voyage of discovery from dopamine drenched romance to oxytocin induced attachment. Making this journey can be fraught with hazards and lead many to question the value of romance and commitment. Nevertheless, the impact of stable long term exclusive relationships on longevity is well established. In a study of one billion person years across seven European countries the married persons had age adjusted mortality rates that were 10-15% lower than the population as a whole. So, on balance, it probably is worth making the effort. Young love; Less well established are the benefits of early phase romantic relationships—that is, dating. Evidence suggests that romantic relationships in adolescence are associated with increased depressive symptoms, although less so as you get older. Romantic relationships in 18-25 year olds are associated with better mental health, but not better physical health.  So it seems that a degree of maturity is required before Cupid is likely to bring a net health benefit. Theoretical perspectives on marriage and other forms of commitment suggest that dating should bring a health benefit. The selection hypothesis says that well adjusted individuals are more

likely to establish long term relationships. On this basis, the observed health benefits are unlikely to be causally related to having a relationship.  Longitudinal evidence, however, suggests this is not a complete explanation. Greater commitment is also associated with a higher standard of living, but this does not fully explain the boost to mental health from committed relationships. The most widely accepted explanation is that being in a committed relationship means that better social support is available. Commitment seems to provide networks of supportive and helpful relationships, beginning with the spouse or partner, leading to more healthy lifestyles and better emotional and physical health. Married/single/other;  Although partnership is protective of health, this varies according to the type of partnership. Marriage and other forms of partnership can be placed along a sliding scale of commitment, with greater commitment conferring greater benefit. A meta-analysis of 148 studies into the impact of social relationships found that both the amount of emotional support available and the legal status of partnerships are related to mortality. That marriage generally indicates a deeper commitment might explain why marriage is associated with better mental health outcomes than cohabiting. In terms of physical health, the duration of a relationship is as strong a predictor of longevity as legal status. However, cohabiting relationships tend to be less enduring. One study has shown that cohabiting seems to be better for men’s physical health whereas marriage seems better for women’s mental health; this is counterintuitive to the social support hypothesis, suggesting the need for further

evidence. Civil partnerships should theoretically confer the same benefits as heterosexual partnerships, insofar as they provide the same types and levels of social support. Arguably the health benefits of partnership in sexual minorities might be greater in buffering against social stigma, but this needs to be balanced against the shorter duration of many same sex relationships. Evidence is needed on these issues. Duration of relationship; Physical and mental health benefits seem to accrue over time. After 30 years’ follow-up, and with adjustment for baseline mental health, the duration of a relationship was associated with better mental health scores, while the difference in mortality rates in favour of marriage, increases with age. In terms of physical health, men benefit more from being in a relationship than women, but in terms of mental health women benefit more than men. The physical health premium for men is likely to be caused by their partner’s positive influence on lifestyle. The mental health bonus for women may be due to a greater emphasis on the importance of the relationship in women. The studies that compare the mental health of men and women, however, are crude and take little account of gender differences in the expression of distress—for example, women may be more prone to depression and men are more prone to alcohol abuse. Strained relationships;  Not all relationships are beneficial. Difficult and strained relationships in both the short and long term are consistently shown to have a negative impact on mental health, and the ending of a strained relationship brings mental health benefits. Being single is associated with better mental health than being in a strained relationship. The transition from a strained

relationship has differential impacts. Leaving a relationship is distressing, possibly more so for women, although this effect is made less severe for women because they have more supportive social networks. Whether divorce is more detrimental to health than widowhood is open to debate. Both can have a devastating short term impact. In the longer term, it may be that men are affected more by relationship loss through poorer quality of lifestyle, whereas women may be affected more through loss of emotional support, but these are simplistic explanations of the break-up of complex patterns of interdependence. For women, multiple partnership transitions are associated with poorer mental health, and increased mortality. Age matters;  The road to commitment may be best travelled later for men than women. In terms of mortality, the optimal time for men to establish a committed relationship seems to be after the age of 25, whereas for women it is between 19 and 25 years. The extent to which this difference is the result of economic issues for men and reproductive issues for women is unknown, as is the extent to which the optimal period is affected by changes in work patterns and wealth. The take home message is simple. Exclusive and supportive relationships confer substantial mental and physical health benefits that grow over time. Although failure of a relationship can harm health, that is an argument for avoiding a bad relationship rather than not getting into a relationship at all. Prof. David Gallacher. News from: Department of Paediatrics, University Hospital of Wales. Department of Primary Care and Public Health, School of Medicine, Cardiff University

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