What is Health?
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What Is Health?

by Chris Kresser

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There’s no shortage of discussion about the factors that contribute to health and how to optimize and improve it. But what is health, really? How do we define it? And can the way we define health actually influence our experience of it?

A few weeks ago, I taught a seminar for clinicians in Pennsylvania. During the Q&A period, someone asked what I think is a very important—and underrated—question: what is health?

The concept of health is so familiar that many of us have never thought much about what it really means. That was certainly true for me prior to my decade-long struggle with chronic illness that began in my early 20s.

If asked, I suspect most people would define health as “the absence of disease.” And in fact, if you look up “health” in the Merriam-Webster dictionary, you’ll find a very similar definition: “the condition of being sound in body, mind, or spirit; especially: freedom from physical disease or pain.”

Is Health Really Just the Absence of Disease?

While this common definition of health certainly has merit, I think it’s too limiting and reductionistic.

Imagine someone (Person A) who is the picture of physical health: he has boundless energy, perfect digestion, a sharp mind, no chronic, inflammatory conditions, and rarely (if ever) get colds and flus. But in other areas of life, this person is a wreck: he has terrible relationships, he’s selfish and doesn’t contribute to the lives of others, he has no sense of humor, rarely has fun, and is miserable most of the time.

Now consider someone (Person B) that is in many ways the opposite of Person A: perhaps she has an autoimmune disease, she struggles with low energy, her digestion is weak, and she sometimes has difficulty sleeping. But unlike Person A, her life is incredibly rich and satisfying: she has deep, nourishing relationships with others, she does meaningful work that makes a difference in the world, she is full of joy and humor, and she loves to have a good time.

Which of these people is truly “healthy”? Both? Neither? If you had to choose between these alternatives, which would you choose?

Of course, there is another possibility: Person C. Person C is healthy physically as well as mentally, emotionally, and socially. This is certainly what most of us aspire to, and it’s a perfectly natural and valid goal.

The problem is that it’s not always attainable.

When “Perfect Health” Isn’t Possible

During the course of my long struggle with chronic illness, I had a lot of time to think about this question of what health is and what it really means to me.

At one stage in my journey, after trying everything I could possibly imagine to get well without a lot of success, I had a breakdown. I reached a point where I just couldn’t see the future I had always imagined for myself when I was a “healthy” person: a successful career, a family, and an active and energetic life. These things no longer seemed possible for me, given how sick I was.

This led to a period of deep depression and despair—and it was without a doubt the darkest and most difficult time of my life.

But as the saying goes, the darkest hour is just before dawn. At some point during this “dark night of the soul,” I realized that the depression and despair I was feeling was the direct result of comparing my actual experience with an idea of what I thought my experience should be. I saw that I was striving for an ideal of health that was—at least at that point—unattainable, and that this was the cause of most of my suffering.

How We Define Health Has Tremendous Power

These realizations led to a profound shift for me. Up until that time, I had been focusing almost exclusively on figuring out the cause of my illness and “fixing” it: I saw doctors all over the country and the world, I took countless medications, herbs, and supplements, and did every special diet you can imagine.

But after this “dark night,” my focus began to shift. I continued to eat well, but I let go of “finding the answer” for a while. I stopped seeing doctors, taking supplements, and obsessively researching new treatments.

Instead, I focused on bringing more joy, pleasure, and meaning into my life. I spent more time with my friends. I took regular walks in the woods and surfed as much as I could. I volunteered to teach meditation at the San Francisco County Jail. I signed up for an improvisation class. I did a massage trade with a friend and got acupuncture once a week. And after a while, I decided to go back to school to study integrative medicine so I could use what I had learned to help others.

Several months after making these changes, the depression and despair were gone, and I was feeling more connected, alive, and hopeful than I had in a long time. But that’s not all that changed; my physical health started to improve as well. I had more energy, my digestion was better, my sleep was less interrupted, and I began to put weight on again (which had been impossible until then). These improvements rejuvenated me and gave me the boost I needed to continue searching for new treatments that ultimately led to further physical recovery.

This time in my life taught me a very important lesson: how we frame and perceive our experience has tremendous power—even the power to change it.

If I had continued to define health only as “the absence of disease,” what would my life have been like? A constant experience of disappointment, “not enough,” frustration, and failure.

But as my definition of health expanded and became more inclusive, new possibilities opened up. I was able to find ways to experience joy, pleasure, meaning, and ultimately, health—even in the midst of physical pain and discomfort. What’s more, the reframing of my definition of health didn’t just lead to more happiness, it ended up improving my physical health as well.

An Alternative Definition of Health: The Ability to Live Your Dreams

Several years have passed since the period I described above, but I continue to think a lot about what health means to me. It’s a subject I am fascinated by and never stop learning and reading about.

In all of that time, I think the best definition of health that I’ve come across is “the ability to live your dreams.” This comes from a man named Moshé Feldenkrais, the creator of the Feldenkrais method (designed to improve human functioning by increasing self-awareness through movement).

I like this definition because it does not refer to the absence of pain, discomfort, or disease. Instead, it points more toward a quality of life and way of being in the world.

An example that comes to mind is my late Zen teacher, Darlene Cohen. She had rheumatoid arthritis, an autoimmune inflammatory condition affecting the joints, for more than 30 years. When the disease first struck her, she lost 40 pounds and was forced to stay in bed. She couldn’t dress herself, hold the phone receiver, or get up from the toilet unassisted. From her book:

In four months of deterioration, I lost everything that meant anything to me: reliance on a strong, young body; my achievements and the sense of self-worth they brought me; my pleasure in being a sexually attractive woman; my identity as a mother; and my ability to do the required practices and sustain myself in the community in which I lived as a student of Zen meditation. I became isolated from everyone I knew by my pain and fear and ultimately even by the consuming effort I had to make to do any little thing – like get up from a chair, pick up a cup of tea.

While Darlene eventually recovered from the worst of her symptoms described above, she continued to struggle with the severe pain, stiffness, and reduced mobility that many people with rheumatoid arthritis experience.

Yet Darlene never let her physical limitations stand in the way of living her dreams. She was one of the wisest, funniest, most joyful and vibrant human beings that I ever met, and she dedicated her life to relieving the suffering of others.

In my opinion, this is true health. Not boundless energy, or perfect digestion, or being able to run a marathon, or living until you’re 120, but the ability to live your dreams regardless of your circumstances.

Now I’d like to hear from you. How do you define health? What does it mean to you? How do you feel about defining health as “the ability to live your dreams”? Let us know in the comments section.

  1. Hello i wouldn’t be writing this if i where not desperate and wholly dissappointed by the health system. I was diagnosed with hyperthyroidism 13 years ago; i had radioactive iodine. more than a half-stable thyroid is a chronic constipation that has generated into a cathartic colon hell after years of taking senna laxatives. Doctors never warned that it could damage my evacuation functions, I spend daily about 6-8 hours trying to go to the bathroom. The problem now is not just the constipation but the permanent urge to go to the bathroom ingrained in my intestine. I hope someone can help me. I have tried reducing the laxatives but i still have the urge to go all the time to the bathroom. Is there anyone who has overcome this same problem? Any recommendations, I am desperate. Thank you.

    • Hi John,

      sorry to hear of your circumstances. I wanted to give your comment a bump so somebody more informed than I might reply. Hope you find help soon.

    • John. I dont have help, but I want to thank you for posting. I also am hyperthyroid and Ive dumped 3 doctors so far who try to force radioactive iodine on me. I had not realized that “the urge” might be connected to hyperthyroidism, so thank you for that information. What I have learned is that my hyperthyroidism is really an autoimmune disease that affects the thyroid. (Graves Disease) Gut fixing protocols might help with your problem. I understand your desperation.

    • Dear Gloria, Please read “Wheat Belly Total Health” by Dr. William Davis. I had similar issues and this book was an answer to prayer, life changing!

  2. I really like this question, what is health because it forces me to pause and reflect. I have 2 answers: one is that it’s multifaceted and encompasses physical,mental, emotional and spiritual health, which is a common definition of wellness. But, I think it’s also much more personal than that. For example, with weight loss, I let my clients tell me what their ideal weight regardless of what the chart says. I have learned that it is rare that 2 people with the same height and even weight have the same target weight. I have concluded that someone’s ideal weight can be very subjective because it involves issues of attractiveness, self-esteem, wardrobe, etc.

  3. I thought these findings from a 2014 report on the Burden of Stress in America (NPR/Robert Wood Johnson /Harvard School of Public Health) were relevant to how changing your outlook and/or improving your coping skills can make a positive difference.

    While about a quarter of Americans report a great deal of stress in the past month, one in seven (14%) report that they had no stress at all. When asked why they had experienced no stress, two-thirds (66%) said it was due to their personality.

    About half said reasons include the steps they take to reduce stress (52%) and not having any stressful events in their lives over the last month (51%). About four in ten (43%) reported their religion or faith is a reason they were not stressed over the last month.

    Those who experienced no stress in the past month are much more likely than those who were under a great deal of stress to see themselves as having control over their stress levels.

    Nearly three-quarters (74%) of those who say they experienced no stress in the past month say they have a great deal of control over the stress in their life.

    Many of those dealing with stress do not see stress as always having only negative effects. A majority (67%) of those with a great deal of stress in the past month believe that, at some point, stress has had a positive effect on some aspect of their life. About four in ten (41%) say it has had a positive effect specifically on their work life.

  4. Thanks Chris for sharing both your personal story and those of others who have faced debilitating physical struggles. They are inspirational. In spite of their physical limitations, these people refuse to have a limited mindset and intentionally have decided they can be positive, useful, and help others.

  5. I tell my clients they have achieved health when they:

    -Can sprint up a trail at their fastest speed
    -Sleeps soundly and wakes up feeling refreshed
    -Is able to laugh, cry, sing, smile and feel the variety of emotions
    -Can handle stress and change their perspective on it
    -Has plenty of energy for physical, mental, spiritual and emotional journeys

    Of course, there’s more, but these are some of the best goals we aim for.

  6. This is a very touching article and a very important topic. How i define great health for myself and with my clients is ADAPTABILITY. Our ability to ADAPT and find meaning and success in changing circumstances (environmental stressors, biochemical stressors, emergencies, missed meals, etc) is the truest marker of health, to me.

  7. Great Question! I am one who has pondered this one most of my life. Losing my father to cancer when I was just 10 years old taught me not to take my health for granted. In less than a year he was gone. The question of health can be related to fitness yet I see both quite differently. Health is a qualitative state. It is difficult to quantify much like happiness. it is a state of subjectivity and definition for the person asking the question. it becomes relative to one’s inclination to become self-aware and journey to understand what optimal health means for them.
    if a person has a disorder or even disease but isn’t focused on the condition(maybe not even aware they have a condition), are they any less healthy than someone who knows they are having problems and is having a stressful time with it. These two scenarios may not be as opposite as one might think. To a certain extent one gets what one focuses on. A situation where you might encounter this someone suffering with short term memory loss. Some of those folks can be as happy as a lark because they are less aware of what’s going on but can feel joyful, surprised, curious and I dare say it, Happy.

    I bring the question of fitness into my comment because I have seen Athletes who smoke. They may be fit for what they do because they have trained and trained and we would still consider these people healthy because they are doing something others may not be able to do. From this point of view, fitness is more static. One can be fit to run a mile under a fast time but if they engage life in ways that could compromise that level of fitness, could we say they are healthy?

    So Health is very qualitative to me while fitness is more of a static state of readiness mostly what one has trained for and can possibly be even detrimental to long term health from overtraining and less than optimal life habits. In the case of the woman in Chris’s article (Darlene) through sheer survival focusing on what her life could be rather than focus on what was wrong or unfair (or dealt) speaks volumes to the determination each of us have inside to become aware and act upon that awareness to make life more of a masterpiece (a work of art) rather than learning and practicing helplessness. Nonetheless, everyone at some point in their life perhaps more often than we admit needs help and support. From that viewpoint the right kind of help and support can add to the quality of life. This too could also contribute to healthy life.

  8. Thanks for this inspiring article, Chris. Like other people have said, it came at a perfect time for me. Thanks for reminding me about Darlene Cohen’s book. Reading it was a turning point for me in dealing with my own chronic health issues years ago. I got it out yesterday and am rereading it and finding it very helpful again.

    Thank you Chris for your commitment to learning about healing and your generosity in sharing what you learn.

  9. As an elder aged 69, I am amidst the decline of my body. I thot it wouldn’t happen to me since my lifestyle has always been healthy — but I still have many issues to deal with. I have found “How to Be Sick” by Toni Bernhardt to be a valuable companion on the journey. Toni has had an incurable, undiagnos-able disease for 10-15 years; she is primarily at home, in bed — and yet she lives a full and joyous life!! Quite amazing to me! She uses Buddhist techniques to maintain her sanity and her delight in the life she has… the book is not just for Buddhists, for these techniques are, like mindfulness, useful to all of us. Like Darlene Cohen, who Chris mentions in his article, Toni teaches how to joyously live the life we’ve got instead of bemoaning the loss of the life we planned…..

  10. Thank you for exploring this concept. I believe it is all about Balance. All my life all I every wanted was joy as I spent a life of being depressed. Even though I suffered from a poor immune system due to removal of my thymus gland at 6 months of age it was the sadness, feeling lonely and useless that plaqued me. I learned about nutrition and choose an attitude of gratitude.

  11. I love your work and your website, Kris, but I must say that as a philosopher of medicine I find this approach to health quite wanting.

    First, you set up the two examples with the assumption that health and happiness or personal fulfillment must be linked. It is possible that they are, but they need not be. Person A can perfectly well be considered healthy, but just living a joyless life, possibly due to circumstances beyond his control. Person B could still be seen as ill, but who has found a way to give her life meaning. These examples just show that health and meaning don’t fully overlap.

    Now, if the retort is ‘well, but the focus is on being ‘truly’ healthy’, then I think we’ve set the bar too high. If the assumption behind Person A is that he may fit the picture of ‘absence of disease’ but he isn’t ‘truly’ healthy, then you are not trying to define health but some ‘ultimate’ or ‘optimal’ health. In that case, almost everyone will fail to be ‘truly’ healthy. This is precisely the problem behind the WHO’s definition.

    Health as the ability to live your dreams is an interesting, though very American, definition, but it still conflates health and happiness. If Person B has that ability, yet is physically a wreck, then saying she is truly healthy seems to distort precisely what is of interest to physicians. The problem is that this definition just doesn’t really do the explanatory work that is needed from such definitions. It does not explain why and how health and disease differ. Is the inability to live one’s dreams a sign of disease? This would be an odd implication.

    Maybe a better approach would be something along the lines of what the philosopher Georges Canguilhem claimed, which is that health is being robust and flexible in the face of changing demands. Here, health is about being able to tolerate variations, stressors, and establish new ways of functioning in a given environment. It is both being able to weather the minor storms and to meet and overcome new challenges. This view does more work than the ‘mere absence of disease’, but it also provides criteria which can be fleshed out physiologically and psychologically (and even psychosomatically).

    Maybe Person A is not happy with his life, but if he is mentally sharp and physically robust, then he is at least capable of finding ways to improve his lot in life (such as reading this great blog). Person B may be mentally robust, largely due to her social environment, but she is still diminished physiologically and in need of treatment (she has autoimmune disease after all). Saying that B is sick in no way undermines the importance of maintaining her social environment.

    I would think that as doctors, of course the aim shouldn’t be merely the absence of disease, but it also can’t be so vague or inclusive that we no longer have a clear idea what health is. If the aim is rather something along the lines of being robust and flexible, something which varies from person to person and even from situation to situation, then patients will be given the basis from which dreams can indeed be pursued, but they won’t be pathologized if they happen to be disagreeable individuals or if they are going through a rough patch, and they can seek the needed medical help even if their lives are filled with joy.

  12. I try my best to transcend physical shortfalls, but in the end, my mental well-being will always revolve around my sense of physical well-being first and foremost, as without vibrant health, life is meaningless. After all, I still live with the body I was given. A good social network is great, but it alone is not a panacea. There is no joy and the dreams are on hold if the body doesn’t function quite right, period. Transcending that 100% is not realistic, not something I have been able to do nor am I interested. I cannot separate myself from my body. I can try, but it never works that well because it’s like trying to fool yourself that you don’t have to live in the physical realm which I do. If I feel like hell, then I will go to the source to try and fix it, not run away and distract myself by wasting time doing things that do nothing to fix the underlying issue. If I feel great, then vice versa. I own the world and can accomplish anything, but take away my health, and I am useless. In the end, one needs BOTH a balance of physical and emotional well-being, not just one, to reach a true state of wellness. Those centenarians who claim they ate processed foods, smoked, drank, etc. and were happy are genetic anomalies who have adapted to handle those toxins unlike the rest of us. I don’t believe it was all because they live a stress-free, happy life.

  13. What a fascinating question – to me health is ‘no conscious thoughts about health’ plus resistance / resilience to the environment we live in.

    Suffering through long periods of extreme fatigue in my life meant I would have to regulate activites based on how tired I was or would be. Even after recovering my energy the psychological shodow of “will this leave me exhausted” lingered in my mind for a few years to come. These days I can just do and the thoughts of will this make me tired don’t enter my mind. If I over-do it a days rest is enough to recover. This to me is a major part of the meaning of health.

    Great topic, great article.

  14. Love this post. My homeopath told me that my problem was not what I was eating that was the problem…it’s what was eating me. Spent so many years experimenting on the perfect diet and obsessing and overthinking what to eat, which supplements to take, reading, researching, etc….that I could not see the forest for the trees. I have learned which foods make me feel poorly…but I have stopped the madness. I love to eat, love to cook, and focus on whole food and limit sugar. Still have my health issues…but no longer let the fear and anxiety of what if keep me from being present. Love your balanced approach…I am a fan.

    • Net, I too have started to limit my sugar intake. I have als been on a gluten/dairy free diet for months now. I am still experiencing some throat pain. When did you get to the point where you are now, length of time?

      • Susan, it was a series of years for me of trial and error…but my real progress began when I started seeing a homeopathic doctor in 2012 (who found Lyme) and at the same time found a MD that learned toward holistic medicine. He did a blood test for gut permeability and came back positive. He gave me recommendations, but it was only when I went totally grain free that I would say within 6 months time I was feeling so much better. Some results were immediate, some still linger but are manageable. But please don’t measure your progress by anyone else…that is a mistake I also made. Progress is the small victories only you will notice… then eventually others because it can change your outlook. My heart goes out to you….keep pressing on!

  15. Hello! Thank you so much for your writings! I’ve found them very encouraging 🙂

    The ability to live your dreams seems to be a great working definition of health. I’d like to argue, however, that continuing to create and chase dreams once some have been realized may be a good idea…I’ll have to think on that one for a while!

    Thanks again,
    Jessi

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