A great guffaw as therapy? You're having a laugh

So the idea that something free - in this case laughter - could actually help health might sound too good to be true. In fact, it might be anything but an early April Fool's gag ... Yet laughter, like exercise, increases endorphin levels. Read on to find out more

I don't know if you've heard, but the NHS is just a bit short of money. It's real, it's not going away, and it's nothing to laugh about. I spend hours of every day squeezing more out of my budget without compromising the care my patients get. So the idea that something free - in this case laughter - could actually help health might sound too good to be true. In fact, it might be anything but an early April Fool's gag.

There's ample evidence that regular exercise can boost your mood. In the short term, it increases production of endorphins, the 'feelgood' hormone. In the longer term, it boosts energy levels and improves sleep, wards off coughs and colds and cuts your chance of type 2 diabetes, heart attackstroke and osteoporosis - what's not to like? Yet when I start talking to patients with depression about the benefits of exercise on their mood, they look at me as if I'll suggest anything that will get them out of my consulting room and save my drug budget. Suggesting they have a daily dose of laughter is a step too far even for me.

Yet laughter, like exercise, increases endorphin levels. It also increases oxygenation of the heart and muscles. It can fire up and then cool down your adrenaline levels, leaving you exhilarated but soothed. It may also help relax your muscles, relieving some of the physical symptoms of stress.

Regular doses of laughter can help with the production of the body's own natural painkillers. This in turn can relieve muscle spasms, reducing the vicious cycle of pain, spasm and more pain found in some conditions affecting the musculoskeletal system. It's difficult to test for certain whether laughter improves your body's immunity to disease. However, there are strong associations between chronic stress and illness, and brain scan research suggests that regular laughter lowers activity in the nerve transmitters that 'light up' in stressful situations.

Of course, the more stressed you are, the less you feel you have to laugh about. But interestingly, the concept of forcing yourself to have fun lies at the root of a well-respected treatment for depression, 'behavioural activation'. Otherwise known as 'acting your way out of depression', behavioural activation recognises that depression often reduces our motivation to do things that give us satisfaction or make us feel good, leading to a vicious spiral of inactivity and low self-esteem.

The ideas behind behavioural activation are simple:

1) You make a diary of the things you are doing on a daily basis now

2) You make three lists of the things you would like to/should be doing, divided into 'necessary, routine and pleasurable'

3) You order these into one big list, ranging from the easiest to achieve (say, sitting down with a crossword for 15 minutes) to the most difficult (such as climbing Mount Kilimanjaro or changing your career). It's essential to mix up the routine and necessary and pleasurable to ensure they're all included

4) Starting with the easy end of the list, you take one activity at a time, spelling out what it is; where and how you will do it; who you'll do it with, if anyone; and what steps you need to complete it.

Success, as they say, breeds success. Achieving the first tasks on your list can spur you on to more, increasing self-esteem and combating the vicious spiral of negative thoughts and low self-esteem that makes depression so hard to cope with.

I'm not suggesting that everyone reading this blog is depressed - but most of us are stressed to some degree. Laughing at the expense of others isn't funny. But making time in your hectic schedule to seek out the lighter side of life could just be good for your health.

Dr Sarah is unable to provide medical advice or respond directly to questions concerning your health. If you have health concerns we recommend contacting your GP.