Our health care system, however, has yet to catch up to this connection. While it promotes preventive care, the emphasis has largely been on physical health, overlooking the significant influence of mental well-being on our overall health and vulnerability to illness. For people to truly be healthy, modern medicine must prioritize the prevention of mental ailments alongside physical ones.

What’s promising is that there are already some innovative approaches to build on. A collaborative care modelLinks to an external site. that includes mental health care managers results in better outcomesLinks to an external site. for depression, anxiety and substance useLinks to an external site.. A new Medicaid rule change allows reimbursement for professional consultationsLinks to an external site., which could help primary care doctors meet their patients’ needs by seeking the advice of their psychiatry colleagues. Mental health services are also being integrated intoLinks to an external site. some school-based health centers. We need more such efforts that aim to dissolve the barriers between physical and mental health.

Many people don’t bring up their mental health at their checkups. And many doctors don’t ask. Patients who do discuss their psychological state during their insurance-covered preventive exams may be served with an unexpected billLinks to an external site.. That these visits are often called annual physicals — emphasizing physical over mental ailments — is itself revealing

Fortunately, while poor mental health can worsen our physical states, the inverse seems true as well. Research suggests that interventions that boost mental health can enhance immune function, reduce inflammation and improve blood pressure and cholesterol.

People with symptoms of depression have a greater riskLinks to an external site. of developing coronary artery disease. Among patients who already have heart failure, those struggling with loneliness have a significantly higher death rateLinks to an external site.. Job stress has been linked to strokes.

For other patients who don’t first raise the idea, when I propose that their mental health could be worsening their physical symptoms, they no longer bristle at that suggestion.

“Do you think my symptoms could be from stress?” This is a question more and more of my patients have been asking me when seeking care for problems such as stubborn colds and aching backs.

The turning point came in 2022 and 2023, when Elon Musk bought TwitterLinks to an external site. (renamed X) and shed three-quarters of its employees, while Meta’s chief executive, Mark Zuckerberg, cut thousands of jobs during what he called “a year of efficiencyLinks to an external site..” GoogleLinks to an external site. and Amazon also conducted mass layoffs. Many of the companies blamed the pandemic for their overhiring during lockdowns as more people turned to digital services.

“From the day before Elon to the day after Elon, it pivoted overnight from ‘how do we improve H.R. management’ to ‘what are the fewest number of steps involved and the fewest number of people needed to pay our employees,’” said Mr. Treitler, who joined Twitter in 2021 and left in January 2023. He now works for the jewelry company Pandora.

“The tide has definitely turned against tech workers,” said Catherine Bracy, the founder and chief executive of TechEquity, a nonprofit that pushes for economic inclusion in the industry. “Companies have even more leverage to use against workers, and A.I. is supercharging that.”

But the shift in tech was compounded by the rise of generative artificial intelligence, which executives say has already made some jobs redundant. In January, Mr. Zuckerberg said he believed A.I. would replace some midlevel engineers this year. Mr. Musk went further, predicting last year that A.I. would eventually eliminate all jobs.

“The beer’s nice and cool,” the man said. “It’s lovely,” the girl said. “It’s really an awfully simple operation, Jig,” the man said. “It’s not really an operation at all.” The girl looked at the ground the table legs rested on. “I know you wouldn’t mind it, Jig. It’s really not anything. It’s just to let the air in.” The girl did not say anything. “I’ll go with you and I’ll stay with you all the time. They just let the air in and then it’s all perfectly natural.” “Then what will we do afterward?” “We’ll be fine afterward. Just like we were before.” “What makes you think so?” “That’s the only thing that bothers us. It’s the only thing that’s made us unhappy.”

“Then I’ll do it. Because I don’t care about me.” “What do you mean?” “I don’t care about me.” “Well, I care about you.” “Oh, yes. But I don’t care about me. And I’ll do it and then everything will be fine.”

Hills Like White Elephants

The frenzied, overstuffed marketplace of happiness optimization will never be able to fix the fundamentals of the human condition or bring a lasting kind of purpose to a new generation. There will never be easy or straightforward answers to our most profound questions of existence, and ranking emotions feels like a diminution of their awesome power.

“The biggest thing that I learned throughout all of my happiness range tracking,” Mr. Sandler said, “is that happiness isn’t the end-all goal that I was looking for.”

But feelings aren’t the same as other kinds of health metrics, like steps and heart rate and liver function. There is a great deal of disagreement on how even to measure happiness and fairly weak evidence that doing so makes us significantly happier. Less considered is the question: Could tracking happiness make us feel worse?

one year spent living in a van and visiting all 50 states. (He flew to Alaska and Hawaii.)

My biggest takeaway, though, is that much of my life consists of things that I don’t particularly want to do, like folding laundry and struggling with the wording of a paragraph. Being reminded that most of my life is obligatory does not exactly spark joy.