By Dr. Anthony Ellis, WCI Columnist
When I was about 50, I read a report called the World Happiness Index. I can’t remember exactly what led me to the site, but it's since published its 10-year anniversary report and it can be found here. The report says it “uses global survey data to report how people evaluate their own lives in more than 150 countries worldwide. The World Happiness Report 2022 reveals a bright light in dark times . . . ” so it may be worth a read if you are curious.
An excerpt: “While interest in happiness has mushroomed over the 10 years of World Happiness reports, the global average of national life evaluations has been relatively stable . . . remarkably resilient during COVID-19. For the young, life satisfaction has fallen, while for those over 60, it has risen—with little overall change. Worry and stress have risen—by 8% in 2020 and 4% in 2021 compared with pre-pandemic levels.”
But the report itself is not exactly what this post is about. In my early 50s (I’m almost 59 now), I was in a period of relative unhappiness and was looking for answers. I remember thinking after I read the report that you could cull the issue down to one question with a ranking on a scale of 1 to 10:
“Rank your happiness and life satisfaction on a scale of 1 to 10 with 1 being ‘I am completely dissatisfied and very unhappy with my life' to 10, being ‘I am completely satisfied and very happy with my life.'”
My initial score was a 6/10, and I remember being a little embarrassed to be below the average level of happiness in the United States, which was 6.8 at that time. I also remember several of the Nordic countries seemed to have about 10% “more happiness or contentment” than the US, clocking in at about 7.6. Despite the pandemic, these numbers have been relatively stable for the past decade. In 2022, the US average is essentially 7 (a bit better), and the range for the perennial “winners” such as Finland, Iceland, Denmark, Switzerland, the Netherlands, and Sweden goes from 7.4-7.8, still averaging about 10% better than the US.
Giving myself a below-average score pushed me to think more about why I was “less than average happy” despite a life that looked pretty good from drone height. I had just taken a job as an associate professor at a university that was developing a psychiatry residency training program. I liked teaching, and I was told I’d be doing a lot of lecturing and curriculum development on a consultation/liaison service. Soon after taking the job, though, the “lunch index” (how many days per week you actually get to eat lunch) declined from 100% to 20%, and the clinical service tripled in size. I was primarily doing evaluations on suicidal patients, psychosomatic patients, and delirious patients in the ICU. It was much harder than I anticipated.
I left the job after just over a year and went to work for a new employer, seeking a better medicine/life balance partly due to changes in the family related to my wife’s father dying rather suddenly. His unexpected passing seemed to “crack open” our minds as to mortality. The whole family was struggling with grief. My wife and youngest daughter were suffering so much that I was worried. I needed to be back closer to home, and I traded the 45-minute commute for a 10-minute drive. It was the biggest career and family challenge to date at that point in our lives.
I started asking patients about their happiness as part of their initial evaluations, and I asked friends and colleagues, as well. The answers were as interesting as my 6 on a scale of 10, and some were about as disappointing.
Results from the Happiness Index
Here's some of what I learned from my questions.
- Psychiatric inpatients ranged from 1 to about 5, averaging about 3/10. Remember, these are patients in a mental health crisis, frequently involving substance use disorders, and many were, frankly, suicidal.
- Psychiatric outpatients at a community mental health center ranged from about 3 to about 7, averaging about 5/10. These were generally patients who had reached some semblance of stability, and this shows what I call the “mental illness burden” dropping their average down from 7 to 5. That is quite a notable drop, and I began to think of 5 and under as more of a “Misery Index.”
- Friends and colleagues ranged from 6 to 9 with an average of about 7.5, suggesting that they were doing better than the US population at large. I surmised that this group was largely college-educated professionals and was stably employed. They had a relative lack of poverty and had a lower amount of “mental illness burden.”
It was interesting to me that I could never get a male that I knew or met out in public to answer higher than 8 on a scale of 10. None. Until, that is, I discussed the idea on The White Coat Investor in a prior post that talked about happiness, and Dr. Jim Dahle said he was a 9/10. Thank goodness the WCI CEO—the published author of several books and many finance courses; the mentor and financial guru; the one who is partially retired from Emergency Medicine; who has what appears to be a happy, healthy family, a long-term marriage, and an eight-figure retirement portfolio; and who reached financial independence before age 45—is a 9/10. There is hope (of course, no one really knows the life or struggles of another person).
So, why write a column about this topic?
I wanted to tell the story of how I went from a 6 to a 9 on the Happiness Index by formulating a plan, implementing the plan, and “getting my points back.” I had to think about the scale and why I gave myself a 6 to start before clawing my way back up. I was shooting for what seemed impossible at the time . . . a male with a score of 9/10. I had never met or spoken to one ever. At this point, I see one in the mirror most days.
More information here:
Figuring Out My Lost Points
Let me say that I did get answers of 9 on the scale from a dozen or so women (mostly from my work peers and among our friends) and even two perfect 10s. The two who answered a perfect 10 made little sense to me. One was the parent of a disabled child that had grown into adulthood but was still functionally a child and required constant care and supervision. I was very surprised when she said 10 on a scale of 10. She was a very positive-minded person who looked for things to be grateful for. She had made peace with her situation, and she leaned heavily on her faith.
The other perfect 10 was a ward clerk on an inpatient psychiatry unit who had been in that position for decades. She was/is a very positive person, is happily married, and was approaching retirement at that time. Liked by everyone, I had never heard her say a negative thing. She deeply cared about the patients and the care they received, and she was the best at that job that I have ever known. Later, she dropped her answer to a 9/10, showing that the number can change with circumstances. As she neared retirement, she had “one regret,” and this cost her that point. She said: “I think I could have done more with my work and career and should have completed more college.”
Back to my dismal and embarrassing 6/10. To explore this, I did what I told patients to do: ponder the question of, “Where did my points go?” I mean, how was I a 6 when I was happily married, had four healthy and accomplished children, was working a good job with better than average pay for my field, was healthy, had grown a seven-figure retirement portfolio by age 51, was living in a McMansion in a gated subdivision, and had access to making as much “side gig” money on weekends as I wanted?
The answer was partly that I was also a psychiatrist tasked with reducing anxiety, panic, depression, psychosis, mood episodes, and trauma-related symptoms of hundreds of patients, and I was working 12-20 “extra” weekends per year. I had been treating depressed suicidal patients daily for about 25 years. When I was running a consultation/liaison service, I was doing many consultations in ICUs on suicidal adolescents every week. I had to look hard at my situation and figure it out. I wanted to be a 9/10, like my most content female friends (and the male teller at my bank—who, at 8/10, told me he had recently married the love of his life, had purchased a house, and had been promoted).
What was going on during this decade? What happened to my points? Where did they go? What could I change? I did not want to be stuck at 6, one point above my own conception of a Misery Index. I remembered being an 8/10 for the bulk of 2001-2011 as the medical director of an inpatient geriatric psychiatry unit, so I was usually not so close to the Misery Index.
It became clear to me that I had lost at least two, or even three, points:
- One point gone: I wanted to retire from full-time work but saw no way to make it happen. In fact, I wanted to be done with all my work, but I had simply not saved enough. It turns out that, like many doctors and others in emergency and crisis work, I was getting burned out.
- Another point gone: I did not want to live in Michigan. I wanted to live in the mountains. I hated the winters, and I wanted out. In fact, I had wanted to move for quite a while, and my wife of 30 years and I had been scouting locations on many of our vacations. We went on a two-week trip to Peru in 2013, and we crossed a pass in the Andes at 16,000 feet midway on a trek that was more than 100 kilometers long with a guide, a cook, and a mule team. On that trip, I knew I belonged in the mountains. My wife luckily agreed.
- Another point gone: A mixture of circumstances and loss. My father-in-law who had been like a second father to me died suddenly in 2014. He was the loving patriarch of the family and was a mentor to me since my own father died more than two decades earlier. He was an excellent father, friend, and grandfather, and the ripple effects in the family were profound and difficult.
By this time, I had identified the problems and planned to get my points back, but another sad and life-changing event occurred in 2016 after we had helped my mother-in-law put her life back together following the death of her husband of over 50 years. This was the year of the stroke that changed the rest of her life and ours. I won’t go into detail, but suffice it to say that my wife’s retirement was focused on taking care of her mother with some help from the rest of the family.
The primary duty fell on my wife, and it was probably the hardest thing she had ever done. I worried about the effect of the stress on her. In fact, I thought it was actually killing her. I didn’t ask her the Happiness Index question at the time, but looking back, she said she was depressed. Depression and unhappiness are different; depression can harm your brain. Luckily, we all got through this time of loss, and my wife survived being the primary caretaker for her mother for about five years. She and the whole family got back to their usual selves.
Grief is like that. At least it lessens with time.
More information here:
How I'm Doing Now
Some lost points can be planned away:
- Put away more money. Learn more about investing.
- Find a place in the mountains and buy it.
- Do more side work to make it all happen.
- Take more vacations to “destress.”
- Sell the big house and move to a smaller house with fewer expenses.
- Some lost points are “just what is,” and they take time to resolve.
So, fast forward to 2022. I was 58 years old. We sold the big house in June 2022. I dropped to half-time employment in August 2022. We moved to our mountain home in warmer North Carolina that same month. We rested up from the move and refocused our energy on our marriage and our new lives. We have been to Mexico, Tamarindo (Costa Rica), Florida, and back up to Michigan to visit with friends. We have had friends visit. We toured five National Parks in the past month. We plan to go to Portugal and do a 100-kilometer trek (part of the Camino de Portugues) for our 30th anniversary.
I have all my points back and can say “I am completely satisfied and very happy with my life.” I can truly say that I’m a 9/10 now. Of course, happiness and contentment can be fickle and circumstances always change, but identifying your score and then asking “Where did my points go?” can be a starting point to getting to the best place you can be at any point in life. You imagine that, through magic, you have become an 8/10 and then you can take stock of what has to be different to “get your points back.”
For me, I dropped to half-time, moved to the mountains, and reconnected with nature. Of course, happiness is mostly internal. People say you must be happy from within and must not be dependent on external events, or your contentment will always blow in the breeze of good and bad fortune and circumstances. People also say that “parents are only as happy as their least happy child.” Luckily, my children are mostly plugging away at about 7/10 each these days. I wish an 8-9/10 upon them all. Maybe they can reach the elusive 10/10 one day.
One can also practice gratitude, use positive thinking, and cultivate a perspective that optimizes your chances of happiness. But then again, maybe that’s a topic for another column.
What will it take for you to be as happy and content as you can be? What is your Happiness Index score, and what are you going to do about it? Is it possible for you to reach a 9 or a 10? Comment below!
We know you visit The White Coat Investor to learn about investment strategies and planning, and we’ve always strived to teach financial literacy to physicians, high earners, and anybody else who finds their way here. But the COVID pandemic has also shined a light on physician burnout and its dangers. That’s why we feel compelled to run articles and columns like the one you just read—to make sure white coat investors stay mentally healthy. We know mental wellness is what leads to a long, fruitful financial life, and we’ll continue to run pieces like this because combatting burnout has become such an important part of everybody’s financial journey.