It is true. Life kills. If you fear death, then rephrase the questions “how can I add years to my life” into “how can I add life to my years?” Nobody knows exactly how many people have died from laughter, and regardless of how many that it’s a number that is infinitesimally small compared to how many benefit from laughter.
A literary review of 67 years of research on laughter published in the British Medical Journal in December 2013 unearthed only one case of death by laughter. She was 50, schizophrenic, and was referred for polymorphic ventricular tachycardia (she had a history of heart problems) after Ziprasidone therapy (an antipsychotic drug known to increase mortality in people with dementia-related psychosis). She had intense, sustained laughter one day after hearing a joke, collapsed and could not be revived. For the record, this is why pathological laughter can be dangerous. People with these symptoms just can’t control themselves and fall into excess, or distress.
More valid concerns were raised in that particular review against hearty and “intense side-splitting laughter” that can adversely impact certain people with pre-existing health conditions. The conclusion however was unavoidable and predictable: “The benefit-harm balance of laughter is probably favorable.”
“The incidence of heart attack while shoveling snow, for persons with impaired heart function, is alarmingly high,” says Dr. William Fry, professor emeritus at Stanford University, a man who has studied the health aspects of laughter for decades. “But unexpectedly and against logic, the incidence of heart attacks suffered while laughing is surprisingly low.”
May I suggest you always take the safe approach and avoid extremes of any kind. Intense and forced laughter is neither helpful nor necessary. Beyond a certain point the body stops producing happy hormones and shifts into distress. It is like everything else. You can’t eat too much food even if it is healthy.
Before I suggest a comprehensive list of contraindicated conditions to laughter for those of you who are interested (I can summarize them all in seven words), first consider this: Life is deadly and statistics are formal. Five out of five people do die, eventually.
More seriously, laughing does increase intra-abdominal pressure and I have no doubt that quite a few of the 12,000+ dis-eases known today genuinely don’t do well at all with it, but listing them all would take far too much time. Whatever you would say will always be either too much or not enough, and focusing on what could harm people would be counter-productive in the context of what we are trying to achieve in laughter programs.
Does Laughter Have Contraindications?
Yes. Laughter is contraindicated for people suffering from advanced (bleeding) piles and hemorrhoids or any bleeding tendencies in any part of the body, any acute symptoms of cough, any kind of hernia, cold and fever, epilepsy, heart disease with angina pain, incontinence of urine, persistent cough with breathlessness, severe backache, uncontrolled high blood pressure, within three months of a major surgery, and way too many other conditions to list here. If in doubt first ask your doctor if it’s OK for you to laugh.
No. Laughter is about breathing, and breathing is not a contraindication to life. Research carried out in December 2013 in a Kidney Dialysis Hospital unit in Melbourne, Australia, showed that a 30-minute Laughter Yoga session every two days for 30 days had no adverse effect on patients with extreme health conditions.
It depends. Are you using force or being gentle with yourself and respectful of your own limitations?
In summary: Laughter is universally well tolerated, but caution is advised in patients with certain concerning health conditions. In clear text: Laughter has no brain. Use your own and in doubt ask your primary healthcare practitioner.
Here is how to make laughter safe and foolproof:
- Follow your heart, but take your brain with you. If you have any kind of concerning medical condition don’t ask for trouble. Always get the advice of your doctor first before starting this or any other exercise regime. If you chose to ignore this advice, you are doing so at your own risk;
- Enjoy everything you do. Respect your own limitations, and take it very easy. A smile is as good as a laugh if that is all that is available to you today;
- No new pain! Avoid extremes. Stop immediately if anything becomes painful or uncomfortable, even to the slightest degree. When in doubt always ask a medical professional before engaging in laughter or any other kind of exercise regime. If you suffer from anything complicated, advanced, acute, severe, unstable or uncontrolled, then you should get written permission from your doctor before doing anything, including laughing.
- If you laugh more, drink more water. Laughing dehydrates. It may not be much, but considering that many people are chronically dehydrated, sometimes even a little can be too much. If you experience some heaviness in the head or mild to moderate headaches after laughter, that could be a warning sign. Always listen to your body. Be gentle next time…and drink more water!
-  Methodical Investigation of Risibility, Therapeutic and Harmful: narrative synthesis – http://lou.pm/bmj.
-  50 year old schizophrenic woman with a heart condition died after intense sustained laughter – http://lou.pm/dbl.
-  International Statistical Classification of Diseases and Related Health Problems 10th Revision: http://lou.pm/icd.
-  Pneumonol Alergol Pol. 2012;80 (4):339-42. http://lou.pm/wltb.
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