Those circumstances that are necessary to be happy

People do not come to psychiatrists, or psychotherapists, in general, because they want to understand themselves better, or because they are looking forward to changing their lives. They come to treatment because they are feeling bad. Often, they feel anxious or depressed; but they can have other more specific variations on these feelings– by being paranoid, for example, or compulsive, or phobic. If these latter symptoms predominate, usually a specific diagnosis is made. These symptoms may represent a true mental illness, that is, an illness in the same sense diabetes is an illness. Sometimes such people are so ill, they are terribly unhappy, very much as anybody who has a devastating medical illness will be unhappy. Certain conditions can overshadow every other aspect of life and make existence miserable. The major psychotic disorders may fall into this group. Some people feel so bad and hopeless, they choose to kill themselves.

But there are others who are unhappy because of the way they live. Certain things are missing from their lives. If enough of these things are missing, no one can be happy. When they come to therapy, wanting to feel better, they have to be convinced that they need to change their lives—to fill in those empty spaces—an undertaking which is always difficult. Developing a better understanding of themselves helps to affect that change. Sometimes. Just understanding how someone got to be the person he/she is does not free that person automatically to become someone else. In order to change, patients are invariably asked to do things that make them uncomfortable and which may not even seem possible to them at first; but that change is what is required.

Most happy people have a number of things in common:

1. A stable relationship with someone, usually of the opposite sex. Not everyone who is single is unhappy, but without such an intimate relationship, more of a burden is put on other aspects of life. Work and friends become more important. When difficulties arise in those areas, there is no one person to turn to for understanding and solace.

2. Work. To a great extent we are defined by work. Upon meeting someone new, men– and women too– are often asked, first of all, about their work. Work need not be prestigious; but it should provide day to day satisfactions, sometimes simply in the social aspects of seeing the same people day after day. It is a chance to be with people and share interests and concerns. Work should have some career path in the background, even if it is vague. There should be some sense of working towards some greater success. But just the fact of getting up at the same time every day and leaving the house is important. When Freud talked about what made life meaningful, he said, “lieben und arbeiten,”—love and work.

3. Children. It is possible for people, especially women, to dedicate themselves completely to children, and then grandchildren. For most people, children are central to their concerns—to the various things they take pleasure in and worry about. Taking care of children occupies a lot of time. Involvement with them when they become adults is desirable, although not always possible. To some extent, other family, siblings perhaps, can substitute for a spouse and for children, but that sort of support requires being part of an unusually close family.

Is it possible for a bachelor or a single woman to be happy without a good job and without children? Yes. I know such people; but they are unusual; and usually they have friends or some over-arching purpose: helping people in some particular way, being a priest, or being an artist, perhaps.

4. Friends. Someone who is single and without children, and without a job also, must necessarily depend heavily on friends. If something goes wrong with a friend, such a person may feel devastated.

5. An overriding purpose. Some– very few—people manage to live contentedly by dedicating themselves to some particular pursuit. I have known such a man who was involved completely in reading about progress in chemistry, a subject that occupied him his entire life. I spoke with him the week before he died; and he told me his only regret in life was not finding out what was going to happen in a current line of scientific enquiry.

I do not think it is possible to be happy without any of these things. Most people have one thing or another in their lives, even when they are unhappy; but the fewer such supports they have, the harder it is to be happy. Sometimes such a patient will come to treatment complaining about being depressed. Naturally, this sort of distress will not be relieved by going on anti-depressants. People have to learn how to reach out for the kinds of things that make up all of life, however difficult that may seem to be at first. (c) Fredric Neuman 2012

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Fred Neuman, M.D. is the Director of the Anxiety and Phobia Treatment Center. After serving as Associate Director for 21 years, Dr. Neuman assumed the directorship in 1994. Educated at Princeton University and the NYU College of Medicine, Dr. Neuman specializes in the treatment of anxiety disorders. He is the author of the following books: Caring: Home Treatment for the Emotionally Disturbed, Fighting Fear: An Eight Week Guide to Treating Your Own Phobias, Worried Sick?: The Exaggerated Fear of Physical Illness, and Worried Sick? The Workbook. Dr. Neuman is also the author of numerous magazine and newspaper articles on the efficacy of Cognitive/Behavioral Therapy for the treatment of anxiety disorders. Dr. Neuman is a member of the American Psychiatric Society, The American Association for the Advancement of Science and the New York Academy of Science. Dr. Neuman is also the author of the following novels: "The Seclusion Room," Viking Press. "Maneuvers" Dial Press "Come One, Come All," "The Wicked Son," "Detroit Tom and His Gang" "Superpowers." All these books are available from Amazon.


  1. This post explains why so many are unhappy. Most people are either single or in an unhappy relationship! Millions are out of work, underemployed, or don’t find meaning in their work. A spiritual life and a positive attitude can change how we view the things we’re unhappy about. Even if we don’t have a loving partner, there are things we can do to uplift us. We can create meaning in our lives, a social life and supportive friendships, and find interesting hobbies, pastimes, or work. Foremost, we can become proactive, rather than feel like victims and be left with only regrets.
    Darlene Lancer, LMFT
    Author of Codependency for Dummies