People who don’t give up on their goals (or who get better over time at not giving up on their goals) and who have a positive outlook appear to have less anxiety and depression and fewer panic attacks, according to a study of thousands of Americans over the course of 18 years. Surprisingly, a sense of control did not have an effect on the mental health of participants across time.

The study was published by the American Psychological Association in the Journal of Abnormal Psychology.

“Perseverance cultivates a sense of purposefulness that can create resilience against or decrease current levels of major depressive disorder, generalized anxiety disorder, and panic disorder,” said Nur Hani Zainal, MS, from Pennsylvania State University and lead author of the study. “Looking on the bright side of unfortunate events has the same effect because people feel that life is meaningful, understandable, and manageable.”

Depression, anxiety, and panic disorders are common mental health disorders that can be chronic and debilitating and put a person’s physical health and livelihood at risk, according to Zainal and her co-author, Michelle G. Newman, PhD, also of Pennsylvania State University.

“Often, people with these disorders are stuck in a cycle of negative thought patterns and behaviors that can make them feel worse,” said Newman. “We wanted to understand what specific coping strategies would be helpful in reducing rates of depression, anxiety, and panic attacks.”

Zainal and Newman used data from 3,294 adults who were studied over 18 years. The average age of participants was 45, nearly all were white, and slightly fewer than half were college-educated. Data were collected three times, in 1995 to 1996, 2004 to 2005, and 2012 to 2013. At each interval, participants were asked to rate their goal persistence (eg, “When I encounter problems, I don’t give up until I solve them”), self-mastery (eg, “I can do just anything I really set my mind to”), and positive reappraisal (eg, “I can find something positive, even in the worst situations”). Diagnoses for major depressive, anxiety, and panic disorders were also collected at each interval.

People who showed more goal persistence and optimism during the first assessment in the mid-1990s had greater reductions in depression, anxiety, and panic disorders across the 18 years, according to the authors.

And throughout those years, people who began with fewer mental health problems showed increased perseverance toward life goals and were better at focusing on the positive side of unfortunate events, said Zainal.

“Our findings suggest that people can improve their mental health by raising or maintaining high levels of tenacity, resilience, and optimism,” she said. “Aspiring toward personal and career goals can make people feel like their lives have meaning. On the other hand, disengaging from striving toward those aims or having a cynical attitude can have high mental health costs.”

Unlike in previous research, Zainal and Newman did not find that self-mastery, or feeling in control of one’s fate, had an effect on the mental health of participants across the 18-year period.

“This could have been because the participants, on average, did not show any changes in their use of self-mastery over time,” said Newman. “It is possible that self-mastery is a relatively stable part of a person’s character that does not easily change.” The authors believe their findings will be beneficial for psychotherapists working with clients dealing with depression, anxiety, and panic disorders. “Clinicians can help their clients understand the vicious cycle caused by giving up on professional and personal aspirations. Giving up may offer temporary emotional relief but can increase the risk of setbacks as regret and disappointment set in,” said Zainal. “Boosting a patient’s optimism and resilience by committing to specific courses of actions to make dreams come to full fruition despite obstacles can generate more positive moods and a sense of purpose.”

Article: “Relation Between Cognitive and Behavioral Strategies and Future Change in Common Mental Health Problems Across 18 Years,” by Nur Hani Zainal, MS, and Michelle G. Newman, PhD, of The Pennsylvania State University. Journal of Abnormal Psychology. Published online May 2, 2019.