We recognise hope when we feel it and when we need it but it’s hard to define and describe. Hope is all about imagining and reaching for a better future for ourselves. Hope is both an emotion and a way of thinking. We experience it in our brain but it comes from somewhere or someone outside ourselves. Hope is crucial in times of uncertainty, and in dealing with adversity. And unfortunately there’s plenty of that in the world at the moment.

Hope is not optimism, which is a belief that everything will work out. Hope is much more active, a feeling and a mindset that you have to work at in order to achieve your goals despite trying and extenuating circumstances. Hope has two systems of operation that work hand in hand, and both are necessary for hope to be an effective therapeutic tool at an individual and collective level. The emotional or feeling part of hope is a sense of trust, of caring and being cared for that comes from outside and is based on relationships and being connected to the world and life. The thinking part of hope involves having the will or agency to do something as well as a pathway for action, that is the knowledge of how to get to your desired outcome. In the case of uncertainty around a diagnosis of cancer or dementia, hope can come from many places outside yourself: your doctor, your friends, your family; but having the will to keep going, to hold on, and the way to get through it, with supports, treatment, interventions and meaning—all of this makes up the hope experienced that can sustain a person at a very difficult time in their lives.

We know that hope works for the brain and in the brain. If you experience hope in the face of adversity, your brain performs better, and you are more likely to make positive decisions regarding your health, such as adhering to medication and adopting healthier lifestyles in the face of chronic diseases.  Experiencing hope dampens the anxiety circuits in the brain, and when you feel less anxious, your brain function improves.

The flip side of hope is fear and sometimes fear and despair are easier to fall into than hope. Fear disempowers hope and paralyzes action by activating the anxiety and fear pathways in our brains. People over the age of 50 now fear a dementia diagnosis more than cancer and stroke and when fear erases hope, despair sets in. This was how people viewed cancer or ‘the big C’ 40 years ago. The attitude to cancer has changed dramatically over time because of the availability of pathways to intervention, care and treatment. This is the direction we need to continue to move in for dementia: towards a new republic of hope. I am convinced that creating a framework of hope around dementia is crucial if we are to address and overcome the negative attitudes that permeate society around dementia, its diagnosis and treatment.

While we often think of hope at the individual level, hope can be collectively experienced.  During the pandemic, we saw how the hope of a nation hinged on an evening briefing, and the importance of the careful articulation of pathways to action but also the sense of caring and trust embodied in those providing updates to the nation on air. Hope was important to us all when there was great uncertainty and fear during the periods of lockdown and our collective hope gave us the will to keep going during those unprecedented times. 

This will to keep going was a top of mind at Conversations on Hope, a recent gathering of Atlantic Fellows from seven equity-focused programs around the world, which explored how hope can drive individual, systemic and societal change. Tackling inequity in all its shapes and forms is not for the faint hearted and attendees emphasized the importance of connection to community in helping to sustain them and generate hope.

So, your brain operates more effectively, and you feel better, if you have hope when faced with adversity and uncertainty. But hope isn’t a given, you have to work at it, and connect outside yourself for it to happen and for it to be experienced in your brain.  Hope can be a powerful elixir for health: trust, caring and setting realistic goals aimed at wellbeing and quality of life can turn fear and stigma inside out. So whether you are facing serious illness, experiencing economic hardship, overwhelmed by or actively tackling the global inequities and challenges facing society, now, more than ever, we need hope to sustain us in a world that increasingly does not make sense.

This piece was written by Professor Brian Lawlor, Conolly Professor of Old Age Psychiatry and Site Director of the Global Brain Health Institute, Trinity College for the opinion section of the Irish Times and appeared on December 31st, and can be viewed here.

Source: Trinity College Dublin