Emotion, Wellbeing and the Neurological Disorders

Wellbeing is now a topic of substantial research interest, yet definitions emphasize health, happiness and the absence of illness. This implies that people with neurological conditions have limited opportunities for experiencing wellbeing. We argue that this is not the case. Here we summarize the neurobiology of emotional processing and wellbeing, and consider how this neural circuitry is compromised following neurological injury or disease. We then discuss how negative psychosocial sequelae associated with these conditions further compound dysfunction, ultimately reducing opportunities for wellbeing. We emphasize the role of individual differences in determining outcomes and, considering emerging work on neural plasticity, we introduce new initiatives that may help to promote wellbeing in these individuals. We conclude that the focus of wellbeing interventions should be expanded to include interventions with a brain-body focus, highlighting the role of the autonomic nervous system and the vagus nerve in particular – the primary nerve supporting the parasympathetic nervous system – as a structural link between mental and physical health. We also highlight a need to sustain positive change, drawing on behavioral change theory. Furthermore, and moving beyond an overly individualized psychotherapy or rehabilitation approach, we highlight the role of communities and environments within which people live, and illustrate the role of sociostructural factors that impact on wellbeing at multiple levels of scale. Overall, these insights provide opportunities for short circuiting the downward spiral of negativity, social withdrawal and inter-related mental and physical ill-health in the neurological disorders, laying foundations for innovative treatment interventions involving a variety of stakeholders.