Happiness is influenced by a complex interplay of various chemicals in our brain, particularly four key neurotransmitters, D.O.S.E or Dopamine, Oxytocin, Serotonin, and Endorphins. These chemicals, often referred to as "happiness chemicals," are responsible for creating feelings of joy, motivation, connection, and calm.

However, when there's a deficiency in any of these, it can significantly affect our mood, energy, and overall well-being. Let’s dive into what these four neurotransmitters are, how their deficiency impacts us, and how we can boost their levels naturally.

Dopamine: The Motivation and Reward Chemical

Dopamine is often called the "motivation molecule." It plays a major role in enabling motivation, learning, and the pleasure-reward system in the brain. When we accomplish something — whether it’s finishing a project, completing a workout, or achieving a goal — dopamine gives us that sense of satisfaction and determination to continue.

Deficiency Effects:

When dopamine levels are low, it can lead to procrastination, low self-esteem, lack of focus, and general fatigue. A person might feel anxious, hopeless, or experience mood swings because the brain isn’t getting the reward signals it needs.

Boosting Dopamine:

You can increase dopamine levels by setting and achieving small goals, exercising regularly, eating foods rich in L-Tyrosine (such as almonds, avocados, and eggs), and practicing mindfulness or meditation. Engaging in creative activities like writing or drawing also helps boost dopamine levels.

Oxytocin: The Bonding Chemical

Oxytocin is often referred to as the "love hormone" or "cuddle hormone" because it plays a major role in social bonding and trust. It’s released when we hug, touch, or engage in other forms of physical affection. Oxytocin fosters feelings of connection and emotional intimacy, making it essential for relationships, family bonding, and even team cooperation.

Deficiency Effects:

A lack of oxytocin can lead to feelings of loneliness, stress, anxiety, and difficulties in forming or maintaining relationships. Low oxytocin levels are associated with feelings of isolation and disconnection from others.

Boosting Oxytocin:

You can raise your oxytocin levels through physical touch, socialising, spending quality time with loved ones, and even engaging in activities like massage or listening to soothing music. Acts of kindness, such as helping others or volunteering, also help release oxytocin.

Serotonin: The Mood Stabiliser

Serotonin is responsible for feelings of well-being and contentment. It helps regulate mood, sleep, digestion, and even social behavior. People who have balanced serotonin levels often feel calm, confident, and emotionally stable. Serotonin is crucial in helping people feel valued and significant among their peers.

Deficiency Effects:

Low serotonin levels are linked to depression, low self-esteem, irritability, and mood swings. Individuals may feel overly sensitive to criticism, experience panic attacks, or struggle with social phobias when serotonin is deficient.

Boosting Serotonin:

You can boost serotonin by getting regular exercise, exposing yourself to sunlight, engaging in cold showers or massages, and practicing mindfulness. Simple activities like walking in nature, meditating, or doing yoga are also effective serotonin enhancers.

Endorphins: The Pain Reliever

Endorphins are the body’s natural painkillers. Released in response to stress, pain, or intense physical activity, they help alleviate discomfort and promote a sense of euphoria. Endorphins are what make you feel good after a workout or a hearty laugh, often referred to as the "runner's high."

Deficiency Effects:

Without enough endorphins, people may experience anxiety, depression, chronic pain, and insomnia. A deficiency in endorphins can make daily life feel overwhelming and physically draining.

Boosting Endorphins:

To boost endorphins, engage in laughter, exercise, and stretching activities. Eating spicy foods or dark chocolate can also stimulate endorphin production. Regular massage therapy and meditation are other ways to naturally elevate endorphin levels.

Could air pollution may do more than harm the lungs and heart? A new study has found that exposure to polluted air could trigger painful flare-ups in people living with rheumatoid arthritis (RA).

The study comes when evidence is mounting that environmental factors contribute significantly to autoimmune diseases.

About The Research

The study, published in the Annals of the Rheumatic Diseases, found that excessive exposure to air pollutants, particularly fine particulate matter (PM2.5), was associated with increased rheumatoid arthritis activity and a greater risk of flare ups.

Researchers say the findings suggest that improving air quality should become an important part of managing the chronic condition, alongside treatment, medications and lifestyle changes.

"Our findings highlight that environmental exposure, especially air pollution, may significantly influence rheumatoid arthritis disease activity and flare risk," the researchers said, noting that patients and clinicians should consider air quality as a modifiable risk factor.

Also read:

About Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease in which the immune system attacks healthy joints, causing pain, swelling, stiffness and, over time, permanent joint damage.

While genetics, smoking and infections have been recognised as risk factors, scientists are investigating how environmental pollutants may worsen the disease.

The latest findings are particularly relevant for countries such as India, where millions are exposed to unhealthy air for large parts of the year. Previous reports have already linked poor air quality in cities like Delhi to rising concerns over autoimmune diseases.

Also read: Severe COVID-19 Can Reactivate Dormant Viruses, May Fuel Long COVID Symptoms: Study

A flare is a period when rheumatoid arthritis symptoms suddenly worsen. During this time, people may experience:

• Severe joint pain and swelling
• Morning stiffness lasting longer than usual
• Fatigue and weakness
• Difficulty performing everyday tasks

Flares can last from a few days to several weeks and are often triggered by infections, stress, missed medications or other environmental factors.

Researchers believe tiny airborne particles like PM2.5 can enter the lungs and bloodstream, triggering inflammation throughout the body.

This inflammatory response may overstimulate the immune system, making rheumatoid arthritis symptoms worse and increasing the likelihood of painful flare-ups.

Also read:

Is There More Evidence?

The researchers emphasised that the study shows an association rather than proving that air pollution directly causes rheumatoid arthritis flares.

However, the consistent link suggests reducing exposure to polluted air may help lower the chances of flare-ups in high-risk individuals.

Experts advise patients to continue prescribed medications, constantly monitor local air quality, avoid outdoor activities during periods of severe pollution when possible, and discuss symptom changes with their rheumatologist.

The findings add to a growing body of research linking air pollution with autoimmune diseases.

Earlier studies have suggested that long-term exposure to pollutants may increase the risk of developing rheumatoid arthritis, while the new research indicates polluted air may also worsen symptoms in people already living with the disease.

Commonly prescribed medicines for high blood pressure and heart disease could also help antidepressants work better, according to a new study by researchers at the All India Institute of Medical Sciences (AIIMS).

The research offers hope for people with depression whose condition is not adequately managed with standard antidepressants.

About The Study

The study found that certain cardiovascular medications, when taken along with antidepressants, may improve the brain's response to treatment, potentially making clinical depression treatments more effective.

The findings establish a foundation for repurposing common medicines to improve mental health treatment. The researchers stress that larger clinical trials are needed to validate the study before it can be included in standard depression treatments.

"Our findings suggest that some drugs already being used to treat hypertension and heart disease may have the potential to act as adjuncts to antidepressant therapy," the AIIMS research team said.

They also said that the strategy could particularly benefit patients who do not respond to antidepressants well.

Also read: NBA Star Kevin Love Says Robin Williams Changed How He Sees Depression; Here's Why Symptoms Often Get Missed

How Can The Findings Help?

Even though depression affects hundreds of millions of people worldwide, almost one-third of patients do not receive adequate relief from their first antidepressant.

Even when medications work, they often take several weeks to show results. This has led researchers to explore more ways to improve treatment outcomes, especially for mental health issues.

Repurposing existing medicines is considered an attractive strategy because their safety profiles are already well understood, potentially reducing the time and cost needed to bring new treatment options into clinical practice.

Also read: Mental Health Crisis In Israel Military: Why Suicides Among Soldiers Are Increasing?

How Could Heart Medicines Improve The Efficacy Of Antidepressants?

Antidepressants, including selective serotonin reuptake inhibitors (SSRIs), are among the most commonly prescribed medicines for moderate to severe depression. They work by changing the levels of neurotransmitters like serotonin in the brain, helping regulate mood over time.

However, individual responses may vary widely, and many patients end up needing multiple treatment approaches before achieving any relief.

While the exact biological mechanisms are still under investigation, researchers believe that some cardiovascular drugs may have an effect on pathways associated with inflammation, blood flow to the brain, or nerve signaling, all of which are increasingly play a role in depression treatment.

The researchers noted that these medicines are not intended to replace antidepressants. Instead, they could eventually be used alongside standard treatment to improve its effectiveness in some patients.

Also read: IIT Delhi, AIIMS Develop First Hindi Music Therapy for Stroke Patients: How Survivors Find Their Voice

Word Of Caution

Experts caution that patients should not start or stop blood pressure or heart medications in the hope of treating depression without clinical supervision.

More clinical studies are required to identify which cardiovascular drugs offer the greatest benefit, which patients are most likely to respond, and whether the combination remains safe over long-term use.

The AIIMS study could pave the way for a cost-effective strategy to improve depression treatment by giving a new role to medicines that are already widely available.

Why looking beyond the obvious can save lives.

A 50-year-old woman recently came to my clinic seeking a second opinion.

For weeks, she had been treated for asthma. She was using inhalers regularly, yet her cough persisted, and her breathlessness continued to worsen, even while resting. Something about her story didn't add up.

A simple chest X-ray revealed the real problem: a massive pleural effusion, a large collection of fluid surrounding the lung and preventing it from expanding normally. Further evaluation confirmed the underlying cause, lung cancer that had spread to the pleura, the thin membrane lining the lungs.

Her symptoms were genuine. The diagnosis, however, was not asthma.

When Common Symptoms Hide Serious Disease

Cough and breathlessness are among the most frequent reasons people visit a doctor. In most cases, the cause is something common, such as asthma, allergies, or a respiratory infection.

But common symptoms do not always point to common diseases. The key is recognizing when the clinical picture no longer fits.

If symptoms:

• Persist despite appropriate treatment
• Continue to worsen or behave unexpectedly
• Are accompanied by warning signs such as unexplained weight loss, persistent chest pain, fever, or coughing up blood

Then it is time to pause, reassess, and investigate further rather than simply changing medications.

In this patient's case, inhalers could never have relieved the pressure caused by fluid around the lung. Nor could they have treated an underlying tumor. The delay didn't change the diagnosis, but it delayed the answers, appropriate treatment, and the opportunity to plan the next steps.

Lung Cancer Is No Longer Following the Old Rulebook

For decades, lung cancer was largely associated with older men who smoked heavily. That picture has changed.

In our practice, we diagnose approximately two to three new cases of primary lung cancer every three months, and nearly 40% of these patients are women or individuals who have never smoked.

Increasingly, we are seeing:

• Younger patients with no history of smoking
• Women diagnosed with adenocarcinoma; a subtype often seen in non-smokers
• The growing influence of air pollution, occupational exposures, genetics, radon, and biomass fuel exposure

If we continue to associate lung cancer only with smoking, we risk missing a significant proportion of patients who need timely diagnosis.

Three Important Lessons

1. Treat the Patient, Not Just the Diagnosis

Asthma should not become a permanent label simply because someone has a cough or wheeze.

When symptoms fail to improve within a few weeks of appropriate treatment, it is important to step back, reconsider the diagnosis, and investigate further.

2. Never Underestimate Simple Investigations

A chest X-ray remains one of the most valuable first-line investigations.

In just a few minutes, it can identify pneumonia, tuberculosis, heart failure, pleural effusion, lung masses, and many other conditions that require an entirely different treatment approach.

Even in an era of advanced imaging and artificial intelligence, the fundamentals of clinical medicine remain indispensable.

3. Earlier Diagnosis Creates Better Opportunities

When detected early, lung cancer is often more treatable and offers significantly better outcomes.

Even in advanced disease, timely diagnosis can make an enormous difference. Procedures such as draining pleural fluid, initiating targeted therapy, immunotherapy, or palliative treatment can greatly improve both symptoms and quality of life.

When Should a Persistent Cough Raise Concern?

Seek medical evaluation if you experience:

• A cough lasting longer than three weeks
• Breathlessness that is new, worsening, or occurring at rest
• Chest pain, unexplained weight loss, persistent fatigue, or coughing up blood
• Symptoms that do not improve despite inhalers or antibiotics
• Significant exposure to smoking, second-hand smoke, air pollution, biomass fuel, workplace chemicals, or a family history of lung cancer
• Persistent symptoms deserve proper evaluation, not repeated assumptions.

I often remind my patients that the body rarely sends repeated signals without a reason.

A persistent cough or unexplained breathlessness should never be dismissed simply because it resembles asthma. While asthma is common, it is only one of many possible causes.

Artificial intelligence can generate a list of potential diagnoses within seconds. But medicine is about more than identifying possibilities. It requires listening carefully, examining thoughtfully, choosing the right investigations, and connecting the clinical clues.

The woman who came to me was looking for reassurance.

Instead, she received something far more important: a correct diagnosis, a clear treatment plan, and the opportunity to move forward with certainty.

Because every cough is not asthma. And every breath deserves an explanation.

(By Dr. Sachin Kumar, Director – Pulmonology & Critical Care Medicine, Sakra World Hospital, Bengaluru)