To some people, the word "neurotic" can conjure images of a certain type of psychotherapy: Woody Allen types splayed out on long divans, with Freudian therapists sitting coolly behind them, asking vague questions about Oedipal complexes. Psychology's come a long way since Freud, though, and today, this scenario feels a bit like an anachronism — and so, in some ways, does the term. In 1994, the condition of "neurosis" was dropped entirely from the Diagnostic and Statistical Manual, psychiatry's encyclopedia of mental disorders. Since then, it has been largely replaced by more specific terminologies, like social-anxiety disorder, obsessive-compulsive disorder, and panic disorder.
But neuroticism does live on in personality research, where it is considered one of the "Big Five" traits, along with openness, conscientiousness, agreeableness, and extraversion. And these days, neuroticism — which is tested by one's responses to statements like "I get irritated easily," "I worry about things," and "I get stressed out easily" — is enjoying a little bit of rebranding: Studies have shown that it can be potentially beneficial, leading to greater creativity, quicker cognitive processing, and increased motivation (that last one is due especially to neurotic people's keener sense of negative outcomes). And in a study published earlier this year in Psychological Science, a team of researchers went even further, arguing that, if the circumstances are just right, neurosis may be the personality trait that helps extend your life.
It's still a fairly counterintuitive claim. Creativity and motivation aside, studies have also shown that on the whole, negative thinking — the hallmark of a highly neurotic person — negatively influences health, whereas happiness and upbeat thinking are positive influences. Since neurotic people have, by definition, more psychological distress, and psychologically distressed people tend to have more life-shortening health issues like depression, it would seem logical that neurotic people would therefore live shorter lives than non-neurotic people.
But that argument didn't entirely convince Catharine Gale, a professor of cognitive epidemiology at the University of Southampton and the lead researcher of the Psychological Science study.
"Previous studies have been inconsistent," Gale tells me. "Some of them have found that being high in neuroticism increases your risk of dying prematurely; others have found that it's been slightly protective."
To make sense of this inconsistency, Gale and her co-authors tapped into the United Kingdom Biobank, a massive set of health data collected between 2006 and 2010 from over a half million U.K. residents aged 37 to 73. In addition to analyzing subjects' neuroticism (based on a personality questionnaire) and self-reported health, the researchers also looked at specific health behaviors (smoking, drinking, diet, exercise), physical attributes (BMI, blood pressure, grip strength), cognitive function (reaction time, mental processing speed), diagnosed diseases (self-reported), and socioeconomic status (education, assets, postal code). On average, each person's data stretched over six years and three months; nearly 5,000 participants died during the data-collection period, which gave their information an especially strong statistical power.
Pooling all this information, the researchers noticed something odd: The people who rated their own health poorly also tended to have higher levels of neuroticism and a lower likelihood of premature death.
At first, Gale thought that these more-neurotic-longer-living people had perhaps been simply taking better care of themselves, thereby extending their lives.
"Initially we looked at the obvious things for what might explain this decreased mortality, like health behaviors," she says. "Did people behave differently with things like smoking, drinking, exercise, and diet if they had poor self-rated health and high neuroticism?" But that wasn't the case. In fact, it was the opposite: More-neurotic people were less likely to eat enough fruits and vegetables or exercise, and more likely to smoke and drink alcohol either every day or nearly every day.
So, on to the next possibility. Maybe, Gale reasoned, the link between higher neuroticism and a lower risk of death was due to an issue of timing. Perhaps people were already ill at the time their personalities were measured, affecting both their neuroticism scores and their likelihood of premature death during the data collection. But that didn't line up, either.
Eventually, she concluded that neurotic people may just be going to their health-care providers more often. "The only thing we could think of was whether people were more vigilant about their health," she says. "Perhaps they saw their doctor more regularly when they had symptoms they were worried about, and that might lead to earlier diagnoses of serious illnesses, particularly in the case of cancer."
There's no data in the Biobank to support or disprove this theory, but Gale believes that, for now, it's the most plausible hypothesis. "We don't know that that's the protective mechanism, but certainly we found that one aspect of neuroticism is that regardless of how you rated your health, it seemed to be protective of health," she says.
And other research backs up the link between neuroticism and increased attention to one's health. A study published in 2010 in the journal PLOS One, for instance, found that people with higher neuroticism tended to seek out health care more frequently. And a 2000 study in the Journal of Personality examined the concept of "healthy neuroticism," or the idea that more-neurotic people tended to be more vigilant about taking care of themselves.
The irony there, as Gale's research revealed, is that in most ways — diet, exercise, drinking, and smoking — more-neurotic people tend to take worse care of themselves. But they do, perhaps, know when it's time to see a doctor, which could be the all-important difference. And while Freud's idea of neurosis may no longer apply to our modern understanding of psychology, he did seem to be ahead of his time when it came to certain aspects of the trait. "Neurotics complain of their illness," he once wrote. "But they make the most of it."
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