1.2 About Safety

Let’s start by reviewing an important question: Are there any health risks associated with laughter?

Maybe this is not a course for you, after all.
But then again, maybe it is!

Not What, How

Similar to other forms of exercise, the safety of laughter is determined by how it is practiced. While gentle laughter may be safe for most individuals, excessive or forced laughter can be harmful. It’s important to remember that laughter is about breathing, and breathing is essential to life, so it is not contraindicated.

Overall, laughter is universally well-tolerated, but caution is advised in patients with specific health conditions are way too many to list here, so here is how to make laughter safe and foolproof:

1. When in doubt, don’t do it. Don’t ask for trouble if you have any concerning medical condition(s). Before starting this or any other exercise regime, always get your doctor’s advice. If you choose to ignore this advice, you are doing so at your own risk;
2. Take it easy and enjoy everything you do. Respect your limitations. A smile is as good as a laugh if that is all that is available to you today;
3. No new pain! Avoid extremes. Stop if anything becomes painful or uncomfortable, even to the slightest degree. Always ask a medical professional before engaging in laughter or any other exercise regime when in doubt.
4. Breathing dehydrates. It may not be much, but considering that many people are chronically dehydrated, sometimes even a little can be too much. If you experience some heaviness in the head or mild to moderate headaches after laughter, that could be a warning sign. Always listen to your body. Be gentle next time. If you laugh more, drink more water.

What Science Says

A literary review of 67 years of research on laughter published in the British Medical Journal in December 2013 reviewed what modern science knows about its beneficial and harmful effects. They found one case of death by laughter. She was 50, schizophrenic, and was referred for polymorphic ventricular tachycardia (she had a history of heart problems) after Ziprasidone therapy (an antipsychotic drug known to increase mortality in people with dementia-related psychosis). After hearing a joke, she had intense, sustained laughter one day, collapsed, and could not be revived. (Read more about pathological laughter.)

More valid concerns were raised in that particular review against hearty and “intense side-splitting laughter” that can adversely impact certain people with pre-existing health conditions. However, the conclusion was unavoidable and predictable: “The benefit-harm balance of laughter is probably favorable.”

“The incidence of a heart attack while shoveling snow, for persons with impaired heart function, is alarmingly high,” says Dr. William Fry, professor emeritus at Stanford University, a man who has studied the health aspects of laughter for decades. “But unexpectedly and against logic, the incidence of heart attacks suffered while laughing is surprisingly low.”

Research carried out in December 2018 in a Kidney Dialysis Hospital unit in Melbourne, Australia, showed that a 30-minute Laughter Yoga session every two days for 30 days had no adverse effect on patients with extreme health conditions, quite to the contrary.

In short, common sense applies: Always take a safe approach and avoid extremes. Intense and forced laughter is neither helpful nor necessary. Beyond a certain point, the body stops producing happy hormones and becomes distressed. It is like everything else. You can’t overeat food even if it is healthy.

7 Core Contraindications

For those who want an exhaustive list, here are what I believe are seven clear and immediate contraindications to laughter. If you suffer from any health condition, that is…

• Complicated
• Advanced
• Acute
• Severe
• Unstable
• Uncontrolled
• Undiagnosed

…then you definitively must get written permission from your doctor before doing anything, including laughing, because technically, you are potentially seriously at risk and could die anytime.