Years ago when I was distributing report cards to my homeroom students, I handed one filled with D's and F's to a boy. A friend seated nearby noticed the poor grades and that many teachers had selected the same word to assess the boy's performance in the comment section.

Unfamiliar with the word, the friend asked what apathetic meant. The recipient's response (and I kid you not): "I don't know and I don't care."

Talk about irony.

But today's column will not. Instead it will focus on something inherent in the anecdote: the boy's feelings toward school. Those feelings, as much as any lack of skill or innate intelligent, lead to the D's and F's.

Now medical research suggests that a similar attitude about your life can adversely affect your health.

While a finding like this is not surprising, the fact that little research has been done in this area is. That dearth of research is just one of the reasons why Nancy E. Mayo, a professor of medicine at McGill University in Montreal, and her colleagues studied middle-aged women who were stroke survivors.

What they found is what you'd expect: that those who didn't care didn't get better. But the unexpected discovery was the association between a feeling of hopelessness and the thickening of the carotid artery, the main blood vessel to the brain, a thickening that increases the incidence of stroke.

In fact, the study found that the women with the highest levels of apathy and hopelessness had triple the thickening in comparison to the overall average of the group of stroke survivors.

Somewhat related to Mayo's study is one published by Psychological Science in 2007 that studied the effects of neuroticism the tendency towards emotional ups and downs and excessive worrying on health.

In 1998, Purdue researchers gave 1,663 middle-aged men a test to determine their degree of neuroticism. By 2000, the men who scored above the 50th percentile on the test and whose condition progressively worsened another 20 percent were 40 percent more likely to have died than the men whose scores remained constant whatever the original score.

A Canadian study from 2007 found that job stress adversely affects already compromised health. In it, researchers kept tabs on 972 heart-attack sufferers for nearly six years.

What they found was that those who had jobs with a heavy workload and little chance to be creative or make decisions three characteristics of jobs with high stress levels were twice as likely to have had a second attack after resuming work.

But there's a positive twist to all of this. Just in the way that a poor mental state increases the odds of poor health, positive emotions seem to increase the odds of good health.

In work with those who have lived to be 100 years old, for example, clear patterns emerge.

Besides having parents who lived long lives most experts believe about 30 percent of longevity is a result of heredity an avoidance of smoking, and moderate-to-high levels of exercise, centenarians possess certain positive traits. According to Dr. Michael Berry, author of Defying Aging and 52 Baby Steps to Grow Young, they have a good sense of humor, possess good coping skills, and are optimistic.

Most experts believe these qualities are not helpful but essential to leading an unusually long life. According to a study released this summer, another benefit to positive emotions is that, regardless of their length, they increase life satisfaction.

Barbara Fredrickson, Ph.D. and Kenyan Distinguished Professor of Psychology in the University of NC's College of Arts and Sciences, says this of the study that she led. Finding happiness even in small doses "helps us build resources that can help us rebound better from adversity and stress, ward off depression and continue to grow."

Interestingly enough, the research found that building positive emotions did not necessarily mean that you needed to keep from having negative ones. What was important was to have a stable level of positive emotions daily, even on days when negative emotions surfaced.

But how do you cultivate positive emotions, especially in trying situations?

If you read Thigh Hat Hahn's books on Far East philosophy, you know that awareness is key, for it allows you to see things as they really are and not take negative events so personally. Consider one of Hahn's observations on mental health: "There is no way to happiness. Happiness is the way."

In other words, there is no recipe for happiness, nor is it some formula. A fulfilling job plus financial security plus a loving spouse does not equal happiness.

It is not a destination. Happiness is a mindset, a conscious decision, a way for you to be.

And if you do your best to be that way, it will not only aid your mental outlook but also bolster your physical health.