The Profound Health Benefits of Being Grateful

By Dr. Joseph Mercola | mercola.com 

Story at-a-glance

  • The ability to experience gratitude to others is a fundamental feature of human cognition
  • Positive effects linked to gratitude include social, psychological, and physical benefits, which increase the more you make gratitude a regular part of your daily routine
  • Gratitude has a positive effect on psychopathology, especially depression, adaptive personality characteristics, positive social relationships, and physical health, including stress and sleep
  • Those who are grateful have even been found to have a better sense of the meaning of life by being able to perceive good family function and peer relationships
  • Two gratitude interventions that you can try in your daily life to promote gratitude include keeping a gratitude journal and expressing gratitude to others, such as by writing thank you notes

Gratitude is a simple practice that can have profound effects on your health and well-being. Its underpinnings are believed to be principles of cooperation that were pivotal in the development of human communication and social reciprocity, and the ability to experience gratitude to others is a fundamental feature of human cognition.1

The positive effects linked to gratitude include social, psychological, and physical benefits,2 which increase the more you make gratitude a regular part of your daily routine.

“The limits to gratitude’s health benefits are really in how much you pay attention to feeling and practicing gratitude,” noted neuroscientist Glenn Fox, Ph.D., a gratitude expert at the University of Southern California. “It’s very similar to working out, in that the more you practice, the better you get. The more you practice, the easier it is to feel grateful when you need it.”3

How Gratitude Changes Your Brain

Gratitude has distinct neurobiological correlates, including in brain regions associated with interpersonal bonding and stress relief.4 When Fox and colleagues elicited gratitude in 23 female subjects, via stories of survivors of the Holocaust, “ratings of gratitude correlated with brain activity in the anterior cingulate cortex and medial prefrontal cortex,” which are associated with moral cognition, value judgment, and theory of mind.5

Individual differences in proneness to gratitude are also linked to increased gray matter volume in the brain,6 and it’s possible that it elicits long-term changes in your psyche. Fox grew deeply interested in gratitude after his mother’s death from ovarian cancer. During her illness, he would send her studies on the benefits of gratitude in cancer patients, and she kept a gratitude journal in her last years.

In one example, 92 adults with advanced cancer engaged in mindful gratitude journaling or routine journaling. After seven days, those who kept a gratitude journal had significant improvements in measures of anxiety, depression, and spiritual well-being, such that the researchers concluded: “mindful gratitude journaling could positively affect the state of suffering, psychological distress, and quality of life of patients with advanced cancer.”7

“Grateful people tend to recover faster from trauma and injury,” Fox told The Pulse. “They tend to have better and closer personal relationships and may even just have improved health overall.”8 When he tried to find gratitude after losing his mother, what he experienced wasn’t a quick fix or an immediate route to happiness, but a way to make his grief more manageable in the moment.

As it turns out, grateful writing such as letters of gratitude is a positive psychological intervention that leads to longer-term changes in mental health. Among 293 adults who sought out psychotherapy services, those who engaged in gratitude writing reported significantly better mental health after four and 12 weeks than people who did not write or who wrote about their thoughts and feelings.9

Gratitude Boosts Health, Well-Being

Gratitude can be difficult to define, as it has elements of an emotion, a virtue, and behavior, all rolled into one. Robert Emmons, a professor of psychology at the University of California, Davis, and an expert on gratitude, defines it as a two-step process.

As explained in “The Science of Gratitude,” a white paper by the Greater Good Science Center at UC Berkeley, the two steps include “1) ‘recognizing that one has obtained a positive outcome’ and 2) ‘recognizing that there is an external source for this positive outcome.’”10

In this regard, the benefits of gratitude may be gleaned from the actions of other people or experienced in an internalized manner, such as when feeling gratitude about good fate or nature. In this way, gratitude is both a state and a trait.11

As a state, it’s based on a person’s ability to be empathic and elicit grateful emotions that promote prosocial behavior. As a trait, gratitude describes the practice of being grateful, noticing the little things in life, and appreciating the positive in the world and other people. Gratitude can be felt both from being helped by others and habitually focusing on the good in your life.

A study published in Clinical Psychology Review found that gratitude has a positive effect on psychopathology, especially depression, adaptive personality characteristics, positive social relationships, and physical health, including stress and sleep. What’s more, they noted that “the benefits of gratitude to well-being may be causal.”12

Fox also explained, “Benefits associated with gratitude include better sleep, more exercise, reduced symptoms of physical pain, lower levels of inflammation, lower blood pressure and a host of other things we associate with better health,”13 including improved resilience.

It’s likely that gratitude leads to benefits via multiple mechanisms, not only by improving life satisfaction14 but also by contributing to an increase in healthy activities and a willingness to seek help for health problems.15 Those who are grateful have even been found to have a better sense of the meaning of life by being able to perceive good family function and peer relationships.16

Gratitude Could Help You Sleep Better, Be Less Materialistic

Gratitude is known to facilitate improvements in healthy eating17 and benefits depression by enhancing self-esteem and wellbeing.18 Further, people who are more grateful tend to be:19

  • Happier
  • Less materialistic
  • Less likely to suffer from burnout

A 2021 study comparing gratitude and optimism similarly found that both traits were associated with:20

Lower heart rate and blood pressure Better sleep quality
More exercise Less stress
More positive expectations and reflections Greater feelings of appreciation toward others

Feeling gracious can help you sleep better and longer, too, perhaps by improving your thoughts prior to sleep. “The relationship between gratitude and each of the sleep variables was mediated by more positive pre-sleep cognitions and less negative pre-sleep cognitions,” according to a study in the Journal of Psychosomatic Research.21

Those who scored higher on measures of gratitude had better sleep quality and sleep duration and less sleep latency (the amount of time it takes you to fall asleep) and daytime dysfunction. Among adolescents, the simple practice of keeping a gratitude journal significantly reduce materialism while reducing the negative effect of materialism on generosity.22

Those who wrote down what they were grateful for donated 60% more of their earnings to charity, for instance. There’s good reason to teach children the importance of gratitude, too, as doing so can improve school performance and orient individuals toward a positive life approach.23

Positive Gratitude Interventions

Fox likens gratitude to a muscle that must be trained — something that you can practice and become better at over time:24

“I think that gratitude can be much more like a muscle, like a trained response or a skill that we can develop over time as we’ve learned to recognize abundance and gifts and things that we didn’t previously notice as being important. And that itself is its own skill that can be practiced and manifested over time.”

Rather than a magic bullet, Fox added, it’s the regular practice of being grateful that makes a difference: “You know, it’s like water cutting rock through a canyon,” he said. “It’s not done all at once, and it’s just steady practice is where you start to get things.”25 Two “gratitude interventions” that you can try in your daily life to promote gratitude include keeping a gratitude journal and expressing gratitude.

With a gratitude journal, you write down lists of what you’re grateful for on a regular basis. The behavioral expression of gratitude involves expressing grateful feelings to others, such as by saying thank you or writing gratitude letters, which you then read to the recipients.26

Showing gratitude to your partner is also a good way to boost your relationship. In a study of romantic partners, gratitude from interactions was linked to increased connection and satisfaction with the relationship, with researchers suggesting, “gratitude had uniquely predictive power in relationship promotion, perhaps acting as a booster shot for the relationship.”27 Emmons also shared tips for living a more grateful life:28

  • Remember hard times in your life, which remind you how much you have to be grateful for now. “[T]his contrast is fertile ground for gratefulness,” Emmons says.29
  • Appreciate what it means to be human by tuning into and appreciating your sense of touch, sight, smell, taste, and hearing.
  • Use visual reminders, including people, to trigger gratitude. This helps to combat “the two primary obstacles to gratefulness,” which Emmons cites as “forgetfulness and a lack of mindful awareness.”30
  • Make an oath of gratitude. Simply vowing to be grateful can increase the likelihood that you’ll stick to the behavior, so write a note “vowing to count your blessings” and post it somewhere where you’ll see it often.

If you want to get started today, keep a notebook by your bedside and make a point to jot down one or two things you’re grateful for each night before bed, and express gratitude to others often, such as writing quick thank you notes to friends.

Sources and References

Is Gratitude Good for Your Health?

By Summer Allen | Greater Good Magazine

After 15 years of research, we know that gratitude is a key to psychological well-being. Gratitude can make people happier, improve their relationships, and potentially even counteract depression and suicidal thoughts. But might the benefits of gratitude go beyond that? Could gratitude be good for your physical health, too?

While some studies have associated gratitude with a whole slew of benefits—from fewer aches and pains to improved sleep to better cardiovascular health—others have found more mixed results. More research is needed before doctors start giving out prescriptions for gratitude, but there’s good reason to suspect that gratitude has positive ramifications for your body.

“Gratitude…can be an incredibly powerful and invigorating experience,” says researcher Jeff Huffman. “There is growing evidence that being grateful may not only bring good feelings. It could lead to better health.”

Are grateful people healthier?

People of all ages and various nationalities who have more grateful dispositions report fewer health complaints than their less grateful counterparts. In one study, more grateful participants reported fewer health problems (such as headaches, gastrointestinal problems, respiratory infections, and sleep disturbances); in another, they reported fewer physical symptoms (including headaches, dizziness, stomachaches, and runny noses). Seems pretty clear-cut, right?

Not necessarily. One big question is whether gratitude causes good health or whether good health causes gratitude—or perhaps something else makes us both grateful and healthy. Indeed, while these studies suggest that grateful people are healthier, they could also suggest that people in poorer health are less likely to feel grateful. To tease apart this relationship, researchers have begun to explore whether people who engage in gratitude activities benefit from improved health.

Results from the GGSC’s own Thnx4 project found that participants who kept an online gratitude journal for two weeks reported better physical health, including fewer headaches, less stomach pain, clearer skin, and reduced congestion. These results are consistent with a 2003 paper published by Robert Emmons and Michael McCullough. In that study, college students who wrote about things they were grateful for just once a week for ten weeks reported fewer physical symptoms (such as headaches, shortness of breath, sore muscles, and nausea) than students who wrote about daily events or hassles.

Other studies, however, have found no health benefits from gratitude. In one study of middle school students, those who completed a “counting blessings” activity for two weeks didn’t report better physical health than other groups. And, in their 2003 study, Emmons and McCullough found that college students who kept daily gratitude journalsfor two weeks (rather than ten) didn’t fare better in terms of health complaints. Emmons and McCullough also found that people with neuromuscular disease who kept a daily gratitude journal for three weeks reported the same amount of physical pain as people who just filled out basic daily surveys.

Do these mixed results mean that keeping a gratitude journal or writing gratitude letterswon’t improve your health? Not necessarily. In the studies that failed to find health benefits, participants tried their gratitude activities for relatively short periods of time (two to three weeks). It could be that people who keep a gratitude journal for longer—say, multiple months—see stronger effects. Future studies will need to test this possibility.

Do grateful people sleep better?

Sleep is vital for good health. Inadequate sleep puts strain on the body and increases your risk of developing obesity, diabetes, cardiovascular disease, and other conditions. But anyone who’s struggled with insomnia knows it’s not always so easy to get enough z’s. Perhaps surprisingly, studies suggest that boosting your gratitude might be a relatively easy way to improve your slumber.

People with heart failure and chronic pain who are more grateful report sleeping better, despite their condition, than less grateful patients. In a study of 401 people, 40 percent of whom had clinically impaired sleep, more grateful people reported falling asleep more quickly, sleeping longer, having better sleep quality, and staying awake more easily during the day. This study also found evidence that more grateful people sleep better because they have fewer negative thoughts and more positive ones at bedtime.

You don’t have to be a natural gratitude guru to get good sleep. Evidence suggests that just performing gratitude exercises can help. In one study, people with neuromuscular disease who kept a daily gratitude journal for three weeks reported sleeping significantly longer at night and feeling significantly more refreshed than people in the control group. And in a 2016 study, women who kept a gratitude journal for two weeks reported slightly better daily sleep quality compared to women who performed other tasks.

While the evidence that gratitude practices benefit sleep is still preliminary, it’s strong enough to suggest that those of us counting sheep may want to try counting blessings instead.

Is gratitude good for your heart?

Gratitude feels heartwarming, and a growing body of work suggests that gratitude might help keep our actual hearts healthy, too.

This line of research began in 1995, when a study found that people feeling appreciation (an emotion related to gratitude) have improved heart rate variability, an indicator of good heart health. In a more recent study, women who kept a gratitude journal where they wrote about “previously unappreciated people and things in their lives” for two weeks ended up with lower blood pressure than those who wrote about daily events. Together, these and other results suggest that feeling gratitude can be good for healthy hearts.

What about people who already have heart problems? Recent studies by Paul Mills, Laura Redwine, and colleagues have probed the relationship between gratitude and health in people with Stage B, asymptomatic heart failure—people whose hearts have suffered structural damage but who show no clear outward symptoms. In their study of 186 patients, more grateful people reported better sleep, less fatigue, less depression, more confidence in their ability to care for themselves, and lower levels of systemic inflammation (an immune response that can have negative effects on the body, including the cardiovascular system). Patients who did daily gratitude journaling for eight weeks also showed decreased markers of inflammation at the end of the experiment.

These results are especially important given that both depression and sleep problems can worsen heart failure, and they suggest that a gratitude journal might indeed be a good addition to the care provided to heart patients.

Gratitude may even help patients recover from a heart attack. In the Gratitude Research in Acute Coronary Events (GRACE) study by Jeff Huffman and colleagues, more optimistic and more grateful people showed signs of improved blood vessel function two weeks—though not six months—after being hospitalized for heart attacks, compared to less grateful patients. Unlike optimism, though, gratitude didn’t seem to improve patients’ physical activity levels or their likelihood of being readmitted to the hospital. A follow-up study found that people who were more grateful or optimistic two weeks after their heart attack were more likely to follow their doctors’ recommendations six months later.

A 2017 study by Neal Krause and colleagues may point to yet another way that gratitude supports heart health. This study found that more grateful people had significantly lower levels of a protein found in red blood cells called hemoglobin A1c (HbA1c). High HbA1c levels are a “biomarker” associated with an increased risk of heart failure and non-fatal heart attacks. HbA1C has also been implicated in poor blood sugar control in diabetes, as well as chronic kidney disease, a number of cancers, and overall risk of death. (This study does not tell us that being more grateful directly affects one’s HbA1C level; it is just as likely that more grateful people engage in other positive health activities that in turn lower their HbA1C.)

Studies focused on identifying biomarkers like this are likely to be an important part of the future of research on gratitude and health. For example, as part of the Greater Good Science Center’s Expanding the Science and Practice of Gratitude initiativeNaomi Eisenberger is testing how a gratitude intervention can change the expression of genes related to inflammation, and Wendy Mendes is examining how experiencing gratitude changes biomarkers related to stress, resilience, and aging.

How might gratitude improve health?

Research on the relationship between gratitude and physical health is still developing, but studies so far suggest that there may be a connection. At the very least, it appears that more grateful people report feeling healthier and sleeping better, and they may even have some physiological markers of better health.

This raises a clear question: How is it that gratitude might make people healthier? Besides helping them sleep, gratitude may lead people to engage in other behaviors that help keep them healthy, like eating well and not smoking. Indeed, more grateful people report having healthier lifestyles, more grateful heart attack patients adhere better to their doctors’ recommendations, and college students who count blessings weekly for 10 weeks exercise significantly more than those who do other writing activities.

But there are other possible mechanisms. Gratitude’s stress-buffering ability and known power to increase happiness and positive emotions may have downstream positive influences on health. And gratitude’s role in fostering and strengthening social connections may be just as important. A growing body of research strongly suggests that our relationships with others can have tangible health benefits.

Still, there is a lot we don’t yet know. As we speak, researchers are exploring how different types of gratitude might have different benefits, whether the target of your gratitude makes a difference, and how gratitude could impact your body in real time.

Additionally, we still need more evidence to determine whether or not particular gratitude activities can improve specific health outcomes, how long these improvements last, and whether characteristics such as age, gender, religion, or personality can influence gratitude’s effects on health. But the evidence is mounting that gratitude may well be one of the fundamental pillars of a healthy lifestyle.

About the Author


Summer Allen, Ph.D., is a Research/Writing Fellow with the Greater Good Science Center. A graduate of Carleton College and Brown University, Summer now writes for a variety of publications including weekly blog posts for the American Association for the Advancement of Science. She is also very active on twitter: follow her, or just reach out and say hello!

Read more great articles at Greater Good Magazine.