If your life is going great, you’re probably thankful for your good fortune.

And it’s logical to assume you have a calmer, happier and maybe healthier life than less fortunate folks.

But what if your life isn’t storybook perfect? Could finding things to be grateful for somehow boost your quality of life, including your mental and physical health?

It turns out, the answer is yes. And that’s not based on pie-in-the-sky wishful thinking or fanciful “woo woo” beliefs. A growing body of research shows that cultivating gratitude can improve physical and mental health.

A recent review of gratitude studies, published in the British Journal of Health Psychology, concluded that gratitude is far more than a platitude.

While more research is needed to pinpoint exactly how feeling gratitude influences body and mind, both biological and social influences appear to be at work.

For example, recognizing you have specific things in your life to be thankful for can lower the body’s stress responses and potentially help prevent hypertension, headaches and other health problems often caused or exacerbated by stress.

And being grateful for the positive aspects of life promotes cooperation and beneficial relationships, resulting in improved mental health, according to the American Psychological Association.

The brain reacts to gratitude
There's good evidence that gratitude promotes psychological well‐being.

But researchers at the University of Southern California (USC) Brain and Creativity Institute wanted to see what actually happens inside the brain when we feel gratitude.

For their research, they used an unlikely tool — personal stories of Holocaust survivors.

The USC researchers recruited 23 volunteers (most were in their 20s, with no connection to the Holocaust), who watched brief documentaries about the Holocaust and listened to recordings of Holocaust survivors recounting their experiences. Many survivors reported being sheltered by strangers or receiving lifesaving food and clothing and having strong feelings of gratitude for the help they received.

The study participants were asked to imagine they were persecuted during the Holocaust and how they would feel when someone helped and sheltered them. As the research volunteers visualized the gratitude-triggering scenario, MRI scans were conducted to map the resulting activity in their brains (Fox GR et al. 2015).

The USC researchers found that feelings of gratitude activated areas of the brain responsible for feelings of reward, moral cognition, and fairness (parts of the pre-frontal cortex and anterior cingulate cortex).

These findings may help explain why feeling grateful can promote a more positive, happier mood.

Heart health benefits from gratitude
In the late l950s, cardiology researchers identified what they dubbed "type A" behaviors that double the risk of heart disease.

Studies have continued to show these stressful traits — including hostility, super competitiveness, and a sense of time-urgency — are linked to greater risks for developing heart disease and to a higher risk of death in heart disease patients.

Paul J. Mills, PhD, professor of family medicine and public health at the University of California, San Diego, and his colleagues conducted a series of studies to see whether feelings of gratitude can do the opposite — improve cardiovascular health.

Their research, published by the American Psychological Association, found recognizing and giving thanks for the positive aspects of life can result in improved mental and physical health in patients with heart failure.

Mills and his research team looked for potential health impacts of gratitude and spirituality in 186 men and women diagnosed with heart failure for at least three months. All the research volunteers had stage B heart failure, meaning they had developed structural heart disease, often following a heart attack, and were not yet suffering from symptoms such as shortness of breath and fatigue. However, stage B patients are at high risk for progressing to the next stage of heart failure, where the risk of death is five times more likely.

Standard psychological tests were given to the research subjects and the results were compared to their scores on sleep quality, levels of depression, fatigue and markers of inflammation. The results showed the patients with higher gratitude scores clearly had less depression and better sleep.

"We found that spiritual well-being was associated with better mood and sleep, but it was the gratitude aspect of spirituality that accounted for those effects, not spirituality, per se," Mills explained.

Moreover, blood tests showed they had less inflammation in their bodies, too. That’s an important finding because inflammation can worsen heart failure. Chronic inflammation is linked to other forms of heart disease and many other health problems, including cancer, too.

Can a gratitude journal be an effective prescription for heart health?
Next, Mills and his research team looked to see if increasing gratitude by noting things to be thankful for in a journal might have health benefits.

For eight weeks, one group of heart failure patients wrote down three things they were thankful for each day in a journal, while another group of patients did not keep a journal.

All the heart failure patients continued to receive their regular medical care during this time. However, only those who kept the gratitude journals showed improvements that could help their heart health.

Tests showed those who wrote in the gratitude journals had reductions in circulating levels of several important inflammatory biomarkers. They also experienced improved heart rate variability (a measure of the variation in time between each heartbeat), which is associated with reduced cardiac risk.

Expressing your gratitude may improve the health of other people, too
If you appreciate someone who helps you or a co-worker who does a good job, your gratitude could be more powerful than you realize. It could improve the mental and physical health of those you thank.

A new study by Portland State University (PSU) and Clemson State University researchers found a positive relationship between expressed workplace gratitude and both physical and mental health.

Their research involved a group of Oregon nurses, whose profession is often considered a “thankless job” and is associated with a high rate of burn-out (Starkey AR et al. 2019).

The study found that when nurses were thanked regularly for their work, their job satisfaction improved and they were more likely to have better health — improved sleep, healthier eating habits and fewer headaches.

By preventing headaches and other stress-related symptoms, there were fewer sick days, and less need for replacement nurses, too, and that can impact the financial bottom-line of hospitals or any business.

Unsurprisingly, researcher and PSU professor of business Dave Cadiz, PhD, urges employers to create formal or informal opportunities for people to express gratitude.

The result, he notes, is that expressing gratitude can create a positive feedback loop that impacts you, the people around you and, in the long run, helps shape a healthier and happier community.

For more about research on gratitude, see 5 Ways – and 3 Good Reasons – to Live in Gratitude.


  • A Grateful Heart is a Healthier Heart. American Psychological Association. Accessed at https://www.apa.org/news/press/releases/2015/04/grateful-heart
  • Dickens L. Using Gratitude to Promote Positive Change: A Series of Meta-Analyses Investigating the Effectiveness of Gratitude Interventions. Basic and Applied Psychology. 2017 Accessed at https://doi.org/10.1080/01973533.2017.1323638
  • Mills PJ et al. The Role of Gratitude in Spiritual Well-Being in Asymptomatic Heart Failure Patients. American Psychological Association. 2015. Accessed at https://www.apa.org/pubs/journals/releases/scp-0000050.pdf
  • Mills PJ. Can Gratitude Be Good for Your Heart? 2017. Accessed at https://greatergood.berkeley.edu/article/item/can_gratitude_be_good_for_your_heart
  • O'Connell BH, Killeen-Byrt M. Psychosocial health mediates the gratitude-physical health link. Psychol Health Med. 2018 Oct;23(9):1145-1150. doi: 10.1080/13548506.2018.1469782. Epub 2018 Apr 29.
  • Schache K et al. Gratitude — more than just a platitude? The science behind gratitude and health. British Journal of Health Psychology. 2018. Accessed at https://doi.org/10.1111/bjhp.12348.
  • Starkey AR, Mohr CD, Cadiz DM, Sinclair RR. will Gratitude reception and physical health: Examining the mediating role of satisfaction with patient care in a sample of acute care nurses. The Journal of Positive Psychology, 2019; 1 DOI: 10.1080/17439760.2019.1579353
  • The Power of Gratitude in the Workplace: PSU Research Shows that Expressing Gratitude Improves Physical and Mental Health. PSU News. Accessed at https://www.pdx.edu/sba/news/power-gratitude-workplace-psu-research-shows-expressing-gratitude-improves-physical-and-mental 2019