Tomorrow we take a day to give thanks. Thanksgiving serves as a reminder of the power of gratitude. Gratitude refocuses your attention so you notice good things around you, acting as an instant mood-booster decreasing stress hormones and increasing feel-good chemicals in the brain. If you’ve been following us on social media, our providers have been sharing what they’re grateful for all month long in the hopes of inspiring others to start their own gratitude practice.

Gratitude has been linked to many beneficial outcomes such as improving symptoms of depression and anxiety, and more. In a 2009 National Health Institute study subjects who showed more gratitude overall had higher levels of activity in the hypothalamus. This is important because the hypothalamus controls a huge array of essential bodily functions, including eating, drinking and sleeping. This is one of the biggest reasons for the positive impact of gratitude. As we explored in a previous blog post, sleep is utterly essential for health and wellbeing. Gratitude improves sleep, which then leads to decreases in symptoms of anxiety and depression.

What is gratitude?

Realizing that other people are worse off than you is not gratitude. Gratitude requires an appreciation of the positive aspects of your situation. It is not a comparison. Sometimes noticing what other people don’t have may help you see what you can be grateful for, but you have to take that next step by actively expressing appreciation for what you have.

How does gratitude work?

One explanation is that gratitude practice loops the brain into what’s called a “virtue cycle.” The brain naturally falls into confirmation bias, meaning it looks for things that prove what it already believes to be true. Confirmation bias, combined with the release of dopamine from the happy feelings gratitude brings, keeps the brain in a continual state of looking for more things to be grateful for.

To explore the precise neurological effects of gratitude, a 2017 study of college students who sought mental health counseling divided the students into 3 groups. One group was asked to write gratitude letters in addition to their counseling, while one group wrote complaint letters, and the control group received counseling only.

After one month, an fMRI scanner was used to measure brain activity while people from each group did a “pay it forward” exercise. The individuals were regularly given a small amount of money by a “benefactor.” In return, this benefactor only asked that they pass the money on to someone if they felt grateful. The participants then decided how much of the money, if any, to pass on to a worthy cause.

In order to distinguish donations motivated by gratitude from donations driven by feelings of guilt or obligation, the participants were asked to rate how grateful they felt toward the benefactor, and how much they wanted to help each charitable cause, as well as how guilty they would feel if they didn’t help. they were also given questionnaires to measure how grateful they are in general.

When people felt more grateful, their brain activity was distinct from brain activity related to guilt, and the desire to help a cause. More specifically, when people who are generally more grateful gave money to a cause, they showed greater neural sensitivity in the medial prefrontal cortex, a brain area associated with learning and decision making. This suggests that people who are more grateful are also more attentive to how they express gratitude.

Most interestingly, when we compared those who wrote the gratitude letters with those who didn’t, the gratitude letter writers showed even greater activation than usual in the medial prefrontal cortex when they experienced gratitude in the fMRI scanner. This is striking effect was still evident three months after the letter writing began. This indicates that simply expressing gratitude may have lasting effects on the brain. Practicing gratitude may help train the brain to be more sensitive to the experience of gratitude in the future, and this could contribute to improved mental health over time.