Can gratitude lead to increased happiness and improved well-being?

The bottom line:  Taking time out of your day for gratitude can lead to improvements in mood, sleep, and overall well-being.

Most of us are accustomed to saying “thank you” throughout the day, but can we use the sentiment behind this simple phrase to improve our lives?
According to the Oxford Dictionary, gratitude is defined as “the quality of being thankful; readiness to show appreciation for and to return kindness”. Gratitude is generally felt towards someone or something outside the self; it can be to another person, a religious figure or even the cosmos. Taking time to appreciate things/people in our lives may make us feel good in the moment, but some research shows its effects are far greater.
A survey study of patients with early stages of a chronic condition (asymptomatic heart failure), found that those who expressed more gratitude had better sleep, less depressed mood, less fatigue, and even had decreased markers of inflammation. While these findings are impressive, we may naturally wonder if, instead of gratitude causing the positive symptoms, maybe the better sleep is what caused them to be more grateful; or perhaps those who are less depressed inherently express more gratitude? This is commonly referred to as a correlation vs. causation argument.
The best way to assess whether there is true causation is by implementing an interventional experiment; which is why this study series lead by gratitude pioneer, Dr. Robert Emmons, is the foundation of much of the gratitude literature.  According to the three studies published together, writing down things we are grateful for may play a significant role in our overall well-being. The series looked at both healthy undergraduate students, as well as patients with chronic neuromuscular disease. The participants were asked to fill out detailed weekly or daily questionnaires regarding mood, health behaviors, overall outlook on life, and physical symptoms.
The intervention groups were given questionnaires that ended by asking them to list up to five things they were grateful for. Controls varied in the three studies; they included listing hassles and annoyances, any impactful life events, social comparisons, and others not having to list anything at all.
In the first study, one that included 9 weekly reports, the grateful group was found to have a better overall outlook on life, fewer physical symptoms, and even spent more time exercising than those listing hassles/annoyances; however, there was no significant change in their mood. The second study was repeated using daily, instead of weekly, reports for two weeks. The grateful participants were found to have a significant increase in positive mood when compared to the hassles and annoyances group. There was, however, no change in exercise or physical symptoms, which the authors hypothesized was due to the shorter duration (two weeks vs. nine weeks).
The third and final study included three weeks of daily reports in the chronic neuromuscular disease group. The grateful group was found to have a significantly more positive affect, life satisfaction, optimism, and even felt more connected with others. They also reported better overall sleep and received higher positivity and life satisfaction ratings from their spouses.
The studies were limited in the lack of long-term follow-up and the overall subjective nature of self-reporting; however further studies have continued to show positive results.  One study has shown that expressing gratitude to romantic partners, and even to friends, increases the perceived communal strength in the relationship. Another study has shown that those who are more grateful have improved sleep quality due to increase positive thinking before bedtime.
If writing down and expressing things we are grateful for has the potential to improve our moods, life outlook, sleep, and relationships- what do we have to lose? Given the broad range of potential benefits, low cost, and lack of obvious side effects, a daily dose of gratitude should perhaps become part of everyone’s self-care routine.


  1. Mills OJ, Rewine L, Wilson K, Pung MA, Chinh K, Greenberg BH, Lunde O, Maisel A, Raisinghani A, Wood A, Chopra D. The role of gratitude in spiritual well-being in asymptomatic heart failure patients. Spirituality in Clinical Practice. 2015; 2 (1): 5-17
  2. Emmons RA, McCullough ME. Counting Blessings vs Burdens: An Experimental Investigation of Gratitude and Subjective Well-Being in Daily Life. Journal of Personality and Social Psychology. 2003; 84 (2): 337-389
  3. Lambert NM, Clark MS, Durtschil J, Finchman FX, Grahame SM. Benefits of Expressing Gratitude: Expressing Gratitude to a Partner Changes One’s View of the Relationship. Psychological Science. 2010; 21(4) 574–580
  4. Wood AM, Joseph S, Lloyd J, Atkins S. Gratitude influences sleep through the mechanism of pre-sleep cognitions. Journal of Psychosomatic Research. 2009: 66 (1): 43-8.
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Negean Afifi MD
Articles: 6

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