Dopamine, oxytocin, and serotonin walk into a bar . . .
No, I’m not going to torture you with a bad joke. Instead, I want to discuss what gratitude does to the brain. Recent research findings are a call to action for a sense of thanksgiving every day, not just the fourth Thursday in November.
Let’s start with the basics on why giving thanks is good for the body and mind.
- An attitude of gratitude upgrades your hormones, from oxytocin to cortisol, and your neurotransmitters, including dopamine and serotonin. Recent data suggests gratitude provides behavioral and psychological “glue”—oxytocin is associated with promoting the glue that connects adults in meaningful relationships. Not surprisingly, gratitude increases blood flow and activity in the hypothalamus, the master gland that controls hormones.
- A pivotal 2003 study on being thankful concluded that, “a conscious focus on blessings may have emotional and personal benefits.” This renowned study, by psychologists Dr. Robert A. Emmons of the University of California, Davis, and Dr. Michael E. McCullough of the University of Miami, recommended using gratitude exercises as an outright psychological intervention, meaning that the subjects actively state gratitude in writing on a routine basis. This recommendation took hold: Much of the research on gratitude cites “gratitude intervention” as a form of treatment.
- Gratitude interventions have been shown to result in improved sleep, more frequent exercise and stronger cardiovascular and immune systems.
- Specific brain regions are affected as long as three months after expressing gratitude in writing. In a randomized trial, gratitude writing improved mental health in a university-based psychotherapy practice at four weeks, and at twelve weeks, compared with controls (psychotherapy only) or a group receiving psychotherapy plus expressive writing (i.e., their deepest thoughts and feelings about stressful experiences).
Here are some of the other data on how gratitude works on the body—and specifically your brain—to make you feel better.
“Gratitude, not understanding, is the secret to joy and equanimity.” – Anne Lamott
Happiness: Lowering Cortisol, Raising Serotonin
If you are thankful for something, you acknowledge that you are happy about it. Therefore fostering gratitude means cultivating happiness, which is associated with astounding benefits for our health. To that end, UC Berkeley’s Greater Good: The Science of a Meaningful Life, published a comprehensive summary of several studies, spanning 2000-2015, that link happiness with health benefits, namely: 
- reduced cortisol
- higher immunity and lower disease rates
In addition, gratitude increases the release of one of the “feel-good” hormones, serotonin, furthering its connection with happiness.
One recent study equated two weeks of daily reporting about gratitude with increased quality of sleep. By sleeping at least seven hours per day, you release optimal amounts of the hormone melatonin, which impacts overall health, and, conversely, a lack of melatonin is correlated with higher rates of breast and ovarian cancers. So, expressing gratitude leads to better shut-eye, which means a healthier you.
In 2013, Hong Kong researchers Ng and Wong published a study which, in part, examined gratitude’s effect on depression; its results showed a direct effect of gratitude on lowering depression.” Similarly, a 2015 study by the American Psychological Association concluded that a gratitude intervention leads to “a decline in stress and depressive symptoms over time.” In my New York Times bestseller The Hormone Cure, I recommend that patients exhibiting mild symptoms of depression might want to address the root cause instead of just taking a pill, and it turns out that affecting gratitude is one way to modulate feelings of depression.
Oh, Do That Again: Dopamine
Gratitude begets gratitude, in part because it releases the hormone dopamine, the brain chemical correlated with reward, pleasure, and satisfaction. Once you have the feel-good benefits of gratitude, you’ll want to keep feeling it. I think of dopamine as the “Oh, do that again” drug that your body makes, and in this case, the more you’re grateful for, the more you’ll want to feel grateful. Gratitude interventions create a positive feedback loop.
Making It Happen
How can you feel grateful on a regular basis? Create your own, DIY gratitude intervention. I practice a daily gratitude writing exercise. Whether you write down what you’re grateful for in journal format throughout the day, a daily list, or a weekly blog, the key is to make it routine. If writing is not your thing, you can think about what you’re grateful for and/or verbally express your appreciation. Here are a few of my favorite practices:
- Every day, I write my 4Gs:
- Gratitude list: What I’m grateful for
- Good things that happened in the past 24 hours
- Glitches that occurred, and
- Goals for the next 24 hours
- At the end of the day, I write in my smartphone “what went well” for just 5 minutes. I’ve written about this practice in the past after learning about it from University of Pennsylvania professor Marty Zeligman’s famous study. Read more about it here in a previous article based on an interview with my friend Dr. Jo Ilfeld PhD.
- When I’m driving and stuck at a stoplight, I count 10 things I’m grateful for on each of my fingers. Goes fast and it works!
The idea of an “attitude of gratitude” deserves major traction around the time of Thanksgiving. Backed by the scientific research on the positive benefits of gratitude, I urge you to write down what you’re thankful for, and suggest others at your table do it too. You’ll feel good not only from delicious food and warm company, but simply by the very act of expressing gratitude.
Now, it’s your turn. Let us know your favorite gratitude intervention. Has it helped your mental state? We’d love to know the details.
 Zahn, R., et al. “The neural basis of human social values: evidence from functional MRI.” Cerebral Cortex 19, no. 2 (2009): 276-283.
 Emmons, R., et al. “Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life.” American Psychological Association – Journal of Personality and Social Psychology 84, no 2 (2003): 377-389.
 Lomas, T., et al. “Gratitude interventions: A review and future agenda.” The Wiley Blackwell Handbook of Positive Psychological Interventions (2014): 1-19.
 Kini, P., et al. “The effects of gratitude expression on neural activity.” NeuroImage 128 (2015): 1-10.
 Wong Y.J., et al. “Does gratitude writing improve the mental health of psychotherapy clients? Evidence from a randomized controlled trial.” Psychotherapy Research 3 (2016): 1-11.
 Newman, K. “Six ways happiness is good for your health,” Greater Good Science Center, University of California Berkeley: 2015. http://greatergood.berkeley.edu/article/item/six_ways_happiness_is_good_for_your_health
 Jackowsa, M., et al. “The impact of a brief gratitude intervention on subjective well-being, biology and sleep.”Journal of Health Psychology 10 (Oct. 21 2016): 2207-17.
 Ng, M., et al. “The differential effects of gratitude and sleep on psychological distress in patients with chronic pain.” Journal of Health Psychology 18 no. 2 (Feb. 2013): 263-71.
 Cheng., S., et al. “Improving mental health in health care practitioners: Randomized controlled trial of a gratitude intervention.” Journal of Consulting and Clinical Psychology Vol. 83 no. 1, (2015): 177-186.
 Korb, Alex. The upward spiral: Using neuroscience to reverse the course of depression, one small change at a time. (2015: 194).