• While practicing gratitude can have many benefits, it has only a modest effect in reducing depression and anxiety.
• Proven treatments like cognitive behavioral therapy are a better option.
• Self-help measures like exercise and mindfulness may be helpful for mild depression and anxiety.
• Self-help should not take the place of seeing a mental health professional.

Previous research has found that gratitude — the act of affirming and appreciating the good in one’s life — can have many benefits.

It has been strongly linked to several indicators of psychological well-being, including positive affect, life satisfaction, extroversion, and forgiveness.

In addition, there’s been some evidence that it might be helpful for depression and anxiety.

However, a new meta-analysis published in the Journal of Happiness Studies suggests it might not be all that effective as a treatment for these conditions.

What the researchers found

The analysis included data from 27 individual studies dealing with gratitude and its ability to reduce depression and anxiety symptoms.

Altogether there were 3,675 people who took part in the studies.

Study participants were asked to perform a variety of gratitude exercises.

Some of the most common ones selected were the “three good things” exercise and the “gratitude visit.”

The former asks the person to list three things that went well that day and then to reflect upon those things.

The latter involves writing a thank you letter to someone who has made a difference in your life and then reading it to them.

In many of the studies, a control group was asked to perform an exercise that was unrelated to gratitude.

For example, college students might have been asked to write about their class schedule.

The studies varied quite a bit in duration, according to lead author David Cregg, a doctoral researcher at The Ohio State University.

Some lasted only one day, whereas others had the participants perform the exercise for up to 8 weeks, Cregg said.

Cregg and Dr. Jennifer Cheavens, an associate professor of psychology at The Ohio State University, analyzed the effects of gratitude on depression and anxiety symptoms.

This was done immediately following the gratitude exercises and at follow up.

Most follow-up periods occurred 1 month after the intervention, although some extended as long as 6 months.

Cregg said he and his research partner found that the effect both immediately after and at follow up were small.

In addition, it didn’t seem to make any difference whether the intervention occurred over a longer amount of time.

What we can take away from this study

While there was some small benefit to performing the gratitude exercises, the study authors said it wasn’t a strong enough effect for it to be recommended as a treatment.

Cregg suggests it would be better for people to use proven treatments such as cognitive behavioral therapy (CBT) instead.

“However, our study only looked at depression and anxiety symptoms,” said Cregg. “It’s possible gratitude exercises may carry other benefits, such as improving your relationships, but we did not examine that specifically.”

“There could be potential for a gratitude intervention to be an add-on to CBT, but we would need to do more research first. I would suggest that if someone is going to engage in a gratitude exercise, do it because it’s inherently valuable for you, not because it will boost your mental health in some way,” concluded Cregg.

Joshua Klapow, PhD, clinical psychologist and associate professor at the University of Alabama at Birmingham, who wasn’t a part of the study, also cautions that we should be careful to not misunderstand the results of the study.

“If you are looking to treat your anxiety or depression, do not rely on gratitude practice alone. However, if you are looking to become more optimistic, have a more positive outlook on life, be happier, and increase your well-being, then… gratitude practice can be a very effective tool,” he said.

Klapow agreed with Cregg’s recommendation of therapies like CBT.

“Cognitive and behavioral interventions that focus on belief systems and testing of distorted beliefs, along with strategies for activation for depression, and relaxation and psychophysiological regulation for anxiety, all are likely to be more effective than gratitude practice alone,” he said.

“But… degree of symptom severity, and whether or not there is a clinical diagnosis, is critical to know,” he said.

Klapow added, “For clinical diagnoses of major depressive disorder and anxiety disorders, the use of medication in conjunction with cognitive behavioral interventions are both standard and effective.”

He further suggested that practicing gratitude could be used as an adjunct to professional treatment.

Other self-help measures

When symptoms are milder and no medical diagnosis exists, Klapow suggested that there are several self-help measures that can be useful for depression and anxiety symptoms.

For depression, he advised:

• exposure to natural daylight 1-2 hours a day
• daily exercise
• routine sleep patterns with 7-8 hours of sleep a day
• social interaction on a daily basis

For anxiety symptoms:

• diaphragmatic breathing
• progressive muscle relaxation
• mindfulness strategies, controlled meditative breathing, and yoga
• daily exercise
• routine sleep patterns of 7-8 hours of sleep a day
• reduction of caffeine intake

“All of these methods have been documented to reduce depressive and anxious symptoms,” said Klapow. “However, they are not a substitute for mental health interventions for the treatment of anxiety disorders and depression.”

The bottom line

Practicing gratitude provides only modest benefit in helping depression and anxiety symptoms.

Other treatments with proven effectiveness, such as cognitive behavioral therapy and medications, are better alternatives.

However, gratitude does have other benefits and may, with more research, prove to be a useful tool alongside therapy and medications.

Self-help measures may be useful for milder cases of depression and anxiety, but should not take the place of evaluation and treatment by a mental health professional.

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