Gratitude and Mental Health: On Thankfulness and Depression

Last year, my client bawled at the Thanksgiving table. She reported being met with disapproval, and later being told that she had ‘upset the children’ (teens).

Gratitude is not a magic act. You can experience gratitude and other feelings simultaneously. It’s important to understand that you can experience feelings of sadness, anger, grief, anxiety, and loneliness alongside gratitude. A societal message is that just because something terrible happens in your life, that doesn’t mean you can’t also be grateful (look for the silver lining/it could’ve been worse/thoughts and prayers). But this rule applies in reverse. Just because you’re grateful doesn’t mean your negative emotions aren’t valid.

While practicing gratitude alone won’t “cure” depression, it does positively impact your life. Several studies have shown that mindfully practicing gratitude may diminish symptoms of mood and anxiety disorders OVER TIME. There are measurable benefits to practicing gratitude (see research from the Positive Psychology Center at the University of Pennsylvania ).

Gratitude is associated with:
better sleep quality
a greater likelihood of seeking help for health concerns
increased self-esteem
feeling more optimistic
improved relationships
greater emotional resilience during difficult times
higher self-efficacy expectations (your own belief that you can do well at a task)

Focusing on positive aspects of your physical and mental health requires mindful decisions. While depression can do a number on both your body and mind, it is possible to exercise your gratitude muscle to strengthen it. Gratitude takes time, practice, and self-compassion.

How to have gratitude when you’re depressed:
Recognize that it’s okay if you struggle with feeling grateful. Your feelings are neither “good” nor “bad.” Feelings just are. So if you find yourself feeling ungrateful, it’s okay. You’re not doing anything wrong. Attempting to focus on things that foster gratitude is a practice.

Authenticity
This isn’t a fake-it-till-you-make-it situation. Pretending you’re grateful when you’re actually not will just serve to bury your feelings. You don’t need to force yourself to think about your life in a way that isn’t true to you.

Stones Across the River
If you’re struggling to find things you’re authentically grateful for, then try to think little over big. In my practice, I have termed this stones across the river. What are the things on a daily basis that get you across the rapids without tumbling in?

Validation of the Gestalt
The German term gestalt means an overall wholeness that is bigger than the singular elements contained within. Practice validation alongside gratitude. Don’t think you must choose gratitude or being upset. Think of it as feeling distressed/anxious/depressed and you also practice gratitude.

Comparisons
Your experience can exist at the same time as others who “have it worse” and be equally worthy of receiving help. This doesn’t mean you’re ungrateful. Some of my clients are told they should have more gratitude, that low moods stem from a cup-half-empty perspective. Being compared to others who have less can make a depressed individual feel guilty and even more depressed.

Practice Self-Compassion
A client told me something that has stayed in my head for years; “that gratitude actually contributed to the pain because, while I could intellectually see all of this goodness before me, I was incapable of enjoying it.” The dichotomy was heart-wrenching for him and led to further self-bashing.

Connect with others
When learning how to practice gratitude when depressed, you have to make a conscious effort to spend time with others who are important to you. Doing so can help you combat loneliness and depression. Obviously, it would be best to spend time with supportive people, not people who drain or criticize you.

Focus on something that doesn’t hurt
Depression can manifest itself as physical discomfort. You may get headaches, body aches, or stomach pain. One client sleeps with her soft, favorite blanket and wakes up to her dog staring at her and joyfully wagging his tail. It gets her going for the day. Another looks in the mirror and notices that her eyebrows are perfect. A third gets a good morning text from a dear friend every day. Focusing on things that feel loving and nurturing IS gratitude.

Write an ingratitude list
Yes, an ingratitude list. Sometimes, separating out the things you’re not grateful for can help determine what you are grateful for. Do you do things out of sheer obligation? Do you have piles of possessions or clothing you don’t use? When you determine the things you’re ungrateful for, remove them, so you don’t have to feel ungrateful every time you see or do them.

Focus on when you experienced kindness
Depression and gratitude may not seem to go together, especially when you have feelings of self-depreciation and worthlessness. Perhaps you feel like nobody does anything for you because you don’t feel worth it right now. Try to visualize a time when someone extended a kindness to you and made you feel special or happy. Think about mentors, family members, friends, or even the kindness of strangers. Focusing on these memories and being grateful for them can help you feel a sense of love and worth. See also The Kindness of Strangers.

Do something nice for someone
Most people are familiar with the term “pay it forward.” Finding the energy or desire to do something nice to help someone else can be challenging. But helping others is a great mood-booster. The gratitude of others can help us be kinder to ourselves.

Neural Pathways Take Time
Gratitude affects the parasympathetic nervous system and can rewire neural pathways through breathing exercises, meditation, cognitive-behavioral therapies, and mindfulness strategies. This takes time and practice.

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