Lonnie Zeltzer, MD
July 28, 2022 / 5 mins read

We hear a lot about gratitude. But what is gratitude?

It is a state of noticing and appreciating people, experiences, and things around us that have value and meaning for us. It is a way of shifting our focus from worries, problems, and things that create stress in our lives to noticing what helps us feel good and connected to others, and to life in general.

Gratitude is a state of appreciation for experiences and people in our lives that make us feel good. Gratitude allows us to feel a sense of connection with people, animals, objects, and experiences. It is not only something we give to others, but having it enhances our receiving gratitude from others, as well.

We tend to think of health as the absence of disease, but we rarely think of it as a state of well-being. There have been many studies in the field of positive psychology documenting the healthful benefits of gratitude. Research shows that when we experience gratitude, there are both biologic changes in our brain as well as neurotransmitter changes in our nervous system.

Changes have been shown in the medial prefrontal cortex of the brain as well as changes in the neuropeptide called oxytocin. Oxytocin has been called the “tend and befriend hormone” because it is produced in large quantities in women during the end of pregnancy and during delivery. It causes breast milk production and expression, and promotes bonding between mother and infant.

There are other situations that increase our oxytocin, such as contact with animals and connection with others in healthful ways. Some early research showed that oxytocin levels may be higher in females. Perhaps that is why women tend to gather in groups to “just talk and hang out” while men enjoy being together engaged in some activity.

There is a research measure called the gratitude questionnaire that was used in a large study of college students who sought psychotherapy. The study divided the students into three groups:

  • Group 1 received psychotherapy alone;
  • Group 2 received psychotherapy, plus they were asked to keep a journal in which they wrote daily about their worries, fears, and emotions; and
  • Group 3 received psychotherapy, plus they were asked to keep a gratitude journal. The gratitude condition individuals also wrote letters expressing gratitude to others.

The study looked at outcomes at four weeks and twelve weeks after the conclusion of the intervention. Results indicated that the gratitude-writing group had significantly higher scores in a variety of mental health domains than either the group documenting their negative emotions or the non-writing, psychotherapy-only group. The higher scores were associated with overall better physical and mental health. Thus, focusing on recognizing, experiencing, and expressing gratitude was associated with overall enhanced well-being.

UCLA Distinguished Professor Dr. Emeran Mayer has a weekly blog with a focus on the gut microbiome and overall well-being, including scientific articles and recipes for healthful eating ( In this week’s blog, UCLA nurse practitioner Suzanne Smith talks about the power of gratitude and how to incorporate gratitude into one’s daily life.

Try noticing things in your life that you feel grateful for. There are exercises that can enhance gratitude and its benefits, such as the gratitude letter and the gratitude journal. Keep a gratitude journal for a week and see how you feel at the end of that week.