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November 22, 2011
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Understanding Depression
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Get your copy of Understanding Depression

Depression is more than a passing bout of sadness or dejection, or feeling down in the dumps. It can leave you feeling continuously burdened and can sap the joy out of once-pleasurable activities. Effective treatment can lighten your mood, strengthen your connections with loved ones, allow you to find satisfaction in interests and hobbies, and make you feel more like yourself again.

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Giving thanks can make you happier

November kicks off the holiday season with high expectations for a cozy and festive time of year. However, for many this time of year is tinged with sadness, anxiety, or depression. Certainly, major depression or a severe anxiety disorder benefits most from professional help. But what about those who just feel lost or overwhelmed or down at this time of year? Research (and common sense) suggests that one aspect of the Thanksgiving season can actually lift the spirits, and it’s built right into the holiday — expressing gratitude.

The word gratitude is derived from the Latin word gratia, which means grace, graciousness, or gratefulness (depending on the context). In some ways gratitude encompasses all of these meanings. Gratitude is a thankful appreciation for what an individual receives, whether tangible or intangible. With gratitude, people acknowledge the goodness in their lives. In the process, people usually recognize that the source of that goodness lies at least partially outside themselves. As a result, gratitude also helps people connect to something larger than themselves as individuals — whether to other people, nature, or a higher power.

In positive psychology research, gratitude is strongly and consistently associated with greater happiness. Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships.

People feel and express gratitude in multiple ways. They can apply it to the past (retrieving positive memories and being thankful for elements of childhood or past blessings), the present (not taking good fortune for granted as it comes), and the future (maintaining a hopeful and optimistic attitude). Regardless of the inherent or current level of someone’s gratitude, it’s a quality that individuals can successfully cultivate further.

Research on gratitude

Two psychologists, Dr. Robert A. Emmons of the University of California, Davis, and Dr. Michael E. McCullough of the University of Miami, have done much of the research on gratitude. In one study, they asked all participants to write a few sentences each week, focusing on particular topics.

One group wrote about things they were grateful for that had occurred during the week. A second group wrote about daily irritations or things that had displeased them, and the third wrote about events that had affected them (with no emphasis on them being positive or negative). After 10 weeks, those who wrote about gratitude were more optimistic and felt better about their lives. Surprisingly, they also exercised more and had fewer visits to physicians than those who focused on sources of aggravation.

Another leading researcher in this field, Dr. Martin E. P. Seligman, a psychologist at the University of Pennsylvania, tested the impact of various positive psychology interventions on 411 people, each compared with a control assignment of writing about early memories. When their week’s assignment was to write and personally deliver a letter of gratitude to someone who had never been properly thanked for his or her kindness, participants immediately exhibited a huge increase in happiness scores. This impact was greater than that from any other intervention, with benefits lasting for a month.

Of course, studies such as this one cannot prove cause and effect. But most of the studies published on this topic support an association between gratitude and an individual’s well-being.

Other studies have looked at how gratitude can improve relationships. For example, a study of couples found that individuals who took time to express gratitude for their partner not only felt more positive toward the other person but also felt more comfortable expressing concerns about their relationship.

Managers who remember to say “thank you” to people who work for them may find that those employees feel motivated to work harder. Researchers at the Wharton School at the University of Pennsylvania randomly divided university fund-raisers into two groups. One group made phone calls to solicit alumni donations in the same way they always had. The second group — assigned to work on a different day — received a pep talk from the director of annual giving, who told the fund-raisers she was grateful for their efforts. During the following week, the university employees who heard her message of gratitude made 50% more fund-raising calls than those who did not.

There are some notable exceptions to the generally positive results in research on gratitude. One study found that middle-aged divorced women who kept gratitude journals were no more satisfied with their lives than those who did not. Another study found that children and adolescents who wrote and delivered a thank-you letter to someone who made a difference in their lives may have made the other person happier — but did not improve their own well-being. This finding suggests that gratitude is an attainment associated with emotional maturity.

Ways to cultivate gratitude

Gratitude is a way for people to appreciate what they have instead of always reaching for something new in the hopes it will make them happier, or thinking they can’t feel satisfied until every physical and material need is met. Gratitude helps people refocus on what they have instead of what they lack. And, although it may feel contrived at first, this mental state grows stronger with use and practice.

Here are some ways to cultivate gratitude on a regular basis.

Write a thank-you note. You can make yourself happier and nurture your relationship with another person by writing a thank-you letter expressing your enjoyment and appreciation of that person’s impact on your life. Send it, or better yet, deliver and read it in person if possible. Make a habit of sending at least one gratitude letter a month. Once in a while, write one to yourself.

Thank someone mentally. No time to write? It may help just to think about someone who has done something nice for you, and mentally thank the individual.

Keep a gratitude journal. Make it a habit to write down or share with a loved one thoughts about the gifts you’ve received each day.

Count your blessings. Pick a time every week to sit down and write about your blessings — reflecting on what went right or what you are grateful for. Sometimes it helps to pick a number — such as three to five things — that you will identify each week. As you write, be specific and think about the sensations you felt when something good happened to you.

Pray. People who are religious can use prayer to cultivate gratitude.

Meditate. Mindfulness meditation involves focusing on the present moment without judgment. Although people often focus on a word or phrase (such as “peace”), it is also possible to focus on what you’re grateful for (the warmth of the sun, a pleasant sound, etc.).


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Alcohol Use and Abuse
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Get your copy of Alcohol Use and Abuse

Nationwide, nearly one in 13 people over the age of 12 has a drinking problem. Millions more engage in risky drinking behaviors that jeopardize their health, relationships, productivity, and general well-being. This report explores the many factors to consider when deciding how much (if any) alcohol is safe for you. It also details the dangers of alcohol misuse, from drunk driving to chronic, life-threatening health conditions.

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Is beer really responsible for my “beer belly”?

Q. I am a healthy, active 39-year-old guy. I enjoy a beer with dinner most nights, and a six-pack most weekends. Over the past year or two, I’ve had to let my belt out, and now I’m letting out my pants. So here’s my question: is beer really responsible for my “beer belly”?

A. Whether it’s called a beer belly, a spare tire, the apple shape, or the middle-age spread, abdominal obesity is the shape of risk. Abdominal obesity is a health hazard, increasing the risk of heart attack, stroke, diabetes, erectile dysfunction, and other woes. Risk begins to mount at a waist size above 37 inches for men, and a measurement above 40 inches would put you in the danger zone. For women, the corresponding waist sizes are 31½ and 35 inches, respectively.

Despite the name, beer is not specifically responsible for the beer belly. Research from the beer-loving Czech Republic tells the tale. In a study of nearly 2,000 adults, beer consumption was not related to girth.

If it’s not beer, what is to blame? The culprit is calories; if you take in more calories with food and drink than you burn up with exercise, you’ll store the excess energy in fat cells. And unfortunately for men, their abdominal fat cells seem to enlarge more readily than the abdominal fat cells in women.

But although beer is not a special problem, it can add to abdominal obesity by contributing calories. In round numbers, a standard 12-ounce beer contains about 150 calories; a light beer, about 110 calories. For comparison, a 5½-ounce glass of wine or a 1½-ounce shot of hard liquor provides about 100 calories. Since all these beverages contain approximately the same amount of alcohol, you can see that regular beer does have extra calories — unless you count the mixers and olives.

— Harvey B. Simon, M.D.
Editor, Harvard Men’s Health Watch