There’s no denying the number of challenges that can come with a chronic condition. Whether it’s the frustration of scheduling dozens of doctor’s appointments or the stress about exorbitant costs of medication, it’s easy to focus on the negatives. However, research shows that when you can find something to be grateful for—from the small things, like a cool breeze on a crisp autumn day, to what matters most in your life, like your friends and family—you can not only shift your overall mental health and mindset, but you might even be able to benefit other aspects of your health, too.

The Many Health Benefits of Gratitude

Generally speaking, the health benefits of gratitude have been well-documented in a number of ways. Research has shown links between gratitude and improved relationship skills, reduced aggression, and even better sleep.

But let’s back up for a second. What do we really mean when we talk about gratitude? And how does that translate to all of these different positive health outcomes?

“Gratitude is the process of noticing things, people, or experiences that you appreciate in your life,” says Elena Welsh, PhD, a licensed clinical psychologist who specializes in chronic illness and mental health. The idea is that, by inviting in more positive emotions, you also create space for positivity to manifest in other ways—such as your health.

Practicing gratitude can look different from person to person, but one common method is to simply journal or write a letter of gratitude (even if you never actually send it to anyone). For instance, in a study of nearly 300 adults undergoing mental health counseling, researchers randomly assigned people to one of three groups. One group was told to write a letter of gratitude to someone each week for three weeks, a second group was told to write about stressful thoughts and experiences, and a third group only received mental health counseling and didn’t do any writing activities. The results showed that, compared with those who wrote about stress or only received counseling, those who wrote about gratitude reported significantly better mental health a few weeks after completing the writing activity.

What about gratitude and its ties to physical health benefits? While more studies are needed to confirm the mechanisms through which gratitude may affect different aspects of physical health, the general idea is that your mindset can affect your body’s physiological processes in more ways than one—especially as it relates to heart health. We don’t totally understand how or why, but according to the UC Davis Medical Center, gratitude has been linked to lower levels of creatinine (a marker of your kidneys’ ability to filter waste from your bloodstream) and lower levels of C-reactive protein (an indicator of inflammation that can be caused by infectious or chronic disease, such as heart disease).

The Benefits of Gratitude In Chronic Condition Management

Whether you live with diabetes, high blood pressure, or another chronic condition, the day-to-day self-care of it all—medication management, scheduling doctor’s visits, waiting in line at the pharmacy, scrutinizing the food you eat, explaining your condition to people who don’t understand it—can present countless difficulties and obstacles that (understandably) may direct your focus toward what’s hard or what’s not working, explains Welsh.

However, she continues, “spending too much of your time focusing on what’s hard or painful or not working can ultimately lead to feelings of hopelessness, which, in turn, is associated with an increased risk of depression” and other mental health issues.

“On the flip side, when you consciously carve out time to shift your focus toward things that bring you even small amounts of joy, relief, or pleasure, you typically enter a more positive emotional state,” explains Welsh. “The more time you’re able to spend in this space, the less likely you are to feel depressed or hopeless, and the more likely you are to think creatively about solutions to your difficulties.”

In some ways, practicing gratitude with a chronic condition means learning how to be present with all the circumstances of your health—positive, negative, and everything in between, adds One Drop coach, Rukiyyah Khan, a diabetes prevention specialist who’s certified in plant-based nutrition. “Being present can allow each moment to come as it does, and to drift away just as quickly,” she explains. “You can step away from the negative and recognize the positive.”

As someone who lives with type 1 diabetes, Khan says she finds that gratitude not only helps her manage burnout but also invites generally positive energy that can “fuel your momentum for healthy habits.”

“When we feel better about where we are, we have the space to imagine where we’re going and the energy to press forward,” explains Khan. “As frustrating as diabetes can be sometimes, the negative moments come and go. We can only look forward to what’s next and use the challenges in the present to inform our decisions about our health in the future.”

How to Practice Gratitude When Living with a Chronic Condition

There’s no one-size-fits-all approach to practicing gratitude. The goal is to simply find a practice that works for you, and that you can commit to.

For Khan, she says she finds that gratitude works best as a daily practice, especially as it relates to managing burnout.

“The more grateful we feel, the more we can show up authentically in the world,” she explains. “When we’re able to appreciate everything as it is, we can better take each rise and fall as they come. We remove blame from ourselves and from our circumstances and simply take moments as they are, decide what needs to happen, and move forward.”

Below are more tips from Khan and Welsh on practicing gratitude with a chronic condition:

• Notice the small things *and* the big things. When you think about what you’re grateful for, you might initially think of the obvious ones: friends, family, pets, the food in your fridge. But cultivating gratitude over the long term means getting more creative with the exercise so you can maintain a genuine feeling of thankfulness each time you practice, says Welsh. Maybe one day you’ll feel grateful for the delicious smell of that new sugar-free coffee creamer you’re using, or for sleeping through the night without waking up from a continuous glucose monitor (CGM) alarm. Whatever it is you’re thankful for, make sure you really feel that gratitude deeply as opposed to just reciting it for the sake of completing the task.
• Make it a habit. “Whether you write it down or even just carve out time to mentally review things you’re grateful for, the more regularly you engage in the practice of being grateful, the better your brain will become at noticing and spending time enjoying the things that bring you joy or feelings of appreciation,” explains Welsh. Khan says she’ll often challenge herself to list at least five things related to her diabetes that she feels grateful for—for example, her access to insulin, and her ability to afford the technology that allows her to manage her condition more easily. “Sometimes I feel grateful about making it through a low blood sugar episode,” she adds. “Other times I feel grateful that diabetes has simply helped me make my health my number one priority.”
• Remember that gratitude and hardship can coexist. “Sometimes a barrier to practicing gratitude is the feeling that it invalidates struggles that are very real,” notes Welsh. In other words, by focusing so much on the positive aspects of your chronic condition, you might feel that you’re neglecting or discrediting the tangible, justified pain or negativity that that condition might bring you, too. “Gently remind yourself that you can be grateful and in pain, or grateful and frustrated,” explains Welsh. Life is about experiencing positives and negatives. As Welsh says: “One does not have to discount the other.”

This article has been clinically reviewed by Alexa Stelzer, RDN, CDCES, and clinical health coach at One Drop.