By Birgitta Vaivai-Soderberg

Author Bio: Birgitta Vaivai-Soderberg is an editor, content writer, and creative writer with over a decade of experience in communications across nonprofit, health care, financial, and tech sectors in both the United States and Europe. She currently serves as a contributing editor and author at the Observatory. Her past roles include working at Planned Parenthood of Hawaii, the American Cancer Society, and Rabobank International. As a former caregiver, she is passionate about raising awareness of the caregiver experience. She holds a bachelor’s degree in sociology and a master’s degree in European communications studies.

Source: Independent Media Institute

Credit Line: This article was produced for the Observatory by the Independent Media Institute.

Informal, unpaid caregivers play a vital role in society by attending to those who require care due to age, illness, disability, or psychiatric disorder. According to AARP and the National Alliance for Caregiving, 63 million caregivers in the United States provided care for another adult or child with special needs in 2025—a dramatic 45 percent increase from 2015. Among the 59 million caregivers of adults, 24 percent devoted a staggering 40-plus hours a week to caregiving. In addition to looking after a loved one, many caregivers also face the pressures of working and raising children. Moreover, most caregivers lack relevant medical skills training, which can make their roles even more taxing. As a result, caregivers experience chronic stress, exhaustion, anger, depression, anxiety, and guilt. This can deteriorate their physical and mental health, their relationships with others, and their overall quality of life.

One way caregivers can reduce this burden is by cultivating gratitude, as research in the field of positive psychology shows that gratitude can have a powerful impact on people’s overall well-being. Robert Emmons, professor at the University of California, Davis, and the world’s leading scientific expert on gratitude, contends that gratitude consists of a two-part cognitive process. First, it is a recognition that there are positive things and blessings in our lives. Second, it is an acknowledgment that these blessings come from sources outside ourselves. These sources may include the people in our lives or even a higher power.

One popular means of expressing thanks is through gratitude journaling, which is the practice of writing about things one is grateful for. This type of journaling can be a convenient way for caregivers to cultivate gratitude, as it can be private, flexible, and cost-effective, while also offering numerous health benefits.

Gratitude Journaling

Studies show that gratitude journaling can serve as an outlet for individuals to enhance mindfulness, gain insight, boost mood, and increase overall happiness. This is because it fosters an appreciation for the positive things, people, and experiences in our lives. It shifts our focus from what we lack to all the blessings that surround us.

In his book, Gratitude Works!: A 21-Day Program for Creating Emotional Prosperity, Emmons contends that writing about our blessings instead of simply thinking about them enables us to acknowledge them more and strengthens their psychological impact:

“Writing helps to organize thoughts, facilitate integration, and helps you accept your own experiences and put them in context. In essence, it allows you to see the meaning of events going on around you and create meaning in your life. Gratitude journaling may help you bring a new and redemptive frame of reference to a difficult life situation.”

But writing about our blessings offers other advantages, too. Many of the studies that have explored the positive effects of gratitude journaling revealed that those who practiced it consistently experienced physical health benefits, as they:

• Exercised more and took better care of themselves. 
• Had lower diastolic blood pressure.
• Experienced reduced inflammation.
• Had fewer symptoms of physical illness, including headaches, stomach pain, chest pain, and stiff or sore muscles.
• Slept more, experienced better sleep quality, and felt more revitalized upon waking.

The studies also revealed that individuals who kept gratitude journals experienced psychological benefits, as they:

• Felt more optimistic and had a greater sense of satisfaction with their lives.
• Experienced higher levels of positive affect, which includes emotional states like happiness, enthusiasm, and energy.
• Experienced reduced negative affect, which comprises emotions like irritability, anger, and fear.
• Experienced decreased levels of depression, anxiety, and stress.

Lastly, the research showed that gratitude journaling had social benefits, as those who practiced it:

• Were more forgiving.
• Felt a stronger sense of connectedness with others.
• Exhibited prosocial behaviors, which may include offering others emotional support or helping them with a problem.

How Caregivers Benefit from Gratitude

Some researchers have specifically focused on the impact of gratitude on caregivers. One such study, conducted in 2015 in China, explored the relationship between gratitude and coping mechanisms among caregivers of individuals with dementia. The researchers found that caregivers who experienced gratitude were more likely to use higher levels of psychological resources, including their own caregiving competence and social support networks, when facing challenges. These caregivers were also more likely to use emotion-focused coping strategies, including acceptance, humor, and positive reframing. Using psychological resources and positive coping mechanisms—rather than dysfunctional ones like denial, disengagement, and self-blame—was associated with lower levels of caregiver burden and depression.

A 2022 study investigated whether spousal caregivers of older adults with chronic illnesses or disabilities benefited from feeling appreciated by their partners. The researchers found that those who experienced higher levels of perceived gratitude had better mental health, while those who experienced higher rates of role overload had worse mental health. They also determined that greater perceived gratitude decreased the impact of caregiver role overload on anxiety levels and psychological well-being.

A 2024 study investigated the impact of gratitude on family caregivers of individuals with Alzheimer’s disease. The researchers concluded that caregivers experiencing burden were more likely to find meaning in life if they cultivated gratitude. They further explained that having a sense of meaning can benefit caregivers significantly, as it can help them view their role as less distressing and enable them to experience better psychological well-being.

Mechanisms That Make Gratitude Beneficial

Studies have shown that experiencing gratitude can impact our brains in positive ways, including by stimulating the production of “feel-good” chemicals like dopamine and serotonin. It can also regulate the production of the “stress hormone” cortisol, restructure cognitive processes by helping us shift from negative to positive thinking, and strengthen neural pathways associated with positive feelings.

According to neuroscientist Glenn Fox, gratitude’s impact on the medial prefrontal cortex can partly explain why grateful feelings lead to positive health outcomes:

“This area of the brain is associated with understanding other people’s perspectives, empathy, and feelings of relief… The regions associated with gratitude are part of the neural networks that light up when we socialize and experience pleasure. The regions are also heavily connected to the parts of the brain that control basic emotion regulation, such as heart rate and arousal levels, and are associated with stress relief and thus pain reduction.”

Such findings and others have led to the development of additional theories as to why gratitude produces benefits. The schematic hypothesis proposes that grateful people have cognitive schemas that lead them to interpret situations in a more positive light, which impacts their emotional responses and contributes to their well-being. The coping hypothesis contends that grateful people seek out instrumental and emotional social support, cope actively, and positively reinterpret situations. The positive affect hypothesis proposes that gratitude, as a positively valenced emotion, can lead to greater positive affect, protecting individuals from mental health disorders and contributing to life satisfaction. Lastly, the broaden-and-build theory suggests that positive emotions like gratitude, joy, interest, and love broaden people’s thought-action repertoires and build their psychological, social, cognitive, and physical resources. This can improve coping abilities, boost awareness, and increase resilience, thereby contributing to well-being.

Gratitude Journaling Tips for Caregivers

Choose your journal: Select a medium you’re comfortable with, whether it’s a new journal, an old notebook, your laptop, or a writing app on your phone. Thnx4.org, a project of the University of California, Berkeley’s Greater Good Science Center, offers a digital gratitude journal you can try out.

Establish a habit of writing: Choose whatever time works best for your schedule, whether it be morning, afternoon, or evening. You can set a reminder for yourself or place your journal in a spot where you’ll see it routinely. You may also find it helpful to write in your journal while practicing an existing habit, like drinking your morning coffee.

Determine how much and how often you want to write: Most researchers recommend reflecting on three to five things you’re grateful for every time you write. Since there are no strict rules about this, it’s important to test it out to see what works best for you.

In terms of frequency, Emmons recommends writing in your gratitude journal once or twice a week. This is because there is evidence that writing too often may lead to habituation, which can reduce its positive impact. Because everyone is different, it’s essential to experiment and find a frequency that suits your goals and preferences.

Find ways to make journaling easy and sustainable: Don’t overthink it or be too strict on yourself. Just write whatever comes to your mind. Also, remember not to worry about spelling or grammar, as you’re writing for your eyes only.If you’re struggling to come up with ideas, try experimenting with these 100 gratitude prompts by Joel Wong, professor of counseling psychology at Indiana University Bloomington.

Be specific: Describing a positive experience in depth is more impactful than writing a long, shallow list of positive things.Specificity is crucial because it encourages us to pay more attention to the details and circumstances of our positive experiences and not take them for granted. When choosing someone or something to write about, Emmons recommends breaking it down into several components and contemplating each one.

For instance, let’s say you’re writing about how thankful you are to the nurse who paid your loved one a home health care visit. Are you grateful that her visit allowed your loved one to receive care from the comfort of his own home? Are you thankful for the compassion she showed, the medical supplies she dropped off, and the much-needed treatment she provided? These are the types of thoughts and feelings you should reflect on.

Focus on people: Gratitude journaling is more effective when you write about people instead of things. When doing so, it’s important to reflect on the blessings you have received from those people. Emmons claims this is beneficial because it takes the focus off materialism and places it on relationships. This can promote deeper bonds with anyone in a caregiver’s life, including friends, relatives, and health care practitioners. It can also foster empathy and goodwill toward others, which may lead to more positive interactions.

Relish surprises: In their book, The Cognitive Structure of Emotions, authors Andrew Ortony, Gerald L. Clore, and Allan Collins discovered that positive experiences that are also surprising elicit stronger emotional responses than those that are expected. This element of surprise can prompt stronger feelings of gratitude. This is why Emmons claims it’s important to write about novel or unanticipated blessings. This will also keep your writing interesting, engaging, and inspiring.

View positive things as gifts: In his book, The Gratitude Factor: Enhancing Your Life through Grateful Living, psychologist Charles Shelton recommends referencing the things, people, and experiences you’re grateful for as “gifts.” Doing so can prevent you from taking the gift for granted or feeling entitled to it. It may also allow you to appreciate the source of the gift, which can encourage reciprocity. Moreover, it promotes enjoyment, as things that are viewed as gifts are more likely to be savored. “As we document our gifts, we no longer take them for granted. We take them as granted, as they were intended to be. We begin to be grateful for the ability to feel gratitude,” says Emmons.

Imagine your life without certain blessings: Envisioning how your life may have turned out if a positive experience had never happened—also known as “mental subtraction”—can enable us to experience a heightened sense of gratitude for such events. In fact, a series of studies conducted in 2008 found that performing this exercise led to increased levels of thankfulness and positive affect in participants. Emmons claims this technique is beneficial because it helps us counter the tendency to “adapt” to our fortunes. You can practice this in your journal by asking yourself questions like, “How much more stressful would my life be if I had never adopted my comfort dog?” instead of reflecting on general statements like, “I’m so thankful I adopted my comfort dog.”

Be grateful for the negative situations you escaped or reframed into something positive: Thinking about near misses can help you acknowledge how many things go well in life and remind you of how blessed you are to receive such gifts. According to psychologist Mike Brooks, “Shifting perspective from regretting the positives that could have been to celebrating the negatives that weren’t can powerfully affect our outlook on life.”

For instance, let’s say you almost forgot to give your loved one their medication. You can write about how thankful you are that you remembered it at the last minute; otherwise, there could have been consequences for the patient’s health. You can also reflect on any positive outcomes or lessons you learned. For example, perhaps you decided to prevent a future recurrence by setting reminders for yourself.

Explore a new angle on a “gift” you’ve already written about: If you write about a specific topic more than once, it’s essential to explore a different aspect of that topic. Emmons claims this can give a fresh perspective on what you’re grateful for, which can prevent monotony and help you sustain your interest in journaling while also fostering deeper self-reflection.

Explore the Positives of Caregiving Through Gratitude Journaling

The caregiving journey is often filled with anxiety, exhaustion, sorrow, and heartbreak. Fortunately, reflecting on one’s blessings through gratitude journaling can be a transformative coping mechanism for caregivers experiencing burden. Gratitude can allow a caregiver to see the abundance that surrounds them. It can turn anguish into peace, loneliness into belonging, and fear into courage.

So if you’re a caregiver, go for it. Grab your journal, put pen to paper, and see where your blessings take you. With time, you may find that your burden has eased and that your life is filled with more treasures than you ever imagined.

List of Questions to Generate Gratitude
By Joel Wong, Ph.D.
Questions to help us reflect on what we’re grateful for and whom we’re grateful to —
these questions could be useful prompts for gratitude journaling.
Micro Gratitude

1. What went well this week? 1a.What are some simple, potentially mundane things that contribute to my well-being?
2. What are some good things in my life that I’ve taken for granted?
3. What are some things in my home that give me with a sense of comfort?
4. What do I like about the chair or table that I’m currently using?
5. What do I like about the weather this week?
6. What do I like about my office/classroom?
7. What do I like about the neighborhood I live in?
8. What is my favorite place in town?
9. What do I like about my organization, job, or school?
10. What went unexpectedly well at work/school this week?
11. What do I like about the mode of transportation I use on a regular basis (e.g.,
    bus/bicycle/car)?
12. What do I like about my electronic device (e.g., cellphone)?
13. What are some resources I have in my workplace/school that others might not
    have access to?
14. What was my favorite meal this week and why?
15. What is my favorite restaurant and what do I like about it?
16. What is my favorite hobby and what I do like about it?
17. What is a habit I’ve developed that contributes positively to your life?
18. What do I like about the city or country I live in?
19. What pleasant activity do I participate in each week?
20. What went better than expected recently?
21. In what ways have I been pleasantly surprised this week?
22. What opportunities have I had to use my strengths/talents?
23. What opportunities have I had to pursue my interests?
24. What opportunities have I had to serve others?
25. What went well in someone else’s life for which I’m grateful?
26. What activity do I enjoy so much that I’m often in the zone [you lose track of time
    and you’re fully immersed in the experience]?
27. In what ways have I enjoyed grace from a stranger or a mere acquaintance?
    Gratitude Savoring
28. What do I enjoy about the food/beverage I eat/drink?
29. What do I appreciate about the view outside the window of my home/office?
30. What do I enjoy about the physical surroundings near my home?
31. What do I enjoy about the music I listen to?
32. [Look at a photograph you recently took] What do I appreciate about the things or
    people in the photograph?
    Interpersonal Gratitude
33. Which of my teachers/mentors contributed positively to my life?
34. Who puts a smile on my face?
35. Who makes me laugh?
36. Who do I enjoy hanging out with?
37. Who appreciates me?
38. Who makes me feel like I truly matter?
39. In what ways do my family members make my life easier?
40. In what ways have my family members made me a better person?
41. In what ways were my parents positive role models?
42. What do I like about my partner/spouse?
43. How does my partner/spouse make my life easier?
44. What did my partner/spouse do for me today that was helpful?
45. Who is my favorite relative and why?
46. Who has been a blessing to my life?
47. Who has been a source of strength in my life?
48. Who has been a source of emotional support or encouragement in my life?
49. Who has been a source of practical help in my life?
50. Who inspires me and why?
51. Which colleague(s) do I like and why?
52. Which colleague(s) appreciates my work?
53. In what ways do my colleagues make my life easier?
54. With whom did I have a pleasant interaction at work this week?
55. Who took the initiative to talk with me or help me at work this week?
56. Who defended me or spoke out on my behalf?
57. Who has reached out to help me recently?
58. What do I like about each of my friends?
59. With whom did I have an enjoyable conversation this week?
60. Who told me I’ve made a positive difference in their lives?
    Redemptive Gratitude
    Think about a stressful or difficult experience in your life.
61. In what ways is my life better now? What have I learned to appreciate as a result
    of this stressful experience?
62. What challenges did I overcome?
63. How have I grown as a person or what character strengths did I develop as a
    result of this stressful experience?
64. What positive insights did I gain about life as a result of this stressful experience?
65. In what ways is my life more meaningful because of this stressful experience?
66. In what ways did this stressful experience provide me with new opportunities
    (i.e., when a door closed, a new window opened).
67. Who supported me during this stressful experience?
68. Whom did I become closer to because of this stressful experience?
69. In what ways have I experienced physical, emotional and/or spiritual healing?
    Macro Gratitude
70. [Think about the major events in your life] What am I most grateful for in these
    events?
71. [Think about a turning point in your life] What am I most grateful for in this event?
72. Who or what changed my life for the better?
73. What aspect of my past has prepared me well to handle my current or future
    challenges?
74. What is something bad that could have happened but didn’t happen in my life?
75. Which childhood event in my life contributed positively to my current life?
76. Which event during my adolescence contributed positively to my current life?
77. Which childhood friends contributed positively to my life?
78. Who has had the most positive influence on my life?
79. In what ways is my life a gift? In what ways have I experienced grace
    (undeserved favor) from life, others, or a higher power?
80. What are the top one or two things/people in my life for whom I am most
    grateful?
81. What opportunities have I been given that not many people have?
82. What aspects of my life tell me that my life is good?
83. In what ways have I grown as a person?
84. What areas of my life has improved?
85. What has been the most important insights I’ve gained about my life?
86. What gives me meaning in life?
87. What gives me hope for the future?
88. What are my strengths?
89. What are my skills?
90. What is something I can easily do that I now realize others struggle with?
91. What opportunities have I been given to contribute to people, my organization,
    and/or my community?
92. What tells me that I matter to others, my organization, and/or my community?
93. What aspects of my spiritual life am I grateful for?
94. What historical event am I grateful for?
    Culture
    Here, “culture” and “cultural group” is broadly defined as any group you belong to that
    has shared values, beliefs, practices, and traditions.
95. What aspects of my culture am I proud of?
96. What aspects of my culture has made me a better or stronger person?
97. In what ways have my culture been a source of strength for me?
98. In what ways have my cultural group contributed to society?
99. Who in my culture do I admire or is a role model? (This could be someone you
    personally know or a historical figure.)