From Gloom To Gratitude: 8 Skills To Cultivate Joy

Enlarge this image Cornelia Li for NPR Cornelia Li for NPR

Feel like you're living under a rain cloud? Life not going your way? Lots of us have a bit of Eeyore's angst and gloom.

But here's the good news (sorry to be so cheery): You can be taught to have a more positive attitude. And — if you work at it — a positive outlook can lead to less anxiety and depression.

The latest evidence comes from a new study of caregivers — all of whom had the stressful job of taking care of a loved one with dementia. The study found that following a five-week course, participants' depression scores decreased by 16 percent and their anxiety scores decreased by 14 percent. The findings were published in the current issue of Health Psychology.

The course teaches eight skills to help people cope with stress. Techniques include mindfulness and deep breathing, setting an attainable daily goal, keeping a gratitude journal and — yes, it works — performing small acts of kindness.

Skeptical? Melissa Meltzer Warehall was too. She's caring for her husband, Paul, who is 64 and was diagnosed with early onset Alzheimer's in his 50s.

"It's very, very frustrating," Warehall says, "to know the man he used to be and the shell of the person he is now."

When she agreed to be a participant in the study, it was a way to reach out for help. She knew she couldn't change her circumstances, but she wanted to learn to cope better.

"When you're experiencing a lot of stress, it's easy to head into a downward spiral," says Judith Moskowitz of Northwestern University. She is trained as a psychologist and studies the ways positive emotions can influence people's health and stress. She developed the program taught to the caregivers.

As part of her research, hundreds of stressed-out people have taken the five-week skills class, including women with breast cancer, people newly diagnosed with HIV, people managing Type 2 diabetes and people with depression. She has documented benefits in each of those studies.

"These skills can definitely help people, no matter what type of stress they are experiencing, even if it is 'minor' everyday stress," Moskowitz says.

Warehall says she began to feel a shift to a sunnier outlook just a few weeks into the program. One skill she learned: how to reframe the daily hassles of life into something positive.

For instance, she says it can be challenging to take her husband on outings; she has to be on guard against him wandering off. Also, he has begun to have trouble navigating in and out of the car, and that can be frustrating for them both. But instead of focusing on the downside, she has taught herself to spend those long moments being consciously grateful for what they're still able to do together.

Though her husband can't work or take trips anymore, she has helped him rediscover music. "I signed him up for harmonica lessons every Saturday," she says. And that's great for both of them. "Just being with him when he makes music — he plays a mean blues harmonica — it's wonderful for me too."

She's learning to cling to the positive moments that come alongside the stress. And this makes it easier. "Everything that we do that's challenging, I look for that silver lining," Warehall says.

But this doesn't come naturally, she says; she has tried to build a habit of gratitude. Writing down one thing each day is a good reminder that there are still lots of joyful moments — despite their stressful situation.

"[Paul] picks up on my energy, and if my energy is positive, it's easier to care for him," Warehall says.

She has learned to focus on what is, instead of what's lost. "I remind myself I still have him. I can still hug him and hold him and tell him I love him."

"In the context of stress, it can be hard to see the positive things," says Moskowitz. "So taking a moment to notice things you're grateful for is really beneficial."

Moskowitz says she knows the hesitation or resentment people sometimes feel when they're told, "Chin up! It'll all be OK." That's a hard message to handle if you're reeling from the news of a serious diagnosis or other traumatic experience.

"We're not saying don't be sad or upset about what's going on," Moskowitz emphasizes. "But we know people can experience positive emotion alongside that negative emotion, and that positive emotion can help them cope better."

She says these strategies and skills are widely applicable. "Anyone can be taught to be a little more positive."

Moskowitz and her colleagues are about to launch another study of dementia caregivers (anyone interested in participating can contact her lab, she says). And though that particular program is not available to the general public outside the research project, Moskowitz points to an online program called It's All Good Here that teaches similar skills. (Moskowitz has consulted with the creator of the program to share some content, but she has no financial ties to the company.)

She says the strength of the eight-technique approach is that there's no single skill that helps everyone. "It's a buffet of skills," Moskowitz says, so it gives people lots of options.

Here's a quick summary of the eight techniques used in Moskowitz' study:

Take a moment to identify one positive event each day. Tell someone about the positive event or share it on social media. This can help you savor the moment a little longer. Start a daily gratitude journal. Aim to find little things you're grateful for, such as a good cup of coffee, a pretty sunrise or nice weather. Identify a personal strength and reflect on how you've used this strength today or in recent weeks. Set a daily goal and track your progress. "This is based on research that shows when we feel progress towards a goal, we have more positive emotions," Moskowitz says. The goal should not be too lofty. You want to be able to perceive progress. Try to practice "positive reappraisal": Identify an event or daily activity that is a hassle. Then, try to reframe the event in a more positive light. Example: If you're stuck in traffic, try to savor the quiet time. If you practice this enough, it can start to become a habit. Do something nice for someone else each day. These daily acts of kindness can be as simple as giving someone a smile or giving up your seat on a crowded train. Research shows we feel better when we're kind to others. Practice mindfulness by paying attention to the present moment. You can also try a 10-minute breathing exercise that uses a focus on breathing to help calm the mind.

Janice Kiecolt-Glaser of Ohio State University was not involved in this study but has researched the effects of caregiving on the aging process, and she says Moskowitz's work dovetails with many of her own findings.

"There's certainly ample evidence from our research and others' that the stresses of dementia family caregiving can take a toll on mental and physical health," Kiecolt-Glaser says.

"This study used a simple intervention that had measurable positive benefits. It's a lovely contribution to the literature, and I would hope to see wider implementation of this and similar approaches," she says.