There is a hymn I’ve often heard, on the familiar theme of being thankful for what you have:
Are you ever burdened with a load of care?
Does the cross seem heavy you are called to bear?
Count your many blessings, every doubt will fly,
And you will keep singing as the days go by.
Count your blessings, name them one by one,
Count your blessings, see what God hath done!
Count your blessings, name them one by one,
Count your many blessings, see what God hath done. 
Now that I hope I have that relentlessly jolly tune stuck in your head, I’d like to talk a bit about being thankful. I’d like to address counting our blessings in first, a general context, and secondly in how it works with severe depression.
In General Terms
I have been surfing the net looking at bits and pieces about whether counting our blessings is psychologically healthy. The material I have found appears to be from a few years ago, so it is entirely possible that the research has been superseded by now though. A 2008 article in Cognitive Daily talks about research done by Robert Emmons and Michael McCullough into whether being grateful causes higher happiness scores. Their first experiment had 201 students on a health psychology course responding to a weekly questionnaire. They rated their well-being, were tested on a measure of gratefulness and reported their levels of fitness and physical health. They were then divided into three groups. The first listed five things they were grateful for each week, the second listed five hassles each week and the third listed five “events or circumstances” each week. This lasted for ten weeks in total. They listed ordinary troubles and blessings such as being grateful for their parents, or hassled by having a hard test.
As you might expect, the students in the gratefulness group scored significantly higher than the hassles group on the gratefulness measure. But they also were more positive about the upcoming week and their life as a whole. They were even healthier than both the hassles and events groups, and they reported significantly more hours of exercise (4.35) than the hassles group (3.01). On the more rigorous measure of positive affect, which assesses many different dimensions of positive emotion, there was, however, no significant difference between the groups.
The researchers thought that the reason they were no more happy than the other participants might have something to do with the blessings and hassles were only reflected on once a week. So they did another study, taking 166 health psychology students and 65 adults with neuromuscular diseases.
This time participants completed their questionnaires daily for 13 days (students) or 21 days (NMD patients). In both of these studies, a significant effect of positive affect was found: Just writing down the things you are grateful for each day appears to cause to improve your overall emotional outlook. In the NMD study, respondents in the gratitude group also reported getting significantly more sleep and feeling more refreshed when they woke up in the morning.
They suggest listing things we are grateful for as a treatment for mild depression. In addition, Richard Wiseman, a professor from Hertfordshire University who produced a similar study was quoted in The Guardian as saying about a study of 26,000 people he undertook that:
“thinking about one positive thing that had happened the day before appears to have been by far the most effective technique. This quick and simple procedure provided an additional 15% boost in happiness.”
So it seems that counting our blessings can indeed help us feel happier, at least according to the websites I have visited. So is this a cure for depression? Can we really “think ourselves happy”? I’m not so sure.
I have suffered from clinical depression (as part of bipolar disorder) many times in my life, and I have heard remarks from well-meaning people to “think positive” and, yes, to count my blessings many times. I think that certainly can be a means of maintaining good mental health, and that if we are feeling sad, or mildly depressed it can be helpful.
I don’t, however, think it is all that helpful for someone suffering from severe depression. When I am that low, my whole perception of the world and my past history is coloured by the illness. I cannot see the good things in my life – any awareness I do have of them makes me feel worse. This is why the old “other people are worse off than you” mantra is not all that helpful. Yes, I lead a privileged life, with material blessings and good family and friends – I know that and I am grateful and thankful for those blessings, when well. When I am ill it is a different story – other people’s suffering makes me feel unworthy of the pain I am in, that I am just making it up, that I am attention-seeking, that I shouldn’t seek treatment for my depression because other people need help and I do not. I reflect on having good friends – and my illness twists that into “they are such good people that if they knew how awful I really am, they wouldn’t be friends with someone like me.” I get such a feeling that I do not deserve these blessings that I withdraw from the people who love me. I also tend to spend recklessly, thinking that there is no point in conserving my money, because I do not deserve it, and I tend to give more money than I can afford to others at this time as well.
Depression, in my experience, gives me a tremendous sense of guilt. I am not worthy of the good things in my life and I deserve all the bad things. Counting my blessings makes me feel guilty that the luck of the draw has landed me in fortunate circumstances, while others, more deserving than I, are in much worse situations.
There are also times when I cannot see past the illness to even notice my good fortune. All I can perceive is the mental pain I am in – I have always found that depression makes me terribly introspective, and I can see little outside myself at this time. In this state, trying to count my blessings and give thanks for the good things in my life is nigh-on impossible because I simply cannot see them – and when they are pointed out to me I cannot really comprehend why I am fortunate. People sometimes say that depressives are self-pitying, and there is an extent to which that is true (although it is true of other illnesses too.) From what is left of my cognitive ability when depressed, all I can focus on is the pain I am in, and trying to think outside the horrible feelings I am experiencing is very difficult or impossible.
I don’t think that telling a depressed person to “count your blessings” can be all that helpful. If someone is severely depressed telling them they should do xyz is not really very useful, because all the person’s resources are tied up in surviving, and there is little energy to do anything else. If I could tell a friend of someone who is depressed one thing it is to listen, rather than tell, and to encourage them to visit a doctor. I am not trained in therapy, and most friends of the depressed will not be either – I found most useful from my friends the ability to sit and listen to me when I am feeling awful, to just be with me, rather than telling me what to do. Praying with and for the person is always helpful, but be wary of giving the impression that God will instantaneously heal the person – because if he does not, that leads to a terrible disappointment and anger with God (and you.)
Counting your blessings is a good technique for keeping us healthy. It is not a substitute for treatment of depression by medical personnel, nor should we demand it of those who are severely depressed. Now well, I can look back on the periods of my darkest depressions and give thanks, counting the blessings I believe I have obtained through those. That would have been completely impossible at the time. Counting my blessings is a part of hind-sight to me – there are circumstances when it is too hard, when at the time awful things are happening. Try to consider whether you would tell someone in a war zone, or being abused by their husband, to count their blessings – and consider that you would probably try to alter their circumstances first, and leave them to think of what blessings they may have after.
 “Count Your Blessings” lyrics by Johnson Oatman Jr, music by Edwin Othello Excel. Full text available at http://biblestudycharts.com/HH_Count_Your_Blessings.html
- The power of gratitude (chrysalisjourney.wordpress.com)
- Count your blessings, name them one by one (Hymn) (bummyla.wordpress.com)
- From Depression To Delight (guardianlv.com)
- Count your blessings (loveisnotaboutgender.wordpress.com)
- Ways to be Grateful when you have absolutely Nothing (lifeharmonyuk.com)