Something's weird, something's off, but I never thought of what it could be. You never think that would happen to you.

In the fall of 2019, Christina Costa knew something was off with her body. She just wasn't sure what.

I started getting migraines, and my dad has migraines. He got them since he was a kid. My sister has migraines, so I know there's a genetic link to migraines, so I just didn't really think much of it.

Christina was a 27-year-old graduate student at the University of Michigan. She kept going to class and living life as usual, but the pain in her head persisted.

I was walking out of the classroom and it was just like, Everything is blurry right now. This is weird. This feels more than just a migraine.

When Christina visited her campus clinic, they suggested she take some Tylenol. She tried that, but it didn't help.

I would get like left side numbness in my hand, very, very strong aura, sometimes nausea.

Christina went to see a neurologist and got an MRI of her brain.

Then I get home. I watch Netflix as all of us do, and I get a call, and I'd let it go to voicemail, and then I think, That could be important. I was with my husband, and I get a voicemail that says, Please come to the emergency department. I found something in the MRI, and I, I fell to the floor. It was surreal. It was something... I just... I never expected it. So I go to the Emerging Department. There's a PA there, a nurse there, and they bring up the picture, which I see for the first time. Takes my breath away because I know what I'm seeing. Today is the day that I I found out that I have a 6 centimeter tumor in my right temporal lobe.

Christina needed an operation. It was a long procedure, about 13 hours, and she had to remain awake for some of that time. In the end, her medical team successfully removed 97% of the mass. As a neurosurgeon, I can tell you that was a huge success. But Christina will still live with this tumor for the for the rest of her life. Here's the thing. After looking at Christina's brain scans and hearing her story, what stuck with me most wasn't the diagnosis itself, but how she responded to it.

I feel safe. I feel grateful that I'm here.

Christina used something so simple, gratitude, as a way to heal throughout a very difficult journey. I think that's a tool all of us use to benefit our own mental and physical well-being. So today, we're going to dive into the surprising health benefits of gratitude. I'm Dr. Sanjay Gupta, CNN's Chief Medical Correspondent, and it's time to start Chasing Life. Christina Costa's story hits incredibly close to home for many reasons. For one, I trained at the University of Michigan. I know many of the exact doors she walked through on the day of her operation. I also know so many of the staff and medical team at that hospital. They're like family to me. But Christina and I have something else in common. We both have a long-standing love affair with the brain. She studied neuroscience in college and is pursuing a PhD in psychology. She's also taught students of all ages, from middle school to college. For years, she's encouraged those students to do something that I find incredibly touching.

When you kiss your brain, I take my pointer finger and my middle finger, and I kiss, make a kiss, and then you touch the top of your head and you kiss your brain. That was so cute. I can't believe Sanjay Gup did just kiss his brain. This is really cool.

I'm going to do this. I'm going to tell people to do this. I really am. This is really cool.

I'm a little freaking bored. Okay. Anyway, in the kindergarten classroom, they get the first math problem where they get the sound of the day and it's, Oh, you're so You should kiss your brain because think of all the amazing things you did, and that is so awesome. And for me, it became, I'm alive today. I am looking at my hands, I'm squeezing my hands at the same time, and I can do that. I'm going to kiss my brain. You are so amazing. You have a great fruit-sized tumor in your brain, and you are doing that, or you are having a conversation. It's just showing gratitude for all the amazing things our brains do as an affirmation.

You are somebody who is uniquely situated to talk about this because you were studying the brain. You received the diagnosis. You probably changed the way that you view your own brain.

As soon as I got my diagnosis, there was these new words I heard, like warrior and fighter, and those really bothered me. And it took me a long time to figure out why. That was this narrative of being a fighter or being a warrior against this illness or disease You didn't want to go to battle with something that you love so much, your brain.

The idea that you had to beat up on your brain, this thing that you had been teaching your students to kiss, to love.

Exactly.

That didn't sit well with you.

Exactly. I was like, How can I be a warrior against what I've been kissing? Hold up, kiss your brain. Be grateful for your brain. Think of all the amazing things our brain can do. This was a very slow-growing tumor, so I probably have had this for a long time. I was thinking I'm thinking of all the things I've done with a brain tumor. My brain can do all of these amazing things with this large disease growing in it. I'm not all of a sudden going to start. I don't want to be a warrior. I don't want to be a fighter. I don't want to live like that. It was contradictory to me. I'm not going to tell my students to kiss their brain and then be a warrior by night.

When it comes to gratitude being the framing, I'm grateful to my brain for all that it's been able to How do you think gratitude helps you, specifically throughout a journey like this?

For me, it was a restructuring technique. Battle made me personally feel bad, like I was doing something harmful. Gratitude helped me feel like I was helping myself. What can I focus on that my body is doing so that it can keep doing those things and so that it can be in the best psychological and physical shape so that the rest can take care of itself?

When I listened to your TED Talk, I was so struck by that aspect of things. You were able to train your brain in the midst of a brain tumor diagnosis to practice gratitude more often. Was this a conscious thing? Like, I will just be grateful. Is that what you're describing?

Yeah. I think immediately right after diagnosis, I knew the practice, the three good things practice. Of course, it's not easy to I remember, I set an alarm. For me, I like to do it in the morning. A lot of people like to do it at night because they get to focus on what happened throughout the day. I found it most helpful when I started my day like that. I have a journal that I keep, and that's how I started my day, and that really helped. The second thing was the affirmation of kiss your brain. When I was scared, I would just do it with my parents of, Let's kiss our brain before we go into surgery, or, Before we get this blood dry, I would teach people at the hospital about it. Just having that as an affirmation of gratitude was helpful. Then these gratitude letters of thinking of all these people, my immediate social network, all the people who showed up, my students, and then all the medical professionals. That was endless. I mean, that was endless gratitude. There were tons of people. Those three things, I think, were the major things that helped me shift to that mindset of having those tangible practices to do.

I'm really curious about something that I think, again, we in the medical field probably don't talk about enough and are exposed to enough, and it is everything else besides what we just talked to, your support system.

Yeah. I mean, we immediately Immediately, we had our team, and my husband and I moved in with my parents, and we were, we call ourselves the roommates. We made a list of questions for my neurosurgeon, had a notebook, right? And when we went to appointments moments, we all went together. It was all four of us.

And what does it mean for you now, for your life? So now that much of the tumor was removed, how often do you have to follow up and treatments, et cetera?

So they call it a watch and wait phase. If we wait, we see what's happening, and we watch it. This is something we keep up on. My surgeon is always really careful to explain to me that even if we got 100% of the tumor, those cells are still there. We still need to treat the area, the cavity, and we need to... This is something we will look at your whole life. And in my pathology appointment, he said, I will see you forever. And my reaction was, Oh, my gosh, yes, because I loved him and he was such a good doctor. I was like, This is so exciting. And my mom was like, What do you mean forever?

People who are listening to the podcast don't realize that Christine and I are on essentially a Zoom call right now, so we see each other, which is really nice. But I can't help myself here as a neurosurgeon. I'm just looking at you and I'm noticing that you're moving your left arm well. I've watched your face, you smile. Your smile is symmetric, all these things. It looks like you're doing really well. Yeah, your shoulder shrug, really good. Are you feeling as well as you look?

How about this? Right now, for listeners, I'm putting my hands out. This one I call the pizza test. You got to put your hands out and close your eyes. That one always scared me because So you put your hands out flat in front of you, and then they ask you to close your eyes. I'm assuming to see if they stay up, symmetrical, right? But I don't like having my eyes closed because the other ones, I can see myself. I know how things are going, but that one I'm always like, Are they moving? Are my hands moving?

You're the perfectionist. You want to make sure it's perfect. No, but you're describing a really important test. It's called the Romberg's test. Based on the fact that you're doing it, and my guess is you passed. You did so with flying colors. Yes.

I have not had a migraine since pre-surgery, which is awesome. I'm feeling really well.

I'm so glad Christina is recovering so well. I'm happy to report she's back in the classroom finishing up her PhD and teaching students about the wonders of the brain. After the break, Christina is going to teach all of us about the surprising science behind how you can use gratitude to benefit your health.

One of my favorite things about gratitude practices is you can start whenever. It is easy, it is free.

That's ahead after this quick break. And now back to Chasing Life. When Christina Costa received her diagnosis, she was in the middle of graduate school studying something called Positive Psychology at the University Michigan. She had to take a break from all of that because of her operation. But she was able to put her studies into real-life practice, and her diagnosis helped inform her research into the power of resilience.

It was really something that was lacking in psychology for so long. We were focusing on adversity, and then the fact that that is just half of human life. That is half of our experience. What about the other side?

I've always been We're interested by this idea that our thoughts and our emotions can impact our physical health and vice versa. It's a reciprocal relationship. I asked Christina to explain what is happening in the brain when we practice gratitude.

The three major things are up in production of our neurotransmitters. We're shelling out dopamine, we're shelling out serotonin, and that is making us feel good. We're getting a little boost. We're getting an actual physical boost, and so that's making us feel good. That's where the positive emotions are coming in. The I'm feeling good emotions, right? We're also regulating our stress hormones, which is why this is such a good bolstering exercise for when we're in a tough space.

You mentioned the neurotransmitters like dopamine and serotonin, decreasing of stress hormones like cortisol. Does the structure of our brain change as well?

When we put people in F MRI scanners, when we're looking at what areas are activating, the main areas are our amygdala and also the medial prefrontal cortex. These two areas, when we compare people to doing a more nominal exercise, think about your day, versus think about all the things that went well today and why you're grateful for them. Those areas seem to be lighting up stronger. The future questions are, what is happening when those areas are lighting up? Or what makes them light up the strongest? And what's then being regulated because those areas are lighting up?

Are there some people who are just more predisposed to gratitude than others? And if so, do we believe that it may have something to do with what their brain structures already look like?

One of my favorite things about teaching gratitude and talking about it is there is no genetic gratitude linkage yet. There's no gene that says you're going to be more grateful than the next person, which leads us to believe that this is really a learned practice and a learned experience. And we learn things in all sorts of ways from our families, from our cultures. There are certainly cultures that express gratitude more than others. We all have different practices, different families. One of my favorite things about gratitude practices is you can start whenever. It is It is easy, it is free. We have a phrase in psychology and neuroscience that if you've gone through a neuroscience program, you've heard a million times, is that neurons that fire together, wire together. Which is the idea that the more we activate certain structures or neural connections, the stronger they become, and then the easier it is for those to light up again. If we're lighting up that gratitude pathway, and we're practicing that every day, it's going to light up more often. It's going to fire more often, and it's going to become part of our practice, our habits.

Is a thank you enough, or are we talking about something more profound here when we're actually being grateful?

Is it the language? Is it more than that?

The crucial thing about this is going into the why, not just a, Hey, thanks for what you did for me last weekend, but going into depth of, This is why I'm grateful for you, and a specific moment of, You did this for me, maybe you didn't realize it. I think getting to that state is really where things start to change physically or chemically.

Over the last several months now, I've been sending notes to people. I'll start off the note by saying, Hey, I'm sending this for no reason at all. Because a lot of times people will see an email on their inbox or a note, and they'll be like, Oh, what's this guy? And nothing. I want nothing except to say that I've been reflecting a lot on life and what's important to me and you're somebody who's at the top of my list. I'm just wanting to send you a note saying you're at the top of the list. And whatever energy you're putting out there and love and all these things you're putting out there, I'm getting it. I'm hearing you and I'm feeling it, and thank you. It's nice. I mean, without question, you get a response back. I feel good about it. I'm the giver, but I feel good, real good about it. I know they feel good. I hope they do, but I feel good.

That's what the science says about it, is intuitively, you are They're thinking, I'm going to make this person feel really good, and you are. But the selfish benefit is it makes you feel really good, too. It bolsters your positive emotions.

I'm curious, how long does it take to feel that impact of gratitude?

Well, the neurotransmitter reactions are pretty immediate. It is hard to feel bad when you are focusing on someone that you are so grateful for, someone that changed your life, or something that is going really well today. It's hard to simultaneously feel bad, and that makes sense with our neurotransmitter production. Getting into those practices is where those longer term benefits come from of I'm practicing this, it's becoming more apparent, and so I'm shifting into that mode quicker than before. Whereas maybe the first time it's hard, it can be hard to think of something to be grateful for. It really can. And that's going to not dismiss the struggles that people are going through. It is hard sometimes sometimes to find things, but it gets easier over time. Once you start that practice, on day 30, if you're doing a 30-day gratitude challenge, on day 30, you are just grateful for everything. I'm grateful for this coffee cup because it's giving me caffeine and I can hold it and it's warm and it feels good. It gets easier to practice those things over time.

I think sometimes people think about this as being nebulous, being a bit more vague, and then to be able to sit down and say, Here are the benefits of gratitude a journey like this, the psychological benefits, the social benefits, and yes, the physical benefits, right?

Yes. Yeah. But for me, what's really interesting is a science behind both the social and the physical. Like the studies that show that practicing gratitude strengthens your immune system, helps you experience less pain. Those are very interesting to me because they are physical, right? They're less obvious. And so knowing that there are those benefits, I think, are even more convincing to people that are really into the science or really into the physical. There are these links, and these are just the preliminary things. We have years and years going into this research, so who knows where this is going to go, but this is what we know already.

Again, maybe easier said than done, but I feel like the idea of practicing gratitude is something that is all within us as well. Was this idea of practicing gratitude for you this predated the brain tumor diagnosis? Was this something that you grew up with?

It's not something I grew up with, although it is very pop psychology. I mean, this dates back to people who have been practicing gratitude forever. Our grandmas, grandmas, grandmas. The first time I heard about the science of gratitude was as an undergrad. Then I began studying gratitude interventions in grad school. I have to be so honest. One time, I was teaching about the three good things practice, which is a practice where at At the beginning of the day, at the end of the day, you think of three things that went well that you're grateful for and why. You either journal or you talk about them. There's some really robust evidence that doing that practice over time increases happiness and decreases depression. I teach about it to my students all the time. One time, a student said, Yeah, so you do this? I said, You got me. Because it's something that is so easy and seemed so obvious, and they really called me out on that. But wouldn't you know that the first thing I did after getting my diagnosis was, okay, it's time to do the three good things exercise. I know scientifically, as a researcher, I know that this is going to bolster these positive emotions.

I mean, that's something that I think we're all guilty of at some point. We do need to practice what we preach. Doctors are really guilty of this in terms of just their overall health. But what is this? It's a gratitude exercise. I'm wondering, can you talk me through it? Is this something that you can walk me through on a podcast?

Yeah. We would actually do it if you want.

Yeah, let's do it.

Really, it is as simple as right now, either you can think of it in the past 24 hours, things that have happened that you're grateful for, or today, what you're grateful for, three things. Then the most important piece is why, is expanding upon it. That's something you can journal. It's also something you can do with a partner. At night, in the morning you wake up with, whether it's a coworker, whether it's a partner at home, your children, a dinner table routine. That's really all it is. Sometimes it leads into conversations, sometimes it doesn't. But just Three things. So right, I'll start. Boy, I am grateful for that sun. It is coming out. It's May. We're in Michigan. We're ready for the sun. I am so grateful because that means I get to go for a walk today with my dog. I'm grateful. I mean, the obvious one. I'm so grateful to be here and speaking with you. This is very, very cool. I'm also... Oh, I have a good one. I'm grateful for my students. We're at the end of the semester. I have a fascination with the hippo, the animal. This morning in my inbox, I received just an email, no subject, just a picture, and it was a picture of me photoshopping dropped onto a hippo.

And that made me laugh. And that is why I love teaching. I love my students. They make me laugh. They do unexpected things like that. And so I'm grateful for them. That's beautiful. So you can walk me through. Yeah, three things. They can be trivial. They can be the sun, the weather, parts of your body, anything that you're grateful for and why.

I went for a pretty long run yesterday, and I love to run. I love it because I get to be outside and the weather is nice and all that. But I think the biggest thing that I'm grateful for about the runs is that it's my time. I feel like I have a lot of things pulling at me. And when I go for a run, it's a statement that, Hey, I was able to regain control for an hour, an hour and a half today and just go for this run. And didn't even take my phone. Another one, it's also an active one, it's actually closer to two days ago, but still really stuck with me, is that I have three daughters who are 17, 15, and 13. So I'm in the wonder years. My older daughter, my oldest, 17, asked me this weekend if we just wanted to go for a walk. We just went for a long walk. It was amazing because I talked very little, I listened a lot, and she had a lot to say, and she just wanted to be me. We didn't talk about anything that was even that important, but it was just the exchange of information and knowledge and love and support and all that stuff.

Yes, Christina, I am truly grateful for you. I mean that sincerely. I treasure these conversations. I feel like when I reflect on my life, we have obviously tons and tons of moments, but the ones that I remember are the real conversations, the real connections that people make with each other. You've gone through this and you're sharing your story with me. I think you have a lot to teach all of us because you're just honest and transparent, and you have knowledge, and you went through this, so you have the experience of it as well. So I'm grateful for you.

Wonderful. A plus. You did a great job.

Thank you.

Practicing the three things exercise with Christina did make me see gratitude in a new way, a more concrete way, an objective way, a way that could last for me. So I want all of you to give it a try as well. Say aloud, right after this episode, three things you're grateful for. And why? It's that simple. It's such a small task that can have such a major impact on our overall well-being. Now, like many great teachers do, Christina also gave us some homework in the form of a few tips that can help you get started with your gratitude practice. Tip one, start today. Don't wait until something goes wrong.

It's so easy, but it's something that sometimes if you're not in crisis mode, if you don't need it, it's hard to practice it as a preventative of, Okay, this is something I'm going to do, right? When things are going well. When things aren't going so well and you're relying on these tools, that's often when people start to use them. I'm an advocate for getting people to start these as preventative measure rather than in crisis mode.

Tip two, try a gratitude circle. It can work with your family, friends, or even your coworkers.

I think work meetings, starting a work meeting with instead of, Here's our agenda, What went well for you all over the weekend? What's one thing that went well this morning or over the weekend? Small things like those practices, I think, can make a real difference.

Tip number three, write a letter, make a phone call, or share it in person.

When I do this with my students, I say, You're going to send this letter. Do not say it's for a class assignment. Write it. And then you can get double points, not actually, but I just joke and say double points if you read this in person or if you call the person and read it to them. Because it turns out that quadruples the effect. It's called the gratitude visit, where you write the gratitude letter, but then you are delivering that message in person. And it makes you feel good. It really does.

I did really learn so much from Christina about the wide-ranging benefits of practicing gratitude every day. Besides making ourselves and the people we share it with feel good, practicing gratitude can help reduce our own physical pain, depression, fear, anxiety. Christina says it helped with her own recovery after brain surgery. I got to tell you, I'm really trying to put Christina's advice into practice. At It's family dinners in my house, we try to share something we are grateful for, even if it's something small. I continue to write those gratitude letters to people who make a real difference in my life.

As for Christina's health, she still gets MRIs every three months and has regular check with her neuro team. The size of her tumor has remained stable. She's also the proud mom of a five-year-old son who Christina says she is very grateful for. All of this makes me incredibly happy to hear Christina. We're so proud of you We've learned so much from you. Thank you for that. There's another reason that I thought it would be the perfect time to revisit Christina's interview. That's because right now we're hard at work on an all new season of Chasing Life, the 10th season of the podcast, which we are very grateful for. It's all about the science of happiness. Such fascinating stuff. What does it mean as a starting point to be truly happy? And can it have an impact on our health? We have some great conversations coming up soon. And in honor of our 10th This season, we want to hear from you. Leave us a message at 470-396-0832 and tell us how you chase life. It could be used on an upcoming episode. Thanks for listening.

Chasing Life is a production of CNN Audio.

Our podcast is produced by Erin Mathieson, Jennifer Lye, and Grace Walker.

Our Senior Producer and Showrunner is Felicia Patinkin. Andrea Cain is our Medical Writer, and Tommy Bazarian is our Engineer. Dan Dizula is our Technical Director, and the executive producer of CNN Audio is Steve Ligtie. With support from Jameis Andrest, John Dianora, Haley Thomas, Alex Manasari, Robert Mathers, Lainey Steinhart, Nicole Pessereau, and Lisa Namerot. Special thanks to Ben Tinker, Amanda Sealy, and Nadia Konang of CNN Health, and Katie Hinman.