The Connection Between Heart Rate Variability and Mental Health

This article originally appeared on Trail Runner

More than one in five adults in the United States struggle with mental illness, according to the Centers for Disease Control and Prevention, and those are just the reported statistics. The truth is that most people will experience some form of stressor in their life that will affect how their body and mind function.

Simply defined, mental health refers to a person's emotional, social, and psychological well-being, including how they deal with stress, relate to others, and function in society. Not only does mental health affect how a person understands and controls their actions, but also how their body and nervous system send cues to the brain.

When the body deals with stress, there is an almost instantaneous and unconscious physical reaction, frequently thought of as an adrenaline rush, during which heart rate and blood pressure increase, adrenaline and cortisol are released in the body, and the body pumps blood to the heart, lungs, and muscles to ensure safety from all threats.

When multiple or continuous stressors are observed, whether it is from daily life stress or the reaction to a mental health disorder, the body can no longer maintain homeostasis, causing several physical maladaptations. The protective factors put in place by the body become a burden to the modern-day human whose stress revolves more around getting through traffic than fleeing danger.

The physical impact of declined mental health can be harmful to the body, and an otherwise healthy athlete is no exception. Athletes will likely notice several obstacles in their training and lifestyle that were not prevalent before the stressful episode. The physical reaction to stress can be indicated in an athlete's heart rate variability (HRV) and can have a negative impact on athletic performance and slow recovery.

Mental Wellness and HRV

Heart rate variability refers to the time between heartbeats. A low HRV has less time between beats and often indicates stress or decreased fitness. A high HRV correlates with good health, fitness, or low stress. In terms of athletic performance, individuals want a high HRV to help their body stay in homeostasis longer into the event and recover faster from a hard effort.

While the use of HRV in training is a newer concept, it has been backed by several studies in examining where an athlete is in their training, and whether they are prepared for a key workout or need a recovery day. There are several apps and devices that will track HRV, all of which encourage measuring one's resting heart rate first thing in the morning and trying to track it daily for the best readings.

While there are many ways to track fitness, fatigue, and recovery, HRV provides a data-driven approach to understand better where the body is on any given morning--explaining to an athlete how stress, both from working out and life, might infringe on their fitness. By following cues of HRV, an athlete can better understand how mental wellness, life stress, or underlying issues could affect them physically while also tracking cycles in their life.

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"Mental health is physical health," states Neal Palles, Sports Performance Psychologist at Colorado Psychotherapy and Sports Performance in Longmont, Colorado. "If you don't meet your basic needs, you will not accomplish your goals." Palles's point is furthered by looking at the direct correlation between an athlete's ability to recover and perform and their mental wellness. Key factors, such as sleep, stress, hormone response, substance use, and self-image, profoundly impact the mind and body.

How Mental Health Impacts Athletic Performance

The nervous system is just the beginning of mental health's connection to HRV and athletic performance. The impact that a low HRV has on recovery and growth processes make it extremely difficult for an athlete to build strength or speed while going through emotional stress.

The following conditions from poor mental health all have a huge impact on athletic performance and can cause maladaptations in the training process. Mental illness can contribute to factors such as decreased sleep, increased stress, fluctuations in hormones, substance use, and decreased confidence as well as self care--all of which have a negative impact on effective training and performance.

Sleep

Mental health and sleep often find themselves on the same cycle. Poor sleep leads to decreased mental health, just as deteriorating mental health can lead to sleeplessness or unrestful sleep, furthering the issue.

In a 2021 study of over 22,000 adults, over one-third of the participants could be diagnosed with insomnia, meaning that most of us must set ourselves up for success. Sleep is when the body heals, both mentally and physically. Sleep decreases a person’s ability to cope with stress and limits cognitive function, affecting memory, attention, and learning.

RELATED: Sleep Aids And Running Performance

According to Colombia University's Psychiatric Department, studies have concurred that healthy individuals who are sleep deprived are more likely to experience feelings of anxiety, depression, and suicidal ideation.

Stress

The body does not differentiate stress. A hard workout is handled like an argument with a significant other, a crying baby, or getting reprimanded by a boss. This means that athletes, especially those pushing themselves cardiovascularly, are more likely to enter a continuous cycle of stress, living with heightened hormones and high heart rates.

Continuing life through a constant state of stress wreaks havoc on the body. Common physical symptoms include digestive issues (acid reflux, gastral indigestion distress, and feelings of nausea), headaches, muscle aches and pains, and fatigue.

Working out is made to be even more difficult when the body is already being put through the wringer of physical and mental distress. Even if the athlete can muscle through a workout, the body is limited in recovering, making the gains negligible.

Hormone Response

The body releases different hormones based on where it is in the stress cycle. Most notably, cortisol builds and infringes on healing as a person becomes chronically stressed. While cortisol serves the purpose of helping the body deal with a stressor or threat immediately, increasing physical functions for fight or flight, existing for a prolonged time in the body is highly detrimental.

Cortisol decreases the body's ability to recover and increases the amount of glucose in the bloodstream, increasing the risk of high cholesterol and blood pressure. The hormone increase also slows down the digestive system, causing stomach issues and increasing bloating and fat retention, especially around the waist. Furthermore, it suppresses the body’s reproductive and immune systems and growth processes. It decreases the brain’s response system, making it difficult for a person to engage with appropriate mood regulation and impulse control.

Because of the limitations of growth processes and the reproductive hormones, cortisol makes muscle growth incredibly difficult, hindering athletes from reaching their full potential and recovering from a workout.

Self-Medicating

Not every obstacle from poor mental health comes directly from the body. While using substances is an athlete’s choice, using them to medicate or deal with stress can cause concern. The issue of self-medicating is hugely detrimental to the training cycle, as well as the body as a whole. Alcohol increases resting heart rate considerably and causes disruption in the sleep cycle, both of which can significantly lower HRV and recovery.

Similarly, according to the Centers for Disease Control, marijuana, and caffeine can increase heart rate and blood pressure and disrupt the sleep cycle, leading to the same hindrances as alcohol of lowered recovery and decreased athletic performance.

Confidence

A lowering of self-worth and confidence can accompany decreased mental health. Negative thoughts about oneself or a loss of interest in self-care can build on a negative mental state, making it nearly impossible for a person to actively participate in life.

An athlete can cause a preemptive heart rate increase if they go into a workout already feeling like they have failed. The stress of feeling like a failure, and increasing cortisol, can lower productivity and motivation or cause the athlete to lose focus and fall into a vicious cycle of under-performing and becoming frustrated.

RELATED: Developing Sustainable Confidence

Self-Care

One of the greatest risks of poor mental health on athletic performance is loss of self-care. The body needs to be nourished and loved to grow strong. When an athlete enters into a period of poor mental health, they are less likely to follow a productive sleep schedule, feed the body well, or allow themselves rest and rejuvenation.

"If an athlete is not psychologically well, it could drive them to illness or injury," states Palles. "Not taking care of basic needs will increase stress, a major factor in overtraining."

Working with Body and Mind

While stress is inevitable in life, and mental wellness is a journey with many ups and downs, it is possible to find systems that make dealing with the ebbs and flows manageable. As a human, this makes functioning in a turbulent world more tolerable, and as an athlete, it helps reach full athletic potential without physical setbacks.

While the cycle of stress can feel frustrating, finding the right set of emotional tools and creating balance in life can lead to a decrease in stress or negative emotion.

Using the Full Toolbox

When it comes to managing maladaptive stress patterns or dealing with dips in mental health, it is crucial to have several tools in the mood-management toolbox.

"The stress cycle is a very human way to respond," explains Emily Hemendinger, Clinical Director of the Obsessive-Compulsive Disorder Program, in the Department of Psychiatry, at the School of Medicine at the University of Colorado Anschutz Medical Campus. "It gets a bad rap, but it can be helpful."

She explains that stressors can either be predictable and controllable or exhaust resources. For example, the Norepinephrine hormone, released with the Sympathetic Nervous System (or SNS, which is responsible for triggering the "Fight, Flight, or Freeze response) can help focus and productivity, ensuring that a workout gets done or a work assignment is complete. The issue arises when the stress state becomes maladaptive.

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"It is important to let the body complete the stress cycle," states Hemendinger. "Rather than allowing the body to stay in chronic stress, find ways to reduce stress, such as gentle physical activity, creativity, deep breathing, and emoting." She also recommends eating regularly, attending therapy, and finding ways to connect with others.

Having the cues from HRV can help an individual know when the body is becoming overly stressed before the brain makes the message clear. When there is a drop in HRV without a clear workout indication, practice therapeutic techniques to let the body and mind heal.

Becoming a Self-Actualized Athlete

As in Maslow's Hierarchy of Needs, the goal is to become a self-actualized individual who can purposefully navigate the world’s idiosyncrasies.

As psychologist and coach, Palles leads a course in becoming a self-actualized athlete.

"A self-actualized athlete is someone confident in who they are as a person, not just athletically," he says. "They are fulfilling their values and truly understand their 'why.' Their identity is not wrapped up in running. Their passion is harmonious, not obsessive."

Finding a balance in technology and social media use while practicing balance and self-presentation is necessary for good mental health. Falling into a comparison trap can be easy, especially in a training cycle. Figuring out what triggers a stress response or feelings of inadequacy is crucial in keeping a healthy mindset.

Reaching Out for Support

When things are not feeling right, it is essential to seek support. Going to a medical doctor for a referral or reaching out to a therapist is a great start, but taking the first step can feel overwhelming. Being proactive and knowing where to go in a low place is extremely helpful.

"Write down changes you have noticed in your body, physical and emotional, and present them to your doctor or a therapist," Hemendinger recommends. "Be ready to advocate for yourself and ensure you get the support you need."

Mental and physical health are dependent on one another. While many means can be used to track the body's responses to stress and recovery, using the science of HRV can ensure that one is getting the full benefit from their training and predict an oncoming decrease in mental wellness.

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