HRV and Mental Health

HRV in the Mental Health Space

By now, you’re probably familiar with our passion for heart rate variability (HRV) and in particular, its role in managing fatigue. But we believe that HRV holds potential beyond fatigue management. One area that has captured our attention in recent years is the realm of mental health…


You might be wondering, how does this tool relate to mental health? Well, we are here to fill you in on the exciting connection. 


In this blog, we’ll explore the fascinating, research-backed, ways in which HRV is linked with mental health, and how we can utilise it as a tool to improve mental health outcomes. 


Stress Management


Stress management plays a crucial role in maintaining our mental well-being, and Heart Rate Variability (HRV) is a valuable tool in understanding and addressing stress levels. HRV, which is inversely related to stress, provides insights into an individual’s stress response and can help identify periods of heightened stress, as well as a measurement of changes in stress overtime. 


In recent years, research has started to emphasise these links between HRV and stress. In a meta-analysis conducted by Kim et al. (2018), a clear correlation between stress and HRV was identified, supporting its use as an objective assessment tool for psychological health and stress. Additionally, Järvelin-Pasanen et al. (2018) conducted a systematic review focusing on occupational stress and HRV. The main finding of the study was that heightened occupational stress was associated with lowered HRV, specifically with reduced parasympathetic activation.


Emotional Regulation


Emotional regulation is another key player when it comes to mental well-being, and Heart Rate Variability (HRV) is intricately linked to this process. Low HRV has been associated with difficulties in regulating emotions and may serve as an indicator of mental health conditions such as anxiety and depression. 


The research in this space is eye-opening and becoming more and more prominent. Geisler et al. (2010) found that HRV was positively associated with sustained cheerfulness and calmness, and that these effects were mediated by executive emotion regulation. The study supported the use of HRV as an index of self-regulatory strength and its association with overall life satisfaction. Similarly, Williams et al. (2015), in a study involving nearly 200 undergraduate students, observed that HRV predicted specific aspects of emotional regulation, namely emotional clarity and impulse control. These findings support the notion that emotion regulation and autonomic regulation within the brain have shared neural networks, directly influencing one another. Further supporting the connection between HRV and emotional regulation, Di Simplicio et al. (2011) discovered that individuals with reduced autonomic flexibility (low HRV) are at a higher risk and more vulnerable to psychological struggles. 


Similarly to stress-management strategies, by tracking HRV, individuals can gain awareness of their emotional states, identify triggers, and develop effective strategies for emotional self-regulation. 


Biofeedback Therapy 


Biofeedback therapy, including the use of Heart Rate Variability (HRV) biofeedback, integrates with the principles of stress management and emotional regulation, providing a tangible tool. By using HRV data in real-time, this practical technique teaches individuals to self-regulate their Autonomic Nervous System (ANS) acutely. Biofeedback therapy is said to be effective in supporting those with anxiety, stress-related disorders, and mood disorders.


Research has demonstrated the significant benefits of HRV biofeedback therapy. In a pilot study by Beckham et al. (2012) on perinatal women with depression, HRV biofeedback significantly improved mental health outcomes, particularly reducing anxiety. Similarly, HRV biofeedback showcased promising results in anxiety reduction and improved quality of life for individuals with Long Covid, as found by Freda (2023).


In Summary…


As we continue to delve deeper into the world of HRV and mental health, it becomes evident that this tool holds tremendous promise. By leveraging HRV data and incorporating it into our stress management techniques, emotional regulation strategies, and biofeedback therapy, we can empower individuals to take an active role in their mental well-being journey.


The possibilities are endless, and we are excited to witness the ongoing advancements and discoveries in this evolving field.

Author: Tessa Nielsen 
Clinical Exercise Physiologist and
Content Creator at Specialised Health


  • Beckham, A., Greene, T. B., & Meltzer-Brody, S. (2012). A pilot study of heart rate variability biofeedback therapy in the treatment of perinatal depression on a specialized perinatal psychiatry inpatient unit. Archives of Women’s Mental Health, 16(1), 59–65. 
  • Simplicio, M., Costoloni, G., Western, D., Hanson, B., Taggart, P., & Harmer, C. J. (2011). Decreased heart rate variability during emotion regulation in subjects at risk for psychopathology. Psychological Medicine, 42(8), 1775–1783. 
  • Freda, C. (2023). Biofeedback and Anxiety Reduction: An Occupational Therapy Intervention for Persons with Long Covid. Encompass. 
  • Geisler, F. C. M., Vennewald, N., Kubiak, T., & Weber, H. (2010). The impact of heart rate variability on subjective well-being is mediated by emotion regulation. Personality and Individual Differences, 49(7), 723–728. 
  • Järvelin-Pasanen, S., Sinikallio, S., & Tarvainen, M. P. (2018). Heart rate variability and occupational stress—systematic review. Industrial Health, 56(6), 500–511. 
  • Kim, H., Cheon, E., Bai, D., Lee, Y. H., & Koo, B. (2018). Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature. Psychiatry Investigation, 15(3), 235–245. 
  • Williams, D. P., Cash, C., Rankin, C., Bernardi, A., Koenig, J., & Thayer, J. F. (2015). Resting heart rate variability predicts self-reported difficulties in emotion regulation: a focus on different facets of emotion regulation. Frontiers in Psychology, 6.

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