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• The mind-body connection is a strong one—so strong, in fact, that your emotions, both positive and negative, can affect your heart (and vice versa).
• Research shows that negative emotions, such as chronic stress, can damage your heart and increase the risk of cardiovascular issues in the long term. On the flip side, positive emotions may actually protect your heart.
• Over time, strong emotional responses can either benefit or harm your heart, depending on how you cope with those emotions.

When you hug someone you love, you might get that warm, comforting feeling in your chest—as if your heart itself is being hugged. And when you see someone you fear, like a villain in a horror movie, you might feel your heart skip a beat or pound through your chest. Either way, it’s clear that your emotions can elicit certain reactions from your heart. But how do we explain these connections? And can our emotions affect our heart health long-term?

What Happens In Your Body When You Experience Stress?

The connection between your mind and body can be so strong that, sometimes, “your body reacts to an emotion before your mind can even consciously recognize its impact,” says Dr. Harpreet Nagra, PhD, VP of behavior science and advanced technologies at One Drop.

Let’s say you just had a tense meeting with your boss at work, and you can suddenly feel your heart racing or your shirt sticking to your chest with sweat. What exactly is happening inside your body to cause these types of reactions?

“A typical ‘fight-or-flight’ response involves the hypothalamus and pituitary gland, two small structures at the base of the brain, which communicate with one another and send signals to the adrenal glands, which sit on top of the kidneys,” explains Andrew Gerber, MD, PhD, president and medical director of Silver Hill Hospital, a psychiatric hospital in New Canaan, Connecticut. “This system is referred to as the HPA (hypothalamus-pituitary-adrenal) axis.”

In an “acutely stressful” situation, he continues (think: short-term stress, like a traffic jam), the adrenal glands produce several different stress hormones, including cortisol, which increases your blood sugar and adrenaline, which in turn heightens your attention, gives you energy, and increases your heart rate and blood pressure, focusing blood supply on where it’s needed most to ensure your muscles and brain work faster and better.

“As long as this is a short-lived and temporary response to an acute stressor (e.g., in prehistoric times, running away from an animal predator; in current times, perhaps playing a sport or taking an exam), and these responses return to normal once the stressful event has passed, you’re fine,” says Dr. Gerber. “However, if these negative emotions become ongoing and unresolved, such as in the case of chronic anxiety or depression, the response of the HPA axis can become damaging to the body.”

Chronic Stress and Heart Health

Of course, we all experience stress to some degree. It’s a normal part of life. But chronic stress, as Dr. Gerber notes, may lead to chronic anxiety or depression, which can then be linked to certain heart health issues.

Why? Again, it’s all about those hormones that flood your bloodstream in response to stress. Once a stressful event is over, your hormone levels are supposed to return to their normal baseline. But when stress becomes chronic—meaning your body’s stress response system is constantly activated, whether as a result of a toxic job, relationship, or some other ongoing stressor—those hormone levels can remain elevated and begin to disrupt the organs they affect, including your heart.

Over time, “your heart, blood vessels, brain, and other organs may struggle to maintain a level of hormones that they were never meant to sustain, and may suffer temporary or even permanent damage,” says Dr. Gerber. High cortisol levels, for example, are associated with increased cholesterol, triglycerides, blood sugar, and blood pressure. Moreover, research shows that chronic stress, depression, anxiety, and even insomnia are all associated with heart disease.

But it’s also important to acknowledge the ways in which many of us cope with chronic stress and other mental health concerns, adds Dr. Nagra, such as overeating, emotional eating, smoking, drinking, or forgoing exercise in favor of vegging on the couch. “Over time, these small actions can build up into something bigger,” she says—namely, heart health challenges like high blood pressure, heart attack, stroke, or other cardiac events.

To be clear, though, stress itself—even when chronic—isn’t a direct cause of heart health issues, notes Silvi Saxena, a licensed social worker and clinical trauma professional. But it can still be a risk factor for heart disease that’s worth keeping an eye on.

When Heart Health Challenges Affect Mental Health

The link between heart health and emotions is bidirectional, says Dr. Nagra. Your emotions can not only impact the state of your heart, but your heart health can also affect your mental well-being.

According to the Centers for Disease Control and Prevention (CDC), mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD) can develop after heart-related health incidents.

Why are these mental health conditions so common among people with heart disease? Think about it this way: When you have to consciously think about managing your heart health day-to-day, explains Dr. Nagra, you’re likely thinking more about what you eat, how much exercise you’re getting (or not getting), how much stress you’re exposing yourself to, and at least a dozen other variables that you may or may not have any control over. “That mental load, in turn, can lead to mental health concerns like chronic stress, depression, and anxiety,” says Dr. Nagra.

How Positive Emotions Can Benefit Your Heart

We know that chronic exposure to stress and other mental health challenges can create some issues for your heart. But what about the effects of positive emotions?

Research suggests that “positive psychological well-being” (characterized by positive emotions, life satisfaction, purpose in life, and optimism) may be associated with reduced heart-related health incidents in both healthy populations and, “to a lesser extent,” in those with existing heart conditions. It’s unclear what exactly underlies the relationship between the two, but researchers believe that positive well-being may indirectly affect heart health via healthy habits like a proper sleep schedule, avoiding smoking, exercising, and eating fruits and vegetables.

It makes sense, right? When you feel good, you’re usually more motivated to invest your time and energy into the behaviors that continue to make you feel good, like getting enough sleep and nourishing your brain and body with movement, nutrients, and activities that make you feel fulfilled and satisfied. (Find out how working with a One Drop coach can help you establish and stick to these healthy habits.)

Still, many researchers are keen to point out that “positive psychological health” and its relationship to reduced heart health risks does not imply an absence of negative emotions. According to a 2021 scientific statement from the American Heart Association (AHA) that was commissioned to evaluate and summarize the relationship between psychological and cardiovascular health, “findings to date suggest that positive psychological factors are independently associated with cardiovascular benefits beyond simply the absence of negative states.”

In other words, it’s not about having an “all-or-nothing” approach to certain emotions and your heart health. It’s up to you to regulate how you respond to those emotions so you can reduce any potential negative effects they may have on your heart.

Coping with Difficult Emotions and Their Impact On Your Heart

“There’s no such thing as a life with only positive emotions,” says Dr. Gerber. “We need negative emotions, both to adapt to the world and its challenges, as well as to help us identify and feel positive emotions when good things happen.”

The key, then, is to figure out how to handle negative emotions when (not if) they happen, he notes. Generally speaking, he says the goal is to mitigate these emotions and their impact on you through resilience, adaptation, and acceptance of these emotions as normal parts of your life and everyday experiences.

“There is no one right way to achieve this goal,” says Dr. Gerber. Rather, it’s all about finding what works for you. Below are a few suggestions on where to start:

• Call out negative self-talk. You can’t always control your initial knee-jerk reactions to certain stressors, like a difficult boss or a delayed train during rush hour. But you can control the internal dialogue that ensues during those stressful events, says Dr. Nagra. Whether you tend to jump to all-or-nothing thought patterns (“I’ll never find a job with a boss I like”) or blame yourself for situations beyond your control (“I was left out of that meeting because people don’t like me”), “everybody has some sort of negative bias they use when they initially experience a negative event,” she explains. It’s crucial to not only be in tune with these biases and recognize how they contribute to your emotional and physical reactions, but also come up with ways to counteract them. For example, for each negative thought that you catch in your mind, try countering it by writing down something positive, or at least neutral, such as, “I’m handling this hard day to the best of my abilities.”
• Use “top-down” and “bottom-up” techniques. Licensed mental health counselor, Evan Lawrence, recommends that everyone has at least one “top-down” technique and one “bottom-up” technique to help with processing emotions. “This essentially means one technique where you’re processing with your mind, and one where you’re processing by working with your body,” he explains. For example, a top-down technique might be “cognitive reappraisal,” he says, where you reassess your thoughts (read: call out that negative self-talk!) or practice systematic problem-solving to work your way through an issue. “Some bottom-up techniques might be exercise, controlled breathing techniques, or yoga,” he explains.
• Establish your support system. For some, a support system might mean a close-knit circle of family and friends. But it’s also important to recognize when you might benefit from some extra support outside of your immediate circle. “I always recommend a checkup with a therapist every once in a while to review your mental health,” says Dr. Nagra. Ask your primary care doctor if they can recommend someone, or, if you’re employed, ask your company about any mental health benefits you may have. You can also check out sites like MentalHealth.Gov, the National Alliance on Mental Illness (NAMI), and the Substance Abuse and Mental Health Services Administration (SAMHSA) for more resources. (And, if you already live with a heart health condition, One Drop’s Complete Heart Health program can provide holistic support through personalized health coaching and healthtech tools and devices that make it easier to maintain consistent healthy habits.)

This article has been clinically reviewed by Jamillah Hoy-Rosas, MPH, RDN, CDCES, and VP of clinical operations and program design at One Drop, and Dr. Harpreet Nagra, PhD, VP of behavior science and advanced technologies at One Drop.