It caught me once on a crowded Karachi street. No sprint, no fight, just a surge of panic. My heart kicked like I’d run a mile. Then, minutes later, it slowed as if nothing had happened. I brushed it off—heat, fatigue, maybe the tea was too strong. But science says otherwise. Stress itself can bend the rhythm of the heart.
A Hidden Pulse Within the Pulse
Doctors call it heart rate variability (HRV)—the tiny changes in time between beats. High HRV means your body can adapt. Low HRV means rigidity, a nervous system stuck in overdrive. Harvard Health describes it as the difference between a body that bends and one that breaks. Source
Controlled lab studies show stress pushes HRV down. Sympathetic nerves fire (“fight or flight”), parasympathetic ones fall silent. Source A large study of 900 adults found something more striking: the severity of stress—not just the number of stressful moments—predicted lower resting HRV. Source
Depression and the Rhythm of Disease
Depression deepens the pattern. A Frontiers review found that patients with major depressive disorder had consistently lower HRV scores—RMSSD, HF power, SDNN. Source
An umbrella review in Nature widened the lens: PTSD, dementia, schizophrenia, depression—each marked by reduced HRV. Source
Another study tracked the chain: low HRV → broken sleep → worsening depressive symptoms. A vicious loop, harder to escape the longer it runs. Source
Two Voices in My Own Family
I turned to my daughters. They see these patterns every day but from different angles.
Dr. Fareha Jamal, working in Munich at BioNTech:
“In cancer research we track HRV as a resilience marker. If stress keeps suppressing HRV, recovery slows. It’s not only about mood. It can worsen cardiovascular outcomes.”
Maryam Jamal, who just cleared her MBBS finals in Karachi, adds from the hospital wards:
“Patients come with palpitations. We check blood pressure, prescribe pills. But research shows HRV drops long before disease. If we monitored stressed patients earlier, maybe we’d prevent complications instead of just treating them.”
One grounded in the lab. One at the bedside. Both pushing the same message: stress doesn’t just make you feel unwell—it reshapes your biology.
Why You Should Care
Palpitations sound harmless until they’re not. Prolonged irregular rhythms raise risks for hypertension, arrhythmias, even diabetes. A Washington Post feature recently called HRV a “window into whole-body health.” It’s not about obsessing over daily ups and downs, but watching long-term trends. Source
And here’s the shift: monitoring is no longer locked in clinics. Wearables now measure HRV on your wrist. The technology is here. Awareness is lagging.
What Helps
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Move daily. Exercise restores balance.
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Guard your sleep. Insomnia destroys HRV.
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Breathe, pray, pause. Mind-body practices raise HRV through vagal stimulation.
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Track wisely. A gadget won’t replace your doctor, but it can show you when stress is winning.
Fareha calls HRV a “stress barometer”. Maryam says numbers aren’t everything: “Patients know when stress eats at them. HRV just makes it visible—for them and for us.”
Closing Beat
Stress is invisible—until your body makes it audible. That thump in your chest during an argument, that sudden silence in your pulse, those aren’t quirks. They’re signals. Science is telling us: listen.

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