Millions of people use a portable health and fitness tracker. These devices can be useful for monitoring activity levels, sleep quality and heart rate. But for some, wearables may have unintended consequences on well-being.
This is something I came across recently. At a public speaking event, I spoke to a man who told me a story that stuck with me.
He had just finished a long hike and felt great. Then he glanced at his smart watch. Heart rate: 130 bpm. Momentary panic.
About 30 minutes later he realized the cause: the altitude. However, in that moment, it had gone from feeling great to awful – all because of the smartwatch’s readout.
This man is not alone. Some users have found that the wearable increases their stress just as much as they needed stop wearing it.
A key reason wearable health devices can increase anxiety for some people comes down to a mismatch between expectations and what the device says.
Our brain is a prediction engine. It continuously, automatically creates and updates a mental model of our environment by comparing its predictions with the sensory information it receives.
Processing each sensory input from scratch would be slow and inefficient. By anticipating what it expects to encounter, the brain can interpret noisy sensory information quickly and usually accurately.
Some examples of this include feeling your phone vibrate when you’re expecting an important message – only to discover it never rang. Or existence abel ot raed tihs snetnece despite the typos, because your brain predicts what should be there.
The same principle applies to us physical conditions. Our brains don’t just read physical states, they predict them.
We go through the day with an internal model of what our body “should” be doing: roughly what our heart rate, temperature, and breathing usually look like when we’re calm, active, or nervous.
When sensory information arrives that does not match these expectations – such as a higher heart rate – the brain produces a “prediction errorThis alerts us that the sensory information is not meeting our expectations.
Most forecast errors are trivial and simply a mismatch between expectations and incoming information. The brain often resolves these errors automatically by updates its model and adjusting his predictions.
Since this process usually happens automatically, we usually don’t notice it. But if it reaches the level of our conscious awareness, we may seek an explanation for why our expectations and experience differ.
So, if your heart rate is faster than expected, you can attribute it to the fact that you drank too much coffee. Because we expect our bodily sensations to vary throughout the day, such explanations may be enough to prevent us from worrying about prediction error.
The same can happen when we have a portable indicator that contradicts expectations. However, because smartwatch metrics seem clear and objective, we can put more weight on them and may not dismiss an unexpected reading as easily. Even if you feel great, seeing an elevated heart rate on your smartwatch can make you think something is wrong and start a cycle of worry.
My research shows that this can be especially worrying for people prone to anxiety, who already tend to pay close attention to their internal bodily signals.
The research my colleagues and I did during COVID also found that the more anxious a person was in general, the more likely they were to monitor their physical condition through objective measures (such as taking their temperature).
This behavior in people with anxiety is not surprising. Hypervigilance towards the body can they feel protectivea way to spot problems early and reduce uncertainty. But it can quickly lead to a cycle of worry and reassurance seeking.
When such safety-seeking behavior is reduced through treatment, anxiety symptoms tend to diminish—at least in part because people are less hyper-focused on their bodies.
However, the relationship can go one of two ways. In the same study on COVID, we found a two-way connection between anxiety and attention to bodily signals. Paying more attention to bodily states increased anxiety, and anxiety increased attention to bodily states – a negative loop.
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Emerging research suggests that mobile devices may reinforce this loop. In a study of people with atrial fibrillation, heart rate monitors were associated with more frequent symptom screening and higher stress.
A larger study, involving a random sample of about 500 smartwatch users, found a similar pattern. People reported feeling anxious when their normal data looked abnormal. Some participants even reported feeling dependent on their health tracker and getting frustrated when they couldn’t wear their device or forgot it. Some recognized the effect and considered abandoning the device altogether.
However, wearables don’t seem to have the same effect on everyone. For some, this information may be reassuring and it can even reduce stress.
Essentially, we don’t know why for some wearables they provide reassurance and for others they increase anxiety.
Avoiding health stress
There are many reasons why people may wish to use mobile devices. Often, this is because this health information can be useful – like alerting us to issues we might otherwise miss. But tracking the body in this way can also sometimes they make us feel worse.
Taken together, the current evidence suggests that this effect may be particularly pronounced in anxiety-prone individuals, as well as in situations where hypermonitoring of the body or behavior may be maladaptive – such as eating disorders.
As with many things in life, it’s all about moderation. If you’re more concerned about your data than your well-being, try an experiment: leave the watch off for a day or hide the data so you don’t get constant feedback about your body.
Notice how your body feels unmonitored. You might discover what this hiker did: that sometimes trusting what you feel is best.
