This blog is going to begin with a personal story.

I was in Vienna, waiting to catch a train with a friend. I went to purchase drinks for the ride while she watched our stuff. I returned with four large bottles: two one-liter bottles of green tea and two one-liter bottles of water. She asked me if I was serious and I replied “hydration is important.” We laughed and stayed thoroughly hydrated during our journey.

This was four years ago, but I still get playfully teased if I am toting a large water bottle, or multiple water bottles, or multiple, large water bottles. Hydration is truly very, very important. Hydration and dehydration can impact the severity of several cognitive, emotional, and physical symptoms associated with mental health issues. In other words, staying hydrated alone will not cure anxiety, depression, or other mental health presentations BUT it can make them less severe. Hydration can make the difference between feeling like a one out of 10 (where zero is the worst you can feel and 10 is the best) and a two out of 10.

The Role of Diet, Sleep, and Exercise in Counseling

So why am I mentioning this on a blog about mental health counseling? Hydration and counseling are related. When you enter counseling with a wellness-oriented practitioner, he or she will likely ask you about your diet, exercise, and sleeping habits. This is done in order to establish a functioning baseline. It also helps your counselor tease out potential causes for your symptoms.

Consider the following: Billy comes to counseling because he is feeling depressed. He reports that he feels tired constantly, he cannot concentrate, and he feels unmotivated to do his work. When asked about diet, sleep, and exercise, Billy reports that he drinks three sodas per day, doesn’t exercise, and stays up until 4:30 AM playing his favorite video game. He catches a quick nap before waking up and getting ready for work at 7:00 AM. Are Billy’s symptoms the result of depression or chronic sleep deprivation? At this point, the counselor cannot know for certain. Depression can affect a person’s ability to sleep, which in turn can cause all of Billy’s symptoms. Some of these symptoms may still exist even if Billy gets the recommended amount of sleep. However, the counselor will need to rule out that these symptoms are the direct result of poor sleep. Most likely, he or she will work with Billy to explore sleep hygiene, to provide information on the importance of sleep, and to establish a new, healthier sleep schedule. The counselor will continue to assess Billy’s symptoms and work with him towards his counseling goals.

Hydration can effect a person’s symptoms, just like sleep. Dehydration can cause headaches, muscle cramps, dizziness, fatigue, sleepiness, rapid heartbeat, confusion, and irritability. Furthermore, even mild dehydration can decrease a person’s energy level, decrease a person’s ability to think, and even effect their mood (Nauert, 2015).

The Evidence

It is not enough to say that “hydration is important” and that “hydration affects a person cognitively, physically, and mentally.” Therefore, it is my goal to provide you with a summary of the research that supports the role of hydration in our mental health.

In 2011, Ganio, Armstrong, Casa, McDermott, Yamamoto, and others conducted a study on the effects of dehydration in young men. They found that dehydration negatively effected their subjects working memory, their ability to react quickly to things that they see, and their reaction times (Ganio et al., 2011). Furthermore, they found that dehydration increased tension, anxiety, and feelings of fatigue (Ganio et al., 2011). This study also demonstrates that dehydration negatively influences a person’s attention span, ability to concentrate, and feelings of anxiety.

In 2014, a literature review was compiled that examined the relationship between cognitive functioning and hydration (Masento, Golightly, Field, Butler, & Van Reekum, 2014). The authors noted that many studies pointed to dehydration resulting in decreased attention, decreased working memory, increased feelings of tension or anxiety, and decreased mood (Masento et al., 2014). They noted that many studies demonstrated that these negative effects can be reversed via dehydration (Masento et al., 2014).

In a 2015 study, Nauert found that mild dehydration increased tension, decreased working memory, and increased anxiety in men and women. These symptoms were significant in both sexes but were found to be more severe in woman (Nauert, 2015). Furthermore, even mild dehydration was found to decrease individuals’ motivation to exercise. This demonstrates how dehydration might influence a person’s concentration and anxiety in a negative way.

In 2016, the American Journal of Nutrition published a study on whether hypohydration (dehydration) influences cognition or one’s ability to think. The study found that “thirst was associated with poorer memory” (Benton, Jenkins, Watkins, & Young, 2016, p. 603). In addition, they found that dehydration was associated with decreased attention, decreased energy, increased anxiety, and increased feelings of depression (Benton et al., 2016). They also found that these symptoms decreased quickly when test participants were given a glass of water (Benton et al., 2016). Participants who were not given water found the tests to be more difficult than those who were allowed to rehydrate after exercising (Benton et al., 2016). In other words, hydration can influence your energy level, how anxious you feel, how depressed you feel, and how difficult you perceive tasks to be.

As you can see, there are several studies that point to the fact that hydration (or lack thereof) can influence attention span, working memory, tension, anxiety, depression, and energy level.

What it all Means

Many of the studies above explored how dehydration is related to negative symptoms such as decreased attention, decreased working memory, increased tension, increased anxiety, increased depression, and decreased energy. Many of these studies also demonstrated that these negative symptoms could be reversed through rehydration or drinking water.

Drinking an adequate amount of water will not eliminate all of your tension, anxiety, depression or fatigue – but it can help make your symptoms less intense. Consider scheduling water consumption into your day. I frequently work with clients to identify places in the day that they can take time to hydrate. If you are regularly dehydrated, consider adding one glass of water to each meal.

In my personal life, I drink a 16 ounce glass of water with my vitamins in the morning. I have a 32 ounce Nalgene that I bring to work and that I make sure to finish before I leave work.  I make a point of having at least two 16-ounce glasses of water with dinner. I usually need more than 80 ounces of water per day, however, I know that I have the first 80 ounces scheduled in, which makes it easier to add more.

How much water you will need varies based on weight, health conditions, temperature, exercise, and a variety of other factors. Although it is rare, it is possible to over hydrate. When clients ask me how much water they should drink, I always recommend that they consult with their medical doctor or a nutritionist.

Finally, always remember: hydration is important.

Happy Hydrating!

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References:

Benton, D., Jenkins, K. T., Watkins, H. T., & Young, H. A. (2016). Minor degree of hypohydration adversely influences cognition: a mediator analysis. The American Journal Of Clinical Nutrition, 104(3), 603-612.

Ganio, M. S., Armstrong, L. E., Casa, D. J., McDermott, B. P., Lee, E. C., Yamamoto, L. M., . . . Lieberman, H. R. (2011). Mild dehydration impairs cognitive performance and mood of men. The British Journal of Nutrition, 106(10), 1535-43.

Masento, N. A., Golightly, M., Field, D. T., Butler, L. T., & van Reekum, C.,M. (2014). Effects of hydration status on cognitive performance and mood. The British Journal of Nutrition, 111(10), 1841-52.

Nauert PhD, R. (2015). Dehydration Influences Mood, Cognition. Psych Central. Retrieved on June 20, 2018, from https://psychcentral.com/news/2012/02/20/dehydration-influences-mood-cognition/35037.html