Exercising WELL with Anxiety

Many people with anxiety avoid exercise, and exercise can even cause panic attacks in some people, even though exercise has been shown to help reduce anxiety symptoms and prevent anxiety attacks as well or even better than medication or placebo. This article takes a look at the complicated connection between exercise and anxiety, and provides five steps to take to help you use exercise well* for managing anxiety.

Anxiety and exercise: two sides of the same coin

Anxiety starts with the thought you might not have enough of what you need to be okay in the future. Because all thoughts instantaneously change the body, that worry is felt in your body. That feeling signals the brain that there is in fact a problem and the cycle between thoughts and body sensations are what cause anxiety.

It does not matter if that thought is about a real or potential threat in your future, your body starts to prepare now, by getting ready to move, to fight or flee the threat to your safety. Your heart rate goes up, blood flow shifts away from digestion and into the muscles, you start sweating to cool your body. This is why the feeling of anxiety and the sensations of exercise feel similar—both are your body ready to move.

The way out of anxiety is more than thinking differently

If these feelings start with a thought, shouldn’t anxiety be curable by changing thoughts? Well, anxiety is a brain and body event. It’s the way the thoughts change the body and the body changes thoughts in a rapid back-and-forth pattern that turns a worry into anxiety.

This is why managing anxiety is not as easy as changing your thinking. Treating anxiety needs strategies that help the body and brain work together in a positive way. Those body strategies need to incorporate movement because that is what your body is preparing to do to fix the problem.

How does exercise help anxiety?

The evidence is mounting that exercise is a powerful treatment for anxiety. How does it work?  The answer is not completely clear, but exercise may help with anxiety by:

  • Improving the way the brain and body communicate through hormones, to help you calm the central nervous system when it is in a stress response.
  • Increasing growth factors like brain-derived neurotrophic factor (BDNF), which helps with learning, and creating new memories. This can be helpful with creating new associations with thoughts and anxious feelings to reduce the cyclic pattern that leads to anxiety.
  • Stimulating the growth of new brain cells and blood cells, helping the body and brain heal and protect from diseases that are often associated with anxiety.
  • Improving the function of the hippocampus, the region of the brain that may be impaired with by PTSD. Better hippocampus function may help reduce the heightened stress response and reduce PTSD symptoms.
  • Lowering inflammation which is associated with anxiety. Anti-inflammatory measures have been shown to have a positive impact on treating anxiety disorders.
  • Regulating neurotransmitters, such as dopamine, a chemical critical to central nervous system functions such as movement, pleasure, attention, mood, and motivation.
  • Reducing the sensitivity to the sensations of anxiety by creating a new more positive association to the common symptoms of elevated heart rate, sweating, and shortness of breath.
  • Improving self-confidence in ability to deal with anxiety-producing situations.

So why do many people with anxiety avoid exercise?

Exercising to treat anxiety sounds great on paper, but when you have anxiety, the last thing you want to do is willingly create the same feelings in your body as when you are feeling anxious. You may logically know that exercise could help, but what your body tells your brain is much more powerful than logic.

  • Avoiding the unpleasant: The feeling of anxiety is unpleasant, and the brain is hardwired to avoid what is unpleasant. Therefore, avoiding exercise is what makes sense to your brain, even when you are told over and over that exercise can help with anxiety. Knowing you should exercise but not feeling motivated to do it, only makes anxiety worse by adding to the list of activities that are a struggle when you have anxiety.
  • Reminder of not having enough: The word exercise can be a reminder you don’t have enough time, energy, motivation, stamina, strength, flexibility, balance, coordination, equipment, know-how, or support to do it successfully. Since anxiety starts with the thought that you won’t have enough of what you need to do something in the future, certain ideas of what counts as exercise can make it especially anxiety-producing.
  • The feeling of not being enough: It’s natural to compare yourself to others and whether it is an athletic competition or the person next to you at the gym, making sure your physical capabilities measure up is what we are hardwired to do. If you were an athlete or in the military, this physical ‘measuring up’ has been drilled into your idea of success with exercise. This innate and learned connection between exercise and ‘being enough’ can create anxiety when your body just cannot do what it used to do or what everyone else can do.
  • Images that say you are not enough: When you exercise, your brain has to contend with all those media images of what your body ‘should’ look like and the ideas about what it means to be an ‘exerciser’. Walking into a gym can be incredibly intimidating when your body does not look like those media images and everyone else seems to know how to use the equipment. Starting to exercise when you are ‘not an exerciser’ feels like you are wearing a big sign on your forehead that says ‘I’m not enough’.

It’s no wonder people with anxiety often avoid exercise and that exercise can even induce panic attacks

Studies show exercise can promote an increase in anxiety initially, but over time reduces anxiety levels.  The problem is that getting over that hump is not so easy and sets your brain up to want to avoid exercise in the future.

If exercise is going to calm anxiety in a way that you stay motivated to keep using it as part of your toolbox for anxiety, it needs to be designed to calm anxiety from day one, so your brain wants you to keep coming back for more. This takes a whole-person approach to exercising before you even take your first step.

The five steps to Exercising WELL for managing anxiety

Since exercise can cause anxiety, and even panic attacks, just doing it is not the answer. Here are the five steps to be Exercising WELL for managing anxiety:

Step 1: Prepare for feeling better. Think about the types and amount of exercise you feel confident you can do and know will be calming from the moment you start. Consider also the location and environment in which you feel comfortable. This lets you start in a way that sets you up for success. When you feel better from day one, your brain automatically wants you to go back for day two and every day after that. Creating that positive experience, though, requires attention to the details that only you know about yourself and what allows you to feel safe, contented, and connected.

Step 2: Know how to move smart. You could do the best kind of exercise, but if it is done in a way that works against how your body is designed to move, it won’t feel good, could cause more anxiety, and before you know it, your brain will be urging you to avoid exercise rather than return. When you know the right way to move in the body you are in right now, exercise leaves you feeling better from the very first step.

Step 3: Give your body enough of what it needs. There may be one type of exercise you feel most comfortable doing and that is a great place to start. However, your body needs a balance of strength, stamina, and mobility. Doing exercise for just one of these—for example, walking for stamina—means your body will gradually lose strength and mobility, because it is a use-it-to-keep-it system. That loss sends signals to your brain that you don’t have enough of what you need for certain activities, and thus there is the potential for anxiety in those situations. For example, you might be walking regularly and have built up stamina, but when your family takes a challenging hike and you need to step higher than you normally do to lift your body up a rocky part, the lack of strength and mobility can cause anxiety. Having a balance of exercises for strength, stamina, and mobility means your body will have enough of what it needs for the wide range of physical activities needed for everyday life, and for the fun stuff too.

Step 4: Stay present as you move. In past blogs, I have defined presence as knowing you have enough and are enough in this moment. It’s the knowledge that you have enough that allows you to stay in the present moment. What you know in the present moment is your best guide to moving smart and making adjustments to exercise that helps you feel better mentally, physically, emotionally and spiritually. When that happens, exercise can calm anxiety.

Step 5: Learn to change your brain. Because exercise changes your brain in a way that maximizes learning, exercise is a tremendous opportunity to lay down new, more helpful memories about how you have what you need. When you pause after exercise to notice, write down, or verbalize how you feel compared to how you felt before exercise that day, you are helping your brain learn that you have enough of what you need to make yourself feel better. This puts all that BDNF to good use and creates a positive habit loop for exercising and moving with confidence in the future.

Bottom line

Anxiety starts with the thought that you won’t have enough of what you need to be safe, contented, or connected in future. This quickly changes the body, preparing it for movement to take care of this ‘shortcoming’ in your resources. Anxiety is this cycle of thought and the body’s reaction to thoughts that can be paralyzing and limit your ability to fully enjoy life. When exercise is carefully designed to be a positive exercise in your body and mind, it works as one of your best tools for managing anxiety by breaking the thought/feeling cycle that causes anxiety and restores calm in your whole person.

*Important Note: This article provides general information about exercising with anxiety. The specifics about how much is enough and the timing of exercise when you have anxiety is very individual. 

Exercising WELL is the way to have a  clinical exercise physiologist as part of your mental health team. Along with your health care providers, I can help you decide the way to use exercise to help control anxiety.  Click the button below to learn more about the Exercising WELL online program and coaching. If you have specific questions, please  feel free to contact me. 

Sources:

  • 2. Helgadóttir B, Forsell Y, Ekblom Ö. Physical activity patterns of people affected by depressive and anxiety disorders as measured by accelerometers: a cross-sectional study. PLoS One. 2015;10(1):e0115894. Published 2015 Jan 13. doi:10.1371/journal.pone.0115894
  • Kandola A, Vancampfort D, Herring M, et al. Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety. Curr Psychiatry Rep. 2018;20(8):63. Published 2018 Jul 24. doi:10.1007/s11920-018-0923-x
  • Andreas Ströhle, Barbara Graetz, Michael Scheel, André Wittmann, Christian Feller, Andreas Heinz, Fernando Dimeo, The acute antipanic and anxiolytic activity of aerobic exercise in patients with panic disorder and healthy control subjects, Journal of Psychiatric Research,Volume 43, Issue 12,2009,Pages 1013-1017,ISSN 0022-3956,
  • Lattari E, Budde H, Paes F, et al. Effects of Aerobic Exercise on Anxiety Symptoms and Cortical Activity in Patients with Panic Disorder: A Pilot Study. Clin Pract Epidemiol Ment Health. 2018;14:11‐25. Published 2018 Feb 21. doi:10.2174/1745017901814010011