Integrating physical activity regularly (150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity per week)¹ into a daily routine can enhance your mood and calm anxiety.^2–4 Indeed, research indicates that consistent physical activity can improve symptoms of depression and anxiety, as well as enhance overall mood, drive, and self-image and improve sleep, in individuals with diagnoses of anxiety and/or mild-to-moderate depression.^1–4 Though the benefits of physical activity are within everyone’s reach, there are many factors involved in how these benefits are best achieved. For example, responses to physical activity and developing a consistent exercise routine can vary dramatically person to person, especially in the presence of depression or anxiety/panic disorders.

ANXIETY/PANIC

Though physical activity can relax the sensory nervous system, release endorphins (“feel-good” hormones), and lower resting heart rate, other hormonal and bodily reactions (shallow breathing, racing heart rate, and sweating) that typically accompany moderately or vigorously intense workouts can elicit symptoms of anxiety and panic responses in susceptible individuals.^3–6 When cortisol, a stress hormone, is activated during exercise or subsequent exhaustion, it can potentially induce a fight-or-flight response in some people with pre-existing anxiety and/or panic disorder.^3–6 However, maintaining a consistent exercise regimen over the long term has been shown to lower overall cortisol levels, reducing the risk of exercise-induced nervous system arousal and improving symptoms of anxiety. Here are tips on how to get the most out of physical activity when faced with symptoms of anxiety and/or panic.

Tips

• Opt for aerobic (cardio) exercises, if possible (e.g., brisk walking, jogging, swimming, dancing, cycling). According to the National Institute of Mental Health, aerobic exercise can help manage symptoms of anxiety; however, researchers caution that exercise should not replace standard care by a qualified physician or mental health therapist; rather, it should be used in conjunction with standard treatments for anxiety and/or panic disorders (e.g., cognitive behavioral therapy, antidepressant and/or anti-anxiety medications).⁷ Other research has shown that regular aerobic exercise can enhance the activity of calming neurotransmitters, such as gamma-aminobutyric acid (GABA), in the brain.^4–6
• If aerobic workouts aren’t for you, try Pilates or yoga. Both incorporate monitoring heart rate and breathing and encourage mindful relaxation.⁶
• If you experience a panic attack during a workout, stop the activity and practice breathing and other relaxation exercises, wet your face or take a shower, talk to a friend, or do some stretches instead.⁶ When your heart rate slows and anxiety/panic dissipates, resume the workout or do some stretching and breathing exercises.
• Learn your symptoms and triggers. By becoming aware of bodily responses, you’ll be able to gauge your limits and prevent the occurrence or exacerbation of anxiety and panic attacks during exercise or other triggering events

MILD-TO-MODERATE DEPRESSION

According to researchers, physical activity and exercise can be the optimal treatment for depression. Further, data from clinical studies suggest that regular physical activity and exercise is as effective as anti-depressants in patients with mild-to-moderate depression.^8–10  Unfortunately, the actual symptoms of depression that are improved by physical activity are also the ones that weaken the drive to engage in physical activity in the first place.^8–10 Depression typically hinders adaptation to novel circumstances and experiences by interrupting the communication of important neurotransmitters, such as dopamine, serotonin and norepinephrine, throughout the brain.^9,10 This can result in feeling “stuck” and a lack of interest and/or motivation to engage in any physical activity, let alone a workout. Exercise, however, can amplify the production of brain-developed neurotrophic factor (BDNF), which enhances the ability of dopamine, serotonin, and norepinephrine neurotransmitters to do their jobs, increasing your ability to feel interested and motivated to exercise and helping you overcome that “stuck-in-a-rut” feeling.^8–10

Tips

• Though the exact amount of time and level of intensity of physical activity required to improve symptoms of depression has yet to be nailed down, experts from Harvard Health Publishing agree that individuals with depression who begin exercising should start to “feel better within a few weeks.”¹⁰
• Sustainability of physical activity for the long-term is integral to experiencing and maintaining improvement in one’s mood.¹⁰ Set short-term goals that are achievable (and not overwhelming), start small, and increase gradually.¹¹ For example, start off doing five minutes of exercise a day for a week. Then, next week, increase it to 10 minutes of exercise a day, and then 15 minutes a day the following week, and so on.
• Try a variety of activities and do ones you enjoy, rather than focusing on building a routine doing specific exercises you don’t enjoy. Note: Any level of physical activity can elevate mood and energy levels; it does not have to leave you breathless and sweating—even a leisurely stroll around the block can provide physical and mental benefits. The important thing is to get your body moving in one capacity or another^11,12
• Push yourself to move, even on the days you do not feel like moving.^11,12 Take a brisk walk around the block, practice a few yoga poses or a group of dance moves, or weed a small patch of garden.

Sources

1.     Laskowski ER. How much should the average adult exercise every day? 27 Apr 2019. https://www.mayoclinic.org/healthy-lifestyle/fitness/expert-answers/exercise/faq-20057916. Accessed 4 Apr 2021.

2.    Sharma A, Madaan V, Petty FD. Exercise for mental health. Prim Care Companion J Clin Psychiatry. 2006;8(2):106.

3.    Anderson E, Shivakumar G. Effects of exercise and physical activity on anxiety. Front Psychiatry. 2013;4:27.

4     Maddock RJ, Casazza GA, Fernandez DH, Maddock MI. Acute modulation of cortical glutamate and gaba content by physical activity. J Neurosci. 24 Feb 2016;36(8):2449-2457.

5.    Nonaka S, Arai C, Takayama M, et al. Efficient increase of gamma-aminobutyric acid (GABA) content in tomato fruits by targeted mutagenesis. Sci Rep. 2017;7:7057.

6.    Leiva C. Yes, workout-induced panic attacks are a real thing. 25 OCT 2019. https://www.shape.com/lifestyle/mind-and-body/workout-panic-attacks-anxiety. Accessed 4 APR 2021.

7.    National Institute of Mental Health. Anxiety diorders. Last revised Jul 2018. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml#part_145338. Accessed 11 Apr 2021.

8.    Craft LL, Perna FM. The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry. 2004;6(3):104–111. 

9.    McMillen M. Exercise for depression: how it helps. Updated 16 FEB 2012.  https://www.webmd.com/depression/features/does-exercise-help-depression.
Accessed 4 APR 2021.

10.  Harvard Health Publishing site. Exercise is an all-natural treatment to fight depression. Updated 2 FEB 2021. https://www.health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression.
Accessed 4 APR 2021.

11.   Greenlaw E. Getting started: exercise for depression. Updated 22 JUL 2010. https://www.webmd.com/depression/features/exercise. Accessed 4 Apr 2021.

12.             Mayo Clinic site. Depression and anxiety: exercise eases symptoms. 27 SEPT 2017. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495. Accessed 4 Apr 2021.