Exercise Guidelines and Anxiety
The World Health Organization set forth a physical activity guideline of 150 minutes of moderate-to-vigorous physical activity per week [5]. Individuals who do not meet this guideline significantly increase their risk for anxiety [5]. High levels of physical activity serve as a protective mechanism against anxiety, and low levels of physical activity may be a risk factor for anxiety disorders [1,7]. In general, exercise provides anxiolytic effects not only for individuals who suffer from anxiety disorders, but also those who do not have an anxiety disorder diagnosis [2,3,4,6,7,8].
Additional Health Benefits for Individuals with Anxiety
While exercise can reduce anxiety symptoms, additional benefits exist for those who suffer from anxiety. Individuals with anxiety have a greater risk of physical health complications such as cardiovascular disease [4]. Exercise can reduce the risk of cardiovascular disease by improving cardiorespiratory fitness [4]. Current conventional anxiety treatments such as SSRI’s and therapy are not suitable to reduce the risk of cardiovascular disease, making exercise a viable alternative or conjunctive treatment for anxiety [4].
How Does Exercise Act as an Anxiety Antidote?
Exercise is a healthy stressor that activates and regulates the HPA axis, a neuroendocrine pathway that is involved in anxiety [1]. By activating this pathway on a regular basis, an individual adapts to the physiological stress response over time [4]. This adaptation to the activated HPA axis de-sensitizes the individual to other life stressors, thereby reducing the stress response [4]. Additionally, exercise is thought to decrease anxiety by releasing endogenous opioids called beta-endorphins, increasing a neurotrophin called BDNF which promotes neuronal growth, and the growth of new neurons in the brain [1].
How Often Should I Exercise, and What Type?
Even engaging in acute bouts of exercise before a stressful event can reduce anxiety symptoms [2]. However, a greater volume of exercise may have a larger impact on anxiety symptoms [2]. Although more exercise may be better, the type of physical activity should be a combination of different aerobic exercises to create the maximum benefit [2]. Below are examples of aerobic exercises that may help alleviate anxiety. Start small, but eventually try to reach the recommended 150 minutes or 2.5 hours of moderate-to-vigorous physical activity each week. As always, consult your physician before trying any new exercise regimen.
1. Running
Train for three days per week. Start walk/running two days per week for 20 to 30 minutes. Use the third day as a longer 40-minute to one-hour walk/run. Cross train with weightlifting on your off days.
2. Power Yoga
Begin with learning basic power yoga poses from the internet. The first poses you can learn are chair pose, squat, lunge, warrior one, downward facing dog, extended side angle, and high plank. Next, work through these poses for a continuous 20-minute exercise.
3. Hiking
Find a hill and briskly walk up and down for 20 to 30 minutes 2 to 3 times per week. Cycling or walking are great ways to cross train on your days off.
4. Brisk Walking
Because of its low impact, you can increase the duration of walks quickly. Start with 30 minutes and try to reach 1 hour three times per week. Remember to hold your head up, keep your back straight, and loosely swing your arms.
5. Swimming
Freestyle is the best stroke for beginners to learn. At first, don’t worry about learning how to tumble turn or flip turn. Just swim to one end of the pool, turn around in the easiest way, and then continue your lap. After you have mastered the stroke, learn the tumble turn and try to reach 30 minutes of swimming three times per week.
6. Cycling
Starting at the gym is an easy way to learn if you want to pursue cycling and purchase a bike. Practice engaging the core, relaxing the shoulders, chest open, and angling the upper torso forward. Start with 20 minutes and increase as you are able.
7. Dancing
This is another exercise that is easiest to start with the internet. Simply search dance workouts or Zumba on YouTube and start with 20 minutes. Make sure it is a cardio routine for your aerobic needs.
8. Jumping Rope
First, choose a jump rope of the correct size. The rope length between the handles should be your height plus 3 feet. Be sure to jump low around three inches on the balls of your feet with wrists close to the body at hip height and elbows pointed backwards.
9. Kickboxing
First, learn basic movements and stances like the jab, cross, hook, uppercut, slip, and kick. Then find a kickboxing class for beginners to attend. Most places can provide the first class for free, provide gloves and other equipment for you to use. It is harsh on the body, and you will need a lot of recovery time in the beginning.
10. Circuit Training
This is a workout that involves rotating through a circuit of up to 10 exercises to target different muscle groups with little or no rest. You can think of it as cardio weightlifting. Search YouTube for circuit training exercises for beginners. Exercises can include jumping jacks, squats, push-ups, alternating lunges, crunches, bench dips, glute bridges, and burpees.
11. Rowing
Start with only 5-10 minutes at first when just beginning. The rowing stroke has 4 parts: 1) catch: starting position at the front with vertical shin to the floor, 2) drive: legs initiate the drive, hips swing back, and arms bend, 3) finish: straight legs with arms bent back, and 4) recovery: arms lead forward, hips swing forward, and legs bend.
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References:
- Anderson, E. H., & Shivakumar, G. (2013). Effects of exercise and physical activity on anxiety. Frontiers in psychiatry, 4, 53115. https://doi.org/10.3389/fpsyt.2013.00027
- Connor, M., Hargreaves, E. A., Scanlon, O. K., & Harrison, O. K. (2023). The Effect of Acute Exercise on State Anxiety: A Systematic Review. Sports, 11(8), 145. https://doi.org/10.3390/sports11080145
- Jayakody, K., Gunadasa, S., & Hosker, C. (2013). Exercise for anxiety disorders: systematic review. British journal of sports medicine. https://doi.org/10.1136/bjsports-2012-091287
- Kandola, A., & Stubbs, B. (2020). Exercise and anxiety. Physical Exercise for Human Health, 345-352. https://doi.org/10.1007/978-981-15-1792-1_23
- Santana, E. E. S. D., Neves, L. M., Souza, K. C. D., Mendes, T. B., Rossi, F. E., Silva, A. A. D., ... & Gil, S. (2023). Physically Inactive Undergraduate Students Exhibit More Symptoms of Anxiety, Depression, and Poor Quality of Life than Physically Active Students. International journal of environmental research and public health, 20(5), 4494. https://doi.org/10.3390/ijerph20054494
- Stonerock, G. L., Hoffman, B. M., Smith, P. J., & Blumenthal, J. A. (2015). Exercise as treatment for anxiety: systematic review and analysis. Annals of behavioral medicine, 49(4), 542-556. https://doi.org/10.1007/s12160-014-9685-9
- Stubbs, B., Koyanagi, A., Hallgren, M., Firth, J., Richards, J., Schuch, F., ... & Vancampfort, D. (2017). Physical activity and anxiety: A perspective from the World Health Survey. Journal of affective disorders, 208, 545-552. https://doi.org/10.1016/j.jad.2016.10.028
- Stubbs, B., Vancampfort, D., Rosenbaum, S., Firth, J., Cosco, T., Veronese, N., ... & Schuch, F. B. (2017a). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry research, 249, 102-108. https://doi.org/10.1016/j.psychres.2016.12.020