1. Anxiety
UGA PEDB Program
While anxiety can help motivate us and was once thought to be an advantage in certain evolutionary aspects, excessive levels of anxiety can have a negative impact on your quality of life.
What is Anxiety?
Anxiety is characterized by a state of worry, apprehension, or tension that often occurs in the absence of real or obvious danger. Anxiety can be classified in three ways: acutely (state anxiety), chronically (trait anxiety), and anxiety disorders. State anxiety refers to an immediate psychological and physiological response to a perceived threat. Have you ever felt your heart race right before a test, did you feel worried? If so, then you have experienced state anxiety. It is natural for acute anxiety responses to occur in certain situations.
Trait anxiety is a personality characteristic that refers to an individual’s propensity to perceive situations as threatening. Those with high trait anxiety are more likely to experience anxiety with greater intensity and frequency than those with low trait anxiety.
One of the critical factors for a diagnosis of an anxiety disorder is anxiety that impairs your ability to function in daily life. Anxiety disorders include, generalized anxiety, social anxiety, separation anxiety, selective mutism, phobias, panic, and agoraphobia. Anxiety disorders are among the most common mental health issues. Approximately 31% of females and 19% of males in the U.S will develop an anxiety disorder at some point in their life1. You or someone you know will likely develop an anxiety disorder during your lifetime.
Development and Symptoms
Like cardiovascular diseases or cancer, mental health disorders have both a biological basis and environmental risk factors. Anxiety disorders are much higher in females. Females are nearly twice as likely as males to develop an anxiety disorder. Genetic and biological factors contribute to an individual’s risk of developing an anxiety disorder. Individuals with a first degree relative with an anxiety disorder are at a greater risk of developing a disorder. Genetic factors contribute to the development of an anxiety disorder, anywhere from 20-46%. While having a gene related to anxiety does not guarantee that someone will develop anxiety, our genes respond to the environment. Environmental factors such as low household income, parenting style, and exposure to trauma also contribute to the development of anxiety disorders. It is the interaction between an individual’s environment and genetic make-up that impacts their propensity towards an anxiety disorder.
General themes across all the disorders include:
- A heightened sense of worry or apprehension in response to stressful stimuli, or an interpretation of a neutral stimulus as threatening.
- Excessive tension, elevated heart rate, an increase in respiration, sweating, gastrointestinal discomfort, or feelings of restlessness.
- Another key characteristic of anxiety is avoidance. People with anxiety disorders avoid situations, people, places, or even thoughts that induce anxiety.
Exercise for Anxiety
Exercise has been shown to decrease anxiety, both acutely (state anxiety) and chronically (trait anxiety). As well, exercise can lower an individual’s risk of developing an anxiety disorder2. Both aerobic and resistance exercises can decrease feelings of anxiety in healthy, physically active individuals3,4. If just starting an exercise program, feelings of anxiety may initially increase immediately after exercise. However, over time as an exercise program continues, anxiety will be reduced. The largest reduction is generally observed twenty to thirty minutes after a single bout of exercise. Training studies show large reductions in trait anxiety and diagnostic anxiety symptoms within six weeks of starting an exercise program, with exercise programs of 12 weeks showing a continual decrease in anxiety symptoms.
Exercise Recommendations
Aerobic exercise lasting between 20 to 30 minutes at moderate to high intensity have the greatest benefit for anxiety symptoms4. If you are just starting an exercise program, starting at a lower intensity and slowly increasing can help you become accustomed to the physical and psychological effects of exercise. Resistance training two days a week has been shown to improve anxiety symptoms3. Resistance exercise focusing on the major muscle groups consisting of 2-3 sets of 8-10 repetitions has been shown to be just as effective as aerobic exercise of the same intensity.
Trying several different types of exercise classes and sports can assist in finding a mode of activity that will work best for you! It can take time to have the physiological changes occur, being patient and consistent with your exercise regime will likely produce the greatest benefit.
Why Might Exercise Help?
There are several theories about why exercise would help improve anxiety:
Distraction theory- This theory states that physical exercise improves psychological aspect due to the removal of the individual from stressful life events.
Cross stressor hypothesis- This hypothesis states that exercise is a physical “stressor” and over time the body will have biological improvements (e.g., low heart rate at rest, improved oxygen extraction in the tissue) that will carry over when psychological “stressor” occurs.
One possible mechanism by which exercise may improve anxiety is through improved fear extinction. Fear extinction is a decline in the fear condition response. In humans, two weeks of moderate exercise prior to exposure therapy significantly improved anxiety symptoms compared to exposure therapy alone. Furthermore, this study also found significant increases in plasma brain derived neurotrophic factor (BDNF). BDNF is important for the health of neural tissue. Exercise training could plausibly act both through physiological changes in the brain, such as increased BDNF which could contribute to improved fear extinction, or through cognitive changes due to a new interpretation of the somatic symptoms.
Although one third of the U.S. population will develop an anxiety disorder, many individuals will not seek treatment. Many suffer in silence due to the stigma surrounding mental health treatment. As you have learning, there are biological factors which are strongly related to the development of anxiety disorders. Exercise may plausibly induce physiological changes which can improve anxiety. Early intervention is best and developing healthy coping skills to deal with anxiety can help in your mental health journey.