A recent review of the literature regarding the effects of exercise on anxiety (Asmundson, 2013) clearly shows that with individuals diagnosed with anxiety disorders exercise can reduce both acute anxiety and chronic anxiety as effectively as medication. However, both exercise and medication have high drop-out rates due to the unpleasant side effects of medication and most likely motivational factors with exercise. Studies combining exercise with CBT show greater reductions in symptoms in a one-year follow-up than exercise alone.
We can conclude from this review that exercise is an effective treatment for anxiety disorders but not a singular treatment. In other words, exercise may help reduce anxiety but cognitive therapy can help address the thinking that increases anxiety as well as the thinking that can affect the motivation to continue exercise as a lifestyle practice.
For some people, however, exercise may be a main focus of their anxiety management. In fact, I've had a number of clients who experienced anxiety and panic for the first time when they were unable to engage in their usual exercise routine due to circumstances such as an injury. Which is why a person shouldn't rely on only one technique but have several different methods that help reduce anxiety.
A number of reasons have been proposed to explain how exercise can aid those with anxiety disorders: 1) exposure to body sensations resulting in decreased anxiety sensitivity; 2) physiological changes that decrease negative stress reactions; 3) improved sleep; 4) increased feelings of success; 5) improved mood; 6) distraction from anxious states; and 7) reduction in social withdrawal (Asmundson et al, 2013). The specific mechanism may vary from person to person are may even involve several of these explanations.
Best of all, exercise not only helps manage anxiety but it has many other mood-enhancing and health benefits. Therefore, developing a plan for exercise in your lifestyle is an important aspect of treating an anxiety disorder.
However, exercise doesn't have to be intense to aid with managing anxiety. One review of the research showed that even meditative movement such as Tai Chi or Qigong can be as effective as other types of exercise for reducing anxiety particularly in milder cases (Payne and Crane-Godreau, 2013). Most research shows that exercising several times a week for 20-30 minutes is helpful for anxiety. A couple of caveats, however: 1) some people feel anxious initially with cardiovascular exercise but experience anxiety reduction post-exercise, and 2) it may take 10 weeks or more of consistent exercise to obtain the benefit of general anxiety reduction.
If you are new to exercise, start slowly and gradually work up to the frequency suggested above. Also, if you do have anxiety with cardiovascular exercise, try the meditative movement type of exercise. The benefit you experience from exercise appears to strengthen over time. So, don't give up!
Many people with anxiety disorders try to use distraction as a way of managing anxiety but frequently find that distraction is not very effective. However, this outcome is more likely due to how distraction is being used rather than it not being a useful method at all.
Primarily, distraction needs to be considered a temporary measure. Too often people want to use it as the main way of coping with anxiety but there are several reasons this is not a good idea. First, it is not always possible to distract from anxiety due to the anxiety being too intense or the situation doesn't allow for distraction. In addition, relying on distraction exclusively prevents the development of more effective long-term strategies. Finally, distraction can interfere with fully understanding the anxiety and triggers because it prevents focusing attention on these issues.
Thus, using distraction as one of many tools of anxiety management can assist in learning to cope with anxiety. However, as a sole method, distraction can potentially cause more harm than it can help. Often distraction is best if you are faced with an unusual situation that you need to manage and don't have time to learn other methods. For instance, it is similar to people who have a fear of flying but only fly occasionally so they use an anti-anxiety medication to cope with a single flight rather than develop other psychological tools to cope with flying. As long as it is a unique event, using distraction is less likely to cause problems.
You need to determine when distraction can appropriately be used temporarily but not relied upon exclusively. If you find yourself using distraction excessively, focus on developing other tools that can help you manage anxiety and reduce the reliance on distraction.
Too often people with anxiety have general or ambiguous goals such as “I want to get rid of this anxiety.” However, such a goal does not provide a road map to learning to manage anxiety. In fact, such goals can be overwhelming and frustrating because they place a demand on the individual with no method as to how to achieve the goal.
By developing goals that include very specific steps you are more likely to be successful. For instance, once you have an idea of which of these 50 tools to manage anxiety might be helpful for you to try, develop a plan for how you will incorporate the tools into your daily life. Some of the tools require regular practice and other ones will build upon earlier methods. So you may need to change the plan periodically as you achieve earlier goals.
When I write a treatment plan for clients with anxiety I first write the specific goals followed by the steps to achieve those goals. The goals are written in a form that is achievable such as “Improve ability to manage anxiety” rather than “Don't feel anxious.”
Once the goals have been written, then the specific steps to achieve the goals can be written. For instance, the steps for the above goal can include tools such as: practice short anxiety management techniques, use deep relaxation daily, practice mindfulness throughout the day, listen to panic assistance audio, challenge thinking using the cognitive diary. Although the steps need to be specific, try to not make the achievement of the steps too concrete. In other words, develop a plan that you can achieve most of the time but don't expect 100% compliance.
The other benefit of specific, achievable goals is that such goals are easier to reward. Thus, the list of rewards you identified previously can now be used with your list of goals to improve motivation. You can develop a plan such as “Each day I achieve 70% of this list of anxiety management tools I want to use I will reward myself” or “If I practice mindfulness for a minute several times throughout the day I will get a reward.”
Read the article: Guide to How to Set Achievable Goals for more on how to develop goals.
Tracking behaviors related to anxiety can not only provide you with important insights regarding your anxiety but can sometimes be a treatment in itself. Some of the behaviors to track can include how high your anxiety was in certain situations, how long the anxiety lasted, what thoughts or events seemed to trigger the anxiety, what methods you used to reduce the anxiety.
By tracking these behaviors you can develop a better understanding of your anxiety which can be used to help you cope. For example, many times my clients will claim that the anxiety lasts for hours yet when I have them time the anxiety they find that it doesn't last as long as it felt. Or, they might find the anxiety varies in a predictable way which makes it more potentially manageable.
In addition, some behaviors change just because you are tracking them and are more aware of them. For instance, when people keep a written record of what they eat they are likely to eat less. The same thing can be true of anxiety. I know you are probably thinking “I'm already very aware of my anxiety! I don't want to be more aware!” However, the act of keeping a record of the anxiety can impact the intensity or frequency of the anxiety. If nothing else, keeping a record reminds you that you have tools that can help manage anxiety. When people try to ignore the anxiety, they prevent themselves from taking positive steps to manage it.
Also, tracking your use of the tools to manage anxiety helps to reinforce those tools particularly if there is an accompanying decrease in anxiety. In other words, if you are tracking your anxiety and you track the tools you use, you are more likely to discover which methods can be effective for you. READ MORE: page 3
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