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Anxiety Disorders and Exercise: The Role for Health and Fitness Professionals

ANXIETY DISORDERS ARE PSYCHOLOGICAL CONDITIONS THAT HAVE BOTH BEHAVIORAL AND PHYSIOLOGICAL RESPONSES THAT CAN BE DETRIMENTAL TO HEALTH AND QUALITY OF LIFE FOR THOSE WHO EXPERIENCE THEM. IN ADDITION, ANXIETY DISORDERS SHARE FEATURES THAT DEFINE AND SEPARATE THEM FROM DEPRESSIVE DISORDERS. TYPICAL TREATMENT INCLUDES PRESCRIPTION MEDICATIONS AND COGNITIVE BEHAVIORAL THERAPY. THE PURPOSE OF THIS ARTICLE IS TO FAMILIARIZE THE HEALTH AND FITNESS PROFESSIONAL (HFP) WITH THE SPECIAL CONSIDERATIONS THAT SHOULD BE ADDRESSED WHEN WORKING WITH CLIENTS WHO HAVE ANXIETY DISORDERS. SPECIFICALLY, THE PREVALENCE OF THE CONDITION AND CLIENT RESPONSES TO AEROBIC, RESISTANCE, AND YOGA EXERCISE WILL BE COVERED. INTRODUCTION A nxiety disorders are the most common mental illness. They have a 1-year prevalence of 18% (25,32) and are characterized by intense and prolonged feelings of fear, distress, excessive worry, preoccupation, obsessive thoughts, and apprehension. In addition to mental symptoms, those who experience anxiety disorders also exhibit physical symptoms, such as hypertension, atherosclerosis, rapid breathing and heartbeat, and myocardial ischemia (2,31,33,46). Anxiety disorders can be classified into subgroups such as general anxiety disorder, obsessivecompulsive disorder, post-traumatic stress disorder, panic disorder, and social anxiety disorder. Therefore, in this article, we will discuss how anxiety disorders affect the body and how exercise with special considerations can improve the lives of those who experience anxiety disorders. PHYSIOLOGY Although anxiety disorders are considered mental or psychological disorders, they can present with physical symptoms. When exposed to danger, stress, or fear, the body reacts by activating physiological and behavioral responses such as increased alertness, increased cardiovascular tone, and increased respiratory rate (9,47). When the threat is no longer present, the body’s physiological processes return to a state of homeostasis (10). In the case of anxiety disorders, individuals perceive continued stress that results in prolonged deviations from homeostasis (10). When the stress becomes chronic, there is a hyperactivation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, in addition the release of inflammatory mediators (46). As a result, individuals who experience anxiety disorders report physical symptoms such as diabetes, hypertension, irritable bowel syndrome, trembling, shortness of breath, chest pain or discomfort, nausea, dizziness, and hot and cold flashes (11,23,28,34). Treatment often includes prescription medications and cognitive behavioral therapy (1,23). An additional treatment for anxiety disorders that is often neglected is a carefully planned exercise program. When exercise is performed 2–3 times per week, there is an improvement in mood (11) and a reduction in stress (12,19). Exercise can be an inexpensive and an easy treatment modality that has been shown to increase self-confidence while promoting feelings of satisfaction and overall wellbeing. Furthermore, exercise is associated Address correspondence to Justin Brown, justin@parvo.com.