During the economic recession, there are and will be many moments of panic. When stocks are in free fall and the world seems to be falling apart, there is widespread panic that makes the market even worse. Now, in the middle of one of the worst recessions ever, we will also have to face the constant question of whether we have reached rock bottom yet. This anticipation of the possible worst-case scenario erodes our confidence and the resulting anticipatory anxiety can make our thinking and decision-making uncertain. While there are several ways that we can work with our minds to handle this panic, how can we deal with panic when we are mentally exhausted or paralyzed?
When we are anxious or feeling stressed, there is a point at which no further thinking can actually help. We may try to talk ourselves down, or think of other things, or even try to meditate or find a quiet place to relax, but the constant internal chatter disrupts our sense of peace. When things are more extreme, any attempt to "think" our ways out of the stress and anxiety may not work because our thinking feels paralyzed. What can we do when we are faced with this thinking paralysis but still feel anxious and stressed?
A recent review of existing research has shown that regular physical exercise reduces anxiety in people who are not anxious at baseline and in people who have severe anxiety in the form of panic disorder [1]. Another study [2] showed that an acute bout of aerobic exercise (a one-time session) actually reduced anxiety and panic attack frequency even in people who had panic disorder. In fact, yet another study showed that even when people are trying to use their minds to reduce stress or anxiety, a walking program can significantly reduce stress and anxiety [3].
The practical significance of these studies is that they back up what my clinical experience has been. While a few people feel too panicky when they exercise, because increasing their heart rates reminds them of the panic that they may feel at other times, many people I have worked with find that going for a brisk walk, running or doing something physical at the time of the panic takes their minds off the panic and actually reduces the anxiety.
A gentleman who had been extremely stressed about not having enough contractual work as a plumber approached me for help with his panic which had become so severe that he would get panic attacks three to four times a day that would just occur out of the blue. Even though medication and talking him through some of this helped him, he found that there would be times when his mind would just stand still and he could do nothing. However, when he used this "mind-numbing" moment as a cue to exercise, he would either go for a brisk walk or when he could, he would go running. He found that during these times, his stress would appear to completely go away and his mind felt as though it was completely at rest. From a scientific perspective, why would this be?
While there is no certainty about these mechanisms, exercise appears to reduce panic caused by carbon dioxide as well as panic caused by a hormone called CCK-4. Also, exercise leads to the release of endorphins and possibly enkephalins that are partly responsible for the "high" that one may experience with exercise. But why would the brain respond to these or other substances that may be reduced or increased with exercise?
It turns out that the brain regions that activate when you have anxiety are connected to those that activate when you move. When you are anxious or stressed, a brain region called the amygdala has increased activation. This and other regions involved in anxiety are linked to brain regions that are responsible for movement. It appears that when we exercise, we increase brain activity in the movement centers that then decreases brain activity in the amygdala. One of the reasons for this is that when the brain is forced to attend to demanding tasks such as strenuous physical exercise, it has to increase blood flow to the "attention" regions and this may decrease blood flow to the amygdala thereby reducing anxiety [4].
This is just one of many examples that illustrates the value of recognizing the connection between the "physical" and the "psychological". This principle can be used to address anxiety and stress whenever you are feeling it. The basic idea is that for the anxiety regions to shut off, you have to give the brain something more demanding of your attention than anxiety. Exercise counts as one of these things and is a simple, practical way to force your brain's attentional system to change its focus away from the anxiety and to release calming hormones and substances that will also decrease your anxiety even further.
References:
1.Strohle, A., Physical activity, exercise, depression and anxiety disorders. J Neural Transm, 2008.
2.Strohle, A., et al., The acute antipanic and anxiolytic activity of aerobic exercise in patients with panic disorder and healthy control subjects. J Psychiatr Res, 2009.
3.Merom, D., et al., Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders--a pilot group randomized trial. J Anxiety Disord, 2008. 22(6): p. 959-68.
4.Geday, J. and A. Gjedde, Attention, emotion, and deactivation of default activity in inferior medial prefrontal cortex. Brain Cogn, 2009. 69(2): p. 344-52.