Typically, exercise is supposed to be one of the best remedies for anxiety and depression. For example, aerobic exercise has been shown to elevate mood, improve sleep and decrease tension. This is ideal for the anxious person.
But what happens when exercise increases anxiety? I once had a client who told me that at the end of his workouts his face would turn white, he’d feel dizzy, and his heart would pound.
He was terrified that a panic attack was imminent and that he wouldn’t be able to stop it. There was a time when exercise was a relief for him, but now he avoids working out because he doesn’t want to experience these panic like symptoms.
But he certainly isn’t the only one facing this problem. There are many people that struggle with this kind of exercise sensitivity.
Why does the body mimic anxiety like symptoms during exercise?
When a person begins a workout their body is in a calm, steady state. As you work harder, the body has to borrow oxygen from itself to power the workout, which creates an oxygen deficiency.
This is the first way your body mimics anxiety symptoms, or even panic. During a panic attack for example, you feel like you can’t breathe or like you might suffocate.
This makes sense because like anxiety, exercise increases your heart rate, respiration rate, and may even cause you to feel slightly lightheaded. But this is normal and due to temporary changes in the body during work.
So I want to be very clear here, you are NOT necessarily having a panic attack it just feels similar to panic like symptoms. If you’ve ever had a panic attack, chances are that the experience is still very much with you – so I can see why this is so hard for you to deal with.
A big part of the problem isn’t just anxiety though. Your memory plays a big part in this process as well. People that have suffered panic attacks, or even near panic attacks, never want to feel like they can’t breathe or lose control ever again.
After all, it is a very powerful experience. Unfortunately, it’s often recalled automatically when there’s even a small hint that you might experience anything remotely similar.
Panic, memory, anticipation, sudden changes in the body – all of this stuff comes together in a perfect storm during exercise.
So, let’s breakdown what happens during exercise and what you can do to reduce the fear factor.
EPOC – Post-Exercise Oxygen Consumption
At the end of a workout your body will go into an EPOC state. This means the body is paying itself back the oxygen it took in the beginning. This is very important for two reasons:
- Reconversion of Lactic Acid
- Removal of excess Carbon Dioxide from the body
What is Lactic Acid? It is the byproduct of glucose which is fuel for the body. Lactic Acid can protect our muscles during anaerobic exercise and can turn into Pyruvate which helps the body burn fat.
Lactic acid also decreases the body’s pH balance. The increase in acidity leads to elevated levels of Carbon Dioxide, which causes us to exhale more CO2.
There is an interesting article that came out of the University of Iowa, Panic Attacks as a Problem of pH. They found that increased acid and Carbon Dioxide in the brain can trigger fear responses.
The pH levels in the brain can affect the synapses, communicators, of the brain. Some synapses contain proteins that increase neuron activity when the brain’s acidity level increases.
In short, it’s possible that you are sensitive to the increased acid in your body, lack of oxygen and increased neuron activity in your brain.
The EPOC state is important because one, it will use the lactic acid as fuel which is one way your body will get rid of the extra acid in your body, and two, it will help remove the excess Carbon Dioxide through exhalation.
What are the best workouts to create this EPOC state?
- HIIT (High Intensity Interval Training)
- Resistance Training
HIIT
High Intensity Interval Training means going back and forth between high intensity and low intensity exercise for a specified amount of time.
Here is a very simple way to have a HIIT workout. Start off on the treadmill, elliptical, StairMaster or just a simple walk/run around your neighborhood.
Begin in “Zone 1” for 2 minutes which means you can talk while you are exercising. Then go into “Zone 2” for 30 seconds, which means you cannot talk while you are exercising.
The longer you have been doing this workout the more you will be able to extend the time in Zone 2. Using the Zone 1 and Zone 2 method is an easy and simple way to know if you are at a low or high intensity level.
You don’t want to overdo it in the beginning though, so start off with 20-30 minutes 3-4 days a week.
The reason why interval training is helpful to an anxious person is because it buys you time. While you are in zone 1 your body is recovering, which means a slight decrease in heart rate, slower respiration rate, which culminates in you feeling more in control.
Resistance Training
Resistance Training includes activities such as lifting weights. There are many different variations that can be done to decrease lactic acid and carbon dioxide in your system, so do what is best for you.
Here is an example of a very simple way to perform resistance training. Complete 3 sets of bicep curls and rest for 1-2 minutes between each set.
A set may be 10-15 reps. A longer rest period between sets will give your body more time to recover by reconverting the lactic acid and removing the carbon dioxide from your body.
Aerobic vs Anaerobic – which is better for decreasing anxiety?
Aerobic exercise requires oxygen. A benefit is you burn fat in this state. The downside is this state will create more carbon dioxide in your blood which increases acidity in the body.
The Iowa study I mentioned above, actually found that when mice inhale higher rates of carbon dioxide it triggered a fear response.
People aren’t too far behind, either. The study also found that when anxious subjects were given air with 35% carbon dioxide they panicked too, while “normal” people did not.
Examples of aerobic exercise include endurance sports like marathon running or cycling.
Anaerobic exercise may be a better way to go for the anxious person because anaerobic exercise, like weight lifting or circuit training, leads to a more significant “EPOC effect.”
Being in an EPOC state increases your rate of oxygen intake and reverses the oxygen deficiency experienced at the start of your workout and brings you closer to a calmer, steady state.
Now you may feel overwhelmed, confused, even surprised to learn about what is physiologically happening in your body during exercise.
But you aren’t the only one. When I’ve shared this information with people many were shocked to hear that rather than exercise calming someone it can sometimes cause them to feel like they are having a panic attack.
Here is the bottom line: Research shows that both Aerobic and Anaerobic exercise are beneficial to the anxious and depressed person (Hiedary, Emami, Eskandaripour, Saiah, Hasanlu, & Shabazi, 2011).
Research has also shown that the body can mimic a panic attack during exercise (Muotri & Bernik, 2014).
With so many different theories out there first and foremost, consult your doctor or a personal trainer to find out which type of exercise works best for you to effectively manage your anxiety symptoms.
Everyone is different and therefore every situation will be different. One person’s way of managing their anxiety may not work for you.
That said, give HIIT or Resistance Training a try, rather than a long jog and see how you feel, see if you feel better or worse.
Use moderation in the beginning until you figure out what works best for you.
In this week’s episode of The Anxiety Guru Show I interviewed personal trainer George Nolan to help us better understand this process.
Listen to The Anxiety Guru Show…
To listen, you can click the play button below or visit the AG iTunes page.
References
Emami, A., Eskandaripour, S., Hasanlu, H., Heidary, A., Saiah, A., Shabazi, M. (2011). Effects of aerobic and anaerobic exercise on on anxiety of 60 anxious students in Zanjan_Iran. Procedia – Social and Behavioral Sciences, 30, 2418-2419.
Bernik, M.A., Muotri, R.W. (2014). Panic Disorder and Exercise Avoidance. Revista Brasileira de Psiquiatria, 36, 68-75.
Whilst I appreciate this information, I am more interested in how you can start exercising again after a panic attack has precipitated fear of heart attack, which in turn has lead to a phobia of exercise. No matter what I do I can’t seem to get the kahunas to go beyond a brish…ish walk, not for fear of having a panic attack, but for fear of having a heartie. This fear persists even after multiple doctors have given me the all clear (but they could be wrong, eh, eh!)
This podcast is awesome and I find it so ironic that I was listening to it as I was feeling like I was having a panic attack after a strenuous workout. Every symptom felt the way I feel when I panic; I’m tense, my breaths are short, and my muscles ache. I automatically jump to the fact that I must be anxious and something truly must be wrong. I’m glad to see a podcast on exercise, because there are times when I feel like giving up on my workouts because of having panic attacks associated with them, but am glad I haven’t because exercise has so many benefits, especially in the recovery process!!
Love your positive attitude Melinda. Unfortunately, there are a lot of people that give up on exercise because of the close association to anxiety, but like you pointed out, exercise is a huge part of getting better. Pace yourself and keep at it!
Hey Todd, you pose a good question. What do you do after you’ve been scared off by fear of heart attack or some other medical issue? Well, I actually think that really absorbing the information in this podcast is the first step. Trying to normalize what happens in the body during exercise is a big part of building confidence in your ability to workout safely.
Beyond that, you have to just get out there. Exposure, rather than avoidance, towards your fears should be the focus. Of course, this has to be done in phases. So you might want to start with even a slow walk, for example. Just be consistent about it, so maybe take that slow walk 3-4 days a week for 1-2 weeks. Then slowly pick up the pace over time.
OMG…if I can relate 100% to any of your blogs, it would be this one. I’ve been listening to your podcast now for a few months (LOVE IT!) and when I saw the title of this, I was so hopeful. I had a panic attack (I think?) a couple years ago, and I think some since…and I am now terrified of feeling dizzy. It’s a daily struggle, hourly…it’s like it’s consumed me. It’s affected my workouts a lot, BUT, I guess the important thing is, I still go everyday. I’m not afraid of having a heart attack, I’m afraid of passing out. A lot of times when I exert myself, I feel a little lightheaded. During your podcast the whole lactic acid thing intrigued me, so I try to focus more on my breathing, and making sure I’m actually doing it correctly. I can sometimes hold my breath while working out, not even knowing it. I also do yoga, and we do a lot of things where your head is kinda upside-down…yep, that gives me major anxiety because when you stand back up, it’s like a swoosh of dizziness. I hate that feeling more than anything. I am looking forward to your webinar you mentioned (in today’s podcast March 9th) about the symptoms. Cuz if I could just look past the way I’m feeling at any given moment, I’d be so much better off. Thanks for what you do, and btw…I like the new site!!!
Hi Guys,
I have written an article on how you can overcome the fear of having a panic attack after exercising, you can read it here: https://www.calmandcourageous.com/exercise-for-the-anxious/
I used to get really bad attacks after exercise, but now I don’t even think about it.
Hope it helps 🙂
Hugo
I’m really glad I found this post. I started having exercise-induced panic attacks a little over a year ago so unfortunately I spent many many months simply avoiding physical activity because clearly exercise was “not good for my nerves.” What I failed to realize is that I was doing far too intense workouts too many hours a week, on top of traveling frequently and working a stressful job, so my body was just in a heightened state of stress nearly all the time and I rarely gave myself proper recovery time. I simply became afraid of the fear and the anxiety symptoms, so I lived in a neverending state of panic. This resulted in daily panic attacks, GAD and agoraphoia, which lead to me having to quit my job. Now I’m almost 100% recovered yet I’ve been terrified to venture back into HIIT because I believed this whole time that was the sole factor in my “meltdown” last year. I love the scientific explanation of what I’m actually feeling during workouts and that in the long run (as long as I listen to my body and take it easy when I need to) my mental health will be better for it.
For several years I had been experrience major panic/stress issues after 20 mins or so of aerobic exercise. In the pastt I could do full boot camp like workouts no problem, but soon I had to switch to largely anaerobic/weight lifting becuase of this. I could not even stomach 20 minutes on a treadmill. I measured heart rate, blood pressure, sugar and no correlation. Long story short.. i was found to have 98% blockage in an artery. 4 stents. 1 month of relaxing. now in rehab. First two rehab sesions of 35 minutes of treadmill and ZIPPO issues. None. Its only 2… if the owner of this site will bump me.. i will update again.. i will not be convinced until i see several weeks worth of testing the theory. Could my body have known there were issues? Unfortunately I never thought of checking blood oxygen levels.. shoot.. but i was not short of breathe.. just angry and ‘panicky’.
Glad I googled “having a panic attack when working out”. This was one of the sites that popped up, so instead of blowing up Paul’s email like I would’ve when I got home tonight, I’ll just post on here in the hopes I get some feedback, while at the same time, helping others who undoubtedly will experience what I went through today.
Long story short, while finishing up my workout today (which consisted of 3 sets each of bicep curls, overhead shoulder presses, jumping jacks, mountain climbers, knee and leg raises, as well as a one-minute sprint on a 5 degree incline), I felt as if I was going to hyperventilate/have a panic attack. I was already out of breath. I was “thinking” I was going to have a panic attack, which would’ve lead to hyperventilating, out of breath, all bad stuff, etc. I was in the gym with a few of my coworkers who I usually workout with, so I played it off as if nothing was wrong (again, it was the last exercise for the day, so I was fine and didn’t embarrass myself.) I took a shower, came back to my office, but still felt the effects of ‘pending” panic attack (I guess after reading the article, my body was in need of oxygen.) I decided to take a Lorazepam, and I’m feeling better now.
Funny thing is the whole time I was showering, and changing into my clothes, I felt the “dread” of having to run next week. Will I lose my breath? will I hyperventilate? Will I have another panic attack come Monday? Yup, I started to “what if”, and for a short while, everything I thought about I was fearing (I need to call the cable company to fix a bill, I need to drive home, I need to work tomorrow, etc.) Everything brought on a sense of fear.
Anyway, this feeling sucks, but I got through it. Yes, I took medication, but it made me feel good. I only take Lorazepam during “emergencies”, which for me are flying, and driving over bridges (sometimes but not all the time). Anyway, I’m not fearing anything right now (not even the workout on Monday.) Since I believe I didn’t let the panic manifest itself, it caused me to feel crappy for a few hours after. I probably would’ve let the panic hit me IF I wasn’t feeling out of breath already (at one point, I felt as if I couldn’t swallow, which has happened before). That is all my bad. But, It is tough to feel that “out of breath” sensation because it’s not normal, so I get it. But, I need to accept the fact my body will eventually breath for me because that’s what it’s suppose to do. I do not have asthma, nor do I have a heart condition, or lung cancer (or whatever else we associate the feeling with.) I know it’s just anxiety and that is all. If I need to stop the workout and take a breather, then I will do that. If I need to cut down the number of exercises I do in a day, then I will do that. Bottom line is I’m okay now and I’ll be okay next week. I’ll continue to workout, drink tons of water, eat right, and get a good nights sleep (along with taking my daily supplements).
Don’t try to push through unless you truly accept the feelings and sensations you’re experiencing. I believe that I wouldn’t have hyperventilated or lost my breath, but I “thought” I would, and that was enough for me to fall into a minor tailspin. That’s where I messed up, but I will take this a lesson learned and not beat myself over it.
Stay strong everyone. We’ll all get through this. Thanks for this article Paul, the info was very helpful.
Arturo
I’m curious … I suffer with anxiety and panic attacks but have had it under control for a while. I started yoga two weeks ago..the first week was gentle and I came away really relaxed and calm..the second week was more intensive and I woke the next day with tight muscles all over…I knew the muscles were tight from
Exercise but my brain read it as anxiety…weirdly I end up having a terrible nights sleep and major muscle
Tension and panic attacks. How on earth do I get my brain to understand that not all muscle tension is anxiety…I was telling myself over and over its just from
Exercise and lactic acid build up but my adrenalin just shot through the roof..any advice
I don’t get a panic attack while working out it comes about 3 hours after the workout. So it is not as you described in my case. It happens after the body has come down and at rest then out of no where panic.
Hi people, I suffer(ed) from this for ages, I was diagnosed with anxiety and managed to overcome it (we all can) but full on exercise can often bring those feelings back – try a small amount of magnesium, in dissolvable tablet form mixed with water – it works wonders as it relaxes the body’s muscles and relaxes you. Also don’t do strenuous exercise at night, and don’t drink alcohol after exercising either. 🙂
What if you feel worse after HIIT? IDK if it’s the intensity or what, but HIIT in the morning seems to guarantee a panic attack by or in the evening. I also tend to have trouble sleeping on days where I run intervals. It sucks because I enjoy the exercise, but now it comes with anxiety. Is there any food/vitamin/mineral I can consume after HIIT to help calm my system? I usually eat a banana, take 200mg and drink water after. I feel like I’m doing everything I should be doing, yet I still have probs. Very frustrating and discouraging.
Kevin,
Have you ever tried magnesium oil/spray? It works wonders for me during a panic attack.
Thank you everyone for sharing your experiences. I was very apprehensive about starting a work out regimen because of my attacks… and in the same token hate that I sit here feeling like life is wasting away because of my fears. It’s very reassuring to know that other people have survived these crazy bouts. I’d like to recommend magnesium oil/spray to help calm your heart and ease muscles. Good luck to all!
I have a huge phobia of excersize. When I was playing tennis I would get light headed, dizzy, and turn pale and end up throwing up ever time, only hours and hours of sleep would make me feel better. People told me I was dehydrated so I started to drink lots of water and that didn’t help. It was time to play softball and I refused and begged my mom to not makee play. I finally figured out I was having panic attacks . I’m lazy now , I even locked myself in my room for like a year in a half. My medicine isn’t really working, I’m out of options. I miss playing sports, I even wanted to play football with the boys, I was gonna play soccer, basketball, I wanted to play volleyball even though we don’t have a volleyball team. I wanted to play every sport I could, I loved them all. Now I say I hate exersize and sports but the truth is I miss them all. I don’t even recognize myself anymore.
I have dealt with some panic attacks during HIIT, and have avoided these exercises for a while. I had previously read that a lot of us breath inefficiently on a regular basis. (I believe it is involved with anxiety, and makes anxiety worse). I learned about the Bohr effect, that in our blood stream hemoglobin and oxygen are bounded together, and if carbon dioxide is too low, hemoglobin will not release the oxygen, thereby lead to oxygen deprivation (less oxygen in the brain, pain/impulsivity). I know it sounds like the opposite of logic, that sometimes the harder we breathe (especially through our mouth, we need to breath through our nose, if possible), the less oxygen may get to our cells. I have learned the Buteyko method, which attempts to increase our CO2 slightly (feeling a little starved of oxygen), to improve our breathing efficiency. CO2 is also a vasodilator, which relaxes blood vessels, and can be extremely helpful with asthma. Have read it may even have a connection to sleep apnea. All that said, I have not practiced this method very much, and am still hesitant to go back to HIIT.