See how calm they look? Courtesy of sophiea

See how calm they look?

Courtesy of sophiea

You are probably familiar with the idea that exercise appears to be helpful in controlling anxiety. You are probably in favour of that over taking medication if I were to ask you over a cup of coffee. Later, when you go home and you start feeling anxious the feeling gets so bad that you need instant relief and our earlier conversation will be the last thing on your mind. I think one of the issues that will contribute to you reaching for a tablet rather than reaching for your tracksuit is that the exercise we discussed was a rather hazy idea. We did not sit down and make a plan about what to do and how to do it. What helps and what does not.

Here comes the science

So, running this kickstarter campaign has me feeling a bit anxious. To make sure I do the right thing I recently reviewed an open article on Evidence-Based Complementary and Alternative Medicine published in August this year. It is really worth a read if you can spare the time. To answer the original question of what to do I will focus on only the exercise section of the paper. The evidence available according to the authors supports regular exercise at least 4 times a week. It appears that a 60 minute walk or a 30 minute run are equally good. This level of exercise is good for both anxiety and depression.

That sounds simple enough, but is it?

To complicate matters the relationship between mental health and physical exercise is not as straightforward as it may seem. The recommendations for men are different than for women.  Men seem to benefit more from intense exercise. In men intense exercise seems to reduce anxiety, but not so much in women. In contrast, women appear to get more benefits from light exercise – such as walking – than men, but only in areas such as well-being and somatisation. In women anxiety appeared to be unaffected by exercise.

So, get to the point already

On balance the evidence supports doing moderate exercise to reduce anxiety.  To get to the bottom of how useful it is long-term more studies are needed. It is safe to assume that it stands a good chance of being useful. If you do not do regular exercise now, before you start on your four-times-a-week plan get yourself checked by your physician.

If you are going to succeed you need to actually schedule it in your diary and identify the time you are going to be doing it. Take it as you would any other treatment: it needs to be scheduled, it needs to be regular, and you need to stick to it. Most people make the mistake of comparing it to medication and saying it does not work. When you dig in they stick to taking the medication regularly, but they skip the exercise.

Having said all that exercise is most effective when anxiety rises acutely. Going back to the scenario where you went home, your anxiety was getting worse and worse, and you were reaching for the pills; that is the exact time to exercise. Running around the block a couple of times or turning up the music (be considered with your neighbours, use headphones) and dancing to your favourite song can help you calm down instantly. Who would have thought a healthy dose of Gangnam Style would be such a stress buster.

In conclusion

You can do regular exercise that seems to help over time in most cases (remember: 1 hour walk or 30 minute run 4 times a week). You can also do it in spurts when anxiety is bad, which is clearly effective in the great majority of cases.

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