The following article is a chapter from my book, The Mental Health Prescription: Personalized Exercise and Nutrition Strategies for Anxiety, Depression and Stress Relief.

If you have anxiety, exercise is a two-edged sword. One the one hand, it has tremendous benefits, like:

  • Decreasing heart palpitations
  • Sleeping better
  • Reducing stress

But on the other hand, in some people with anxiety, exercise can actually induce panic attacks. Not just a little nervousness, but a full-blown panic attack:

  • Shortness of breath
  • Heart palpitations
  • Nausea
  • Dizziness
  • Choking feeling
  • Chest pain
  • Thinking that you’re having a heart attack, or you’re about to die.
Exercise-induced panic attacks

Original source: here.

So if you, or someone you know has anxiety, and gets this reaction to exercise, how do you get the upsides of exercise, without any of the downsides? That’s what we’ll cover in this article. Though if you’d like to delve into this in more detail, I wrote a whole book about this, called The Mental Health Prescription. If you’d like to pick up a print version of the book, you can do so on Amazon.

If you want to watch a video version of this article here it is:

But first…

Why Can Exercise Cause Panic Attacks?

A lot of people who experience a panic attack during exercise wonder “did that really just happen? Can physical exercise cause panic attacks? Isn’t exercise supposed to be good for you?”

Well, the answer is yes. Working out can cause panic attacks. Aerobic exercise can cause intense anxiety symptoms if you have a previous panic disorder. Your brain will go into fight or flight mode, and you may experience paralyzing symptoms. When done the right way, you can avoid anxiety symptoms during intense aerobic exercise.

There are a lot of commonalities between exercise and a panic attack, like:

  • Increased heart rate
  • Increased adrenaline
  • Faster respiratory rate (you breathe faster)
  • Sweating

So if you have anxiety, and you’ve experienced a panic attack before, aerobic exercise can sometimes feel just like that. And it can be hard to tell the two apart. So once you reach a certain intensity threshold with your exercise, a panic attack comes immediately.

Strategies to Reduce Exercise-Induced Panic Attacks

Strategy #1: Proper Warm-Up and Cool-Down

Yes, this is a “basic” of exercise, but for someone suffering from panic attacks during exercise, this becomes that much more important.

If your normal heart rate is 70 beats per minute, and you just start exercising, without a warmup, it can spike very quickly. It might go from 70 all the way to 150 in a matter of just a few seconds. To someone who doesn’t suffer from panic attacks, that’s not a big deal. To someone who does suffer from panic attacks, this very sudden rise in heart rate might trigger a panic attack.

The sympathetic nervous system gets activated when aerobic exercise begins. When you have an overactive sympathetic nervous system, you can experience anxiety symptoms such as fear, gasping for air, heart palpitations, and irritability. This overwhelming fear is also known as panic disorder.

So you want to gradually, and slowly increase your heart rate over a period of 5-10 minutes.

Likewise with a cool-down. Sometimes, panic attacks happen not during workouts, but after workouts. This can often be due to a sudden drop in heart rate. Again, that’s something that can be avoided with a proper cool-down. Also, 5-10 minutes.

Strategy #2: Self-Reflection

After you experience a panic attack, it’s important to do a little introspection. Panic disorders can interfere with people’s lives when it is triggered by aerobic exercise. Although a panic attack is scary, it’s not fatal, even though it feels like it at the time. So how can you take the edge off from panic attacks?

Next time you have one, afterwards, reflect yourself, and ask yourself two questions:

  1. Did I die?
  2. Did it hurt?

This works better, if you write down these questions, and the answers to them using pencil and paper, as opposed to just verbalizing it.

You’ll notice the answer to both questions is “no.” It might not have been a comfortable experience, but it usually doesn’t physically hurt. Do this after enough panic attacks, and eventually, the panic attacks decrease in intensity. If initially, you believed that you would die during a panic attack, the next time you have one, you’ll remember that last time it happened, you didn’t die. Knowing that you didn’t die, and that you weren’t hurt will make the next one more tolerable. It still won’t exactly be pleasant, but at least, you’ll be calmer.

Strategy #3: Exercise in a Comfortable Environment

You hear that exercise is good for anxiety, so you decide to join a gym that feels intimidating. There are people who look like they know what they are doing, and you are a first-timer, and you feel like everyone is watching you, and judging you.

First of all, that’s not true. For one thing, people are too self-conscious to worry about anyone else, but themselves (yes, even the ones that look like they’re in really good shape). Others are too narcissistic, so they spend 95% of their gym time checking themselves out in the mirror. You have nothing to worry about.

But even so, it can be intimidating. So you have a couple of options:

  1. Find a gym that isn’t intimidating to you. Look for one with ugly, fat people. Just kidding. But look for a gym where you’d feel comfortable.
  2. Work with a person trainer who you’re comfortable with, and makes you feel at ease.

Strategy #4: Distract Yourself

Sometimes, if you focus on the sensations you have during exercise, you’ll notice that your heart rate speeds up, your breathing speeds up, you start to sweat, and that all reminds you of how you feel during a panic attack. So you start to backwards rationalize that you must be having a panic attack.

However, if there’s a TV show that you’re watching, that’s really engaging, and makes you forget that you’re exercising, it might just be the distraction you need.

Strategy #5: Baby Steps

Start with an amount of exercise, that even you think is too low. You know how “they” say you need to exercise for ___ minutes (fill that in with whatever number you want… 30, 40, 60, whatever), or it doesn’t count? Forget about that.

A 5-minute workout is better than a 0-minute workout. So do something light, and do something short. Right now, your goal is just to break the psychological connection between exercise and anxiety. It takes a lot less time to break that connection, than it is to improve your cardiovascular fitness or your strength.

Strategy #6: Lower the Intensity

As I talk about in my article on exercise for anxiety, if your exercise intensity is too high, you could make anxiety worse. For depression, however, high intensity is good. I elaborate on the reasons why in my article on exercise for depression.

So keep the intensity of your cardio below 85% of you maximal heart rate. To figure out your maximal heart rate, just subtract your age from 220. So if you’re 40 years old, your max would be 180 beats per minute (bpm). Don’t cross 85% of 180, which is 153 bpm.

Some people wonder “can too much exercise cause panic attacks?”, to which the answer is really not about the total amount of exercise, but the intensity. So by using a lower intensity of exercise, you can decrease the chances of experiencing an exercise induced panic attack.

Strategy #7: Avoid Cardio-Induced Panic Attacks by Choosing Strength Training

Most of the time when someone has panic attacks during exercise, they’re usually cardio-induced panic attacks. Rarely does someone experience a panic attack while strength training. Usually, they get a panic attack on a treadmill… not the squat rack. Not to say that you can’t get a panic attack with strength training (you definitely can), but the frequency is much lower. Though to hedge your bets, just take longer rest periods between sets and exercises. Somewhere in the 1-3 minute range should do the job.

An anxiety attack while running is much more common than an anxiety attack while doing lat pulldowns.

Cardio induced panic attacks

Original source: here.

Final Thoughts

Don’t let your sympathetic nervous system trigger a panic disorder during your aerobic exercise. Learn the right way to do aerobic exercises to keep those symptoms of anxiety at bay.

So if you’re wondering “does exercise help anxiety and panic attacks?” the answer is “yes, if you do it right.” And that’s a big if. “Doing it right” is all in the details.

If you’d like to dig into this much deeper, and learn more about:

  • Exercise for anxiety
  • Exercise for depression
  • Nutrition and supplements for both anxiety and depression

…then pick up a copy of my book, The Mental Health Prescription: Personalized Exercise and Nutrition Strategies for Anxiety, Depression and Stress Relief.

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