Exercise- A Natural Treatment For Anxiety & Depression
With the current situation with COVID-19, most of us find ourselves stressed not only by the fear of us and our loved ones contracting the virus, but also because of the uncertainty that quarantines and changes in income streams can bring. We can’t always change our external circumstances, but we can do something to help us deal with the anxiety and depression that a global pandemic can bring. I wrote this piece in 2013 and here it is in updated form and I hope you find it to be of some use and consolation. Keep training and stay safe out there. -Kevin Richardson
Stress is an integral part of our existence and plays a crucial role in our development as individuals. While typically thought of as a negative aspect of life that needs to be reduced as much as possible, the reality is that stress is a key factor in both the physical and mental development of all sentient beings. In a sense, who you are as a person is little more than a reflection of how well or how poorly you adapt to the stressors encountered in your daily life. Adaptations are by definition, developed traits that help us minimize stress, and one of the main points of evolutionary biology is the idea that we as a species that has spent hundreds of thousands of generations hunting and gathering and then later living an agriculture centered existence, have not had adequate time to fully adapt to the stress imposed by modern life. While those of us in developed parts of the world are no longer threatened in by the constant possibility of starvation, physical assault, communicable disease, injury and predation from wild animals, the stress we endure as a result of modern life is just as real, and our bodies cannot differentiate between the stress of a dispute with a loved one, problems at work and financial problems with the life-threatening stress of imminent danger. Worrying about work, relationships, social status and finances triggers the same “fight or flight” response that once helped us avoid being eaten by wild animals and fight for survival. Unfortunately, many of us today find ourselves locked in a loop of constant worry and anxiety. Thus, it should be no surprise that anxiety disorders are the most common mental illness in the United States, affecting 40 million adults in the United States age 18 and older, or 18% of the population. Interestingly enough, several studies have demonstrated the ability of exercise to improve mood and reduce anxiety in healthy adults.[1,2,3,4] So much so that just one bout of exercise appears to bring about the same degree of anxiety relief as quiet meditation.[11, 12,13] In this article we will take a look at exactly how effective exercise is as an anxiety reducing tool and also explore our possible evolutionary link to exercise as a way of dealing with stress and maintaining mental balance in the face of seemingly overwhelming stressors. The findings are compelling to say the least and I invite you to share this article with anyone whom you think would find it to be of interest.
Exercise and Stress & Anxiety Relief- Our Innate Need For Transcendental Experiences
As human beings we are very much constituted to seek out experiences that allow us to transcend the mundane, stressful and often repetitive aspects of our daily life. Be it religion, music, sex, art, drugs or exercise, we are in a way coded to seek out activities that bring about different forms of consciousness. Exercise for many, is a simple and positive way to step outside of the norms of our daily lives with an activity that changes our state of mind. The Greek word ‘ekstasis’, from which the word ecstasy is derived, translates as ‘venturing outside of what is the norm’ and is a perfect description of what an intense bout of exercise can be. A hard workout can touch us deeply by lifting us momentarily above and beyond our regular way of being. An experience that many describe as ‘feeling truly alive’ and one that allows us to transcend conventional ways of looking at ourselves. While intense exercise can very often be painful, the effects of exercise seem to take us to a place that transcends pain. Offering us a vantage point from which we can see the world somewhat more objectively and where the difficulties and sufferings of our everyday existence become a bit more bearable. (See my article Bodybuilding As A Spiritual Practice)
This notion of exercise as a tool that can be used for temporary stress relief is one that anyone who has ever seriously exerted themselves may find to be self-evident. However, questions still remain about how much of a difference does that transformative experience from a tough day at the gym translates into concretely helping us deal with real life situations encountered after the fact. Unfortunately, we have to contend with the limitations offered by studies on the subject, as they can only at best approximate situations that may be stressful but cannot for example, examine in a controlled environment how exercise helps us deal with the stress of a difficult day at work or a situation induced panic attack. That said, we do have some evidence that exercise may a key role in anxiety reduction long after the activity itself has ceased, and that its effects are far more profound and long lasting than non-physical means of dealing with anxiety.
Exercise & Anxiety Relief- The Long Lasting Anxiety Reducing Effects
One of the amazing discoveries of modern neurology is that the physiological and neurological systems governing our emotional responses are considerably intertwined with the systems controlling our muscles and motor behaviors. So much so that exposure to emotion producing images has been documented as bringing about the same neurological changes that occur during exercise,  thus, it is no surprise that exercise has an effect on our anxiety levels. One experiment meant to document the effects of acute exercise on anxiety used arousing pictures from the International Affective Picture System, a series of images that have been shown to induce a shift in mood and affect baseline anxiety levels. Subjects were made to exercise at a moderate intensity for 30 minutes after which they were shown 90 pictures from the IAPS system, several of which were rated as being highly unpleasant. Researchers found that baseline anxiety levels were reduced in all subjects immediately after the bout of exercise, (which to be honest, is not that much of a surprise), but what was interesting was the finding that anxiety levels remained lowered even after viewing the emotionally charged images. As a control, another group was made to spend 30 minutes in what was described as quiet rest time- which also lowered state anxiety levels to a degree similar to the reduction in anxiety due to exercise. The difference however, was that anxiety levels increased after viewing the arousing IAPS images in the quiet rest group unlike the exercising group where anxiety levels remained lowered. What this simple study highlights, is perhaps the most important and practical aspect of stress reduction and that is the idea of resilience.
Exercise and Stress & Anxiety Relief- A Natural Form of Cultivating Resilience
Exercise performed at certain intensities appear to enhance our resilience to the cumulative effects of emotionally disturbing stimuli. While this experiment was, as we noted earlier, somewhat removed from reality, it nevertheless highlights the fact that exercise may play a significant role in our ability to deal with stress in real world settings. From an evolutionary point of view, it makes perfect sense that physical activity would grant some measure of stress protection given the degree of anxiety that we had to endure for the earlier part of our species’ existence on the planet. Long before the relative comfort and safety of modern life, survival was a never ending concern and activity levels were considerably higher that what it is today. Changes in our response to stressful stimuli due to physical activity could have thus been one of the ways that our ancestors were able to cope with the stress of having to persevere in environments where famine, conflict and threats from nature itself were constant. See also How Muscles Aid In Survival
Exercise-Stress & Anxiety Relief- An Evolutionary Argument
All organisms develop with species-specific capabilities, limitations and requirements as a result of the environment in which they inhabit, and for us, our ancestors lived a predominantly hunter gatherer existence for the better part of our 2 million years on the planet. The shift towards agriculture occurred a mere 10,000 years ago and ushered in an age of changing (and often times harder) physical requirements to stay alive and maintain a steady supply of food. This shift represents but a blip in the face of the millions of years that we were mostly hunter-gatherers, during which time our fight or flight response was very much employed on a regular basis in order to stay alive.
Given that our genetic constitution has changed little in the face of enormous recent changes in our environment, it could be that the higher levels of physical activity required to stay alive served to keep our mental health in balance in the face of the most potentially anxiety producing situations. We are several hundred thousand years removed from those times, but if we evolved for all those years to have exercise as a requirement for optimal mental health, it is perfectly understandable that there would be higher incidences of depression and heightened anxiety levels in populations that are relatively sedentary.[19,20] It would also explain to some degree the improved mental health among those who engage in some form of regular physical exercise or activity. Several studies have shown that changes in the hypothalamic pituitary adrenal (HPA) axis seem to have a connection with anxiety related disorders. Anxiety usually occurs concurrently with activation of our ‘fight or flight response’ resulting in hypervigilance, fear and sympathetic dysregulation.  Traits that would have been invaluable to us to be able to hunt, fight and survive the rigors of our world several thousand years ago and it is perfectly reasonable to conclude that we would have a built in way to not be consumed and destroyed by these very much needed attributes. Exercise and physical activity, thus, seem to be a natural method by which we were able to do just that, as some forms of exercise appear to regulate cortisol levels and thus reducing anxiety at the level of the HPA axis.[22, 23]
Exercise & Anxiety Relief- Less Exercise Equals More Stress
We may no longer need regular adrenal surges to deal with possible threats to our survival in the relative comfort of a Westernized 21st Century environment, but we are genetically the same as we were during the Pleistocene Period when we did. As a result, our bio-neurological systems have the same reactions today to the stresses of work and social life as we did in our ancestral environment, but without the balm of regular physical exercise to attenuate it.
With the exception of human beings, all other mammals have to work in order to procure food, however the technological advances in food cultivation and distribution have made it such that in affluent nations there is no direct link between physical activity and the food we eat. Technology and mechanization have dramatically reduced work related physical exertion for most who live in developed countries and has also made recreational pursuits far more sedentary in nature. Exercise and physical exertion are today extraordinary activities that occur separately and apart from the daily lives of most of the population in developed countries.
Given the fact that activity levels in developed countries are far below the level of physical exertion for which our genetically determined physiology, neurobiology and bio-chemistry have been programmed for through evolution  it is not surprising that 22% of Americans over the age of 13 suffer from an anxiety related disorder in any given year and that 16% of Americans will suffer from a depressive disorder during the course of their lifetime.[19, 24] These mental health issues occur in conjunction with increased body weight, reduced muscle mass, disproportionate amounts of fat tissue relative to bone and muscle, [17,25,26] and of course epidemic levels of cardiovascular and metabolic related diseases- the number one cause of death in developed nations.
Assuming that today’s hunter gatherer tribes such as the !Kung and Ache have activity levels close or equal to that of our Stone Age ancestors, researchers estimate that the energy expenditure per unit mass for the average contemporary Westerner is as much as 38% less than of today’s hunter gatherers. Putting that into perspective, to match the energy expenditure of a hunter gatherer a 150lb male Westerner would have to add 72 kilocalories/kg per days’ worth of activity which works out to be an additional 12 mile walk every day performed in conjunction with their normal activities. Exercise requirements that fall far below current standard guidelines put forward by the ACSM which are about 44 % lower than activity levels observed among modern foraging humans. [17,28, 29]
Exercise and Stress & Anxiety Relief- The Benefits of Resistance Training
With today’s world of hectic schedules that abbreviate our time for family, social and recreational activities, it is impractical to expect the average citizen to increase their activity levels to that of our foraging ancestors. However, as demanding as the daily activities of a hunter gatherer may be, it lacks the efficiency of physical exercise protocols available to us today such as high intensity type training. A form of training that makes it possible for us to attain similar physiological and neurological effects within the framework of a much lower time expenditure. Weight training, for example is not an activity that would have been performed during our formative years as a species, but in addition to its benefits of increasing muscle mass, strength, bone density and endurance it also appears to decrease anxiety across age groups by directly affecting cortisol levels and altering the HPA axis. [22, 23] Studies have also found that resistance exercise may enhance the anxiety relieving effects of other modes of exercise such as aerobics among individuals suffering from severe anxiety. Research found that aerobic exercise alone had little effect in lowering anxiety levels among individuals with primary anxiety symptoms, but had a robust effect on lowering anxiety when paired with resistance training. 
Reduction in anxiety has been found from engaging in low intensity resistance training at intensities as low as 10% of one repetition maximum and what’s most important is that the anxiety relieving effects last well beyond the duration of the activity. Although far more research is needed, there is a consensus that resistance training is an effective form of treatment for individuals suffering from anxiety as a primary and secondary symptom  and there is a considerable amount of research that find positive outcomes in cognition and mental health from aerobic exercise. Which appears to improve mood through changes in brain derived neurotrophic factor (BDNF) and monoamine neurotransmitters [32, 33, 34, 35] a different pathway than the exercise induced changes to cortisol and HPA axis brought on by resistance training. Studies verify the fact that physical inactivity increases both the likelihood and duration of depression and that physical activity significantly reduces the risk of developing a depressive disorder. Furthermore, research has shown that the anti-depressant effects of both resistance and aerobic forms of exercise are comparable to that of psychotherapy and the use of pharmaceutical drugs.[8,9,10]
Far more research is needed for us to understand exactly how different forms of exercise affect us in terms of our mental states, but what is clear is that exercise is an important component of our mental health as a species. A component that needs to be embraced not only by the medical community as a prescribed form of treatment for depressive and anxiety related disorders, but by the general public at large as a natural and relatively safe method of dealing with the stress of everyday life. Our response to physical activity can be seen in many ways as one of nature’s gifts to us as a species. A defense mechanism of sorts to help give us hope and stability in the face of countless wars, famines and the harsh, brief lives we lived during the earlier part of our existence as a species. One that you should most certainly take advantage of on a regular basis if you have any desire to be truly healthy in mind and body.
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