Intense Exercise More Effective with Chronic Anxiety

Early in my career as a strength and conditioning coach I believed my job was to help people play, feel and look better.

We helped athletes attain their highest levels of performance. We helped those with chronic pain and health issues live better lives. And we helped a number of other people shed some pounds, add some muscle and improve the composition of their bodies.

In other words, everything we did was from the neck down and had to do with with the physical.

If you had a head or neck issue, there were other specialists for that. And if you wanted to improve your vision that was available but not something we spent a lot of time on. And if you lacked confidence there were sports psychologists for this.

Fast forward a number of years, almost 30 to be exact, and I'll admit my approach is completely different now. While there is more awareness and consideration for concussions and head injuries, that's not what I'm getting at.

Instead what I mean is that more and more people want to feel better. And feel better emotionally. We are seeing more and more people that lack confidence, have anxiety and suffer from depression. 

So now, I see our goal at Okanagan Peak Performance Inc. is to help people from the neck up. We want them to feel better about themselves, to walk a little taller, smile more and be happier. And exercise is a great way to achieve this.

Because when we win championships, rehab a painful low back and fit into our favourite jeans again, we're happy. 

But what about the connection between exercise and our mood?

A recent study in Sweden looked at how different exercise intensities helped those that suffer from anxiety.

The study included 223 adults with an average of 39 years. The majority of the subjects in the study were female (70%) and suffered from chronic anxiety for at least 10 years.

In the table above anxiety was measured with a BAI or MADRS-S score. Don't worry too much about what these acronyms mean. Instead the main takeaways are that the scores go from 0 to 30, with higher scores indicating higher levels of anxiety. Tiers, indicated by gray bands, show anxiety as severe, moderate, mild or minimal. 

The subjects were assigned to one of three groups for the 12 week study:

* a low intensity exercise group i.e. 60% of maximum heart rate

* a high intensity exercise group i.e. 75% of maximum heart rate

* a control group

The exercising groups trained three times per week for 60 minutes doing a combination of cardiovascular and resistance training. The control group received one appointment with a physiotherapist and a 3 month gym membership. The control group was asked to not perform other exercise activities.

What they found was the group that performed the more intense exercise reduced their anxiety by a factor of 4.88 (see red bars in the table) and the lower intensity group reduced their anxiety by a factor of 3.62 (see blue bars in the table). Both exercise groups reduced their anxiety more than the control group (see green bars in the table).

If you have a heart rate monitor you can set the zones on your device so that your exercise is 75% of maximum heart, to reap the mental health rewards discovered in the study.

If you don't have a heart rate monitor you can use one of the following  three formulas:

220 - age = 220 - 49 = 171

(207 - 0.7 x age) = 207 - 34.3 = 172.7 ~ 173

(211 - 0.64 x age) = 207 - 31.36 = 179.6 ~ 180

So using my own age, 49 years, as an example, you'll see a range of 171-180 beats per minute (bpm) for my maximum heart rate. 

Now if I want to train at 75% of my maximum heart rate this produces a range of 128.25 - 135 bpm.

The last thing to mention is how this should feel. For most people, this would be the intensity of jogging. You work up a sweat but you're able to carry on a conversation. If you slow down too much from this pace you probably won't work up a sweat and is a little faster than a brisk walk. 

The take home message is the value of intense exercise to manage chronic anxiety. Ease into it if you're new to exercise and then make sure to monitor your exercising heart rate.

Citation

Henriksson, M., Wall, A., Nyberg, J., Adiels, M., Lundin, K., Bergh, Y., ... & Åberg, M. (2022). Effects of exercise on symptoms of anxiety in primary care patients: a randomized controlled trial. Journal of affective disorders, 297, 26-34.