Exercise as it relates to Disease/Improvements in General Anxiety Disorder Symptoms with Physical Activity

Generalised anxiety disorder (GAD) is a form of anxiety disorder in which sufferers experience excessive and unnecessary anxiety and worry about regular occurrences in everyday life. In Australia, GAD affects approximately 3-6% of the population and is most common during adolescence and mid-life.Hunt C DSM-IV Generalized Anxiety Disorder in the Australian National Survey of Mental Health and Well-Being http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=109455 Psychological Medicine Journal Saturday 20 October 2012 The onset of GAD can either be genetic, caused by prolonged stress, a traumatic experience or distorted beliefs.Clark D.M Anxiety Disorders: Why They Persist and How to Treat Them Journal of Behaviour Research and Therapy 1999 37 5–27 22/10/2012 Symptoms Symptoms of anxiety can be classified as either mental (affecting the psyche) or somatic (affecting the body but excluding the psyche). Mental symptoms can be categorised as apprehension and vigilance, whilst somatic symptoms can be categorised as either motor-based or exaggerated physiological responses. Category (Mental or Somatic) Associated Symptoms Mental: Apprehension Excessive worry Fear Agitation Mental: Vigilance Difficulty concentrating Irritability Fidgeting Somatic: Motor-based Muscle tension Restlessness Somatic: Exaggerated Physiological Responses Accelerated heart and sweat rate Breathing difficulties Headaches Dizziness Fatigue InsomniaBrown T.A Generalised Anxiety Disorder http://commonweb.unifr.ch/artsdean/pub/gestens/f/as/files/4660/21992_121827.pdf Clinical Handbook of Psychological Disorders, Third Edition: A Step-by-Step Treatment Manual 20/10/2012 In order to meet diagnostic criteria for GAD, patients must suffer from persistent and uncontrollable apprehension, and the consequential somatic responses, for at least six months.Kessler R.C Patterns and Correlates of Generalised Anxiety Disorder in Community Samples http://psylux.psych.tu-dresden.de/i2/klinische/studium/literatur/587.pdf 20/10/2012 Comorbidities GAD has a high comorbidity rate as many symptoms of GAD overlap with those of other psychiatric illnesses, including depression, bipolar and other forms of anxiety (namely social phobia and panic disorder).Simon N.M Generalized Anxiety Disorder and Psychiatric Comorbidities such as Depression, Bipolar Disorder, and Substance Abuse Journal of Clinical Psychiatry 2009 70 10–14 10.4088/JCP.s.7002.02 17/10/2012 Common Treatments Common treatments for GAD include: Pharmacotherapy Cognitive behaviour therapy Hypnotherapy Sharma Renu Hypononsis: Psycho-philosophical Perspectives and Therapeutic Evidence 2011 Concept Publishing Company New Dehli 13-978-81-8069-727-2 207–211 Dietary modifications (elimination of caffeine and alcohol) Hughes R.N Drugs Which Induce Anxiety: Caffeine New Zealand Journal of Psychology 1996 June 25 1 36–42 22/10/2012 Exercise can be used in conjunction with these treatments to help minimise the symptoms of GAD. Barriers to Exercise or Physical Activity There are several factors that dictate the likelihood of a GAD patient adhering to an exercise regime: Interest in the activity Perception of physical activity and exercise (i.e. incidental physical activity) Motivation Fatigue Low self-esteem Mind control Benefits of Exercise Endorphin release which masks pain, and produces feelings of euphoria and well-being Harbor VJ Endorphins and Exercise http://ukpmc.ac.uk/abstract/MED/6091217 Journal of Sports Medicine 22/10/2012 Stress relief and clearing and calming of the mind Lower resting heart rate - elevated heart rate is a symptom of GAD and exercise works to regulate this Rodriguez Diana Anti-Anxiety Workout http://www.everydayhealth.com/anxiety/anxiety-and-exercise.aspx 22/10/2012 Lowering airway resistance which improves the breathing difficulties experienced by GAD sufferers Aids in alleviating muscle tension associated with GAD Improves concentration Exercise Recommendations Aerobic exercise is the recommended exercise modality, as it is more pleasurable and achievable for the patient, and therefore increases the likelihood of adherence. Brisk walking, jogging, cycling and swimming are best. Exercising in social situations (for example, social tennis or dancing) is beneficial in two ways; the body undergoes the physiological adaptations associated with exercise, whilst also relieving emotional tension and improving self-value. Constantly elevated heart rate is a complication associated with GAD, however aerobic exercise improves the efficiency of the heart, thus lowering resting heart rate and helping to alleviate this symptom. [9] Yoga is recommended, and, whilst is it not seen as an aerobic exercise, it calms the body, regulates breathing, and alleviates stress, whilst also stretching the muscles and strengthening the body. Further Research, Reading and Support It is well-documented that there is a positive link between exercise and its role in preventing or lessening the burden of mental illness, however the clinical recommendations for exercise prescription are very general and limited. Future studies into standardising an exercise regime for sufferers of mental illness would be extremely beneficial in both prevention and treatment. References