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

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. GAD is most common during late teens to early twenties, and also in the elderly - as we have an ageing population, the number of people living with disorder may increase over time.Generalised Anxiety Disorder http://www.raminader.com/PDFs%20Uploaded/GAD%20-%20AnxietyBC%20-%20GAD.pdf Anxiety BC 23/10/2012 GAD is also more common in people of lower socio-economic status due to increased uncontrollable stressors. [1] 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 As a result, 75-90% of GAD sufferers will also be diagnosed with one of the aforementioned psychiatric illnesses. [1] 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 Self-esteem Mind control Benefits of Exercise in GAD Patients 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 16/10/2013 Stress relief and clearing and calming of the mind Lowers 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 Lowers airway resistance which improves the breathing difficulties experienced by GAD sufferers Aids in alleviating muscle tension associated with GAD Improves concentration Provides a sense of self-mastery and changes in self-concept Strohle A Physical Activity, Exercise, Depression and Anxiety Disorders Biological Psychiatry 2009 777–784 10.1007/s00702-008-0092-x http://robertwhitaker.org/robertwhitaker.org/Solutions_files/Physical%20activity,%20exercise,%20depression%20and%20anxiety%20disordrs.pdf 22/10/2012 Exercise Recommendations Moderate-intensity aerobic exercise, such as brisk walking, jogging, cycling or swimming, are recommended as they are more successful than vigorous intensity-based programs. [10] 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.Nefer B Exercises for General Anxiety Disorder http://www.livestrong.com/article/129475-exercises-generalized-anxiety-disorder/ Live Strong 23/10/2012 It is recommended that patients partake in aerobic exercise 3-4 times per week, with a duration of 20 – 30 minutes per bout. The exercise program should continue for 8 –14 weeks to see overall improvements in their condition, but should be maintained for life. As well as exercise, incidental physical activity should be encouraged (for example, cleaning the house or climbing stairs) [10] 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 GAD sufferers would be extremely beneficial in both prevention and treatment. [10] Further reading and support: http://au.reachout.com/Generalised-Anxiety-Disorder http://www.patient.co.uk/health/Anxiety-Generalised-Anxiety-Disorder.htm ** http://www.anxietyonline.org.au/ Life line: 131114 Lifeline online: https://www.lifeline.org.au/Get-Help/Online-Services/crisis-chat Beyond Blue: 1300 22 4636 Beyond blue online http://www.beyondblue.org.au/index.aspx?link_id=103.883 References