{"id":4655,"date":"2018-12-16T10:55:49","date_gmt":"2018-12-16T15:55:49","guid":{"rendered":"https:\/\/www.amyork.ca\/academic\/zz\/?p=4655"},"modified":"2019-05-25T22:44:09","modified_gmt":"2019-05-26T02:44:09","slug":"anxiety","status":"publish","type":"post","link":"https:\/\/www.amyork.ca\/academic\/zz\/exercise\/anxiety\/","title":{"rendered":"Anxiety"},"content":{"rendered":"<ul>\n<li>\u00a0\u00a0 \u201cPathological counterpart of normal fear, manifested by disturbances of mood, as \u00a0well as thinking, behavior, and physiological activity\u201d<\/li>\n<li>Anxiety is more than chronic stress and increased arousal \u00a0o Perception and concern over the threat\u00a0 stressor\u00a0 are disproportionate to the \u00a0actual threat<\/li>\n<\/ul>\n<p>o Anxiety is usually experienced far longer than the arousal lasts \u00a0o Anxiety can occur in the absence of an actual threat<\/p>\n<p>&nbsp;<\/p>\n<h2>Anxiety Disorders<\/h2>\n<ul>\n<li>\u00a0\u00a0 Panic Disorder<\/li>\n<li>\u00a0\u00a0 Phobias<\/li>\n<li>\u00a0\u00a0 Generalized Anxiety Disorder<\/li>\n<li>\u00a0\u00a0 Obsessive-Compulsive Disorder<\/li>\n<li>\u00a0\u00a0\u00a0 Post-Traumatic Stress Disorder<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Panic Disorder<\/u><\/p>\n<ul>\n<li>Intense fear and discomfort associated with physical and mental symptoms \u00a0including: \u00a0o Sweating, trembling, shortness of breath, chest pain, nausea\u00a0 \u00a0o Fear of dying or loss of control of emotions<\/li>\n<li>Induces urge to escape or run away, and often results in seeking emergency help\u00a0 Ex: \u00a0Hospital<\/li>\n<li>\u00a0\u00a0 Frequently accompanied by major depressive disorder<\/li>\n<li>\u00a0\u00a0 Twice as common in women as in men<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Agoraphobia<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 Severe, pervasive anxiety when in situations perceived to be difficult to escape from, \u00a0or complete avoidance of certain situations\u00a0 Ex: Crowded areas, alone outside of \u00a0home, travelling in a bus or plane<\/li>\n<li>\u00a0\u00a0 Often seen after onset of panic disorder<\/li>\n<\/ul>\n<p>Twice as common in women as in men<\/p>\n<p>&nbsp;<\/p>\n<p><u>Social Phobia<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 Marked, persistent anxiety in social situations\u00a0 Ex: Public speaking<\/li>\n<li>Possibility of embarrassment or reticule is crucial factor<\/li>\n<li>Individual is preoccupied with concern that others will notice the anxiety symptoms\u00a0 Ex: Trembling, sweating, halted-rapid speech<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0\u00a0 Accompanied by anticipatory anxiety days or weeks prior to the feared event<\/li>\n<li>\u00a0\u00a0 More common in women than in men<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><u>Obsessive-Compulsive Disorder<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 Obsessions, such as recurrent thoughts or images that are perceived as \u00a0inappropriate or forbidden, elicit anxiety<\/li>\n<li>\u00a0\u00a0 Individual perceives loss of control, thus acts on impulses or thoughts<\/li>\n<li>Compulsions, including behaviors or thoughts, reduce anxiety associated with \u00a0obsessions \u00a0o Incudes overt behavior\u00a0 Ex: Hand washing\u00a0 and mental acts\u00a0 Ex: Counting, \u00a0praying<\/li>\n<\/ul>\n<p>o Take long periods of time to complete<\/p>\n<ul>\n<li>\u00a0\u00a0 Disorder has fluctuating course, including periods of increased symptoms, usually \u00a0linked with life stressors<\/li>\n<li>\u00a0\u00a0 Equally common in women and men<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Generalized Anxiety Disorder<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0\u00a0\u00a0 Defined by worry lasting more than six months, along with multiple symptoms\u00a0 Ex:<\/li>\n<\/ul>\n<p>Muscle tension, poor concentration, insomnia, irritability<\/p>\n<ul>\n<li>\u00a0\u00a0 Anxiety and worry not attributed to other conditions\u00a0 Ex: Panic disorder, phobias<\/li>\n<li>\u00a0\u00a0 Disorder has fluctuating course, including periods of increased symptoms, usually \u00a0linked with life stressors<\/li>\n<li>\u00a0\u00a0 Twice as common in women as in men<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Post-Traumatic Stress Disorder<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 Anxiety and behavioral disturbances following exposure to extreme trauma\u00a0 Ex: \u00a0Combat, physical assault , which persists for more than one month<\/li>\n<li>\u00a0\u00a0 Dissociation, symptom involving perceived detachment from emotional state or \u00a0body, is critical feature<\/li>\n<li>\u00a0\u00a0 Symptoms also include generalized anxiety, hyper-arousal, avoidance of situations \u00a0that trigger memories of trauma, recurrent thoughts \u00a0Occurs in about 9\u00a0 of those exposed to extreme trauma<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Prevalence of Anxiety <\/strong><\/p>\n<ul>\n<li><strong>National Comorbidity Survey \u00a0<\/strong>o 18.1\u00a0 of U.S. adult population will have a diagnosable anxiety disorder <strong>\u00a0\u00a0<\/strong>o Of those individuals diagnosed, 22.8\u00a0 are categorized as serious, 33.7\u00a0 as \u00a0moderate, and 43.5\u00a0 as mild<\/li>\n<li><strong>U.S. Department of Health and Human Services \u00a0<\/strong>o 16.4\u00a0 of population will have an anxiety disorder <strong>\u00a0<\/strong><\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Costs of Anxiety <\/strong><\/p>\n<ul>\n<li>Economic burden in terms of treatment and lost productivity\u00a0 \u00a0o Approximately one-third of costs are for psychiatric treatment \u00a0o Approximately one-half of costs are for non-psychiatric medical treatment \u00a0o 10\u00a0 of costs are indirect expenses<\/li>\n<\/ul>\n<p>o 5\u00a0 of costs are for prescriptions and mortality costs\u00a0 anxiety-induced \u00a0suicide<\/p>\n<ul>\n<li>\u00a0\u00a0\u00a0 Drug and substance abuse adds to the costs<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Symptomatology\u00a0 <\/strong><\/p>\n<ul>\n<li>\u00a0\u00a0\u00a0 Unpleasant feelings\u00a0 uncertainty, feeling overwhelmed<\/li>\n<li>\u00a0\u00a0 Bodily symptoms\u00a0 muscle tension, autonomic hyperactivity<\/li>\n<li>\u00a0\u00a0 Changes in cognitions\u00a0 obsessions, compulsions, irrational fear of objects or \u00a0situations<\/li>\n<li>\u00a0\u00a0\u00a0 Changes in behavior\u00a0 avoidance of situations<\/li>\n<li>\u00a0\u00a0 Vigilance\u00a0 looking out for a problem<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Clinical Anxiety vs. \u201cNormal\u201d Anxiety <\/strong><\/p>\n<ul>\n<li>\u00a0\u00a0\u00a0 Anxiety is characterized by worry, self-doubt, nervousness, and tension<\/li>\n<li>\u00a0\u00a0 When anxiety disrupts thought processes and behavior so much that normal \u00a0behavior is disrupted, it becomes clinical<\/li>\n<li>\u00a0\u00a0 Clinical anxiety is distinguished from \u201cnormal\u201d anxiety is based on the number and \u00a0intensity of symptoms, degree of suffering, and degree of dysfunction<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Treatment <\/strong><\/p>\n<p><strong>Medications:<\/strong> Tranquilizers and antidepressants<\/p>\n<ul>\n<li>Effective but can be costly<\/li>\n<li>Have side-effects<\/li>\n<li>\u00a0 <strong>Psychotherapy: <\/strong>Cognitive-behavioral therapy\u00a0 CBT\u00a0 for coping strategies<\/li>\n<li>Can be costly o Can be time consuming<\/li>\n<li>\u00a0\u00a0 <strong>Physical Activity:<\/strong> A potential tool in both the prevention and the treatment of \u00a0anxiety<\/li>\n<\/ul>\n<p><em>Note:<\/em> All three treatments may be combined<\/p>\n<p>&nbsp;<\/p>\n<h2>Measuring Anxiety<\/h2>\n<ul>\n<li><strong>State Anxiety: <\/strong>A transient emotional state characterized by feelings of apprehension \u00a0and heightened autonomic nervous system activity\u00a0 increased heart rate, sweaty \u00a0palms, increased breathing rate, increased muscle tension\u00a0 \u00a0o Usually assessed after single bouts of exercise<\/li>\n<li><strong>Trait Anxiety: <\/strong>A more general predisposition to respond with apprehension, worry, \u00a0and nervousness across many situations\u00a0 lack of confidence, difficulty making \u00a0decisions, feelings of inadequacy\u00a0 \u00a0o Usually assessed after chronic exercise\u00a0 i.e. after an exercise program<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><u>Psychological and Physiological Measures of Anxiety<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0\u00a0 <strong>Psychological Measures:<\/strong><\/li>\n<\/ul>\n<p>o Self-report inventories<\/p>\n<ul>\n<li><strong>Physiological Measures:<\/strong>\u00a0 \u00a0o Muscle tension, via electromyography\u00a0 \u00a0o Blood pressure and heart rate\u00a0 \u00a0o Skin responses \u00a0o EEG\u00a0 Electroencephalography<\/li>\n<\/ul>\n<p><em>Note:<\/em> It is best to incorporate both types of measures when measuring anxiety<\/p>\n<p>&nbsp;<\/p>\n<h2>Research on Preventative Effects of Exercise<\/h2>\n<ul>\n<li>\u00a0\u00a0 Greater self-reported physical activity is associated with better mental health, and \u00a0fewer symptoms of anxiety\u00a0 Stephens, 1988<\/li>\n<li>\u00a0\u00a0 Goodwin\u00a0 2003\u00a0 concluded that there is a potential link between regular exercise \u00a0and a reduced likelihood of a variety of anxiety disorders<\/li>\n<li>\u00a0\u00a0 Higher levels of physical activity are sometimes related to lower self-reported \u00a0anxiety\u00a0 Brunes et al, 2013<\/li>\n<li>\u00a0\u00a0 Individuals who are physically fit have less anxiety than their unfit counterparts \u00a0\u00a0Landers and Petruzzello, 1994<\/li>\n<\/ul>\n<h2><\/h2>\n<h2>Research on Use of Exercise as a Treatment<\/h2>\n<ul>\n<li>Initially low-fit and highly anxious individuals have the most to gain from exercise \u00a0training<\/li>\n<li>\u00a0\u00a0 Both anaerobic and aerobic training resulted in significant psychological \u00a0improvements\u00a0 Martinsen, Hoffart, and Solberg, 1989<\/li>\n<li>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Significant relationship has been noted between aerobic capacity and anxiety levels, \u00a0with greater fitness levels related to lower anxiety\u00a0 Sexton, Maere, and Dahl, 1989\u00a0 \u00a0&#8211; \u00a0\u00a0\u00a0\u00a0 Vigorous exercise is not necessarily for improvements\u00a0 Sexton, Maere, and Dahl, \u00a01989<\/li>\n<li>In patients with <strong>panic disorder<\/strong>: \u00a0o Pharmacotherapy\u00a0 medication\u00a0 is most effective, but exercise results in \u00a0significant improvement\u00a0 Broocks et al., 1998<\/li>\n<\/ul>\n<p>o Patients show significant anxiety reductions following exercise\u00a0 O\u2019Connor, \u00a0Smith, and Morgan, 2000<\/p>\n<p>&nbsp;<\/p>\n<h2>Relationship Between Exercise and Anxiety<\/h2>\n<ul>\n<li><strong>Aerobic Exercise: \u00a0<\/strong>o Anxiety reduction<strong> \u00a0<\/strong>o No difference between modes<\/li>\n<li>Reductions in state anxiety following acute exercise and in trait exercise following chronic exercise<\/li>\n<li>Reductions are seen in self-reports and measures of muscle tension, the cardiovascular system, and the central nervous system<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><strong>Resistance Training: \u00a0<\/strong>o May result in slight <em>increases<\/em> in anxiety\u00a0 that are very short-lived and return \u00a0to baseline levels relatively quickly <strong>\u00a0<\/strong><\/p>\n<ul>\n<li><strong>Acute Exercise: \u00a0<\/strong>o Effect does not last indefinitely; <u>lasts for 2 to 4 hours<\/u><strong> \u00a0<\/strong>o Anxiety returns to pre-existing levels<\/li>\n<li>Possibility that over time pre-exercise levels of anxiety may become reduced<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><strong>Exercise vs. Other Treatments: \u00a0<\/strong>o Exercise has been shown to be better than not doing anything and is as \u00a0effective as other treatments\u00a0 and it costs less <strong>\u00a0<\/strong><\/p>\n<ul>\n<li>Exercise many be more effective than anti-anxiety drugs<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2>Consensus Statements Regarding Exercise and Anxiety<\/h2>\n<ul>\n<li>\u00a0\u00a0\u00a0 Exercise can be associated with reduced state anxiety<\/li>\n<li>\u00a0\u00a0 Long-term exercise is usually associated with reductions in neuroticism and trait \u00a0anxiety\u00a0 neuroticism is mentioned because people with anxiety usually show some \u00a0traits of neuroticism<\/li>\n<li>\u00a0\u00a0\u00a0 Exercise can result in the reduction of various stress indices<\/li>\n<li>\u00a0\u00a0\u00a0 Exercise can have beneficial emotional effects across all ages and both genders<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>What We Don\u2019t Know About Exercise and Anxiety<\/h2>\n<ul>\n<li><strong>Intensity levels of exercise \u00a0<\/strong>o More research is needed on recommendations of minimal exercise intensity \u00a0levels<\/li>\n<li>\u00a0\u00a0 <strong>Duration of exercise <\/strong><\/li>\n<li>Some research shows that durations of less than 20 minutes were as effective as those greater than 20 minutes<\/li>\n<li>Anxiety reduction seems to be achieved regardless of duration<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Mechanisms of Change<\/h2>\n<ul>\n<li>\u00a0\u00a0 Thermogenic Hypothesis<\/li>\n<li>\u00a0\u00a0\u00a0 Distraction-Time-Out Hypothesis<\/li>\n<li>\u00a0\u00a0 Other possible mechanism of change are similar to those proposed in previous \u00a0chapter\u00a0 ex: mastery, self-determination<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Thermogenic Hypothesis<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 Elevated body temperature resulting from exercise may lead to psychological \u00a0changes such as reduced anxiety<\/li>\n<li>The brain senses the temperature increase ! leads to muscular relaxation response \u00a0! feeds back to the brain ! interprets the muscle response as relaxation or reduced \u00a0anxiety<\/li>\n<li>\u00a0\u00a0 It could be brain temperature, not body temperature, that drives the affective \u00a0response<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><u>Distraction-Time-Out Hypothesis<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 The anxiety-reducing effects of exercise may be due to the distraction it provides \u00a0from one\u2019s normal routine<\/li>\n<li>\u00a0\u00a0 An anxious or depressed individual who exercises is taking a \u201ctime-out\u201d from \u00a0his-her worries and concerns<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Practical Recommendations <\/strong><\/p>\n<ul>\n<li>\u00a0\u00a0 Exercising on a regular basis does seem to be useful in reducing-treating anxiety, \u00a0although the minimal level required is unknown<\/li>\n<li>\u00a0\u00a0\u00a0 Aerobic forms of exercise seem to be most effective<\/li>\n<li>Individuals with more severe forms of anxiety should consult a mental health-care \u00a0provider<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>\u00a0\u00a0 \u201cPathological counterpart of normal fear, manifested by disturbances of mood, as \u00a0well as thinking, behavior, and physiological activity\u201d Anxiety is more than chronic stress and increased arousal \u00a0o&hellip; <a class=\"continue\" href=\"https:\/\/www.amyork.ca\/academic\/zz\/exercise\/anxiety\/\">Continue Reading<span> Anxiety<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[120],"tags":[],"_links":{"self":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4655"}],"collection":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/comments?post=4655"}],"version-history":[{"count":2,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4655\/revisions"}],"predecessor-version":[{"id":4793,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4655\/revisions\/4793"}],"wp:attachment":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/media?parent=4655"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/categories?post=4655"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/tags?post=4655"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}