Exercise as it relates to Disease/General Anxiety Disorder and Aerobic Exercise

Generalised Anxiety Disorder (GAD) is consistently feeling fearful and anxious at an unwarranted level. Although it is not known what is the direct cause it is associated with the amygdala and hippocampus of the brain, and elevated levels of norepinephrine, gamma-aminobutyric and serotonin in the brain, and trauma. If left untreated symptoms seem to become progressively worse.

Symptoms include difficulties with sleep, muscle tension, nausea, dizziness, excessive urination, restlessness, low concentration, sweating, and hot flushes

Risk factors include a family history of mental illness, stressful events or environments, long-term illness, and certain personality traits.

Prevalence - The 2007 mental health survey showed anxiety disorders effected 14% of the Australian population. Females consistently showed higher rates than males in all age groups, especially in teenage years. GAD was responsible for 2.7%. Sufferers experienced the highest perceived interference of life, and higher psychological distress than many other anxiety disorders. In the UK 9% of the population had an anxiety disorder (less than Australia), while in the US 3.1% of the population had GAD (more than Australia).

Treatment through counselling can include cognitive behavioural therapy, interpersonal therapy, family therapy, and psychodynamic therapy. Medical treatment includes antidepressants and benzodiazepines.

Generalised Anxiety Disorder and Exercise
It has been shown that levels of anxiety in patients with GAD and other anxiety disorders decrease with physical activity. This is thought to be due to the increased presence of excitatory hormones and bodily responses at the time of exercise and the decreased influence they have with continued exercise, which may be due to down-regulation.

Type of Exercise
It is currently thought that aerobic exercise is best for reducing anxiety. This may be due to adherence, or from the ability to maintain the exercise for a longer duration. Best results are seen with walking, jogging, riding and swimming.

Frequency
It is recommended that the exercise is in sessions of 20 minutes or longer. Australian government recommendations for physical activity for general health are 30 minutes of moderate intensity exercise every day if possible, which is a sufficient amount to reduce anxiety. However, the recommendations also mention the possibility of breaking this time up in to 10 or 15 minute sessions, which may not be effective specifically for anxiety. As with many physical improvements, the reductions in anxiety take some time, with best results occurring after ten weeks or more.

Benefits
The sufferers of GAD report having problems with many aspects of their lives, in particular their social life. Participation in group fitness may help make the participant feel involved. With GAD concentration is also a problem, with exercise work and school lives could be improved as concentrating becomes easier. Exercise may also increase the ease of sleeping. The weight gains associated with taking antidepressants, can be managed.

Cautions
Always make sure the participant is comfortable with the type of exercise, as you do not want to further anxieties. When taking antidepressants the side-effects of nausea, sweating, dizziness, and headaches may effect ability. With benzodiazepines, as well as the side-effects above they may have impaired motor coordination, blurry vision and tremors, which all mean greater precaution should be taken. The symptoms of GAD should always be taken into account when exercising. Always consult a general practitioner if you are unsure of your ability.