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How Exercise Can Calm Anxiety (nytimes.com)
253 points by gruseom on July 4, 2013 | hide | past | favorite | 71 comments



I'm more of a cyclist than a runner, but my limited experience has been that when I consistently cycle longer distances each week (100km+) I feel better, my brain is clearer and I sleep longer and more soundly at night. Historically I've been a night owl, but during the times when I was consistently riding I could hardly stay awake past 10pm.

Cycling, running, rowing, whatever - just get out there and do it. As the article noted, exercise is not only good for the body but the brain as well.


If we use our energy and break down our muscles during the day, our body will want to sleep and recover... this is GENIUS. Im starting a startup.


I know you were trying to be sarcastic but being physically tired is not the same as being mentally tired. During different periods of my life, I've had difficulty sleeping before midnight regardless of the physical activities I engaged in during the day. I've run marathons, trained for ultras, swam mile+, kayaked for 8 hours and yet I've had problems sleeping the very same night. In fact, sometimes you can be too tired to sleep. Other times, I can be relaxed, barely walk a thousand feet during the day and still need to fall asleep within 12-14 hours of waking up.


I don't think there is actually a causal link between exercise and anxiety reduction. All of the self reports can be explained by the placebo effect. And there is a strong bias toward believing in a causal link that is all-pervasive. When regular people experience anxiety reduction in conjunction with exercise, the belief in exercise as the cause is unquestioned, and researchers like these in the article need never fear that their interpretation will be scrutinized. Nobody has a vested interest in opposing exercise. Everyone knows it's just plain good for you.

What did this study prove? The assertion is that mice that are locked in cages so they forcibly can't do what they would normally be doing make good representatives for people that are not exercising, for any reason, including personal preference. Do the researchers actually find that convincing? No, apparently not:

>> Of course, as we all know, mice are not men or women. But, Dr. Gould says, other studies “show that physical exercise reduces anxiety in humans,” suggesting that similar remodeling takes place in the brains of people who work out.

In other words, this study didn't really need to prove anything, anyway, because it's already known from "other studies."

If you were going to design the definitive study to answer the question of whether exercise relieves anxiety, how would you control for the placebo effect? You can make sugar pills that are, plausibly, convincing enough to separate drug effect from placebo. But how do you make a placebo for exercise? Exercise itself would seem like the perfect placebo. If a research study was able to motivate a group of sedentary, depressed subjects to start regular exercise, it would seem to make it very hard to argue that those subjects didn't believe they were genuinely doing something. A rigorous, double-blind, controlled study of exercise sounds all but fundamentally impossible to do.

What about an observational study? How do you take two people, one who exercises regularly, and one who is sedentary, and claim that they are otherwise perfectly matched?

Why are scientists so sure it's been proven? Nature abhors a vacuum. It seems like the less testable something is, the more certain people are of it.


Do you ever exercise? Or maybe more pertinently, do you have any anxiety problems?

I do on both counts, and what you're saying is laughable. It would be like telling me that all the self reports that alcohol causes drunkenness are just placebo.

It's such an obvious effect, both immediately following a workout, as well as over time (months that I work out vs. months that I don't) that it could never be confused with a placebo effect. Hence studies like this that attempt to determine /why/ it happens, vs /that/ it happens.


How would you tell the difference whether exercise reduced your anxiety, or the fact that you were exercising was a sign that your mental health was better? I definitely feel more like exercising when I'm not anxious or depressed. Almost nobody is going to bother with exercise if they feel hopeless.

Besides, anxiety is not like cancer, where the tumor is either there or not. There are probably biological inputs, but psychology is obviously important. If you can get someone to believe they are not anxious, then they're not anxious. So, arguably, a placebo effect is the only known cure.


Replying to myself--

What bugs me about the subject of exercise is that it's plainly a moral issue masquerading as a scientific issue. There is the Romantic strain to which exercise is natural and pure, and the Puritanical strain that equates exercise with virtuous labor and discipline. People would love to find scientific evidence of its curative powers, as if having evidence mattered.


Fellow cyclist here. I can confirm what you said. In my experience as well, cycling has proven to be an activity that would bring me more happiness and well-being than any other. I sometimes suffer from mild depression, and when I go on a cycling trip (150-200km), through forests, on mountain paths, my mood changes significantly for the better. The effect can last more than a week.

Obviously, your sleeping habits and appetite improve significantly as well.

I used to portray cycling as a extraordinary (even magical) activity, the bike as a magical device to my mates, but I realise now that indeed, there's nothing unusual about it. It's more of a placebo effect. I would say that spending time in nature, away from the destructive urban environment, has the biggest calming effects.


I'm a marathoner and ultramarathoner. My first running event was a half-marathon in 2007. From there, one thing lead to another over the years, and now the most recent event I ran was a 50 mile ultra.

What I can say from my personal subjective experience is that I feel good all the time. No aches and pains. No trouble sleeping. Mentally quick and sharp. Never sick. The list goes on.

I recommend running to anyone. Not necessarily becoming a marathoner, unless you enjoy the challenge, the sport and the subculture of it, but running in general, for fitness.


To me, long-distance running also has the effects you describe, but you and I are lucky to have bodies that allow it. Cycling is great in similar ways but can be a lot easier on the knees, for example.

I've found other higher level psychological effects of exercise, too. For example, having a group that meets for a run every week at a given time and goes out no matter what the conditions (snow, rainstorm, heat wave, tornado warning...) was incredibly inspiring and liberating. Exploring the neighborhoods of my city on different routes made me happy in ways that a treadmill never could. And hard self-defense workouts always gave me the best stress relief and a sense of perspective (especially when we took a moment to meditate, too).


I recommend running to anyone.

Unless you have severe joint problems, in which I case I think non-impact activities like swimming and flat cycling are a better alternatives.


Humans seem to know how to run naturally. Run down the hallway in your house with no shoes on and your technique is likely very good. Strap on a pair of nice, thick, impact absorbing running shows and your technique often goes out the window.

The problem with most running shoes is that they permit you to run terribly without (immediate) pain. They allow you to land with significant pressure on your heel or back half of your foot without really noticing. The flex in your foot and elasticity of your calf muscle help significantly in absorbing the energy of your foot striking the ground (and ideally returns some of it).

Try this test: Without shoes, bounce up and down on your toes. Now try again on your heels. Ouch! And yet this is how many people run without noticing. Of course significant knee/ankle pain comes at some point.

I'd recommend to anyone who experiences knee/ankle pain from running to try running without shoes for a very short distance, take note of your technique, and then replicate that with shoes on (or buy some very thin soled running shoes like those five-fingered variety). Your calf muscles will likely hurt like hell for the first few runs (because you weren't using them before), but they will soon adjust.


Can anyone actually point me to a study that provides significant evidence for this? As a non-specialist with quite severe meniscal damage from an old rugby injury, swimming has often been suggested to me, but I found it the very most painful and upsetting activity of all. Whereas running (in Fivefingers, for the last four years) has more or less brought my knees back to normal.

I'm not challenging that for some value of "severe" this is true, and I'm sceptical that my own experience represents anything useful at all for anyone else. But my question is: is there actual clinical evidence that this is the case, or is this actually just an old wives' tale?

There are plenty of things online that suggest the opposite[1] - but can anyone who actually knows what they are talking about chime in with the state of the art?

[1]: http://www.runnersworld.com/injury-treatment/joint-myth?page...


Not an expert, but a confusing aspect is open chain vs closed chain exercises.

Open chain exercises leave the foot or hand free to move (like swimming) and because of the lack of support they can actually exacerbate injuries. Instead of putting a joint under compression they put it under tensive strain.

Closed chain exercises are the opposite, the hand or foot is rooted in place (pushups, running, squats, etc) and because of this they add stability through the compression, BUT because of the compression they can also exacerbate injuries (especially because closed chain exercises are often weighted or involve repeated impact).

In the end, like most things, there is no one size fits all. In some situations closed chain is better, other open chain is better. For the average person it doesn't matter as much as most people think. If you're injured consult an expert for exercise to do, if you don't want to do that avoid exercises that cause joint pain.

Most of the studies are injury-specific and not in 100% agreement.


This isn't exactly what you're asking about (I think you're challenging swimming as a go-to activity for someone too injured or otherwise unable to run) -- but there is a related myth, which is that running ruins your knees. Studies have shown evidence the opposite is true: that running strengthens and thickens bone. I mention this by way of saying that, with the amount of myth and half-truth out there as relates to running and the impact on the body, I'm never surprised by what people believe anymore.


I was always under the understanding that running (potentially) ruins your knees by damaging your cartilage - bone thickness or density isn't the issue. That's why swimming is often recommended because there is no impact on your cartilage.


I'm running cartilage mapping MRI sequences on knees today - and while its hardly scientific, I would have to agree. The big runners I scan have some pretty munted hips and knees. So very messed up that I can't find any decent cartilage to use as baseline normal for the scanner.


This is precisely why I'm a cyclist and not a runner. I like to think that I gave running a sincere effort, but the little aches and pains just bothered me constantly. Maybe I had poor form, or maybe my body just isn't built for it, I don't know. By contrast, after tens of thousands of kms on the bike, all I ever get are sore muscles after a hard effort.


"A study at Boston University School of Medicine looked at the continuous impact of the foot with the ground and the commonly accepted belief that running causes degeneration of the knee and can lead to all sorts of arthritic conditions.

Said lead researcher and epidemiologist David Felson of BU: “We know from many long-term studies that running doesn’t appear to cause much damage to the knees. When we look at people with knee arthritis, we don’t find much of a previous history of running, and when we look at runners and follow them over time, we don’t find that their risk of developing osteoarthritis is any more than expected.” Felson added that recreational running doesn't increase the risk of arthritis."

Quoted from: http://www.mizunousa.com/running/blog/article/the-planet-wav...


I recall that the research I've seen on this in the past showed reduced bone density etc. only in serious endurance runners (e.g. multiple marathons, ultra-marathon) and indicated improvements in your "average" runner.

Bone density is definitely an issue, especially for women.


Running is vary dependent on age, stride, body size and style. For example a tall and slightly over weight runner with a poor stride has far more impact stress than shorter, thinner, runners with a more efficient stride. Add to that the importance of not running every day to tive the body time to heal and you end up with wide range of issues.


I don't have the study, but I do have my own experience. About 5 years ago I was lucky to survive being hit by the propellor of a speedboat. I was struck across the sacrum, crushing nerves and fracturing both the sacrum and tailbones, as well as a deal of laceration for good measure. There is always a pressure, stiffness and dull spinal ache and occasional acute pain - though fortunately not too often for the latter.

Anyway, I find now that if I do any duration of impact-based activity that I will pay for it; I feel each impact in my spine, though that is bearable for a while, but the next day my lower spine and sacral area will be stiff and sore. Whereas when I swim there is neither immediate nor consequential pain relating to the injury.

It's lucky that I'm a lazy bastard and didn't intend on running anyway :p


I prefer to run on thick grass, mountain bike trails, tracks, etc. for this reason. I don't have joint problems yet, but every time I run on pavement I can feel how hard it is on the body.

Uphills runs and stair-training are also significantly lower impact on the knees and hips, though both can be harder on certain muscle groups like hamstrings.

I recommend to everyone to find some winding, hilly mountain bike trails and go run on them. I could never get into running outside the context of team sports until I tried this; it's an absolute blast, especially if you have a background in sprinting.


But when you do, please leave the earphones at home. And don't jump in a random direction like a deer when you hear someone behind you with squealing brakes. Us MTB'ers will appreciate it.


This, definitely. Of course the said sports are a good addition to us runners too. I personally find it actually even more rewarding to do the longer aerobic workouts by swimming or cycling than always running. Mixing things up is hardly ever a bad thing.


Like you, running has changed my life. I started on a whim last year and haven't looked back even though I've been hit with a few minor injuries that have been frustrating.

If you've always been curious but never found you could handle running, then do yourself a favour and check out C25K and the Robert Ullrey podcasts (http://www.c25k.com/). They're a great way to ease into running by giving you progressively increasing difficulty. Best of all they're free and I don't know anyone who's stuck with it and hasn't been able to run a 5k by the end of the 9 weeks.

I've solved many a startup challenge during my longer runs, solved bugs during the meditative bliss and felt a huge boost in my self confidence. Perhaps best of all, you'll also get better in the sack, but don't take my word for it : http://www.canada.com/story.html?id=2dc6f60b-11a7-421f-9ab2-...


I started speed walking about one year ago. I finished my first 10k this jan. I am training for my half-marathon at the end of this year and last week I was able to run three days in a row, which was unthinkable about a year ago, I am not overweight, but speed walking or light jogging used to cause me a hell of a lot of pain and it used to take me a lot of time to recover, sometime more than one week from light jogging.

I do weight training too, but running is a totally different feeling, before I used to force myself to go for runs but now it takes a lot to stop me to go for a run. Its hard to explain, its like I am addicted to it, even though its still painful, but I am recovering much much faster.

I too recommend everyone to give running a try, if you can through the initial hurdle, I don't think you will ever regret it.

Just today, I also finished reading "born to run", while I understand that there are exaggerations in the story to make it more interesting for the readers, and science of "born to run" is still 'up there' and perhaps debatable depending on who you ask, its still one of the best book I have read. Highly recommended to read.


> I am not overweight, but speed walking or light jogging used to cause me a hell of a lot of pain

If you're talking foot/leg pain, see a podiatrist. Foot problems are very common, and you may be able to get a lot of relief with simple orthotics.


It used to be foot pain mainly, but now its not anywhere nearly as bad as it used to be. I think it was mostly due to not using my legs for anything more than a brisk walk for more than a decade.

Now my pains are gluteus and calf related, but I think they are mainly because I have been pushing myself pretty hard. Gotta slow down a bit and give myself more time to recover.


I'd recommend seeing a podiatrist anyway[1].

I've known about my alignment issues for years - mega tight hamstrings and weak gluteals so I got my first pair of (corrective) running shoes from a local, reputable, running shop[2] after a gait analysis. I couldn't run further than 3 miles before the pain in my knee became too much.

The shop then referred me to a podiatrist and switched my corrective shoes for a neutral pair, with insoles from the podiatrist. Since then I've had no problems and have run a half-marathon and 10k.

[1] Not that I'm an especially experienced runner but I've known about my alignment issues for years and, with running in particular, really notice the difference the right correction makes.

[2] http://www.mymoti.com/


I will see if there is any good podiatrist where I live (I highly doubt), but thanks for your suggestion, I appreciate it.


My subjective experience is a little different.

I never did marathons, but I consistently ran 4miles a day ~7:30min/mile pace for 2 years rarely missing a day.

Never got sick and definitely had no trouble sleeping, but I would get knee pain, leg pain and foot pain randomly that wouldn't go away. Mentally things seemed good, but I did notice being more tired in general and unless you run early in the morning it does take up a decent amount of time.


I had little issues like that, as well. Prior to 2010, I hadn't ever run a full marathon because I couldn't train enough. It hurt too much, basically. I was never injured, but just persistent pain and little issues while running.

So, as you're probably sick to death of hearing about, I switched to flat shoes. Mizuno Wave Universe 3, specifically, which is a racing flat made for 1,000 to I'd say 5,000 meter racing.

Changed everything. Changed my running form, I should say, but "everything" fell in line right behind that. All those issues melted away and have, to this day, never recurred, and now I'm able to run as much as I want, train as hard as I want, and so forth, with no pain. It's amazing really. It's personal success stories like this which have made it such a trend. For good reason, in my case. For me, there's no going back, it's not even a question.


I feel like I have those exact pains, but I'm not sure about racing flats.. I usually run 5+ miles (not racing) and flats are more for shorter distances (and racing).

What shoes do you wear for marathon training?

p.s. Are those exact flats still purchasable anywhere? Can't find them online (size 11').


I wore the racing flats for all road runs, including marathons, for years. Now I wear NB Minimus for both roads and trails. But the principle is the same. It's flat, flexible, light shoe.

The racing flats I mentioned are designed for racing, definitely. But the idea is that you wear them for all road runs, fast or slow, as a means to changing your running form.

You can probably get Wave Universe on Amazon.


Thanks, I'll take a look at the NB Minimus this weekend from my local runner's shop. It looks like Vibram 5 fingers minus the toes.


All the anecdotes I've heard have been in the direction of increased susceptibility to colds around and after a marathon event. Maybe if you don't spend time around people when so weakened you could avoid sickness.

Have you considered that you may just be lucky in not falling ill lately? I've had several >1yr stretches without illness and have never done endurance exercise (max was a single half marathon).


I think you're on the wrong track. It's been over 6 years since I've been sick. I also eat really well. Too much stress compromises the immune system, sure. Of course. And for many people, running a marathon constitutes that threshold of too much stress. I haven't felt that. Perhaps doing a 100-mile mountain race would, though...


I used to be an avid runner in high school and enjoyed the same benefits as you describe, until junior and senior year when I developed a dull aching pain in my lower legs whenever I ran. I began taking a lot of OTC anti-inflammatories to counter it, which worked for a while.

After seeing a few doctors, it was eventually diagnosed as chronic compartment syndrome. I've been debating whether to go forward with the surgical cure. It's a tough decision, because the condition doesn't present itself outside of long-distance running, and the surgery is rather invasive.

I seriously miss running. For those of you who can run, I strongly recommend it. It can be an immensely enjoyable way to stay in shape.


Sorry to hear about that.

Anything is possible in life. Something could happen to me where I can't run anymore. In which case, I will likely take up cycling.

That said, someone who is basically my running mentor right now has has been running marathons for 30 years (he's 58 years old), and, as an example, was 11th place last year in a marathon that had several hundred of runners. No sign of slowing down. The simple fact is, this is the running future I hope for. (And there are a lot of examples like him!)


I like running but regularity seems to be the biggest hurdle. Do you think one has to push oneself to improve running or that improvement part takes care of itself as one maintains regularity.]?


A little of both. If you maintain a certain number of miles per week, you will become stronger. If you actually work out, somewhere in among those weekly miles, you will become a lot stronger. "Work out" means some type of running workout. That could be track work, or that could mean simply running a bit faster than your normal, comfortable distance pace, such as a tempo workout or a threshold run.


As someone whose anxiety is triggered by physical activity, this is a bit of a conundrum for me at the moment.


I was having this issue earlier this year after about ten years of not enough exercise (with some years excepted). A couple of years ago, a routine physical showed a small blip on my EKG, "nothing to worry about, but here, go see this cardiologist". A (very stressful) stress test and a holter monitor test later, the doc didn't seem to think my EKG issue (a right bundle branch block) was much to worry about, but "you really need to get your fast heartrate down, if it's not a medical issue then you need serious psychological help", so thanks doc! It's known as "white coat syndrome", medical settings scare the crap out of me.

Anyway, for the next couple of years I found exercise in some ways to be stress-relieving as it always did, but the shadow of "what if your heart is bad" was really messing it up. I developed palpitations which persisted for about a year, scaring the crap out of me regularly.

The two things that have at least for now ameliorated it are: 1. I went on antidepressants (lexapro), this is not the first time I've been on them and despite HNsers who think they're bunk, it's pretty obvious they have a positive effect, and 2. I got a personal trainer at the gym. Both have downsides: one is side effects, the other is PTs are incredibly expensive. But the advantage of the PT is, she pushes me so hard that you get to experience levels of cardio workout that are way beyond what I normally would do on my own. So between just experiencing ridiculous, prolonged cardio workouts as well as the heart strengthening effect they have, my resting heartrate is down to 60 at night and I don't generally have palpitations. I wouldn't say the problem is solved, but working out very intensely with someone there who will most likely call 911 if you keel over has been helpful.


> "you really need to get your fast heartrate down, if it's not a medical issue then you need serious psychological help",

... then ...

> 1. I went on antidepressants (lexapro), this is not the first time I've been on them and despite HNsers who think they're bunk, it's pretty obvious they have a positive effect

Unwarranted anxiety is a common symptom of depression. The doctor was right, you needed psych treatment.


I've been there, and meds helped me get over the initial hump. Using an exercise heart rate monitor also helped. For me, the thought of heart failure was a trigger for panic attacks. The heart rate monitor allowed me to watch my heart rate rise as I ran harder and fall when I went back to walking. It had an anxiolytic effect. After a few sessions on the treadmill I no longer needed benzos to get through 30 minutes of activity.


That's interesting. The heart rate monitor is a great idea, I'll have to try that. Thank you.


It's not something to beat yourself up over, or to feel stuck because you can't do it. I think the benefit of exercise has more to do with a feeling of accomplishment than the exercise itself. I wish I had a surefire cure for anxiety, but I'm sure it's not exercise.


That's tough and I hope you find a way to manage this.

Regular exercise has all sorts of benefits including (in general) reducing anxiety, but single sessions of exercise often feel like they have negative consequences.


Very true. I try to view it as an investment with a payback period. Or another way is to see the initial investment as a sort of "activation energy" required to get you over the hump.


It gets easier...i find when i am running it is stressful naturally because of the physical hardship on your body. However i find the big payoff is how you feel afterwards.


Thanks for the response, it helps to know others have been there.


Walking is a good place to start.


I suffer quite badly from anxiety. I consider myself a good developer, but sometimes the stress of the job will make me nervous and I'll make silly mistakes. I'm used to it enough now to make myself take a step back and relax before continuing, but it really affected my confidence a few years ago. Something as simple as having someone watch me while I code would make me feel to pieces.

Although I don't exercise as much as I'd like to, I still go to the gym three times a week and get in a ton of cardio. Nowadays, I tend to go to the gym after work and I find myself craving it after a hard day. It's almost as if the fitness benefits are a secondary goal for me, as the sole reason I do it is to cheer myself up and to relieve the stress of work. I can have a terrible day, and I know that if I run 10k and do a ton of cardio I'll head back home happy and relaxed.

Ideally, later on in my career, I'll land a job with an on-site gym so I can get my exercising done during my lunch break.


Interesting. This goes hand in hand with the saying that "When you are too stressed to have time to exercise, you need it the most." In this case, the science seems to back up the heuristic.


Remember that 7-min routine someone posted a few weeks back? (http://goo.gl/vwmYH). I've doing that every single day and I feel much better everyday, with more energy. Might sound silly for some that a routine that short would do anything, but it actually made a change. Anxiety is something that can block you from finishing projects and doing simple stuff, I totally agree with this article.


I like it a lot, it's a great basis for working out, though a few of the exercises are a bit advanced for beginners (in particular the tricep and rotating pushups should be gradually entered into to avoid injuring yourself). You can simplify and use some small weights to help work on some muscle groups before moving to the full workout.

I've rounded it out by including a few isometric exercises, some free-weights and balance exercises in between 7 minute rounds. You can get a real sweat from it if you take it seriously.


Seven minutes of effective exercise, done regularly, is miles better than being sedentary 100% of the time.

I've visited rehab centres before, and have seen elderly stroke victims doing little more than lifting their arms for exercise. When you've been bedridden for months, this sort of thing is real progress. So it is for the sedentary, when they start to get active in even "minor" ways, I'd say.


FWIW, it's a circuit meant to be done 3 times -- 21 minutes. Probably closer to 25 minutes with unplanned breaks.


Imagine what 3 times can do if I already see change with one set per day. I'm gonna start doing two.


Running: not just good for the body but good for the mind too. Makes me glad I started running a couple of months ago


I definitely feel better after a run, but I thought/assumed it was down to endorphins. In fact the reverse seems to be true (for me) - I get really antsy if I haven't exercised.


Interesting that GABA increases activity in young brains, but not brains flush with young neurons. http://hilinkit.appspot.com/yhgjdr


Quoting and linking to wikipedia is too hard?


I think the word "exercise" is used a bit loosely in this context and not all exercises are equal. What happened with me was that I tried strength training while going through a brief, stressful period, and it shot up my cortisol levels and/or caused adrenal fatigue in the worst kind of way : I could not sleep at all and was pacing around the house like a rat in a cage. I suppose I should have done running or cycling instead, which would have calmed me down.


I started running few years back, but I couldn't run more than two miles, I used to get pain in my ankle. I know this is due to my snicker shoe. So, I bought 5-finger shoe, after that I can't stop running. Now I run around 6 miles, but I get bored beyond that, I think can do more than that.


Sorry, I couldn't resist:

"a portion of the brain known to be involved in thinking"

You don't say? ;P


Your whole brain is not involved in thinking process, it is possible to cut off parts of your brain and it will not effect your thinking ability.


Right. I believe the distinction is conscious thinking. Most of ones caloric consumption by the brain is from subconscious/passive processes, for maintaining the body, motor skills, alertness etc.


I'm aware.


Oh, boy, what a finding.) Guess why people are running long distances..))

To put it simple - running and swimming are all about better circulation and "massage" for all internal organs.




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