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Health & Exercise Forum

Healthy Ways to Cope with Anxiety

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Jul 31, 2023

Part II of II

According to the National Institutes of Health, an estimated 19.1% of U.S. adults 18 and older had an anxiety disorder in the past year. Anxiety disorders were higher for females (23.4%) than for males (14.3%). An estimated 31.1% of U.S. adults experience an anxiety disorder at some time in their lives.

There are a wide variety of anxiety disorders and will vary by the objects or situations that induce them. However, the features of excessive anxiety and related behavioral disturbances are similar. Anxiety disorders can interfere with daily activities such as job performance, school work, and relationships. Symptoms include: distress, nausea, shortness of breath, bowel pattern changes, excessive perspiration, frequent laughing or crying, restlessness, and is often associated with depression. While there are many types and degrees of anxiety and there is no substitute for medical and psychological care, there are some simple and basic tools to help manage the problem…daily exercise is one easy, affordable and accessible suggestion for most. Multiple studies have discussed the incidence of unhealthy self management of anxiety, including the use of alcohol and recreational drugs.

Last week, I presented coping tips for the management of anxiety. In this column, I will discuss one of the most understated benefits of exercise – mental health! Specifically, aerobic exercise (exercise that increases your heart rate for 30 minutes or more) such as walking, biking, running, swimming, hiking, elliptical & stepper machines to name a few, is the secret to “runner’s high.” This exercise euphoria is not limited to runners alone, but all who engage in aerobic exercise are more likely to experience high energy, positive attitude and mental wellness.

Physical activity, specifically aerobic exercise, is a scientifically proven useful tool for preventing and easing anxiety and depression symptoms. Studies in the British Journal of Medicine and the Journal of Exercise and Sports Science found that anxiety and depression scores were significantly reduced in groups that engaged in aerobic running, jogging or walking programs, 30-45 minutes 3-5 days per week for 10-12 weeks, when compared to a control group and a psychotherapy counseling group.


According to research reported in sports medicine journals, exercise reduces anxiety and depression in two ways, psychologically (mentally) and physiological (physically). 

Psychological or Mental Benefits of Exercise on Anxiety and Depression:

  • Helps a person gain control over their lives
  • Increases self-esteem
  • Diverts attention away from worry, concern or guilt
  • Improves mood – with visible signs of improvement in physique & body weight
  • Increases sense of pleasure and satisfaction
  • Anger management – release pent-up frustration, anger and hostility

Physiological or Physical Benefits of Exercise on Anxiety and Depression:

  • Increase in brain serotonin (natural mood elevator chemical in brain)
  • Increase in beta-endorphins (natural mood, stress & pain control chemical in brain)
  • Improvement in natural sleep patterns


  • First and most importantly, consult your primary care physician to confirm the diagnosis of depression. Be sure that your symptoms are not related to other health problems. Also, if you are using antidepressant or other medications discuss the impact it may have on your exercise program with your physician.
  • Recognize and fight depression symptoms that are contrary to or prohibit physical activity such as: fatigue, lack of energy, slow motor skills.

Work hard to recognize and overcome these symptoms to begin an exercise program. An aerobic exercise routine should eventually lessen these symptoms.

  • Be realistic. Expect that aerobic exercise will take time to have a noticeable benefit. Do not get overly ambitious and set yourself up for failure.
  • Begin with an aerobic exercise program that is practical and destined to succeed. For example: inactive and deconditioned people should begin walking 5 minutes per day, 3-5 days per week for 1 week. Then, add 3-5 minutes each week until you attain 30-45 minutes per walk 3-5 times per week. Younger and fitter people can begin to walk for 15 minutes and continue until they attain 45-60 minutes per walk, 3-5 times per week. Remember, what seems impossible today will be easier and routine in 3-4 weeks so JUST DO IT !
  • Find a pleasurable environment: a beautiful park (Nay Aug), a scenic lake (Lake Scranton), quiet countryside (rural farmlands of Dalton or Lackawanna State Park). Use a mall in inclement weather.
  • Find a friendly, uplifting group of people to enjoy a good walk and talk. This may be more appropriate for people feeling isolated or withdrawn. Others may enjoy the peace and quiet of exercising and meditating alone.
  • Be specific and compliant! Make a serious commitment. Keep a journal or exercise log. Mark a calendar. 30-45 minutes, 3-5 days per week – NO EXCUSES! Get and exercise buddy you can count on and help keep you compliant!
  • Make it fun! Mix it up. Walk 3 days, swim or bike 1-2 days, some days alone, some days with a buddy.
  • BE RELIGIOUS! Be religious about exercise BUT don’t get too compulsive!

Visit your doctor regularly and listen to your body.     

SOURCES: University of Pittsburgh Medical Center (UPMC); National Institutes of Health (NIH); The American Journal of Sports Medicine

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM. For all of Dr. Paul's articles, check out our exercise forum!