# Exercise as it relates to Disease/General Anxiety Disorder and Resistance Training

General Anxiety Disorder (GAD) is an anxiety disorder that is characterized by a constant feeling of anxiousness or worry that often interferes with the daily routines involved with living a normal life. The excessive worrying and stress associated with GAD often makes it harder for GAD sufferers to continue to undertake everyday activities like work, study and even socializing, as GAD can create unnecessary worry around any aspect of an individuals life. GAD is present in approximately 3% of the Australian population and tends to more commonly affect the elderly or people in their late teens and early twenties. While GAD affects approximately 3% of the Australian population, Research suggests that GAD is rarely present in isolation and tends to be present more commonly with other conditions such as panic disorder, social phobia and mood disorders such as depression and dysthymia.

## Symptoms

The symptoms of General Anxiety Disorder like many other mental health disorders aren't always obvious and easy to identify as they can often develop slowly over a prolonged period of time, as well as individuals being different and being able responding differently to situations or stimulus. GAD symptoms can be classified into two categories, either mental or somatic depending on whether they affect the psyche (mental) or body (somatic).
| Mental | Somatic |
| Difficulty Concentrating | Muscle Tension |
| Obsessive Thinking | Breathing Difficulties |
| Compulsive Behaviour | Accelerated Heart Rate |
| Fear | Headaches & Dizziness |
| Fidgeting | Insomnia & Restlessness |
| Irritability | Fatigue |
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However in order for a patient to be diagnosed with General Anxiety Disorder they must meet the Diagnostic Criteria for GAD. In order to meet this criteria the patient must exhibit persistent and uncontrollable anxiety for more days than not over a six month period.

## Common Treatments

There are numerous treatment options for patients suffering from GAD and they are often used in conjunction with exercise programs in order to reduce the symptoms of GAD. Common treatments for GAD consist of:
* Pharmacotherapy (Antidepressants, Buspirone, Benzodiazepines)
* Cognitive Behaviour Therapy
* Psychotherapy
* Hypnotherapy
* Diet Modification (Eliminating alcohol & caffeine consumption)

## General Anxiety Disorder & Resistance Training

Over the course of the past two decades there has been a great deal of research surrounding the positive effect exercise can have on the mental health of an individual. Due to this research it has been revealed that physical activity can reduce anxiety levels in patients suffering from GAD and other anxiety disorders. This is believed to be due to the release of endorphins during exercise which mask pain as well as providing a positive feeling of euphoria and a sense of well-being. While aerobic exercise is predominately associated with reducing anxiety levels in people, studies prove that resistance training can be equally effective in the reduction of anxiety amongst GAD patients.

### Benefits of Exercise

Other benefits of exercise for GAD sufferers include:
* Provides Stress relief
* Improvements in concentration
* Provides a sense of self mastery & changes in self-concept
* Eases muscle tension
* Improve quality of sleep
* Can lower resting heart rate & reduce airway resistance (In certain training types)

### Resistance Training Recommendations

When it comes to resistance training moderate intensity (50-60% 1RM) training is believed to reduce anxiety levels better than high-intensity training. Exercise sessions should be at least 30 minutes as larger reductions in anxiety are achieved in sessions lasting more than 30 minutes than those that don’t. In order to achieve overall improvements in GAD, the exercise program should run for between 6–12 weeks as they appear to be more effective than long term programs exceeding 12 weeks as people lose motivation and interest.$_{[5][8]}$ However for the maximum benefits of a resistance training program for GAD, sufferers should attempt to get into a routine of undergoing a resistance training program that consists of 3-5 sessions per week over the course of their life.
CAUTION: Before undertaking a resistance training program you should always consult your general practitioner for advice and medical clearance to partake in such activities.

## Future Research, Further Information & Support

Current research shows that resistance training does reduce anxiety in GAD patients and patients with other mental health illnesses. However there still needs to be more research conducted in the area as current research is often very vague in regard to exercise prescriptions and aerobic exercise is predominately viewed as the only form of exercise that can reduce anxiety, therefore there needs to be more studies regarding the effects of aerobic v anaerobic exercise on mental health in the future.
Further Information and Support for GAD can be found at the following:
* https://www.anxietyonline.org.au/default.aspx
* http://au.reachout.com/
* Beyond Blue: 1300 22 4636
    Beyond Blue Online: http://www.beyondblue.org.au/the-facts/anxiety/types-of-anxiety/gad
* Lifeline: 13 11 14
    Lifeline Online: https://www.lifeline.org.au/Get-Help/Online-Services/crisis-chat

## References

* ↑ "Generalised Anxiety Disorder" (PDF). Anxiety BC. Retrieved 10/10/2013. {{cite web}}: Check date values in: |accessdate= (help)
* ↑ Brown, T.A. "Generalised Anxiety Disorder" (PDF). Clinical Handbook of Psychological Disorders, Third Edition: A Step-by-Step Treatment Manual. Retrieved 10/10/2013. {{cite web}}: Check date values in: |accessdate= (help)
* ↑ Kessler, R. C; Wittchen, H. U (2002). "Patterns and correlates of generalized anxiety disorder in community samples". The Journal of Clinical Psychiatry. 63 Suppl 8: 4–10. PMID 12044107.
* ↑ Harber, V. J; Sutton, J. R (1984). "Endorphins and exercise". Sports Medicine. 1 (2): 154–71. PMID 6091217.
* ↑ Hale, B. S; Raglin, J. S (2002). "State anxiety responses to acute resistance training and step aerobic exercise across eight weeks of training". The Journal of Sports Medicine and Physical Fitness. 42 (1): 108–12. PMID 11832884.
* ↑ Herring, Matthew P; Jacob, Marni L; Suveg, Cynthia; O'Connor, Patrick J (2011). "Effects of short-term exercise training on signs and symptoms of generalized anxiety disorder". Mental Health and Physical Activity. 4 (2): 71–7. doi:10.1016/j.mhpa.2011.07.002.
* ↑ Martinsen, Egil. W; Hoffart, Asle; Solberg, Ø Yvind (1989). "Aerobic and non-aerobic forms of exercise in the treatment of anxiety disorders". Stress Medicine. 5 (2): 115–20. doi:10.1002/smi.2460050209.
* ↑ Melville, NA. "Resistance Training Improves Generalized Anxiety Disorder". Retrieved 14/10/2013. {{cite web}}: Check date values in: |accessdate= (help)
* ↑ O'Connor, Patrick J; Herring, Matthew P; Caravalho, Amanda (2010). "Mental Health Benefits of Strength Training in Adults". American Journal of Lifestyle Medicine. 4 (5): 377–96. doi:10.1177/1559827610368771.
* ↑ Herring, Matthew P; O'Connor, P. J; Dishman, R. K (2010). "The Effect of Exercise Training on Anxiety Symptoms Among Patients". Archives of Internal Medicine. 170 (4): 321–31. doi:10.1001/archinternmed.2009.530. PMID 20177034. {{cite journal}}: Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)