# Exercise as it relates to Disease/Optimal exercise prescription for General Anxiety disorder
## General Anxiety Disorder

While it is common for most people to experience anxiety at one or more points of time in their life, this does not classify them with a General Anxiety Disorder. Those diagnosed with General Anxiety Disorder experience severe, disabling anxiety which has a prolonged negative impact on their function at work, home, school or general life.

## Symptoms

Each of the specific forms of anxiety disorders will have their own set of symptoms that lead to their own prognosis, however, commonly people with GAD will experience constant and chronic worry about their health, family, money, work, etc. This worry will continue every day, sometimes all day, and interfere with social activities and relationships.
Alongside with these symptoms, it is common to experience the following physiological symptoms;
* Muscle tension
* Fatigue
* Restlessness
* Difficulty sleeping
* Irritability
* Edginess
* Gastrointestinal discomfort/diarrhea

## Common Treatments

Treatment for GAD can be broken down into 3 different categories, psychological treatments, medical treatments and other treatments.
Psychological Treatments:
* Cognitive Behaviour Therapy; A patient undergoing CBT works with a professional to analyse the ways they think and act that may be causing them anxiety.
* Behaviour Therapy; While behavior therapy is a major part of CBT it differs in that it focuses completely on increasing the patient’s level of activity and pleasure in life.
Medical Treatments:
* Antidepressants; Antidepressants are designed to correct the imbalance of chemical messages through neurons in the brain. People do not need to be experiencing depression symptoms for antidepressants to be an effective method of controlling anxiety.
* Benzodiazepines; Benzodiazepines are a form of sedative and can be used as a short-term method (two –three weeks) of reducing anxiety and assisting to cope with panic attacks. Long term used is not recommended, as they are known to be addictive.
Other Treatments:
* Family & Friends; Family members can offer support, understanding and help for an individual suffering from anxiety. They offer a way to keep the individual connected and feeling confident.
* Exercise; Exercise can assist by lifting mood, improving sleep and increasing energy levels. It also offers opportunities to socialize and block out negative thoughts.
* Diet; A good diet will generally give people a sense of well being, assisting with the individuals outlook on life. A nourishing diet can also improve mood and maintain healthy brain functioning.
* Relaxation Therapy; Relaxation therapy helps to relax the muscles, which in turn may help to reduce anxious thoughts and behaviours.

## Benefits of Exercise on GAD

Exercise can help reduce anxiety through a number of means. Exercise allows the person to;
* Reduce tension levels
* Reduce stress
* Increase energy levels
* Improve and regulate sleep
* Feel a sense of achievement
* Lower anger and frustration levels
* Regulate appetite levels
* Increase their social life

## Optimal Exercise

Persons wishing to us this alternative form of treatment for generalized anxiety disorders should undergo an exercise program under the supervision of a professional. An exercise program should be written incorporating 3-4 sessions per week of low to moderate intensity exercise at around 30-40% of VO2 max (light jogging, cycling, swimming etc.). As well as this, leisure activities or sports are advised, particularly those involving high social interaction. These are intended to encourage socializing and to allow the person to work their way into situations that tend to bring on panic.
The program should last, with proper adherence, 3–12 weeks to take full advantage of the benefits. Programs lasting less than 3 weeks have been shown to have little to no impact on anxiety levels, while programs lasting longer than 12 weeks have shown less promising results. One explanation could be that motivation levels for programs lasting longer than 12 weeks tend to be lower. Reevaluation of the program should be made every 2–3 weeks to ensure its relevance.
Programs involving high levels of resistance training and high intensity exercise should be avoided where possible. Studies have shown that resistance training and high intensity exercise could in fact be increasing anxiety levels and brining on panic attacks.
Meditation, in combination with exercise, has been shown to decrease overall anxiety levels in people with high anxiety. Relaxation for 20 minutes a day has been shown to have a profound impact on those suffering from anxiety. Correct technique isn’t as important as personalizing the experience to create the least stressful environment possible.

## Future Research

Further research is required in the field of Exercise as a treatment for Generalized Anxiety Disorders. There is a particular need for research into the difference between high intensity and low intensity exercise and the effect different forms of exercise have on anxiety levels. As well as this further research is required to provide more information about high level anxiety disorders and the effectiveness of exercise as an alternative treatment program.

## Further Reading and Support

For more information about anxiety disorders, visit one of these sites;
* Anxiety Australia - http://www.anxietyaustralia.com.au
* Anxiety and Depression Association of America - http://www.adaa.org
* Anxiety Disorders Association of Victoria - http://www.adavic.org.au
* Anxiety Canada - http://www.anxietycanada.ca
For anybody who believes they are suffering from any form of Anxiety Disorder, visit one of these sites;
* Beyond Blue - http://www.beyondblue.org.au
* Youth Beyond Blue - http://www.youthbeyondblue.com
* Lifeline Australia - http://www.lifeline.org.au
Or visit a professional for help.
“On order for man to succeed in life, god provided him with two means, education and physical activity. Not separately, one for the soul and the other for the body but for the two together. With these two means, men can attain perfection” (Plato, fourth century bc)

## References

* ↑ Anxiety Australia, Anxiety Disorders. http://www.anxietyaustralia.com.au/anxiety-disorders/
* ↑ Anxiety Disorders Association of Canada, About Anxiety Disorders. http://www.anxietycanada.ca/english/index.php retrieved 17/10/13
* ↑ Anxiety and Depression Association of America, Anxiety Symptoms. http://www.adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad/symptoms retrieved 17/10/13
* ↑ Beyond Blue Australia, Psychological Treatments For Anxiety. http://www.beyondblue.org.au/the-facts/anxiety/treatments-for-anxiety/psychological-treatments-for-anxiety retrieved 1/10/13
* ↑ Beyond Blue Australia, Medical Treatments For Anxiety. http://www.beyondblue.org.au/the-facts/anxiety/treatments-for-anxiety/medical-treatments-for-anxiety retrieved 17/10/13
* ↑ Beyond Blue Australia, Other Sources of Support. http://www.beyondblue.org.au/the-facts/treatment-options/other-sources-of-support retrieved 17/10/13
* ↑ Mental Health Foundation "Let's get Physical" http://www.mentalhealth.org.uk/publications/awareness-week-2013-report/ retrieved 21/10/13
* ↑ Byrne, A., & Byrne, D. G. (1993). The effect of exercise on depression, anxiety and other mood states: a review. Journal of psychosomatic research, 37(6), 565-574.
* ↑ Mi Rye Suh, R. N., Hyuk Jung, H., Bae Kim, S., Sik Park, J., & Seok Yang, W. (2002). Effects of regular exercise on anxiety, depression, and quality of life in maintenance hemodialysis patients. Renal failure, 24(3), 337-345. retrieved 21/10/13
* ↑ Herring, M. P., O'Connor, P. J., & Dishman, R. K. (2010). The effect of exercise training on anxiety symptoms among patients: a systematic review. Archives of Internal Medicine, 170(4), 321. retrieved 21/10/13
* ↑ O'Connor, P. J., Raglin, J. S., & Martinsen, E. W. (2000). Physical activity, anxiety and anxiety disorders. International Journal of Sport Psychology, 31(2), 136-155. retrieved 21/10/13
* ↑ Bahrke, M. S., & Morgan, W. P. (1978). Anxiety reduction following exercise and meditation. Cognitive therapy and research, 2(4), 323-333. retrieved 21/10/13
* ↑ Ströhle, A. (2009). Physical activity, exercise, depression and anxiety disorders. Journal of neural transmission, 116(6), 777-784.
* ↑ http://exerciseonthemind.com/about/