How to Exercise When Exercise Makes you Anxious

It seems like everything you read says exercise is key to reducing anxiety and depression. "Get those endorphins pumping and you'll feel better!"  "Exercise helps the brain cope with stress more effectively!" And, so on...

Now, I know that all this is based on scientific evidence and is true. But, exercise doesn't do any of that for me. It makes me hot, tired, and irritable at best. At worst, it makes my anxiety increase. Here's what happens when I exercise.

1. I start to work out.
2. I feel myself getting hot.
3. Sweat starts to form on my face and hair. I hate to be sweaty.
4. I notice my heart is beating faster. Oh my gosh. My heart is speeding up. I tell myself to calm down; that my heart is supposed to speed up when I exercise.
5. All I can think about is my heartbeat. Is it too fast? Should it speed up this quickly? Was that a pain in my chest? Am I finally having that heart attack I worry about all the time?
6. I start feeling anxiety symptoms because I can feel my heart.
7. I force myself to keep exercising. I'm not going to let this get the best of me.
8. I go through the cool down portion.
9. I can still feel my heart beating fast.
10. I'm now hot, tired and sweaty with a big dose of anxiety thrown in. Sometimes I even have a panic attack.

Sounds fun, right?

I don't get it when people say things like, "If I weren't a runner, I'd need a therapist." "Exercise is my therapy." "I feel so energetic on the days I work out." Why doesn't it work like that for me?

Well, the truth of the matter is that I know I have to get some exercise for both my mental and physical health. And, I also know that if I exercise on a regular basis, it's like exposure therapy. I do it, I don't die, and each time the anxiety symptoms get a little better. And, when I get regular exercise, my general anxiety is less.

So, how do I make myself get started and keep going? Here are a few common sense tips:
1. Start slow. Do just a little at a time. Even five minutes is better than nothing.
2. Do something that doesn't feel like exercise, like gardening, dancing or even vacuuming, so that your mind doesn't automatically focus on your heartbeat.
3. Watch TV as a distraction while you work out.
4. Do a lengthy cool down so your heart rate is back to normal by the time you finish.

Now, all I need to do is get up from my computer and do some exercise...

The Doctor is In

One of the worst triggers for my anxiety is a visit to the doctor. To make it worse, I worry obsessively about my health. Back in the day they called it being a hypochondriac. These days, the fancy term is "medical anxiety." Well, let me tell you, I've got medical anxiety in every sense of the term. I'm anxious  that there's something physically wrong with me, and I'm anxious if I have to go to the doctor to be checked out.

One of the worst parts of having anxiety and panic attacks is that most of the symptoms are also symptoms for scary stuff, like heart attacks and strokes. Chest pain, tingling hands, numbness, feeling like you can't breathe, dizziness, nausea. The list goes on. Google those symptoms and you're going to find things you don't want to have. And, when anxiety starts to spiral, your mind starts saying things like, "This feels different than it ever has before." Or, "This time there really is something wrong."

Also, for those of us with medical anxiety, every twinge, every slight pain, every twitch or muscle jump takes on significance. We constantly scan our bodies for changes, are hyper-vigilant about our breathing and heartbeat. We have unrealistic expectations about how good we should feel, so that if we catch two colds in a row we think it's because of some scary, underlying disease.

The question is, what do you do? If you run to the doctor with every symptom, you'll be broke, because the doctor will be professionally obligated to run tests because the symptoms are similar to the ones for serious physical illnesses. And, believe me, I've done this. Or, if the thought of going to the doctor creates so much anxiety that you can't bring yourself to go, you don't get the medical care you need. I've done that, too.

The best answer I've come up with is to find medical professionals that understand anxiety disorders and are willing to work with you. This has meant being very honest with my medical doctors and their staffs, being able to tell them about my anxiety without being worried they'll think I'm a lunatic, and then very honestly describing any symptoms. I've been happily surprised that most of the medical professionals I've used have been understanding about anxiety and have answered my questions patiently. They've explained why I should or shouldn't have tests or medications, and have understood that to treat me properly they also have to take my anxiety into consideration. It's also meant finding doctors who have great phone nurses who're able to talk with me and (with the doctor's input) determine if I need to come in. In fact, some of my doctors take the time to call me personally. This eliminates a lot of unnecessary office visits and alleviates a lot of my health fears.

Does this mean I'm cool, calm, and collected at the doctor's office? NO! I'm a mass of jittery nerves. But, when they call my name and I head back, I remind both the staff and the doctor that I have anxiety about being there. And, it's almost always a part of the discussion I have with the doctor. After all, they always notice that my pulse is fast and my blood pressure's up! And, almost without fail, everyone is calm, reassuring, and understanding. No one has acted like I'm a lunatic, that they're annoyed with me, or that it's "all in my head." And, if they did, I'd change doctors...

Flexing Your Mental Muscles

The other day I read an article from Forbes called "Mentally Strong People: The 13 Things They Avoid." The article was hugely popular and was shared like crazy on social media. I read it when Healthy Place (one of my favorite mental health websites) posted it on their Facebook page. You can read the article and form your own opinion about mental strength. The main reason I mentioned it here is because it made me start thinking about the concept of being "mentally strong."

What exactly does "mentally strong" mean? Does it mean you're smart? Does it mean you're in control of your emotions? Does it mean you'll be more successful, more happy, more capable if you're "mentally strong"? And, exactly who decides what it means to be "mentally strong"?

I decided to come up with my own definition. And, here's what I think.

Mentally strong people get out of bed every morning and put one foot in front of the other, even when they're so anxious they feel like their hearts will come out of their chests. They continue through the day even when their thoughts won't stop racing around in their brains. They go to their therapists and talk about things that scare them, that depress them. They use the tools their therapists teach them, even when it seems like they don't work. They take the medicines their doctors prescribe, even when they don't like the side effects. They keep trying, keep getting up, keep going no matter how hard it is. When they feel better, they celebrate. When anxiety or depression sets in again, they still get out of bed in the morning. When it's so bad they can't get out of bed, they remind themselves that it won't be so bad tomorrow and they'll be able to get up again. They do whatever it takes to keep themselves safe from the frightening, depressing, anxious thoughts that run through their heads. They hang on to the memory of the days when they felt a little less anxious, a little less depressed. And, then, they get out of bed again and put one foot in front of the other. And, eventually, they feel better.

To me, mental strength has less to do with the characteristics of people who achieve what our society calls success and more to do with living your life the best way you're able. It has to do with trying new things when the old ones aren't working. It has to do with going forward no matter how much you want to stop. It means you never, ever, give up.

Grounding

Have you ever used a technique called "grounding" when you felt anxious? I learned about it when I was in the Clarity program that I mentioned in a previous blog. Grounding is a set of easy strategies that allow you to detach from emotional pain by focusing outward on the external world instead of inward towards yourself.  For me, it helps stop a panic attack from accelerating. It also stops me from ruminating or "catastrophising" when my thoughts start heading down their familiar, depressing paths.

Grounding gives you ways to detach yourself so that you can gain control over your thoughts and feelings. It anchors you to the present, to reality, and puts you at a healthy distance from the thoughts that create anxiety or depression. The best thing is that it's easy to do any time, any place, and no one can tell what you're doing. It also gives me immediate gratification by reducing anxiety or depression.

There are three ways of grounding: Mental, physical, and soothing. Mental works best for me, but I've described all three ways here so you can discover which is best for you. And, if you get bored easily, it's good to have options.

Mental grounding means focusing on your mind. Some ways to use mental grounding are:
~Describe your environment in great detail silently (or out loud if you're in a place where it's appropriate.) For example, "The walls are tan, there is a blue sofa with three red cushions, and a window with a green tree outside."
~Read something, saying each word deliberately. Or, say the letters of the words rather than reading the words.
~Count forward or backwards slowly, or say the alphabet.

Physical grounding is focusing on your senses. Some ideas for physical grounding are:
~Run warm or cold water over your hands. Focus on how the water feels on your skin.
~Grab tightly on to your chair as hard as you can. Concentrate on how the chair feels.
~Walk slowly, noticing each footstep and saying "left" or "right" with each step.

Soothing grounding is talking to yourself in a very kind way. To ground yourself with soothing you can:
~Say kind statements, either silently or out loud, almost as if you're talking to a child. For instance, "You're coping with this situation well," or, "You'll get through this because you're using all your tools correctly."
~Think of your list of favorites, like your favorite color, food, animal, season, book, or movie.
~ Remember the words to a comforting or inspiring song, poem, or quote.

Like anything else that's new, grounding takes a little practice. You can even practice when you're not feeling anxious or depressed, just to get in the habit. At first, try all the types of grounding to see if one is more effective than another. Since it's hard for me to remember things when anxiety or depression start to spiral, I also wrote down some grounding techniques on a card and keep it in my purse. And, just in case I don't have my purse, I put the same techniques on the notes app on my phone, since I never go anywhere without that! That way, if anxiety strikes, I'm prepared.

I hope this gives you a new tool to use if you start to feel anxiety or depression creeping up. Always remind yourself that anxiety and depression are feelings. They don't define who you are. And, if you keep using your tools, you will feel better.