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Can Exercise Induce a Panic Attack?

June 5, 2017

           I used to be extremely active and fit. Working out helped my anxiety and depression and was something I always looked forward to. Having my first panic attack, however, changed everything for me. The television being on at the laundromat is now too much stimulation and can trigger nausea. I tend to prefer dim lighting because even bright lights are too stimulating. After I had my first panic attack I began to live in fear of having another one, making me extremely sensitive to stimulation of all kinds and being triggered by any symptom that resembles that of a panic attack. Intense exercise, specifically cardio, has become a trigger for me. What happens to my body during exercise (the increase in heart rate, shallow breathing, and hot flashes) is the same as what happens to my body during a panic attack. As my heart rate increases my mind panics, thinking it’s having a panic attack. The belief that I’m having a panic attack tends to trigger a real one. Even the adrenaline rush after a workout can trigger panic attacks and anxiety for me because my brain is wired differently now and what’s supposed to feel like energy feels like anxiety. For me, exercise feels how having too much coffee feels to a “normal” person- it’s an unpleasant, I-feel-like-I’m-going-to-jump-out-of-my-skin kind of energy.

            I thought I was weird for experiencing this issue because people always tell you to exercise to ward off anxiety and panic attacks but then I saw someone else on Instagram post about experiencing the same phenomena and I knew there had to be a reason behind this so I did some research. It turns out it’s completely normal for certain types of exercise to trigger a panic attack. Panic attacks are terrifying and the mind’s natural reaction to experiencing one, or several, is to avoid another one. People with a panic disorder are hyperaware of the sensations in their body because of this making even just a tinkle in the throat a cause for concern. When you’re exercising, you naturally become oxygen-deficient as your body borrows oxygen from itself, and this reminds people with a panic disorder of how it feels when you think you’re suffocating.

            A study by the University of Iowa discovered that lactic acid and CO2 may play a role in the brains of people with a panic disorder. Lactic acid, which the body uses as fuel and protection for muscles, decreases our pH balance, leading to more acidity and an increase in exhaling CO2. This study showed that people with a panic disorder tend to have a buildup of lactic acid in their brains and continuously build upon this excess through mental tasks. People with a panic disorder may be responding to an increase in acidity in their bodies if they experience panic attacks and anxiety during exercise, however, exercise is important to stay healthy and can help ease depression, so what can you do to combat this problem? There are different types of exercise that work to use lactic acid as a way of removing excess carbon dioxide and acidity through what’s called a Post-Exercise Oxygen Consumption (EPOC) state. These exercises include weight-lifting or other types of resistance training and HIIT (High Interval Training) workouts. HIIT allows your heart rate and breathing to stay under control by only working out at a high-intensity for a short period and allowing your body to recover for a longer period. Start slow and work your way up to longer periods of time working out at high-intensity. Keep your total workout time short as well if you’re just starting out. When doing resistance training you should also allow yourself to rest for a couple of minutes between exercises to stay in control. Feeling in control is the key here. You may need to take long rests if you’re struggling with severe panic attacks and anxiety during exercise.

            If you have weight to lose or are trying to get fit you may feel like you have to follow “the rules” and push yourself or limit your breaks but your mental health is just as important as your physical health. Your exercise routine won’t be maintainable if you’re living in fear of your workouts and you may even find yourself avoiding the gym if you associate it with panic attacks. As long as you’re moving, you’re making great progress and don’t need to worry about perfection. Even just a light walk is better than being sedentary and will help improve your fitness. You’ll get to the level you want to be at eventually. For now, just focus on being able to exercise without a fear response. I want to gain weight and I struggled with feeling like I had to strictly follow the weightlifting rules but I now recognize that it’s okay, and preferable, to start slow and take good care of my brain. I used to love cardio but I suddenly felt so much better after lifting weights. I don’t feel out of breath and out of control while lifting weights and the adrenaline rush isn’t quite as intense so I feel energized without the nervous energy. I’ve also had this experience while doing yoga and pilates-based exercises. For now, I avoid anything that involves jumping and other high-impact movements. That means if I do want to do cardio, I choose to elliptical or I go on a walk. The impact of a treadmill or running on pavement is too much for me. I also don’t do burpees or jumping jacks but do pushups and crunches instead. Everything I do in the gym is low-impact and I prefer to move at a slower pace so that I feel in control.

            Be careful of aerobic exercise if you experience fear during exercise because non-stop cardio, like during a cycling class, can make you feel panicked. Those who fear a heart attack during their panic attacks may experience that same fear during intense cardio. When I tried to do a cardio class thinking I should just push myself through the fear I almost fainted and threw up, not from being out of shape, but out of fear. You may also want to avoid classes. With a panic disorder, crowded spaces are often feared and are overstimulated by loud music. For me, the fear of embarrassing myself if I have a panic attack and get sick or need to leave keeps me from joining a class or working out with a group. You may also find you prefer to workout at home. The goal is to feel comfortable and safe. You should also drink plenty of water and eat well. If your blood sugar is low you’ll have unpleasant symptoms of dizziness which can mimic or trigger a panic attack. If you are dehydrated while exercising, your heart will have to work even harder which can cause a lot of discomfort and trigger a fear response.

            There is no quick-fix for this issue and recovery involves consistent exposure to exercise-induced symptoms. Start small and slow and don’t push yourself past the point of feeling like you’ve lost control. I did that once and it took me hours to calm down. I know it can be tough when you’re surrounded by fitness posts and people telling you to just do it and that your body can do more than your mind thinks it can. While that’s true, this isn’t about being lazy or unmotivated. Your mental health matters and is connected to your physical health. It’s just as important to take care of your mind as it is to take care of your body.

            If you’re a personal trainer or fitness advocate, please be mindful of this subject as well. Talk to who you’re working with and if they are dealing with a panic disorder, understand that their need for accommodations and rest does not come from laziness or a lack of motivation. Be gentle with them and understand that tough love will make it worse for that individual and will not work as a motivator. I tend to see a lot of one-size-fits-all messages when it comes to exercise. People in exercise DVDs will point at the camera and tell you that you better keep going or you’re a quitter. That might work for the average person but this ignores the people who have physical and mental limitations and can make them feel guilty and like they’re a failure. It’s so important to be aware of different physical and mental disabilities and illnesses so that people aren’t being left out of a message you’re trying to send.

            You’re not alone if exercise increases your anxiety instead of helping it. Practice a little every day until you’re comfortable again and focus on progress versus perfection. Your mental health is so important and it’s okay to prioritize it.

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