Anxiety on the run...

May 22, 2012 8:54 PM

I have anxiety. I've recently started running. While I'm running, I have occasional anxiety spikes, some of which get close to panic attack territory. Help?

A (more athletic) friend and I recently started doing Couch to 5k together, mostly to see if running would help strengthen muscles that would help my plantar fasciitis (which I've had since around age 8 and which is now almost entirely under control thanks to custom orthotics). We run on a multi-use path near my house. I'm 22, female, relatively fit, and have been diagnosed with generalized and chronic anxiety at various points in my life. I'm medicated and see a therapist.

Running in public makes me feel a little anxious anyways, because I feel like everyone is looking at me and judging me, especially the more competent runners. I also constantly feel bad because I feel like I'm holding my friend back when I have trouble completing one of the intervals. Running with him definitely helps -- aside from the fact that he holds me accountable to make sure I keep doing this, having him with me definitely makes me feel better about things most of the time. He's also really really supportive and aware of my anxiety issues.

While I'm running, my anxiety levels are usually only a little higher than usual, but once or twice a run, my anxiety will suddenly spike and I just want to go and hide somewhere. Sometimes (but not always) this also has physiological consequences -- breathing gets harder, muscles seize up, et cetera.

I kind of like running (or, at least, I don't dislike it), but I really really don't like the changes in my anxiety levels that happen while I'm running. I also think that my anxiety is making it harder for me to consistently run with good form and run as well as I could be running. Any advice on how to make myself calm down about this, both before and during my runs?

posted by naturalog to health & fitness (18 answers total)

Try breathing more deeply. Do you happen to do yoga? One of the things yoga has taught me is that I can always come back to my breath, whether on the yoga mat, on a bumpy flight, or in a frustrating situation. Try to breathe through running issues, whether it's anxiety, cramps or what have you. Your breath is always there for you so use it.
posted by kat518 at 9:00 PM on May 22, 2012 [3 favorites]

I wonder if there are any physiological triggers for this? Like it's already getting hard to keep going, and it pushes the anxiety over the edge? Or do the attacks seem completely random during the run?

FWIW, most people are not good runners, and regardless will admire you for running rather than criticize. Hey, at least youre out there doing it!
posted by DoubleLune at 9:00 PM on May 22, 2012

All I can tell you is keep with it. Experienced runners don't really pass judgement on novice runners. Running is hard and awesome and we respect you for getting into it.

Non-runners might occasionally judge you but fuck them. They don't run; what does their opinion matter?

Most importantly, the more often I run, the less anxiety I feel in my life as a whole. It takes a few months of regular running to start to kick in, but it's really worth it.
posted by 256 at 9:01 PM on May 22, 2012 [2 favorites]

I've noticed something similar while cycling. For me it's more likely to happen when I'm struggling up a hill or some other situation that's difficult for me.

It's disturbing because I want cycling to be about a sense of release, but if I let those feelings take hold, it can really just turn me into an exhausted mess both mentally and physically.

So far, it seems I can do a few things about it:

-Listen to a bit of slow, relaxing music before my ride (speed of: Funeral by Band of Horses came to mind first)
-Listen to relaxing music during my ride.
-Pick a point to stop during anxiety and say, "I need to force myself to chill the heck out."
-Set a goal that I will only exercise until things start to get uncomfortable. (Crazy option from a fitness standpoint, but not bad and I definitely don't get the frustration)

It's become important to me to lessen the chances of this happening because it makes me into an unhappy cyclist.

Hope you're able to find something that works for you.
posted by circular at 9:29 PM on May 22, 2012

I recommend finding running paths that are home turf to fewer "expert" runners. I've had great luck running on the tracks of local schools in the early morning (or evening) hours, and it can help a lot to listen to music while you run, even or especially when you're with a partner. Psyche each other up, smile at each other often during, and congratulate one another after a run, but remove the obligation to chit-chat and keep an even pace while you're running. Tune the outside world out, count footsteps if you like, try to translate the songs you're listening into another language, etc.. In my experience, the more you have to think about in a positive way, the less of a foothold your anxiety can gain.

Also, it sounds like you're second-guessing whether he really means it when he says that enjoys running with you and doesn't mind that you're "less athletic" and/or "holding him back." It's good that you recognize that this is going on... but you need to stop, NOT while you're on a run, but now (and maybe daily) and establish whether in your heart of hearts you think he is telling the truth, or maybe exaggerating, or outright fudging it. Seriously. Stop. When you have anxiety (and I say this from experience), it is very very easy to imagine that the worst-possible explanation or outcome is the more likely one.... but that is, honestly, a trap.

I'd tell your friend directly that you are going to take him on his word when he says that he truly enjoys running with you, period.... and that you also understand, objectively, that he is a more experienced runner and that it'd make you much happier to know that he's picking a few days a week to run alone, or to do more laps than you do, etc., than to think that he's giving up his own goals just to be supportive of you. Remind him that being direct and forthright with you is the best possible way to demonstrate his true friendship with you. Try some different ways to run together (some intervals but not others. for example -- this is why running on a track together is especially helpful) until you find a mix that makes you really maximize and trust the benefit of being in this together. Make running mixes for each other, play around with apps the mark your progress, find lots of other ways to support one another independent of your actual run times.

I guess my point is to try to remove the possible stimuli of anxiety (e.g., the sight of bionic million-mile-per-hour-running strangers, or even a glimpse of your friend apparently breathing easier than you are, or whatever it may be.) You can gently start introducing more of those elements back into your routine as you go, but why not give yourself the best possible environment to get the hang of and truly enjoy what you're doing?

I'm humming the "Rocky" theme for you.
posted by argonauta at 9:55 PM on May 22, 2012 [1 favorite]

Don't know if this is similar/helpful, but I've gotten anxiety attacks when running a few times, and it's always in a case where: 1. I'm struggling, and 2. I'm unwilling to slow down, usually due to peer pressure. I don't know in your case if you'll find it gets better if you push through it, but for me I always ended up hyperventilating by the side of the road with concerned onlookers - usually the peers who I'd been racing to keep up with - wondering if I was having an asthma attack or something.
posted by Lady Li at 10:03 PM on May 22, 2012

I'm a particularly terrible clumsy out of shape "runner" (I shuffle!) who suffers from anxiety My route is one that is frequented by a lot of people that I know - people I know driving by, people I know sprinting gracefully by, etc. (and I hate when I see them at the store, church, school and they mention that they saw me running the other day). What has helped me immensely is trying to be as anonymous as possible - sunglasses, hat, earbuds plugged in. People still see me but for some reason when I'm wearing all that stuff I feel invisible and I love it!

A few months ago I was out running and the tie on my pants came undone and my pants started to slip down. No joke. I was carrying a water bottle, I had a good momentum going and I didn't want to come to a complete stop to remedy the situation. So I stuck the water bottle in my mouth, while still running, to free my hands. Then I adjusted my pants/tied the tie back up. So, I'm stumbling around with a water bottle hanging out of my mouth, fiddling with the front of my pants and this perky young fit girl goes running by and yells to me, "you're doing great!" I just awkwardly nodded (with bottle still hanging out of my mouth and my hand basically at my crotch). But you know what I realized? I realized she didn't see what I saw. She didn't see how awful I was. She saw that I was out there doing something hard - just like SHE was out there doing something hard. Sort of a "we're all in this together."
posted by Sassyfras at 10:10 PM on May 22, 2012 [6 favorites]

I'm a runner of seven or so years standing (ha - running). I know for a fact that other runners do not judge you. If I see someone who is obviously a newbie, or is trying hard at some intervals or whatever, I think, ooh, good. All other runners I've met are the same.

Passers-by might judge you - well f*** them - are they out there running? No they are not. I either listen to music or collect the insults to amuse other people with. Doesn't happen very often anyway.

My IBS has hardly flared up since I started running - such a relief for me.

Here are my suggestions:

1. once a week, just run. No intervals, whatever speed you want - just to ENJOY it (this can be called "a recovery run" if you want to be all technical about it)

2. if you want to stop, stop. Take bus fare in your arm pouch, or whatever, and promise yourself that if it's horrible, you will stop and go home. I have almost never had to use this but having it there is a comfort

3. smile at other runners, don't think of them judging you. Study them, if you want. I bet some of them do ODD things, or you might learn from some of them.

4. no one is looking at you. Nothing will happen if you stop. Heck - I stopped in the last half marathon I did. Thought I was going too fast and couldn't sustain it (by "fast" I mean "slower than most runners, fast for me"). Stopped DEAD - sobbed once - started again. Continued the race, at that pace

5. if it stresses you out to run with your friend, then
a) talk about it. I bet they don't mind slowing for you. I bet they work it into their weekly plan to do this run at your pace. They will get their other stuff somewhere else
b) work out a way they can still run harder than you - when I used to go out with Mr LB, I was faster than him, so I would loop off round a layby or down a side street and back, as long as I stayed near so he could see me. Same time, I ran further
c) run on your own but report to your friend that you've done it.

6. If running still makes you anxious, join a gym and pound on the treadmill or row row row - I find the repetition and mindless activity can really calm me and NO ONE will look at you in the gym, they are all looking at themselves.

Good luck. Running is fab and has made me so much calmer.
posted by LyzzyBee at 10:20 PM on May 22, 2012 [3 favorites]

The likelihood that anybody more (or less) experienced on the trail is judging you is approximately nil. I'm a 40 year old guy built a bit like a fireplug (very dangerous over short distances!) and even when I'm sucking wind and some svelte 20-something (I'm looking at you) totally smokes me running up the most pathetic of little hills, I know they're interested only in doing what they're doing. Very occasionally I'm the smoker, and while I might use the person I'm gaining on as a guide to my own effort, that's all.

I'm not any sort of therapist, but you've got to realize that this fixation is at least partially a symptom of your generalized anxiety, and not just a trigger, right?

The advice to breathe is right on. I also find listening to podcasts rather than just music actually occupies my brain in a way that keeps me from obsessing about the discomfort of pushing through that last mile. You say your running partner is supportive. Figure out a way for you to use that when you're feeling the urge to panic. Good luck.
posted by Emperor SnooKloze at 10:21 PM on May 22, 2012

As someone who is often anxious in every day life, but a comfortable runner, I offer you the following principles, that make me feel good about my runs:

- While on a run, it is difficult to tell who is an experienced runner. I have shown up to races (ultras!) where people wearing jean cut-offs and shirts made of poly-cotton blends have smoked me. I have seen runners with goofy gaits run incredibly fast races. When you and another runner cross paths it is a tiny interaction, and neither of you have time to gauge how strong a runner the other is. It might be helpful to run a (large) race and see all the different body types and clothing choices that finish faster and slower than you, it can be a real eye-opener.

- Know when you have the right of way, and feel comfortable taking intersections slowly. Basically, if you have a walk signal, there is a stop sign, or a 'yield to pedestrian' sign, you have the right of way no matter what any drivers think. If you are waiting to cross a street and a driver in one direction waves you on but you don't feel safe crossing the lane of oncoming traffic, feel free to make them wait.

- I am not psychologically built to run with other people. For me, running is very much about being in my own head and worrying about myself, and I have no interest talking to/keeping up with another person. But, I do use socializing to be 'accountable' in my runs. I tell my significant other how long I plan to run, and when there's a race I want to do I try and post about it on Facebook or Twitter.

- Basically, if you deign to wear spandex in public 99.9% of the population will assume that you are some sort of elite athletic machine. They might imagine that you are an Olympic shot-putter, or a famous curler, or a gymnast, but they will think there's a reason as to why you're running around in skin-tight clothing.
posted by sorrel at 10:38 PM on May 22, 2012

Hi, a few years back I was having a bad time with regular panic attacks and my friend encouraged me to start running with her to help keep my mind off my anxieties. I started to experience anxious feelings before a run and occasionally during the run, I found a couple of tools helped me prevent the onset of a full blown panic attack, I hope you can find something from my experience that will help you:

Before and during a run:
- Listen to your favourite music, in my experience I listened to songs with a "fighter" theme to remind me to keep going. I picked upbeat positive (often cheesy pop) songs that made me feel good and confident!
- If I started to get negative thoughts and could feel my anxiety building, I tried to think positive thoughts and deal with it rationally by telling myself "I acknowledge it but it's not going to stop me from completing this run"...sounds weird I know, but it helped me immensely to feel like I was in control.
- Practice focusing your thoughts to the task at hand, think about the regular steady pattern of your breath, the regular beat of your feet and the goal of getting to your end destination!

Extra stuff:
- I started regular yoga classes that incorporated breathing exercises and meditation. It really helped me learn to clear and strengthen my mind.
- I started running alone. It was the best thing ever! I didn't feel like I was holding my friend back or having to adjust my pace to suit hers...I just ran how I wanted to and as long as I wanted. It felt really good to achieve something on my own.

Over time, I went from couch to 5k to 8k to 10k to my first half marathon. I'm not saying this to toot my own horn, but just give you some real hope that no matter what just keep running, and your anxieties will fall by the wayside. You can do it!
posted by tokidoki at 10:40 PM on May 22, 2012 [1 favorite]

Sounds like you're experiencing spotlight effect due to engaging in an activity you're new to. For what it's worth I can tell you with a fair degree of certainty that, unless you're doing it stark naked with your head on fire, nobody is paying undue attention to you when you run. But I know saying this is probably missing the point of the problem, as anxiety tends not to respect rationality. Still, it's the only tool we've got.

Remember an integral part of any training is controlled adaptation. Just as your calf muscles need to steadily strengthen to the demands of running, so does your brain. Tracking that process of adaptation -achieving the short-term goals in service to the medium-term goals in service to the long-term goals- is how we come to excel.

To this end I recommend more meticulous goal-setting in your running: never run another stride without a precise sense of what it is you're trying to achieve. Time your runs to the second; plot your progress; learn what energy systems you need to develop in order to run faster for longer. This is not just for the sake of physical improvement, but mental improvement. When you have a training plan in your head, you're flowing. You're not bored. You're not anxious. You're not tentative or day-dreamy or unsure. You're fucking focused on the task at hand, because you know how every previous stride plays into it, and how it plays into every stride thereafter.

This isn't to say running ought not to be fun (if anything it'll amplify the fun: the ecstasy of training is vastly more rewarding than the toil of mere exercise), just that you can, if you're willing to put the work in, find amazing strength in it. After a few weeks, the numbers in your training log (which, if you haven't already, you're going to start) will become important; very important; more important by far than any idle thoughts as to whether Casual Jogger Lady thinks you're laughably slow, or what Irate Motorist thinks about your get-up, or whether Luminous Shorts Dude thinks you don't belong on his route. Those thought processes suddenly cease to occur when you've got goals to meet, and you're flowing toward meeting them.
posted by Kandarp Von Bontee at 10:42 PM on May 22, 2012

I tried to keep this short.... =) The first part is encouragement, the last half are hypothetical physiological reasons you may be getting panic attacks while running.

I am an experienced runner, and I ran competitively in college and high school. I love running and have been doing it for over a decade. I am reasonably fast among "the fast people", but of course there is always other people faster than me =).

First and foremost, don't worry about what others think about you as a runner. Running is frickin hard... and I like it! Not just the physical run itself, but getting yourself out the door to go on a run that you don't really feel like doing that day (happens a lot to me.... and I LOVE to run). I think that the only people who are going to look down on you are going to be just generally snobs (and I really think snobbery is based on low self esteem anyhow) Snobs would look down on you for a variety of reasons (the car you drive, clothes you wear, etc..)...so don't let generally snobby people bring you down. Also, a lot of people begin running in their 30s and 40s, so don't worry about starting later in life, if that is also a concern. One guy I know started running when he was 30 and is now in his 60s and is faster than a lot of other people, even the 20-30 year olds, on his team....and he is 60!!!!

Don't worry about holding your friend back. You may be doing him a favor. I have run with people who run slower than me and I really don't mind most of the time because I like the company and I also get lazy and wouldn't get out the door if it was not for the other person meeting me for a workout. If it really is a concern to you, find a place with a loop (around a park, a lake, a few blocks, etc) and you can both do intervals at your own pace but still say hi to your running buddy as you/they go by! =) I suggest to go for ice cream once in awhile after a run with your buddy. It is summer after all..... and ice cream is good for you (calcium? right?)


I have also had problems with anxiety, but never during a run, and running really helps me manage anxiety. But, I think that there may be a physiological reason you are having panic attacks during a run and perhaps it is exacerbated by the propensity of you developing anxiety attacks. I tend to think of anxiety as a threshold. My anxiety threshold is lowered the more stress I have and the less self-care I do, and things that normally wouldn't make me anxious will start to make me anxious because I am "lowering the bar/threshold". So maybe a normal physiological reaction to running is precipitating an anxiety attack because your bar is a bit lower..... but it may also be easily fixed (keep reading!)

IANAD, but two things immediately popped into my head as a potential cause for this, which maybe wouldn't normally be a problem, but is exacerbated by your anxiety threshold:

1) Blood sugar is low. Some people will have adrenaline (aka epinephrine) rushes when their blood sugar gets low. (http://diabetes.webmd.com/video/hypoglycemia-isnt-just-diabetes-patients). The reason is that this helps the liver release sugar into the blood stream. I have had this before after not eating much all day (oops) and that panic attack took me completely by surprise.

When you run or engage in something like running, you use up your blood sugar in the first maybe 10-15 mins and your body has to convert over to other forms of energy during this time. Since you are new to running, perhaps your body is not as efficient at this yet and you get the adrenaline surge "fight or flight response" which precipitates an anxiety attack for you. 3 suggestions- 1) Make sure you are eating to keep your blood sugar steady especially in the hours before your run. Avoid sugar and refined carbs. Eat protein and fat with your carbs Might take some experimenting to see what works for you 2) Eat something about 30 mins before you go running. I like a half piece of toast and peanut butter or plain yogurt and a few berries 3) Run even slower on your runs so you can build up your endurance and allow your body to learn how to make that sugar utilization and transfer over to other forms of energy consumption more efficient. I would expect that in a few weeks or maybe 2 months your body is going to learn how to do this better and you won't get this anymore or as often. Runner's will say it takes about 4 weeks to see gains in a new training program, so I would expect the body to take that long to convert over, but YMMV.

2) Pretty similar to the above. You may be experiencing an adrenaline rush because you are pushing your body harder than it is used to. Perhaps the amount of adrenaline needed to start a panic attack is lower for you since you have pre-existing anxiety. I would suggest to run slower and even walk more. The Couch to 5k plan is to get you to finish a 5k..... I'm not sure how long your training time frame is but there is no shame in having to walk part of that 5k. I had to walk my first race (I hate to admit, but I was new and didn't know how to pace yet.... that takes time). I would hate to hear you quit running when the answer might be to take the initial training a bit easier.... cause there are always a bunch of races to run.

And finally, if this continues, I would bring this up with your doctor. I really hope you are able to figure this out so you can keep running, it's a great sport and you will meet a lot of nice and encouraging people along the way. =) Good luck!
posted by *phoenix* at 10:53 PM on May 22, 2012 [1 favorite]

My ex had way more running skills than I but he wanted to encourage me. We'd start out together and then he'd run off, turn around somewhere, run back to me, keep my pace for a hundred yards or so, run off: lather, rinse, repeat. The little check-ins were nice but we each got to go at our own pace and he probably ran six times as far as I did. It helped my anxiety to know that I wasn't holding him back. As I improved, the system adapted naturally.
posted by carmicha at 6:20 AM on May 23, 2012

I have anxiety and I run. Running doesn't trigger my anxiety. However, I learned how to ride a bike late in life, so I relate to your experiences in that sideways way. When biking, I often felt (and still sometimes feel) like everyone else is judge my relative newbieness.

So, my two cents...

Prove to yourself that you can run. Eliminate the public aspects which give you trouble. Try alternating your runs with your partner with runs in absolute isolation. Use a 24-hour gym if you have to. Get to a point where you don't have to think about it so much.

While I realize that anxiety is often immune to logic, do please remember that the vast majority are people, let alone runners, couldn't possibly give less of a crap about you or how you're running.
posted by Sticherbeast at 8:07 AM on May 23, 2012

Maybe your baseline anxiety is being pushed up a bit by the sensations of exertion feeling a little like a panic attack ramping up, which could make otherwise non-triggers into triggers? When I'm keyed up, it takes less to start a cascade toward panic.

When I started running to help my anxiety, the raised heart rate and out-of-breath sensations of normal exertion felt like a panic attack starting, and then I would get anxious, and sometimes I would have a panic attack, because I was psyching myself up.

To help remove the association between exertion and panic-sensations, I got one of those pulse-o-meter things, so if I started worrying that my heart was beating too fast (and I would explode! Or bad things would happen! Panic attack thoughts don't need logic!), I could just look at the screen on the wristband, and say, oh, okay, I've been at this BPM lots of times, I'm fine! No exploding here! I'm comforted by data.
posted by BigJen at 8:19 AM on May 23, 2012

Not an expert on this topic by any means, but I recall from an entry level psychology class that there is a physiological connection between anxiety, panic attacks, and the body's "perception" of CO2 levels called the False Suffocation Alarm theory.

Here's a short article on the topic from ScienceNOW

"It's long been known that anxiety-prone individuals often experience panic attacks when they breathe in carbon dioxide. Psychiatrists have theorized that emotional distress reflects a built-in response to suffocation. The "false suffocation alarm theory" suggests that the brain has a carbon dioxide sensor and that it is oversensitive in some people, mistakenly spurring panic attacks. Such a sensor could have evolved to alert oxygen-breathing organisms of impending death..."
posted by forkisbetter at 12:12 PM on May 23, 2012

It's not a violation of runner's code to just stop, either, if you get panic attacks. I get them and keeping running just makes it worse. 30 seconds' pause to look at the scenery can do wonders.
posted by pickingupsticks at 12:15 PM on May 23, 2012