Yes I'm weird. Why do you ask?

May 6, 2014 11:15 AM

Is exercise induced anxiety a thing?

I've recently started walking. On the days I walk, I have terrible panic attacks a few hours after I finish. On the days I don't walk my anxiety is at its normal baseline levels. Why is this happening? I can reliability replicate this. I had to take the weekend off because I'm less than graceful and twisted my ankle pretty bad. No panic attacks. Yesterday, a very short (less than .5 miles) walk and I was crawling the walls within two hours.

I currently take .5 mg of Klonopin twice a day. It doesn't touch the panic. I finally got insurance and I have a pdoc appointment scheduled for a few weeks out. My assigned PCP is useless since he won't prescribe any psych meds or even renew my scripts.

Should I give up on the walking until I see the pdoc? Keep at it even though nothing has really changed in two week? Drug myself to the eyeballs?

Help. I know everyone on here recommends exercise for depression and anxiety, but this is not helping my mental health.

posted by kathrynm to Health & Fitness (20 answers total)

I'm no doctor, though you should talk to yours, but could an elevated heart rate and or blood-sugar fluxuations due to excercise be or be triggering your panic-like symptoms?
posted by The 10th Regiment of Foot at 11:26 AM on May 6, 2014 [4 favorites]

What are typical things associated with your anxiety? Does walking alone bring up anxiety-related stuff, like a feeling of danger or too much "in the body" feelings? Walking alone in the daytime (when I'm visible!) makes me really anxious, as does going to the gym, because both bring back the old hypervigilance that I had to have when I was younger - both feel too exposed and like I can't escape. I stopped going to the gym because it was causing me too much stress - not panic attacks, but definitely increased my anxiety.

On the other hand, I have no trouble at all riding my bike around town - it may be that another mode of exercise will help your anxiety.
posted by Frowner at 11:27 AM on May 6, 2014 [2 favorites]

Yes, it's a thing. Though exercise, especially vigorous exercise, helps manage my anxiety, everyone is different. Do your primary anxiety triggers involve fear of a heart attack? If you're exercising (and especially if you're not used to the activity), your heart rate will rise, you'll become sweaty, short of breath...all things that your anxious brain will interpret as "HEART ATTACK! RIGHT NOW! PANIC NOW! NOW!" You do mention that the attacks come on a few hours after you're done, so the above might not be the trigger. Do you have any agoraphobia issues? Perhaps being away from what I'm assuming is a safe place (your home) during your walks, with only your own muscle power to get you back there, is triggering you? Try doing a workout DVD, even a yoga DVD, at home and see what happens. Play around with the circumstances of the exercise, such as time of day, type of exercise, location, etc. Another thing could be low blood sugar, which will mimic (and can cause) a panic attack. Are you eating anything before/after your walks?

I'm sorry that your doctor won't help with your anxiety meds. Definitely see the pdoc and tell him or her what's been going on and that your current med doesn't work. I wouldn't take more than what your doctor prescribed in the meantime. Klonopin can be hard to come off of. Since you only have a couple weeks, suspend the walking if it's bothering you that much. If you're doing it to help your anxiety but it's only making it worse, there's no reason to continue it. There are many other ways to deal with anxiety. Good luck!
posted by msbadcrumble at 11:30 AM on May 6, 2014 [1 favorite]

Is it possible that what you're reading as a panic attack is Exercise-Induced Asthma?
posted by Lyn Never at 11:31 AM on May 6, 2014 [12 favorites]

Straining myself with certain types of exercise past a certain point pretty reliably give me all the physical symptoms of a panic attack. The only way I've been able to take care of it is by treating my anxiety and avoiding the sort of things I know will set me off. Walking never did it for me, but I've always walked a lot. Running, on the other hand, even with proper breathing and form and all, is a pretty reliable way to set it off.

So, I avoid running (and other types of exercise that I've figured out with trial and error) whenever possible. A few days ago I did a few too many crunches in a row, felt it happening, immediately stopped, drank some water, walked around, and did something else. It more-or-less subsided. On the other hand, stuff like lifting weights and cycling doesn't trigger that stuff at all, so when I exercise, that's what I do.
posted by griphus at 11:31 AM on May 6, 2014 [1 favorite]

What else is happening when you're walking? Are you outside or inside? Among other people or alone? Are you alone with your thoughts or listening to music/podcasts/audiobooks? On preview, what Frowner said - I would be more inclined to think that it's the circumstances of the exercise rather than the exercise itself.

Also, do you have this kind of reaction if you're walking for transportation purposes, or is .5 miles of walking a significant departure from your normal activity level?
posted by mskyle at 11:34 AM on May 6, 2014

I've found that anything that increases my heart rate can be an anxiety trigger, presumably because the association between that sensation and all the other anxiety sensations is so strong that my body assumes we're getting anxious anyway and kinda goes for it. It happens sometimes when I exercise (though not always, and not to the extent that it sounds like you're getting this) , and with other heart-rate-raising things/experiences (anything with lots of jump scares, caffeine, etc.)

I mostly came here to say that, anecdotally, you're not weird or the only person this happens to. In terms of advice, I personally tend to avoid the really strong anxiety triggers where possible (I am done with caffeine, for instance). The occasional anxiety I get from exercising is not bad enough to make me want to stop, and I feel the benefits - but in your shoes, I'd be tempted to stop doing the thing that's triggering the anxiety until you see your doctor. Two weeks without exercise is unlikely to actively harm you. I'd also suggest maybe trying a different kind of exercise (or several) to see if maybe other types of cardio or something non-cardio based like strength training are equally anxiety-inducing.
posted by terretu at 11:34 AM on May 6, 2014 [1 favorite]

I have been panicky while exercising and immediately after. I'm very sensitive to the feeling of a racing or pounding heart because it accompanies my worst anxiety. So even if my heartrate is only elevated because of exercise, when I feel my heart pounding or beating fast, it starts my anxious-brain thinking that something is terribly wrong, which makes me anxious, which raises my heartrate more, and yeah.

But honestly, in the long run, exercising has reduced my anxiety. It is definitely worth some effort to try to work through it. Wait until you can get to the pdoc. Then try a different type of exercise. Try exercising at home. Try doing something that relaxes you immediately after (relaxation CD, reading in the bath, petting an animal).
posted by Bentobox Humperdinck at 11:36 AM on May 6, 2014

To follow-up on my note about EIA, it's often not the sort of cartoony wheeze you might think. Most people experience a tight-chest feeling and possibly some of the biological alerts of decreased oxygen consumption. Which is exactly what my panic attacks feel like.

I kind of didn't believe the asthma thing until several events in which the panic attack suspiciously stopped within a few minutes of using the inhaler.
posted by Lyn Never at 11:52 AM on May 6, 2014 [1 favorite]

How much are you walking? During a certain high stress period of my life I was walking for 90+ minutes a day and it definitely made me manic. Try cutting the amount of walking you do in half and see if that helps. What time of day are walking? I find that exercise late in the day hypes me up so that I have a hard time getting to sleep.
posted by mareli at 12:10 PM on May 6, 2014

I would definitely be evaluated for exercise-induced asthma. I have both panic attacks and EIA and they can feel very similar: tight chest, struggling to breathe, fear. In fact, the only way I can tell the difference is by using a peak flow meter (PEF readings normal? definitely just anxiety. PEF low? inhaler time.). Also, my EIA attacks show up 1-2 hours after I finish exercising, not during.

Which is not to say you don't also have panic attacks, asthma and anxiety are best buddies. But if you also have asthma, that's a separate problem that has its own treatment.
posted by epanalepsis at 12:27 PM on May 6, 2014 [1 favorite]

Also, exercise-induced asthma sometimes reappears spontaneously in a less severe event a couple of hours after the initial attack. I can't find the article just now, but I recognised it in myself after reading it. I'd often get an attack immediately during/after exercise, and then 6-8 hours later regardless of exertion. (It's not your timespan, but I don't know how immutable the delay is in time). Second time around feels more like a general tightening of chest and heightened puls, so less obviously asthma-related.

It's happened often enough that I consider it a thing…
posted by monocultured at 12:39 PM on May 6, 2014 [1 favorite]

Best answer: OMG YES. This is totally me. One of the shittiest years of my life was the year that I forced myself to "become a runner" because my daily runs made me feel anxious, cranky, and flat-out bitchy. I never got the exercise high or mental health benefits that people always talked about.

What has helped for me is to mostly do exercise that doesn't really raise my heart level that much. Anaerobic exercise like yoga, pilates, barre or weight lifting are some examples of this. I've also started eating a very low-carb, high-fat diet which has enabled me to stabilize my blood sugar enough that I can do some moderate cardio from time to time without going into a panic.
posted by joan_holloway at 12:39 PM on May 6, 2014 [2 favorites]

I wanted to second whoever asked about low blood sugar. If I have low blood sugar I frequently feel the same as what you described - panicky, sad, depressed. And yes to stretching.
posted by rogerrogerwhatsyourrvectorvicto at 1:04 PM on May 6, 2014 [1 favorite]

Response by poster: Definitely not health anxiey or agoraphobia. Interesting thought on the blood sugar, though if mine dips I usually get extremely nauseated. I checked my peak flow for kicks and it was normal after and when the panic set in again. I used to have some pretty nasty cough variant asthma up until my mid 20s.

I think I'm gonna let it go until I can talk to the pdoc. I'm really too tired to fight against the anxiety on top of chronic pain.

Thanks for making me realize I'm not a freak of nature.
posted by kathrynm at 5:03 PM on May 6, 2014

I wonder if your previous experiences with anxiety are causing your brain to misinterpret the effects of post-exercise endorphins as anxiety? I feel profoundly elevated and "glowy" after heavy exercise, and to me it is a very pleasant feeling, but if I associated some of those feelings with panic it would take on an entirely different complexion.
posted by The Monkey at 6:14 PM on May 6, 2014 [1 favorite]

One more thing on the blood sugar: does the anxiety occur 1/2 to 2 hours after you eat? I have an extremely mild version of post prandial adrenergic syndrome, where hypoglycemic reactions like anxiety occur after a meal. Basically, if I don't eat well, and then drive myself into hypoglycemia by exercising too hard, and then I eat after the workout...in that window of 1/2 to 2 hours after the exercise & subsequent meal, a nice little panic attack can set in.
posted by Lycaon_pictus at 7:40 PM on May 6, 2014 [1 favorite]

Just wanted to second joan_holloway. I have a similar reaction to intense cardio and anaerobic exercises and paying attention to blood sugar are my solutions too.

I'm always jealous of people who get the "glowy" feeling from exercise that The Monkey mentions, but it's just not gonna happen for me.
posted by entropyiswinning at 10:27 PM on May 6, 2014

Response by poster: I'll give it one more go today, for science. I'll have to find my glucose meter.

And the panic usually sets in about 30-60 minutes post walk. This isn't hugely intense (between .5 and 1 mile), but I'm so out of shape, my heart rate can get up there. I don't feel bad while walking (aside from my shitty weak ankle), it's the aftermath.

I doubt I'll ever get that glow. But if I can get to the point where it doesn't feel like a chore, I'll be happy.
posted by kathrynm at 8:27 AM on May 7, 2014

Response by poster: It seems that a blood sugar drop may be part of it. I was dropping down to about 85. So not dangerously low, but it might be enough to trigger anxious feelings.

I'll talk to my useless GP, though he'll probably just write me a referral to an endocrinologist seeing as he doesn't seem to deal with anything more complicated than the common cold.
posted by kathrynm at 4:27 PM on May 10, 2014