This is the fourth and final article in 4-part series focusing on Depression, Postpartum Depression, Anxiety, Attention Deficit Disorder (ADD/ADHD), Obsessive Compulsive Disorder (OCD) and Panic Disorder, and how exercise can be effective in their treatment. 

Panic Disorder 

Panic Disorder is an anxiety disorder characterized by recurring severe panic attacks. It may also include significant behavioral changes lasting at least a month, and ongoing worry about the implications or concern about having other attacks. The latter are called anticipatory attacks (DSM-IVR). Panic disorder is not the same as agoraphobia (fear of crowded places and awkward social settings), although many with panic disorder also suffer from agoraphobia. Panic attacks cannot be predicted; therefore, an individual may become stressed, anxious or worried wondering when the next panic attack will occur. (There are other schools of thought that panic disorder is differentiated as a medical condition or chemical imbalance).  

Panic Disorder and Anxiety are different. Panic attacks have a sudden or out-of-the-blue cause, and are short in duration but with more intense symptoms. Anxiety attacks have stressors that build to less severe reactions that can last for weeks or months. Panic attacks can occur in children as well as adults. Panic in young people may be particularly distressing because the child has less insight as to what is happening, and his/her parent is also likely to experience distress when attacks occur. Some of the symptoms of Panic Disorder that last for one minute or more are:

• Intentional hyperventilation – creates lightheadedness, derealization, blurred vision, dizziness
• Spinning in a chair – creates dizziness, disorientation
• Straw breathing – creates dyspnea, airway constriction
• Breath holding – creates sensation of being out of breath
• Running in place – creates increased heart rate, respiration, perspiration
• Body tensing – creates feelings of being tense and over alert

The common treatment for Panic Disorder is the identification of treatments that engender as full a response as possible, and at the same time, minimize relapse; this is imperative. CBT is the treatment of choice for panic disorder. When CBT is not an option, pharmacotherapy can be used. SSRIs (antidepressants) are considered a first-line medication option.

Here also, we see that exercise is helpful.  In a study that appeared in the American Journal of Psychiatry in 1998, 46outpatients suffering from moderate to severe panic disorderwith or without agoraphobia were randomlyassigned to a 10-week treatment protocol of regular aerobicexercise (running), the drug clomipramine or placebos.In comparison to the group which received the placebos, both exercise and clomipramine ledto a significant decrease in symptoms, according to all criteria of the study. A direct comparison of exerciseand clomipramine revealed that the drug treatment improved anxietysymptoms significantly earlier and more effectively. Depressivesymptoms were also significantly improved by exercise and clomipraminetreatment. These results suggest that regular aerobicexercise alone, as opposed to placebos, is associated withsignificant clinical improvement in patients suffering frompanic disorder, but that it is less effective than treatmentwith clomipramine. Either way, it is clear that a well-rounded and balanced program of exercise can aid in treatment and cure. 

In Conclusion:  It wasn’t very long ago that society would write off the mentally ill.  Today, people with all types of mental health disorders are functioning members of society.  They can do well in school, university, and in every single field of the workplace one can imagine.  Therapies and drugs now exist to help those who need help.  And now, we also know that exercise has yet again begun to prove itself as the one thing that really can never hurt and can only help.  Exercise not only helps us physiologically, but psychologically as well.  Whether you have depression, anxiety, OCD, ADD, or panic disorder, incorporating a balanced exercise program into your life will help you improve the quality of your life – perhaps even significantly.   

ALAN FREISHTAT is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 15 years of professional experience. He is the Co-Director of the Jerusalem-based weight loss and stress management center Lose It! along with Linda Holtz M.Sc. They are available for private consultations, assessments and personalized workout programs. They have begun working with Dr. Michael Bunzel, M.D., a psychologist in Bnei Brak, Israel on incorporating exercise as a therapy for several mental health disorders.  Alan can be reached at 02-651-8502 or 050-555-7175, or by email at [email protected]. You can also visit the Lose It! website at www.loseit.co.il 

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