Exercise and Health Anxiety

[glassgirlw]

Hi all - I'm not a new member, but I haven't made a lot of posts myself. I'm actually doing really well with managing my health anxiety. I've learned to let things go easier and haven't had what I would consider any major panic attacks in over a year.

I've been working on myself -- quit smoking 4 months ago (I do use Nicotine Replacement, just cut out the cigarettes). I'm extremely overweight - classified as morbidly obese, so that's awesome. But - started a new diet plan about 3-4 weeks ago and I'm down 11.6 lbs - so I'm super proud of that. Now comes the issue...I really would like to start exercising. My anxiety over my health has pretty much always centered around my heart. No real reason, necessarily, other than the heart would race during panic attacks. I have had EKG's at the E.R. like most HA'ers, and they've always been normal. Haven't had one in probably 3 years now. I can walk up and down the flights of stairs at home and not be totally winded. I can mow the yard in the 80 degree heat; I sweat and am breathing heavy, but again I wouldn't consider it "short of breath". But when I start exercising, and the heart rate increases, as it's prone to do - I start to get nervous. Well I need my heart rate to get up there a bit to burn some calories - but how to do that without sending myself into a panic? That's what I need help with.

I took a yoga class the other day, was a 60 minute class, I made it about 25 minutes before I had to sit to do some of the movements because my knees just weren't holding out anymore - after about 10-15 mins I was able to stand back up and finish out the rest of the class. Was pretty proud of myself. I was never out of breath to the point where I couldn't breathe, not short of breath or wheezing, no chest pains, etc. But - my heart rate got pretty up there -- like 168 was the high point I think. Keeping in mind, I'm a fairly sedentary person. I do work outside the home. My job is not hugely physical, but I am up walking around the office and plant at least once an hour for 5-10 mins at a time. So I'm not bedridden, but that's the extent of the physical activity that I have done - in many, many years. So I tell myself that I'm going to have a higher heart rate when doing physical activity because my body isn't used to it. That as I continue to exercise, it will take longer and longer for my heart rate to hit those higher numbers. But it doesn't seem to be getting through to the brain.

I don't know if anyone else is in the same boat as me, but I would love to hear from you if you are - or even if you have some experience in this area and can offer some tips for me, I'd appreciate those too. I want to continue getting healthier for myself - both mentally and physically. And I feel like exercise is the next natural stepping stone towards that goal.

If it matters - I am 40 years old, female, and after my 11.6 lb weight loss, I'm at 309.8 lbs. My normal resting heart rate used to be around 95, I've noticed after quitting smoking and losing just a few pounds already, my resting heart rate has gone down to the 80-85 range. But it's the increased heart rate with exercise that seems to stress me out. Thanks all!

[bin tenn]

Hi, and first of all congratulations on making so many positive lifestyle changes. That's fantastic! I hope you stay motivated to keep it up and continue to improve your overall health. I know it's not easy, but I'm sure you won't be disappointed in the long run!

I understand completely about heart related health anxiety and exercise! I find it difficult to exercise for the same reasons. The racing heart, changes in breathing, etc that are normal and healthy during exercise are reminiscent of a panic attack, so I feel like I'm having one when I exercise. And since I fear having a panic attack, it actually TRIGGERS an attack. LoL, crazy isn't it??

I'm sorry I don't really have any tips. I have yet to find something that truly works for me. However, one thing I've tried to do is push through the exercise but also listen to my body and stop when it says it's had enough. There is nothing wrong with letting the body control when you stop; that's normal.

In the long run, exercise will greatly improve your physical health, but it's also proven to improve mental health. Since you have anxiety, and you also have (or had) some poor lifestyle habits, exercise will eventually be doubly great for you.

Congratulations again on the positive changes, and I hope you find your way through this exercise induced panic very soon! Yes, exercise induced panic attacks are very common for sufferers. Feel free to look it up to see just how many others experience this. They may even have some tips to overcome it.

[glassgirlw]

Thanks, bin tenn - I appreciate the response. I’m definitely motivated to keep on my current path!! Nothing’s changing that. I think I may just start with some easy walks with the dogs for the next few weeks. For some reason I don’t get that panicky sensation on walks. Only when I’m doing something I really consider “exercise” like aerobic or strength training. Crazy how my mind works sometimes :roflmao:what must it be like to be a normal person without all these HA issues — sad to say I’ve had them so long, I don’t remember not having them!!

anyway, I hope you have a great night and thanks again for the kind words and encouragement!!

[MyNameIsTerry]

I get that, glassgirlw, it becomes "a thing" once the label of exercise is on it and the subconscious spots it and kicks off the cycle. I'm the same with this and exercise is one I still work on.

I've found you can do things to prove to yourself it's not so bad, typical exposure work. Sometimes a few goes and you see change and sometimes it's like it haunts you without much hope.

Originally my therapist had me do some Behavioural Experiments where I would sprint a short distance and think about how I felt at the end. At first it was typical thoughts of the scary feelings and what thy were, would I tip over into panic, etc. The more you do it though the more you realise nothing really happens.

I also found doing the same when I wasn't expecting to helped. When on walks with my dog he would give me that "I want to have a massive sprint" look and off we went. Again this showed me I could so things I didn't think I could.

Whilst I'm not a HAer my anxiety has always been very tied into the physical symptoms much more than thoughts. So, it's not that I would consider anything like a heart attack, and even an intrusive thought of that would be quickly dismissed without reaction, but it was the fact it felt similar to anxiety. That and the fact your confidence reduces and you worry whether you are capable hence why perhaps it's less of an issue when you are doing it with someone else (distraction helps with others too).

For me the heart racing, the worry about not breathing (I have asthma) and the worry of the next day soreness were the main problems. I still have work to do on this but am past some of it now.

I have found there are some days with anxiety where it's just a bad day anyway. On those days you find yourself suffering and wondering whether you will ever do xyz but I learned these are days to accept/write them off as poor indicators as everyone has bad days. If you are doing things on the days that aren't like this, you can do it. Evenatually you work your way through how the bad days affect you.

Like Ben says I think it's great what you are doing. Cutting the smoking is a challenge and a great way to improve your health straight off. You won't running up mountains or taking on marathons like the nicotine replacement ads like to show :winks: but you will get there eventually if you want to.

At your weight doing something like yoga is far harder than those in the class that are closer to average weights or in good shape. I wouldn't worry too much if you need to adapt the class and perhaps a chat with the instruction will help there as they must be aware a larger body means far more energy used and stress on joints alone. I would imagine they have to risk assess anyway so as not to push people too hard until they are ready.

Yes, walk the dogs! :woof It's still exercise and you can play with them. Walking is good for the heart and whilst it may not be burning as many calories as you would like it's still doing something and strengthening your cardiovascular and other muscles. As you will know because you are bigger you will be burning more anyway but as you get fitter you can also add a bit of weight to the walks and that will burn more calories too. Its surprising more much more effort it takes humping your shopping home.

Despite your weight you do sound quite active anyway. I've known smokers in their twenties who are out of breath just walking up two flights of stairs in the offices I've worked in and they were closer to 200lbs.

There are plenty of resources to help you and there is always your GP if you want to check on health matters. But as for anxiety one of the saddest facts we al have to face at some point is a great deal of getting through is - getting through it. Facing it via structured exposure plans. There is plenty more we can do with self talk, working on acceptance, grounding and things like Mindfulness, etc but at some point it always comes back the exposure tests.

So, have a look at Behavioural Experiments in CBT. Have a look at things you can at the end of exercise or during that helps you change your focus e.g. you could ground yourself with an object you stare at or something you are holding. Eventually you will find you don't need them and if you can't do without them they have become unhealthy safety behaviours so you know you then need to work on them to eliminate them (sometimes we need them to move forward to a better place I think).

I'm not through it myself but these are things I've found helped or others did that I have seen talk about such things.

[ankietyjoe]

I have been through exactly this in the past, to the point where an increased heart rate from exercise was almost crippling.

What I found helped was slow exposure, deliberate slow exposure.

Terry is absolutely correct here.

I would also suggest that you really don't need to do that much to start off. If you are very overweight, a brisk walk is more than enough to be considered exercise, and also the ideal form of exercise for weight loss and overall health. We are bombarded with nonsense programmes about 'boot camp' weight loss solutions, but not only are they not good for you, they are also completely ineffective in the long term. What you need is slow lifestyle change.

I started with a 5-10 minute walk allowing my heart rate to get over 100bpm, knowing it was over 100bpm and then keeping it there for 5 minutes or so. Just doing that every day is a CBT style brain rewire.

Too much exercise in your (our) state can be incredibly counter productive, which I have also experienced.

Try the deliberate 5-10 minute walk on week one, 10-15 minutes on week 2, 15-20 minutes on week 3 etc etc. As long as your heart rate is between 100-120bpm you're doing yourself a massive favour in terms of physical and mental health. The ultimate goal would be 30-40 minute walk at around 120bpm, with a bit of a sweat on! :D

Once you've done that for 3-4 months, only then would I start thinking about yoga or some low impact resistance training.

And well done for getting to where you are now! :yesyes:

[pav1984]

Why not start hiking? The fresh air and exercise does wonders for my spirits and not too strenuous on the old ticker. I know people say walking doesnt lose weight but i personally disagree. When i had a job where i was on my feet all day i never put on weight. I get a job in an office and the pounds went on.

Swimming is also good as it is kind on your joints.

[glassgirlw]

Thank you everyone for your kind words and advice! I think I’ve decided to start small, with walks a few times a week. I’m afraid to push it too hard right out of the gate and discourage myself from trying. So I’ll take baby steps and work towards the larger goals. Hope you all have a wonderful evening!!

[bin tenn]

Thanks, bin tenn - I appreciate the response. I’m definitely motivated to keep on my current path!! Nothing’s changing that. I think I may just start with some easy walks with the dogs for the next few weeks. For some reason I don’t get that panicky sensation on walks. Only when I’m doing something I really consider “exercise” like aerobic or strength training. Crazy how my mind works sometimes :roflmao:what must it be like to be a normal person without all these HA issues — sad to say I’ve had them so long, I don’t remember not having them!!

anyway, I hope you have a great night and thanks again for the kind words and encouragement!!

Eh, I think normal is probably boring and way overrated anyhow. So don't get caught up wondering if you'll ever be "normal". :P Glad to help.