Exercise and anxiety

Physical exercise is one of the interventions with the strongest evidence for anxiety — with effectiveness comparable to antidepressants for mild to moderate anxiety. The mechanisms include: reduced cortisol and adrenaline, increased serotonin and dopamine, endorphin release, regulation of the circadian rhythm (which affects sleep and anxiety), and a habituation effect to the physical sensations of activation (which reduces fear of the physical sensations experienced in anxiety).

It is especially useful for panic disorder: aerobic exercise produces heart palpitations, sweating, and shortness of breath — the very same sensations feared in panic — but in a safe context. This is essentially interoceptive exposure, desensitizing the person to the physical sensations that trigger panic.

The type of exercise matters less than consistency: 30 minutes of moderate aerobic activity 3-5 times a week is a practical, evidence-backed recommendation.