New Study Suggests That Exercise Is the Best Medicine for Panic Attacks

One of the scariest aspects of a panic attack is that it can trick a person into thinking they’re having a heart attack. After all, some panic attack symptoms, such as difficulty breathing, dizziness, and rapid heart rate, look a lot like well-known signs of one.

As such, it might seem counterintuitive for people with panic disorder to intentionally induce these symptoms. But new research suggests that doing just that—via brief, high-intensity sprints—could reduce the severity and frequency of a person’s panic attacks.

The study, published in Frontiers in Psychiatry, highlights the benefits of exposure therapy for people with panic disorder. Exposure therapy involves being repeatedly confronted with anxiety-inducing triggers, in a safe setting with a therapist, to make them less scary over time. The researchers used a specific form of this therapy known as interoceptive exposure. This means intentionally inducing uncomfortable physical sensations to make them feel less threatening over time. For someone with panic disorder, they might engage in physical activities to rapidly increase their heart rate to learn that a rapid heartbeat isn’t inherently bad or dangerous.

“I think the main lesson is that you don’t have to be afraid of your own body,” says Richard William Muotri, a researcher at the Anxiety Disorders Program at the University of Sao Paulo and a researcher involved in this new study. “Many people try to just relax when they feel panic, but this study shows that facing the physical feelings through exercise is actually a more powerful way to feel better.”

Exercise-Based Therapy Proves Better Than Relaxation for People With Panic Disorder

Panic disorder is a type of anxiety disorder that causes people to experience regular panic attacks. Some might have panic attacks numerous times in one day or a handful each year.

This study included 72 adults with panic disorder who followed one of two therapy regimens for 12 weeks. Thirty-five study participants received relaxation therapy, consisting of deep breathing exercises and progressive muscle relaxation techniques. The remaining 37 participants followed what was called a brief intermittent intense exercise program. Their workouts, which were supervised, consisted of moderate-paced walks interspersed with 30-second sprints.

The researchers used a tool called the Panic Agoraphobia Scale (PAS) to determine whether the participants’ anxiety improved during and after the study. (The PAS is used to assess the severity of a person’s panic attacks, anticipatory anxiety, functional impairment, and other factors that contribute to panic disorder.) The researchers also took into account how many panic attacks the participants had before the study took place, at the start of the study, then six weeks in, and after 12 weeks, when the study concluded. The final assessment occurred in a follow-up, 12 weeks after the study ended.

While both groups improved during the study, those in the exercise group had significantly lower PAS scores than those in the relaxation group at the end of 12 weeks. People in the exercise group had fewer and less severe panic attacks than those in the relaxation group. Even when researchers saw an uptick in panic attacks amongst both groups at the follow-up, those from the sprinting group still experienced fewer attacks.

The Link Between Running and Reduced Severity of Panic Attacks

Panic attacks can lead to an intense fear that one’s body is experiencing a medical emergency, says Jaclyn Weisman, an assistant professor of psychology in the department of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine, who was not involved in the study.

Weisman says, “People start getting into this anxiety-driven catastrophizing, which can lead to questions like: What’s wrong with me? Am I having a heart attack? Should I go to the emergency room?”

High-intensity exercises, like sprinting, can help people with panic disorder by acclimating them to the physical sensations that occur during a panic attack. “Exposing yourself to your own body’s internal physiological sensations—by sprinting, running up and down stairs, doing jumping jacks, doing any sort of brief aerobic activity—helps you get used to tolerating these types of sensations,” Weisman says.

Should You Actually Run While You’re in the Middle of a Panic Attack?

Answers to this are a little mixed and may come down to personal preference. The goal? Prioritize safety and comfort.

“The safety and feasibility of doing exercise during a panic attack would depend on the patient and the panic symptoms they experience. Different things can be soothing for different individuals,” says Dr. Daniel Knoepflmacher, a psychiatrist at Weill Cornell Medicine and NewYork-Presbyterian who was not involved in the new study.

He says that if you’re feeling extremely panicky, have a racing heart, and experience any numbness, you’re better off erring on the side of caution and not going into an all-out sprint. But you can still enjoy some movement. “Walking in nature can be an effective soothing activity for people during panic episodes, something I’ve seen be beneficial for some of my patients,” he says.

Interoceptive exposure therapy isn’t intended to be used during a panic attack, says Weisman. Rather, a person with panic disorder could implement sprints into their normal workout routine, says Weisman. After regularly exposing their body to the sensations of aerobic exercise, they may be better able to work through those same sensations when they occur during a panic attack, she explains.

If you’re actively experiencing a panic attack and find that any kind of movement doesn’t feel good, you can always rely on tried and true methods to reduce anxiety, like taking deep breaths, telling yourself that it’s a panic attack, and trying to relax your muscles one at a time.

Healthcare professionals often prescribe interoceptive exposure to people with panic disorder in conjunction with other therapies, Knoepflmacher says. “Normally with that type of interoceptive exposure [used in the new study], it’s coupled with cognitive behavioral therapy.”

The bottom line: keep safety top of mind and always speak with your doctor or mental health professional for guidance.

Should You Add Running to Your Workout Routine?

There are a few caveats to the research that people with panic disorder should know about. The study only included participants classified as “sedentary,” but according to Weisman, “There’s no reason to believe someone who’s more active wouldn’t also benefit.”

The main thing to consider, she adds, is that some might get more out of interoceptive exposure therapy with a therapist’s guidance. A mental health professional can help determine how often to try sprinting, to what extent it might help you, and whether you should try it in conjunction with talk therapy, medication, or other treatments for panic disorder.

“If it’s nothing or this, then do this,” says Weisman. But she explains that you might not maximize the benefits of exposure therapy if you approach it from a DIY angle.

A therapist can also help you get clearance from a medical doctor, such as a cardiologist, to make sure you’re safe to start doing high-intensity exercises. (This is especially important if you haven’t been active in a long time.) “I do not like to fragilize patients, but we have to go through that step to make sure people are able to do this,” says Weisman. Getting a doctor’s stamp of approval to start sprinting—or doing other aerobic exercises—as part of an interoceptive exposure therapy regimen will help you feel even more assured as you start your treatment.

“When you exercise hard, these are the same feelings as a panic attack. By exercising in a safe way, your brain learns that these feelings are not dangerous,” says Muotri. It helps you build confidence that you can get through a panic attack, which is the ultimate goal, he adds.

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