CHAPTER 7
It’s all about the brain – not the ass!
To those struggling with anxiety, OCD, depression: I know it’s madly annoying when people tell you to exercise, and it took me about sixteen medicated years to listen, but I’m glad I did. It ain’t about the ass, it’s about the brain.
LENA DUNHAM, ON INSTAGRAM
Whether you’re a complete workout noob or already working out like a fiend, this chapter will give you more motivation and inspiration to start (or carry on) getting a sweat on, not just for the fab body benefits but for the amazing mind-relaxing results.
NHS experts have said that if exercise came in pill form, it would be one of the most cost-effective drugs ever produced. The benefits of exercise are many, from improved self-esteem and a sense of overall wellbeing to lower risk of disease, depression and stress.
But if the thought of intense training seems decidedly unrelaxing, there’s good news. NHS guidelines state that light, moderate and high-intensity exercise can all reduce your level of anxiety. Light exercise would be something like gentle walking, moderate means you could hold a conversation but definitely not sing during the activity, while high intensity is when there’s no way you can chat because you’re working so damn hard! The NHS recommends we all take thirty minutes of moderate exercise five days a week. That could be brisk walking, bike riding, swimming or tennis.
Sounds easy in theory, right? But if three flights of stairs feels like your own personal Everest, remember to go easy on yourself and start slowly. Even Jessica Ennis-Hill had to start somewhere. Whatever you do, please don’t allow fitness – or lack thereof – to be another reason to beat yourself up. Don’t add it to your list of shoulds – ‘I should have gone for a run but I didn’t so that means I’m bad/lazy/unmotivated/useless.’ It ought to be fun – playful, even – and something you do for yourself with love, not as a form of punishment.
I spoke to personal trainer Matt Roberts, who counts Amanda Holden, the Saturdays and Mel C among his clients. ‘The evidence in support of regular exercise for a healthy body and mind is overwhelming,’ he told me. ‘There’s a lot of confusion created by the fitness industry about what the best approach is and this can often lead to people obsessing about the details and losing focus on the bigger picture. If you find a way that helps you to remain consistently active, regardless of your choice of exercise, that’s what counts and leads to the biggest pay-off. It’s about setting yourself up in a way that means you guarantee success.’
Consistency is key, in other words. So is enjoying it, as it means you’re more likely to stick at it. And if you are unfit right now, the good news is you could have the most to gain from exercise. In fact, it’s been shown that the less physically fit and the more anxious you are, the greater the benefit you can expect.1
The science part
Studies have demonstrated that exercising lowers the activity of the sympathetic nervous system2 – the fight-or-flight response – which explains why after you’ve been to the gym you typically feel more relaxed, safe and at ease. We all need this! And there’s more positive brain chemistry at work. That fantastic high after an adrenaline-pumped spin class or a glowsticks-wielding clubbercise class is all down to endorphins. When you exert yourself through high-intensity exercise your body produces chemicals that are similar in their structure to opiates (such as morphine) and can create a euphoric feeling, or at least a boost in your mood. It’s thought they are released to help you manage any pain, such as sore feet and aching muscles, and are responsible for that much-sought-after ‘runner’s high’. Endorphins are part of the reason exercise is so good for calming anxiety, because afterwards you are inevitably in a better mood.
Another example of the mood-boosting and eventual calming benefits of exercise, this time in cold water, was discovered in the early twentieth-century. Psychiatric patients were often given cold baths, or ‘hydrotherapy’, to calm them down. It was thought the cold water reduced blood flow to their brains, reducing mental over-activity. Additionally, the ‘shock’ of being exposed to the cold water was believed to jolt them out of their agitated mental state. If this sounds outdated, Professor Mike Tipton from the University of Portsmouth has theorized that exposure to cold water really can improve the way we respond to stress. The idea was explored in an episode of the BBC documentary series Trust Me, I’m a Doctor in September 2016, when Dr Chris van Tulleken helped a patient with depression boost her mood by doing laps of a lake. But if cold-water swimming isn’t an option for you, just switching the shower to cold for a minute or two could help you to glean some of the benefits. Lots of self-help motivational speakers, including Tony Robbins and Tim Ferriss, practise this cold-water ‘therapy’ to boost their immune systems and moods. Tony has spoken about the cold-water plunge pool at his house, which he uses daily.
Numerous studies point to the fact that exercise causes changes in brain chemistry and brain structure to make you calmer. One study at Princeton University, carried out on mice, compared sedentary rodents with ones that were allowed to run on a wheel. The ‘runner’ mice were found to have higher levels of the neurotransmitter GABA, which has been shown to calm the brain. (Think of GABA as something that tells your over-anxious brain cells to chill out – who doesn’t want that?). They were more able to handle stress and showed signs of greater confidence and reduced anxiety.3
Animal studies have also shown that exercise helps the brain repair itself from the effects of stress. It causes shiny new cells to be made in a part of the brain called the hippocampus – the part that can become damaged as a result of repeated exposure to the stress hormones adrenaline and cortisol, as would be the case with chronic stress.4 Basically, exercise has a very real and positive effect on your nervous system, on the structure of your brain and its neurochemistry. It’s win, win, win!
Zap your exercise worries
It’s all very well to be convinced of the benefits in theory. But let’s face it, lots of people know they should exercise and still find excuses to put it off. And if you’ve ever experienced a panic attack, the memory might be warning you off digging out your running shoes. After all, exertion can create a similar heart-pounding sensation, and it’s easy to associate that feeling with danger. ‘Anxiety sensitivity’ is when you believe that the symptoms of anxiety, including a rapid heartbeat, are in themselves harmful – even though, in fact, they aren’t. If you are resisting exercise because of fear, take comfort from a 2008 study which found that doing aerobic exercise actually made participants more comfortable and less afraid of the symptoms of anxiety.5 By getting your heart pumping you can teach yourself to be OK with that sensation. You learn that although it’s not very pleasant to feel your heart thumping in your chest like an 808 drum turned up to eleven, it’s not actually going to do you any harm.
If you’re still struggling with the motivation to exercise, try thinking about it as something fun and playful rather than another chore to cross off your to-do list. I spoke to Nicola, thirty-one, a yoga teacher and social media manager, who said, ‘When I’m feeling anxious I exercise with the intention of connecting to my inner child – a state that’s happy, light-hearted and calm. I make sure I choose an activity I enjoy and that’s fun, not just one I think is good for training purposes. I focus on the breath and how it feels rather than how it looks or what the “numbers” are, i.e. how many calories I’m burning. This helps me focus on being in my body and being present again, which combats the anxiety. For me, walking, yoga, cycling and running are proving effective.’
For some of us, exercise feels like yet another thing we have to be good at, another area of life where we will feel awkward and out of place. Perfectionists and people who suffer social anxiety are likely to dread the gym, or the dance class or the running club. Perhaps you’re worried you won’t know how to use the machines or that you don’t have the ‘right’ gear or you’re embarrassed about becoming a sweaty, hot mess.
‘Gym-timidation’ is real but, rest assured, the vast majority of gym-goers are focused on one thing and one thing only – themselves. If you have to spend a few minutes trying to fathom how to use the cross trainer, or you wobble as you get into a lunge, no one is going to notice or care. Allow yourself to be a beginner; you don’t have to be amazing at this straight away. You have to start somewhere, so go easy on yourself. Wear your hot-messiness like a badge of honour. You rock that look! It’s a sign that you’re growing stronger and fitter, both physically and mentally. The trick is to feel the discomfort and to stay with it.
I remember the first time I walked into the weights room at my gym. I was so self-conscious and nervous. The place was filled with huge, muscly men wearing string vests (I’m not even kidding). Everyone seemed to know what they were doing. I wanted to run away and curl up in a dark room! Then I reminded myself why I was there: to do something amazing and positive for myself. So I stayed put, even though I felt nervous. These days, I breeze into the gym without a care in the world; I’m so focused on my workout that I barely even notice the vest-wearers any more. You can do that, too!
Natasha, a twenty-nine-year-old librarian, told me, ‘I have a fair amount of social anxiety. When I started British Military Fitness I would worry about being good enough, what other people thought of me and whether I’d be able to do all the exercises, or even keep up. But I loved the fact it was outdoors, and being with other people made it fun. Being so active took my mind off my anxiety and I soon relaxed into it and made friends.’
The social aspect that Natasha identified is important. Like most things in life, exercise is way better with a friend by your side. If going to the gym or to a class is scary at first, having a wingman or woman there with you can give you the confidence to try something new. Plus, you can’t let your exercise buddy down so you’ll be more likely to continue – or even show up in the first place! Exercising with a friend or joining a group class multiplies the mental-health-boosting benefits, too. Anxiety can feel so isolating at times; it can make you want to hide away and stay at home. But given that more than 20 per cent of women feel anxious most of the time, according to the Mental Health Foundation’s 2014 report, chances are that at any exercise class or group others will be feeling the same as you. Exercising in a group or with someone else gives you an external focus and something to talk about as you build up your social confidence. The science even backs this up; a study at Oxford University found that exercising with others increases levels of mood-boosting endorphins more than exercising alone.6
Get in the zone and out of your head
Anxiety can feel like being trapped in your head and sometimes you’ll do anything to get out of it. Maybe, like me, you’ve turned to booze or food. Maybe you’ve used drugs to quieten those voices and numb your pain. Exercise is one of the best, and healthiest, ways of getting out of your head. Natasha told me, ‘A lot of my worries – things such as “I’m not good enough,” “I don’t earn enough,” and “how will I afford a mortgage?” – stop mattering so much when I work out because I’m too busy trying to complete each exercise.’ Working out quietens your anxious brain because it forces you to be present and focus on what your body is doing in the moment. It’s much easier to forget about worries when you’re trying to keep up with the Zumba moves!
Athletes often talk about getting ‘in the zone’ – a state of flow where you feel fantastic, fully immersed in the moment and less conscious of yourself and your thoughts (which, when you’re anxious, can only be a good thing). Mihaly Csikszentmihalyi, author of Flow: The Psychology of Happiness, believes people are at their happiest when in ‘a state of concentration or complete absorption with the activity at hand and the situation’. Exercise is a great way to get there, as are other activities such as writing, playing music and dancing. Sounds pretty good, right?
Health editor Katy Sunnassee, thirty-seven, told me that during her early twenties, when she experienced a period of severe anxiety and stress, salsa dancing or jogging along the beach were the only ways of lifting the grip anxiety had on her. She spent months locked into a cycle of repetitive negative thinking, worrying about both major and minor decisions. It was salsa dancing that was her saviour. ‘Even now, it totally takes me out of my head and into my body. I can’t help but smile when I dance, as I so love the music and moving my body to the rhythm. What’s more, you have to be in the moment, or in the flow, to connect with your partner and follow his lead. It’s the ultimate stress buster and mood booster.’
Build your self-belief
You know that feeling of achievement and self-assurance you get when you cope with a challenge or do something well? Psychologist Albert Bandura gave it a name: self-efficacy. It’s that glow you get when you complete a tough Pilates class, perfect your tennis serve or master a tricky dance move. It’s a boost of self-belief and confidence that says, ‘I’ve got this.’ The more self-efficacy we have, the less anxious we’re likely to feel.7
Health editor Katy told me how this feeling of accomplishment gave her a massive boost when she really needed it. ‘I was rehearsing for a salsa performance, and there was a bit in the routine that entailed us girls doing handstands in front of our partners. They were supposed to catch our ankles and then we had to flip up on to their shoulders. I was totally freaked out when I saw the teachers do it. I thought, “There is no way on earth I’ll ever be able to do that.” My first attempts were horrendous. I couldn’t even kick my legs up high enough and just did a load of pony kicks! I was so scared of falling on my face and hurting myself. But one day, when no one was looking – other than my partner – I told myself, ‘Oh just f**king do it!’, and you know what? I did! I kicked my legs all the way up into a handstand and managed to flip myself up – that was actually the easy part, as I have strong stomach muscles. The hard bit was trusting myself, and my arms! Anyway, the feeling of euphoria was incredible. I felt invincible! I could barely even do a forward roll as a child so that handstand was the most gymnastic thing my body had ever done. Doing it again and again in front of crowds at salsa clubs across London as we performed our routine was amazing. Even though now, four years later, I’ve lost the ability to do a handstand – if you don’t use it, you lose it, after all – I’ll never forget the excitement I felt doing it for the first time.’
Exercise is a really effective way to increase self-efficacy and self-esteem and you don’t need to do handstands to get your own personal boost. Whether you try a new class, reach 10,000 daily steps or finally get yourself up to running a 5K, it’s the small wins that help you prove to yourself you are capable. It’s been shown that exercising at a moderate intensity actually gives you the most benefits because you get a sense of achievement without it being so hard you risk failure.8 So don’t try to go from zero to a marathon in one week; build up slowly and watch your confidence grow. Setting yourself small, achievable exercise challenges could pay off big time in how confident and capable you feel in your life in general. And it’ll kick stress and anxiety to the kerb with every step you take.
Shake off the stress
According to trauma expert Peter Levine in his book Waking the Tiger: Healing Trauma – The Innate Capacity to Transform Overwhelming Experiences, animals in the wild shake themselves violently after experiencing an episode of stress or fear. He uses the example of a gazelle, when it has survived being chased by a lion. It literally ‘shakes off’ the shock and tension to discharge the excess energy and adrenaline that the fight-or-flight response created. As for humans, we tend to hold on to that shit! We create tension in our bellies, shoulders, hips and necks from stress, panic or fear, and then carry it around with us.
Exercise is a great way of getting rid of that tension as it ‘burns off’ the excess adrenaline that is produced when you’re anxious and removes the stress hormones that have accumulated in your blood which leave you feeling tense and restless. So exercise is known to be a great relaxant, but how about adding some shaking into your routine? I’m not necessarily suggesting you do this at your desk after a tense quarterly review with your boss, but when you can, whenever you experience a shock, angry outburst from someone or a tense train journey, try shaking it off by shaking your whole body, even if it’s just for a few seconds. An accompanying soundtrack of Taylor Swift’s ‘Shake it Off’ or Outkast’s ‘Hey Ya’ is optional (but recommended!). It’s an almost instant way to feel calmer and less tense.
There is a whole area of therapy called Trauma Release Therapy (TRE) that involves getting the body to shake as a means of casting off trauma; check out the videos on YouTube if you’re keen to learn more, or Google local classes or practitioners.
Get back to nature
Could you be suffering from ‘nature deficit disorder’? (Yes, it’s a thing.) We all know that our bodies were not designed to sit still indoors all day in front of a computer screen. We need daylight, trees and fresh air to feel our best. A 2013 study done at the University of Essex and published by the mental health charity MIND9 found that nearly 70 per cent of us experience ‘significant increases in wellbeing’ following ‘eco-therapy’ (that’s getting out and doing things in nature, to you and me). The University of Exeter Medical School also looked at 1,000 people living in urban areas and discovered that those who moved to a place with green spaces had better mental health, including lower levels of anxiety and depression, than those who lived in less green areas. The conclusion? Being outside, even if it’s only in a city park rather than the wilderness, is seriously good for your mental state. Exercising in the great outdoors gives you a double whammy of calm-inducing benefits. Try a jog in the park, a walk in the countryside, a park-based exercise class, a cycle ride through meadows, or even a swim in the sea, if you’re brave (and live close to the coast). There’s nothing like being surrounded by a big, open sky, huge trees and incredible wildlife for helping you to get things into perspective. Being immersed in nature helps you feel connected to something bigger than yourself, and your everyday problems or worries can seem less significant.
Find the thing you love to do
Personal trainer Matt Roberts told me that finding an activity that you enjoy is key to building exercise into your life. If you hate the gym, go swimming. If group sports remind you of anxious schooldays, take up running. If yoga makes you feel intimidated … Actually, if the thought of doing downward dogs is more anxiety-inducing than reducing, please bear with me. I’m convinced yoga is for everyone and I hope to convince you, too. The point is, there’s something out there for all of us, so keep looking until you find it. Here are a few ideas to get you started.
The wonders of walking
Walking is such a simple everyday thing that it’s hard to imagine it could have any impact when you’re feeling seriously anxious. But actually, it’s one of the best things you can do. Going for a stroll can take you away from whatever is triggering your anxiety. It provides a distraction so that, instead of stewing in worries, you’re up, about, moving and doing something positive for yourself. If you’ve been tense, walking relaxes your muscles and helps you to loosen up.
According to the NHS, doing 10,000 steps a day makes you officially an ‘active’ person. Tracking the number of steps you take in a day has the effect of ‘gamifying’ walking and is really motivating. Many of us have pedometers built into our phones, so why not use yours and challenge yourself to reach a steps goal? Fitbits and other wearable tech are also great options for making any activity more fun. Matt advises that, as with all exercise, ‘The key is to start small and build from there. Try a walk around the block. Make your walking goal small enough to simply get started and see whether you can go a bit further each time.’
Run (like the wind!)
Aerobic exercise such as running can help you use up any excessive adrenaline from stressing. It can also trigger a dose of those aforementioned endorphins. But in order to get the endorphin hit it’s necessary to push yourself a bit – just enough so that your body produces the pain-relieving chemicals but not so much that you’re stressing yourself out!
I spoke to Leah, a personal stylist aged thirty-four, who told me, ‘I took up running to change my lifestyle and manage anxiety. It’s helped me to eat better and drink less alcohol and means I now take better care of myself because I have to be fit to run. I ended up joining a running club and have now run a couple of marathons! Running helps me cope and takes my mind off things. I just feel better when I run. An unexpected benefit was meeting so many people and making new friends from all walks of life who have similar problems and symptoms. Being able to share things with people who can relate to my situation has really helped.’
Say yes to yoga
From the outside, yoga can seem pretty intimidating. Yogis of Instagram make it look so easy, gracefully swooping from pose to pose, whereas we imagine ourselves looking like drunken Twister players. But trust me when I say, everyone starts somewhere. I often hear people say, ‘I can’t do yoga; I’m too inflexible,’ or ‘I can’t touch my toes, it’s not for me!’ You do not need to be slim, flexible or kitted out in the latest Lululemon garb to do yoga!
I’ll always remember the sense of relief I felt when a teacher told me, ‘Yoga is a breathing exercise. That’s it.’ When I remind myself of this I remember why I’m doing it. It’s not to get slimmer thighs but to bring my mind into balance. Any booty-toning side effects are a fringe benefit. Remember that you’re doing it for you, not to compete with anyone else. I like to position myself at the front of the class so I’m free from any distractions about what other people are doing and can focus purely on my own practice. And if you’re sceptical or anxious about trying yoga, it really is worth getting past those feelings because, though there hasn’t yet been enough research to conclusively prove that yoga combats anxiety, there is promising evidence that it does.10
My client Natasha uses yoga to manage her anxiety. ‘Yoga helps me figure out what’s bothering me. I don’t do it to become good at it – I will not be doing headstands or anything like that! It’s just a quiet space where I can focus on myself.’
Acclaimed yoga teacher Nadia Narain, who counts Kate Moss and Jules Oliver among her clients, told me, ‘Yoga helps lessen anxiety by bringing you into your body and connecting you to your breath. One of the major things with anxiety is that you are disconnected from yourself and feel out of control. But with yoga, you learn to connect to yourself. Your breath brings you into the present moment, instead of your mind reeling.’
There are so many styles of yoga that you’re bound to find one that suits your vibe. From hot to hatha, Ashtanga to restorative, yin to vinyasa, there’s something for everyone. But don’t let this abundance paralyse you – just find a local class that’s easy for you to get to, and go. The most important thing, as with every form of exercise, is to start small and treat it as something fun. If you don’t get on with one class, try another.
Time to team up
Playing a sport with others can be a great exercise option, particularly if you need help to overcome social anxiety. The focus on the activity helps to distract your attention away from yourself and your worries, and it’s a great way to interact with people and build your social confidence. My client Stephanie plays basketball and finds it really alleviates her anxiety. ‘I admit I had to force myself to go at first – it was painful! But as I keep pushing myself out of my comfort zone I become more comfortable each week. I have to remember to be kind to myself in those moments when I do feel awkward and to feel proud of myself that I’m doing something scary but really positive for myself.’
Exercise: making time to move
Brainstorm some ideas of types of exercise you’d like to try. Maybe something you used to love as a child? Or something new that’s been intriguing you? Can you enlist a friend to exercise with you? Then set yourself a small goal: it might be to have a trial session at the gym with the aim of building up to run 10k, or booking a beginners’ yoga class. Schedule something into your diary now and make it official. Also think about how you can walk more. Can you incorporate some walking into your journey to or from work? Could you have a walk at lunchtime? What about at weekends? Again, schedule it in your diary.
Summary
★ Exercise is one of the best things you can do to manage anxiety; it lowers stress hormones, helps your brain to recover from over-worrying, produces mood-boosting endorphins and quietens mental chatter.
★ Treat exercise as an aspect of self-care, not as another thing on your to-do list. Find something you love to do.
★ Start slowly and build up. Remember, everyone has to start somewhere.
★ For best results, exercise outdoors and/or with a friend.