Ask the Pharmacist

Q) I have really struggled controlling my level of anxiety. I’m taking medication, talking to a therapist but I still don’t really like how I feel. Is there anything you can suggest?

A) Suffering with an anxiety disorder can be extremely disempowering leaving those affected to feel helpless against the onslaught of their thoughts and worries.

It is no great secret that COVID is not the only epidemic we are currently facing as the social isolation, fear of poor health, forced changes in schooling and employment all combine to wreak havoc upon many of us. It is very likely that you are someone you know struggles with this disorder.

In the States one in five people over the age of 18 is dealing with anxiety and the numbers get truly scary when we look at our teenagers. It has been reported that one in three between the ages of 13 to 18 have a chronic anxiety disorder and that a massive 63% of freshman students at post secondary institutions felt tremendous anxiety. These numbers are from 2019 so it is likely that they have only gotten worse in the interim.

The cost of anxiety is exorbitant. There are the immediate costs that are easy enough to spot (loss of social interactions, insomnia, performance issues at work/ school…) but there are also the long-term implications. Having an anxiety diagnosis puts people at risk for other psychiatric disorders such as depression as well as diseases that impact other areas of the body such as diabetes and cardiovascular problems.

One cannot help but be extremely sympathetic to the plight of the individuals who are dealing with this disorder but there is a silver lining that comes with this diagnosis. An affected individual is not just a passenger in this disorder, they can, and in fact must, play a crucial role in their return to good mental health above and beyond just taking their medications and meeting with their health care team.

Making sure you eat right, sleep long enough and avoid triggers that flare up your symptoms (social media seems to be a major culprit here) can all have powerful impacts in your ability to manage your level of anxiety and a new study just released reinforces the very powerful effect that exercise can have. The study was conducted in Sweden and looked at over 200,000 cross-country skiers who participated in races between 1989 and 2010.

Researchers looked at data from the Swedish national registry of patients to compare the incidence of clinical anxiety disorder to a matching group of patients in terms of age and sex but were relatively inactive. The results showed that the skiers were diagnosed with anxiety less than half as often as the inactive control group was. Does this mean we should all take up cross-country skiing? Not really.

There is an abundance of scientific evidence showing that any type of aerobic exercise elevates our moods which in turn helps us to feel calmer, more resilient, happier and less apt to feel sad, nervous or angry. Exercise in fact is not just great at preventing and treating anxiety but there is also strong evidence of its positive effects when it comes to dealing with depression, even in those who suffer from a severe form of it. There is a biochemical explanation for all of this and not just a coincidence. Getting your heart rate up changes your brain chemistry in a multitude of ways. It increases the availability of important emotion controlling neurochemicals such as serotonin (the neurotransmitter that most pharmaceutical drugs target), gamma aminobutyric acid (GABA), endocannabinoids (naturally occurring chemicals that cause effects in the body similar to the positive ones induced by cannabis with respect to pain, sleep…) and brain derived neurotrophic factor.

Exercise has also been proven to activate the frontal regions of the brain which are responsible for executive thinking (higher level cognitive skills that include flexible thinking, working memory, self-control…) and controlling the amygdala, our system that reacts to threats, be they real or imagined. Beyond this, exercise decreases body tension which lowers its contribution to feeling anxious.

Lastly, exercise simply helps to divert your attention from the stressors that can dominating your mind. The case for the positive effects of exercise upon anxiety is irrefutable which makes it sadly ironic that people with anxiety tend to live more sedentary lifestyles. There’s an inertia to getting started with a program that can be awfully hard to overcome when one is already feeling overwhelmed but it’s a fight that should absolutely be undertaken. There is quite possibly no better way to overcome this disorder than putting on your sweats and getting out and being active. For more information about this or any other health related questions, contact your pharmacist.