The Best Exercise for Health Anxiety: Bikram Yoga.

I’m sure we can all agree that exercise is good for you. 💚

According to Mayo Clinic, regular physical activity helps control weight, combat heart disease and other health conditions, improve mood, boost energy, promote sleep and more.

The problem with anxiety and exercise is that many of the physical sensations associated with rigorous exercise closely resemble physical symptoms of health anxiety.

 For someone challenged by health anxiety, the sensations of physical exercise (like a rapid heartbeat) can cause them to fear the worst, like an imminent heart attack.

For someone challenged by health anxiety, the sensations of physical exercise (like a rapid heartbeat) can cause them to fear the worst, like an imminent heart attack.

When physical symptoms (like rapid heart rate and respiration, muscle tension and sweating) arise in the absence of rigorous exercise, someone challenged by health anxiety can misinterpret them as signs they may have an undiagnosed physical illness, an imminent heart attack or some other health crisis - even though they’re the body’s normal physiological response to anxiety.

To be “safe,” they reduce the frequency and intensity of exercise.

In their minds:

Exercise → Rapid heart rate and respiration, muscle tension and sweating → Healthy, but unsafe. 🤔

Ironic, eh?

A 2009 study agreed, revealing an inverse relationship between exercise frequency and sensitivity to anxiety.

In other words, the more severe one’s anxiety, the less exercise they get in a misguided attempt to avoid the physiological sensations of exercise - which may be interpreted as those of anxiety, panic, and in the case of someone with health anxiety, a serious medical condition. 

The paradoxical relationship between anxiety and exercise feeds the anxiety, increases the severity of physical symptoms - and in time has the potential to reduce the subject’s overall physical health. 📉

Exercise helps reduce anxiety

People who are more physically active have lower rates of anxiety than those who live a more sedentary lifestyle, as evidenced by numerous scientific studies. One study revealed that people who practiced regular exercise were 25% less likely over the next five years to develop an anxiety disorder or even depression.

This evidence suggests that exercise may help people better manage and respond to negative and stressful thoughts or situations.

Exercise boosts endorphins

The release of endorphins during physical exercise is a well-documented process whose purpose has been been suggested to be to support maintenance of a regular exercise routine.

Endorphins are feel-good chemical neurotransmitters in the brain that reduce pain, improve sleep, improve mood and reduce stress.

Exercise boosts serotonin and reduces cortisol activity

Serotonin helps improve mood and a sense of calm and well-being. 😌

Cortisol (“the stress hormone”) inhibits bodily functions not required to deal with a threat to survival - such as digestion, growth, immunity and reproductive (sex) drive.

Now you might be thinking “wait a minute, doesn’t exercise cause stress? Shouldn’t it increase cortisol, and reduce serotonin?”

If all stress were created equal, the answer would be “yes,” but it’s not. 

Here’s why:

Stress induced by exercise (“good stress”) is different than stress from negative thoughts and life experiences (“bad stress”) in that it’s associated with greater availability of serotonin in the brain and lower cortisol activity throughout the body.

Exercise improves your stress response

Aside from reducing physical tension held throughout the body, regular physical exercise can:

Dr. J. Kip Matthews, Ph.D, a sport and exercise psychologist, explains:

"What appears to be happening is that exercise affords the body an opportunity to practice responding to stress, streamlining the communication between the systems involved in the stress response," says Matthews. "The less active we become, the more challenged we are in dealing with stress."

Exercise promotes self-efficacy

Self-efficacy is one’s belief in their abilities.

In the case of health anxiety, low self-efficacy manifests as distrust in one’s ability to manage threats - leading to negative thoughts and anxious “safety” behaviours like avoidance of stressful situations, including exercise.

Studies have suggested that regular, moderate exercise boosts self-efficacy by a steady stream of self-mastery experiences - that is, successfully overcoming the physical sensations of exercise - reducing anxiety in time.

Exercise shifts focus from negative thought to positive action

Everyone wants good health. Thing is, the actions of good health come first; the feelings of good health come second. ✌🏼

In other words, waiting to feel healthy before beginning to act healthy gets you nowhere, fast.

Exercise can help shift your mindset from worrying about your health to taking care of your health, and provides the mind and body ample rewards for your decision to prioritize positive action over negative thought.

The best exercise for health anxiety

The worst exercise for health anxiety is no exercise at all. Any regular exercise routine (even walking!) is an essential part of a holistic health anxiety recovery plan. 🚶🏻‍♂️

Of the many options available to you, though, one type of exercise stands above them all when it comes to overcoming health anxiety: Bikram Yoga. 🧘🏻‍♂️🧘🏻‍♀️

What is Bikram Yoga?

Bikram Yoga (the original hot yoga) is a specific sequence of 26 postures and two breathing exercises practiced in a heated room and taught by a Bikram-certified instructor. 

Each posture and breathing exercise is performed twice over the course of a 90-minute class. Shorter (usually, 60 or 75-minute) variants exist, but don’t offer the optimal benefits a 90-minute class provides.

Bikram Yoga’s Standing Bow (Dandayamana-Dhanurasana) posture builds patience, determination and concentration in addition to the healing benefits of flushing oxygenated blood from one side of the body to the other.

How Bikram Yoga reduces health anxiety

On top of the many benefits of exercise in general, Bikram Yoga:

Bikram Yoga is a moderate-intensity, low impact workout almost anyone can do.

Students of all ages and abilities, practice as individuals together in one room, sharing their positive energy with one another.

Every posture has multiple stages, from beginner to expert, that provide complete benefits to students of all levels. Postures can also be modified to accommodate chronic or acute injuries, if needed.

During my 60-day health anxiety recovery (and ever since), Bikram Yoga struck the perfect balance of physical intensity (to get the heart pumping, exposing me to the uncomfortable sensations I once feared) and mind-body relaxation (promoting restoration, healing and calm). 💓

Bikram Yoga promotes physical health of every organ and system in the body.

Bikram Yoga’s unique sequence is specifically designed to oxygenate and promote healing throughout 100% of the body, including:

  • The heart, lungs and blood vessels.

  • The musculoskeletal system, including the spine and every joint.

  • The kidneys, liver, gallbladder, pancreas and spleen.

  • The reproductive system.

  • The thyroid and parathyroid glands.

  • The digestive system including the stomach, intestines and colon.

  • The lymphatic system, and more.

In other words, Bikram Yoga is really good for you. 💚

Many Bikram Yoga teachers, as they provide their verbal instructions, often include each posture’s respective physical health benefits, which is especially motivating to someone challenged by health anxiety. 😀

Bikram Yoga improves mental health.

I’ve completed over 200 Bikram Yoga classes, and with each practice, I’ve developed greater: 

  • Focus

  • Concentration

  • Patience

  • Mindfulness

  • Calm

  • Flexibility

Dr. Alex Korb Ph.D. sums up why in Psychology Today:

“The stress response in the nervous system is triggered reflexively by discomfort and disorientation. The twisting of your spine, the lactic acid building up in your straining muscles, the uneasy feeling of being upside down, the inability to breathe, are all different forms of discomfort and disorientation, and tend to lead reflexively to anxious thinking and activation of the stress response in the entire nervous system. However, just because this response is automatic, does not mean it is necessary.  It is, in fact, just a habit of the brain.  One of the main purposes of yoga is to retrain this habit so that your brain stops automatically invoking the stress response.”

In her article This is Your Brain on Yoga in Psychology Today, Rachael Grazioplene agrees, saying:

The real point [of yoga] is to gain mindful control over your body and emotions. It encourages you to work with yourself patiently, swallow your pride, do the best you can at that moment without overextending.”

The same article opened my eyes to scientific evidence supporting my anti-anxiety yoga experience, citing a study revealing that GABA (or gamma-aminobutyric acid) concentrations are significantly higher in the brains of those who practice yoga. This study also compared GABA levels in students directly before an after an hour of yoga practice, resulting in a 27% increase! 

Bring it on, because GABA is an important neurotransmitter that blocks impulses between nerve cells in the brain, boosting mood and having a calming effect on the nervous system… the same effect traditional anti-anxiety medications (including benzodiazepines) are designed to mimic.

Further supporting what yoga practitioners worldwide already know (and medical professionals are just beginning to realize), is another study that resulted in decreased cortisol, tumour and inflammation markers alongside elevated levels of β-endorphins just 10-days after adding yoga to subjects’ lifestyles.

Yoga versus medication? Talk about a no-brainer! 🧠

It’s no wonder yoga is being prescribed as treatment for numerous physical and mental medical conditions by health practitioners. 

Dr. Ina Stephens, University of Virginia Associate Professor of Medical Education, concludes:

“The practice of yoga is not as easy or as quick as taking medication, but mounting evidence suggests it is worth the effort and investment. Yoga helps one to reconnect with oneself. It can help to uncover why and how one’s illness may have started, and can work with the body to start the recovery period from the ground up. The practice can help one to see how they may be reacting to the world around them, and may help them learn to respond from a different perspective. Slowing down, quieting our minds and connecting with our inner selves all help to bring one into the present moment. This can ultimately help to relieve one from the pressures and stressors from the hustle and bustle of this very busy world.”

Bikram Yoga super-charges self-efficacy.

The consistent sequence of 26 postures and two breathing exercises unique to Bikram Yoga makes it easy to recognize progress in the mental and physical practice, while the standard 90-minute class provides students the ability to learn and adapt their approach through two sets of every posture, accelerating achievement of self-mastery and crushing anxiety like no other exercise routine I’ve experienced. 🎯

Another efficacy-boosting factor unique to Bikram Yoga is that, unlike many other types of yoga, the instructor doesn’t practice along with the class. (S)he provides only verbal instructions, and is otherwise 100% focused on students, recognizing them for progress offering and suggestions on how to correct their postures and improve their practice. 📈

Now, apply.

📖 In your journal, reflect on your current level of physical activity. How often do you exercise, and for how long? What variety of physical activities do you typically engage in, and what are your feelings about those activities?

😕 Do you experience anxiety over the physical sensations of exercise? If so, how has anxiety affected the consistency, frequency or intensity of your exercise routine?

🔎 Find a 90-minute Bikram Yoga class in your area and sign up! Read these important tips on how to prepare for your first class. If you’re located in the Greater Vancouver Area, come practice with me at Yoga 360. Pro tip: Email me to let me know you’re coming (if I have a guest pass available, it’s yours)!

👩🏼‍⚕️ If you have concerns about your body’s ability to tolerate any new exercise routine, talk to your doctor first.

✏️ Take this 1-minute health anxiety (hypochondria) quiz to measure your progress and reveal your next steps to overcoming health anxiety.

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