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Being Fit May Lower The Need To Buy Anti-Anxiety Medication

In 2019, an international team of researchers led by Linds Ernstsen of the Norwegian University of Science and Technology published a study that identified a correlation between higher levels of cardiorespiratory fitness (CRF) and lower risk of depression.

For this cross-sectional study, data from 26,615 people who participated in Norway's Nord-Trøndelag Health Study (HUNT) showed that being in good shape was correlated with lower odds of depression depending on someone's level of fitness—indexed as low, medium, or high CRF.

For example, Ernstsen and colleagues found that among those who participated in the HUNT study, people with "medium" levels of cardiorespiratory fitness had 21% lower odds of depression. Those with "high" CRF were 26% less likely to experience depressive symptoms than those with "low" CRF.

This 2019 cross-sectional analysis of HUNT data didn't unearth a link between higher levels of fitness and less anxiety but her team's latest (2023) research suggests that higher CRF is linked to buying fewer anxiolytics (anti-anxiety drugs).

Higher CRF Is Linked to Fewer Anxiolytic and Antidepressant Purchases

A follow-up study (Havnen et al., 2023) led by Ernstsen examines how being in good shape (as indexed by CRF) might affect someone's risk for experiencing anxiety and depression based on prescription purchase rates for anxiolytics such as benzodiazepines and antidepressants such as selective serotonin reuptake inhibitors (SSRIs). The peer-reviewed findings of this linkage study were recently published in the Journal of Affective Disorders.

Based on a linkage comparison between the Norwegian Prescription Database and HUNT participants' cardiorespiratory fitness levels, Ernstsen and coauthors found that, on average, increasing CRF by one metabolic equivalent of task (MET) was associated with a 4% lower rate of filling prescriptions for antidepressant or anxiolytic medication.

On a continuum, MET-measured improvements in cardiorespiratory fitness were associated with purchasing fewer antidepressants and anxiolytics. Based on these findings, Ernstsen and coauthors speculate that increasing CRF may protect against the need for anti-anxiety or antidepressant medications.

"We [found] that people who are in better shape fill fewer prescriptions for anxiety and depression medications. Being in better physical shape appears to reduce the need for anxiolytic drugs and antidepressants," senior author Linda Ernstsen said in an August 2023 news release about her team's latest findings.

Correlation Doesn't Imply Causation

Because correlation does not imply causation, it's important to note that all of the findings from this type of research are correlative. It's impossible to know with 100% certainty if doing cardio and being physically fit reduces depressive symptoms and lowers anxiety or if people who are less depressed and less anxious tend to exercise more and stay fit.

Another limitation of this study is that the researchers based their findings on sales information from the Norwegian Prescription Database and could only establish that someone had purchased anxiolytics or antidepressants. However, they couldn't confirm that someone had taken the prescribed medication. As the authors note, "Only information about medication purchase and not actual use was available."

Physical Fitness May Lower Your Odds of Anxiety and Depression but Isn't a Cure-All

Mountains of evidence-based research show a correlation between regular exercise, improved fitness, and fewer depressive symptoms. Accumulating science-backed evidence also indicates that physical activity helps keep anxiety at bay. Additionally, anecdotal evidence based on people's lived experience suggests that staying active and getting in shape lowers one's risk of getting depressed and reduces chronic stress.

That said, exercise is not a panacea. For many people with clinical depression, major depressive disorder, or crippling generalized anxiety disorder, doing cardio and getting in shape isn't a magic bullet that will eradicate mental health issues. Being fit may lower the odds of getting depressed or experiencing acute anxiety; however, working out shouldn't be viewed as a substitute for taking doctor-prescribed anxiolytics or antidepressants.

Disclaimer: This blog post is not intended as medical advice. If you take any prescription medication, always speak to your prescribing doctor before altering your dosage or going off your meds.

People Who Are In Good Shape Take Fewer Mental-health Related Medication

"We find that people who are in better shape fill fewer prescriptions for anxiety and depression medications," says Linda Ernstsen, the senior author of the article and an associate professor from the Department of Public Health and Nursing at the Norwegian University of Science and Technology (NTNU).

The research group based its work on the  Trøndelag Health Study (HUNT). Since 1984, 250,000 Trøndelag residents have voluntarily contributed their health data to this comprehensive research project. The data are available to researchers, who can use the data to estimate people's fitness levels, among other things.

The figures were taken from the third data collection round, called HUNT3, which was conducted from 2006 to 2008.

The research group compared the data from HUNT3 with data from the Norwegian Prescribed Drug Registry, which provides an overview of medications that have been dispensed in Norway.

Reduces the need for medication

"Being in better physical shape appears to reduce the need for anxiolytic drugs and antidepressants," Ernstsen said.

In a previous study, Ernstsen and her co-authors found that people who were in good physical shape during the second HUNT study had a lower prevalence of depressive symptoms when they were participants in HUNT3 ten years later. However, at the time, the researchers found no correlation between good physical shape and anxiety.

But the new study design, which allows the researchers to look at what kinds of medication HUNT3 participants obtained from pharmacies as late as 2018, allowed the researchers to find the correlation.

However, the study does have a theoretical catch. The researchers can only see what kinds of medication were dispensed to people by pharmacies. They cannot see whether people actually took the medication — there's no way to monitor people at their medicine cabinets.

"Nevertheless, there is reason to believe that people who are prescribed medication have more symptoms than those who do not see a doctor," according to first author Audun Havnen, an associate professor at the Department of Psychology at NTNU.

Greatest effect for men and young people

Being in good physical shape helps all age groups and both genders. However, some people get greater benefits from exercise and being in good physical shape than others.

"We find that men experience a greater effect from exercise than women. The correlations are also less clear for the elderly," Ernstsen says.

But that doesn't mean that it isn't important for women and the elderly to exercise.

What came first?

We can, of course, ask what triggers what. Is it actually the case that good physical health helps prevent anxiety and depression? Or is it the case that people who suffer from anxiety and depression exercise less and are therefore in poorer shape?

In order to not include anyone who was already experiencing anxiety or depression at the start of the study, the researchers excluded anyone who had filled prescriptions for these conditions before participating in HUNT3, as well as for three months afterwards.

"We also adjusted for symptoms of anxiety and depression in statistical analyses. To the extent that the figures can be believed, we also feel fairly confident that we started with a relatively anxiety and depression-free cohort in HUNT3," Ernstsen said.

In other words, the subjects were unlikely to have suffered from anxiety or depression beforehand.

Unfortunately there are no shortcuts for people who can't be bothered to exercise. We simply have to get started — unless we decide to give up. But is there really no other alternative?

"The results indicate that you can achieve a protective effect by improving your physical shape from poor to moderate, so any activity is beneficial,"  Havnen says.

You should be physically active in a way that leaves you breathless and sweaty if you want to improve or maintain your physical condition. The Norwegian health authorities recommend that adults be physically active for at least 150 to 300 minutes at moderate intensity each week.

However, one option for people who are short on time is to aim for 75 minutes of high-intensity training each week or a combination of moderate and high-intensity training.

"Research reinforces the finding that each minute of physical activity counts," Ernstsen said.

Reference: Audun Havnen, Ekaterina Zotcheva, Ottar Bjerkeset, Xuemei Sui, Linda Ernstsen, Cardiorespiratory fitness and incident use of anxiolytics and antidepressants in adults. A linkage study between HUNT and the Norwegian Prescription Database Journal of Affective Disorders, Volume 339, 2023, Pages 111-117, ISSN 0165-0327, https://doi.Org/10.1016/j.Jad.2023.07.029  

Journal

Journal of Affective Disorders

Method of Research

Data/statistical analysis

Subject of Research

Not applicable

Article Title

Cardiorespiratory fitness and incident use of anxiolytics and antidepressants in adults. A linkage study between HUNT and the Norwegian Prescription Database

Article Publication Date

10-Jul-2023

Disclaimer: AAAS and EurekAlert! Are not responsible for the accuracy of news releases posted to EurekAlert! By contributing institutions or for the use of any information through the EurekAlert system.

How To Use CBD For Anxiety: Uses, Dosage And Side Effects

The Food and Drug Administration (FDA) has yet to approve any CBD-based medications for anxiety. However, many studies indicate the substance can be an effective anxiolytic.

CBD for Generalized Anxiety

In 2011, a small trial-tested CBD on participants with generalized social anxiety disorder (SAD) and healthy control patients undergoing a simulated public speaking test (SPST), which is a common anxiety testing method . Compared to a placebo, CBD significantly reduced anxiety and discomfort in the participants with SAD. In fact, their reduced anxiety levels were comparable to those of the control participants.

Eight years later, a 2019 test compared the efficacy of three CBD doses (150 milligrams, 300 milligrams and 600 milligrams) and a placebo in men taking an SPST . Compared to a placebo, 300 milligrams of CBD significantly reduced participants' anxiety during the speech, but the 150-milligram and 600-milligram doses did not. These results highlight how dosage can be highly variable and that more CBD isn't necessarily more effective.

Meanwhile, another 2019 study tested CBD in much lower doses than most other clinical studies—some participants consumed 25 milligrams a day while others consumed 50 milligrams or 75 milligrams a day . Researchers thought higher doses might be too expensive for participants to maintain in their normal lives and that low doses would still prove effective. Indeed, anxiety decreased within the first month for most participants and remained low. Sleep quality also improved, although it fluctuated more than anxiety. Only three patients reported side effects.

CBD for Anxiety and Depression

In 2020, researchers tested the effects of CBD oil at varying doses across 397 patients with a variety of ailments . Participants with non-cancer pain or mental health-related symptoms experienced significant improvement in anxiety and depression, as well as in their abilities to complete their usual activities. The use of CBD oil suggested significant pain relief in these groups as well.

CBD for PTSD and Phobia Therapy

A small 2019 study of 11 patients found that, when consumed orally and administered alongside routine psychiatric care, CBD decreased patients' posttraumatic stress disorder (PTSD) symptom severity .

Other studies suggest CBD can reduce PTSD symptoms when consumed with THC . When taken together, the two compounds create what's known as the "entourage effect," where THC enhances the effects of CBD as CBD tempers the effects of THC, resulting in a more well-rounded experience .

Some studies also suggest CBD can enhance the effects of exposure therapy—which assists patients in dissociating certain cues with a fear response—and cognitive behavioral therapy .

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