By using this site you agree to our terms and conditions. The Open Forest website is medical in nature and thus, may include health or medical information. This content is posted for informational and educational purposes only. Open Forest in no way engages in the practice of medicine and does not render medical advice. We do not provide asynchronous telemental health services or any other medical service. Nothing posted on Open Forest is intended to be used for the purposes of medical diagnosis or treatment. The use of Open Forest does not create a provider/patient relationship between a user and Open Forest. Users must always seek the advice of their physician or another qualified healthcare professional with medical questions. Users must agree to contact their healthcare professional or an emergency medical service, by dialing 911 when they believe they are experiencing a medical emergency.
By Joan Swart
Intentionally tensing or contracting as many muscles as possible is proposed as a hack to counter an impending panic attack or intense anxiety episode, or, at least, relieve the distress, according to anxiety treatment guru, Barry McDonagh. But, let's see how science shapes up to support the idea that muscle activation stops panic attacks or provides rapid relief!
In the context of a developing panic attack, voluntary muscle contractions function in two helpful ways that have been proven by scientific evidence, namely the physiology of muscular activation and the mindfulness effect. When stimulated by a specific nerve impulse, in this case, triggered by a mental prompt, the two major protein filaments of a muscle, a thick filament composed of the myosin and a thin filament consisting of actin, react to generate force. The applied energy usually results in concentric or eccentric contraction when muscles tenses and shortens (e.g. lifting a weight) or lengthens (e.g. lowering a weight), respectively.
There is a third type of contraction, which is relevant to this hack. An isometric contraction occurs when a muscle tenses but does not change length, meaning that there is no visible movement in such an exertion of static strength. Examples are pushing against a wall, the poses of a bodybuilder, and holding a weight in place. Isometric exercises have both a short-term and longer-term effect. Research found that repeating isometric muscle contractions over time increases the overall strength of the muscle and delay the onset of fatigue.[i] Another study also demonstrated that a single daily six-second exercise bout using two-third of maximum tension on the wrists and arms of post-pubescent boys increased their strength significantly over a four-week period.[ii] Therefore, in a much shorter amount of time than concentric or eccentric movements, static muscular contractions produce positive results, even in a just few seconds each day. Moreover, in this context, these benefits are not limited to physical strength only.
Isometric training and progressive muscle relaxation are two proven methods to counter anxiety[/caption]
There is also a link between exercise, including static muscle activities, and the release of neurotransmitters such as cortisol, dopamine, and serotonin, and other natural biochemicals, in particular, endorphins.
Repetitive muscle contractions work to activate the hypothalamus-pituitary glands that release beta-endorphin into the brain.[iii] Beta-endorphin is a neuron found in the central and peripheral nervous system and is used as a natural analgesic in the body to numb or dull pain. With approximately 20 times the analgesic effect of morphine, β-Endorphin is incredibly potent, and its release in response to exercise has been studied for decades. The resulting sensation during physical strain is often colloquially referred to as a runner’s high. As such, the secretion of endorphins is associated with improved mood states (e.g. reduces depression and anxiety) that are comparable to taking antidepressant medications.[iv]
The body’s endocrine system plays a critical role in adjustment to exercise, of which cortisol secretion is the first notable effect in the context of attempting to thwart a developing panic attack or anxiety by using muscle contractions.[v] Exercise, including short-duration muscle contractions, causes an immediate increase in cortisol, the natural hormone that is released when the human body is under stress. The three primary functions of cortisol are the reduction of protein synthesis, the facilitation of protein to glucose, and the halting of tissue growth. This means that cortisol regulates the body’s fuel sources such as blood sugar in times of stress to ensure that fuel remains available, as well as controlling inflammatory responses to prevent the body from over-reacting to a perceived danger.
Dopamine, a feel-good hormone associated with feelings of euphoria and the anticipation of a reward, is generated in the brain during anaerobic exercise as part of the “monoamine hypothesis,” which also includes serotonin and endorphin production. According to the monoamine hypothesis of depression, the deficit of these neurotransmitters is responsible for the corresponding features of depression, which includes symptoms of anxiety, attention and memory problems, obsessions, compulsions, and a lack of motivation, pleasure, and interest in life.
Although longer-duration cardio exercises, such as running, walking, and swimming, are best known for the increase in serotonin and dopamine levels, science has shown that any regular muscle activity has a similar effect.[vi] Even more important in the sense of the stress response or fight-or-flight mechanics is the fact that these chemicals, especially dopamine, appear to counter epinephrine (i.e. adrenaline) and norepinephrine (i.e. noradrenaline) patterns. At the slightest notion of a threat, physical or otherwise, adrenaline is automatically secreted and sets the stress reaction in motion, instinctively and immediately preparing the body for action. A panic attack and exaggerated startle reaction fall in this category but are most often an inappropriate and unhelpful response to a situation that may be overestimated or require a more thoughtful response.
Therefore, by neutralizing adrenaline levels, serotonin and dopamine generate a calming effect that does not require a rushed, ill-considered response. With a clearer mind, a person is able to consider more options and make better decisions. Also, by interrupting the adrenaline reaction that can become chronic and hyperactive with repetition over time, the stress response functions better when needed, and many long-term consequences of negative stress are reduced or prevented.
The final, but not less remarkable, effect that voluntary muscle contractions have when one become aware of a developing panic attack is an instantaneous kindling of mindfulness. Being mindful is an attitude that has been described as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally,”[vii] or “bringing one’s complete attention to the present experience on a moment-to-moment basis.”[viii] In everyday terms, mindfulness means to accept one’s situation and abilities and the distress that it may cause, without judging ourselves and others or acting impulsively to force an outcome.
The first step in developing and practicing mindfulness is to connect with all the experiences and sensation of the present moment—how our body feels, what we are thinking and feeling, and the colors, aromas, textures, and sounds around us at this instant. There is no place for auto-pilot responses and unreasonable assumptions. Meditating in a quiet spot is a typical method to train mindfulness skills, but quick and straightforward everyday activities can also be used to quieten the mind, such as walking in nature, drinking a cup of tea, or washing the dishes.
Scientific study has also proven that exercise can be extremely helpful to increase mindfulness. The muscle contractions proposed to prevent panic and anxiety from gaining the upper hand, involves breathing, visualization, energy-work, and focused intention, which are all elements known to induce a mindful state. Research conducted at the Institute of Sport and Sports Science at the University of Freiburg found that physical activity is linked to increases in dispositional mindfulness, the propensity to be aware of one's actions in everyday life.[ix] Similarly, an experiment done at the University of South Carolina linked physical exercise to mindful components that lead to healthy behavior changes over time such as improved breathing rate and depth, and heart rate.[x] In conclusion, a voluntary and controlled physical activity, including muscle contractions, increase mindfulness, a state that is associated with lower self-judgment, and increased confidence and satisfaction.[xi] Such a timely intervention creates the notion of control over emotions and fears that can otherwise spiral out of control.
For these reasons demonstrated by scientific evidence, physical activity, including the isometric muscle contractions proposed to impede or prevent an imminent panic attack or anxiety episode, are helpful, even effective, to produce the desired effect. This positive outcome is achieved by the release of natural biochemical such as cortisol, dopamine, serotonin, and endorphins that produce a feel-good effect while countering the negative consequences of adrenaline, as well as inducing a mindful state linked to thoughtfulness and confidence. In combination, these processes are potent to work against the extreme distress of a panic attack.
[i] McGlynn, G. H. (1971). A re-evaluation of isometric strength training. British Journal of Sports Medicine, 6(1), 20-21.
[ii] Rarick, G. L., & Larsen, G. L. (1958). Observations on frequency and intensity of isometric muscular effort in developing static muscular strength in post-pubescent males. Research Quarterly for Exercise and Sport, 29(3), 333-341. DOI: 10.1080/10671188.1958.10762026
[iii] Deutsch, J. E., & Anderson, E. Z. (2008). Complementary therapies for physical therapy: A clinical decision-making approach. St. Louis, MO: Saunders. (p. 58).
[iv] Dinas, P. C., Koutedakis, Y., & Flouris, A. D. (2011). Effects of exercise and physical activity on depression. Irish Journal of Medical Science, 180(2), 319-325. DOI: 10.1007/s11845-010-0633-9
[v] Bijlani, R. L., & Manjunatha, S. (2011). Understanding medical physiology (4th ed.). New Delhi, India: Jaypee Brothers Medical Publishers. (p. 643).
[vi] Haff, G. G., & Triplett, N. T. (2016). Essentials of strength training and conditioning (4th ed.). Champaign, IL: Human Kinetics.
[vii] Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness and meditation in everyday life. New York, NY: Hachette Books. (p. 4).
[viii] Marlatt, G. A., & Kristeller, J. L. (1999). Mindfulness and meditation. In W. R. Miller (Ed.), Integrating spirituality into treatment (pp. 67–84). Washington, DC: American Psychological Association. (p. 68).
[ix] Mothes, H., Klaperski, S., Seelig, H., Schmidt, S., & Fuchs, R. (2014). Regular aerobic exercise increases dispositional mindfulness in men: A randomized controlled trial. Mental Health and Physical Therapy, 7(2), 111-119. DOI: 10.1016/j.mhpa.2014.02.003
[x] Kennedy, A. B., & Resnick, P. B. (2015). Mindfulness and physical activity. American Journal of Lifestyle Medicine, 9(3), 3221-3223. DOI: 10.1177/1559827614564546
[xi] Tsafou, K. E., De Ridder, D. T. D., Van Ee, R., & Lacroix, J. P. W. (2015). Mindfulness and satisfaction in physical activity: A cross-sectional study in the Dutch population. Journal of Health Psychology, 21(9), 1817-1827. DOI: 10.1177/1359105314567207