No-Pills Anxiety Buster

By Dr. David H. Rosmarin

It is well known that regular exercise has physical health benefits. Running, jogging, and even anaerobic exercise (e.g., lifting weights) are generally good for cardiovascular health and maintaining a healthy body weight. However, the specific effects of exercise on anxiety symptoms are less well known. For this reason, exercise often doesn’t make the list of primary interventions for anxiety symptoms.

This is unfortunate, as some research suggests that adding exercise to behavior therapy or pharmacology for just 12 weeks can have a large (d = 1.69) and lasting effect on reduction of OCD symptoms (Brown et al., 2007, Journal of Nervous & Mental Disease). At the Center for Anxiety, about 90% of our patients are encouraged to engage in 30—45 minutes of cardiovascular exercise, 3—4 times a week. The only two instances when we don’t recommend exercise are if it’s medically dangerous or if we believe that the patient won’t comply. Here are three reasons why exercise can benefit the vast majority of people:

Physiological effects. Long workouts of moderate intensity stimulate the release of endorphins into the bloodstream by the pituitary gland and hypothalamus. These magical chemicals produce euphoria and they numb pain, and can thereby reduce anxiety as well. After all, there is less to be anxious about when you’re feeling happy.

Behavioral effects. Exercise helps regulate one’s day-to-day routine by increasing the mental energy needed to stick to one’s schedule. It can also create physical fatigue, which is essential to the regulation of sleep. This in turn results in less indecision, greater productivity, and less worry.

Psychological effects. Almost no one likes the first five or ten minutes of their exercise routine. Muscles are sore, breathing is labored, and the cardiovascular system is screaming, “I would prefer to be on the couch!” However, after just 30—45 minutes, many people not only feel better but report a desire to keep going. Engaging in exercise thus reinforces the core message of exposure therapy: if you stand up to negative emotions, they go away.

Try it for a month–30 to 45 minutes of breaking a sweat, 3 or 4 times a week–and you’ll never turn back. v

David H. Rosmarin, Ph.D., is an instructor in the Department of Psychiatry at Harvard Medical School and Director of the Center for Anxiety in Manhattan, a clinical-research facility with a focus on the Jewish community. He can be reached at

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