A new study indicates that brief, intense intermittent exercise may be a more effective strategy for treating panic disorder than traditional relaxation therapy.
Panic disorder, which affects 2% to 3% of the population, is currently managed with cognitive behavioral therapy (CBT), often combined with antidepressants. A CBT technique known as 'interoceptive exposure' involves triggering panic attack symptoms in a safe environment to build patient tolerance.
Study Details
Historically, interoceptive exposure has used office-based exercises like voluntary hyperventilation. Researchers compared this approach with a less artificial method: brief intermittent intense exercise. The findings were published in Frontiers in Psychiatry.
Dr. Ricardo William Muotri, a postdoctoral fellow at the Anxiety Disorders Program, University of São Paulo Medical School, Brazil, stated, "Here we show that a 12-week program of brief intense intermittent exercise can be used as an interoceptive exposure strategy to treat panic disorder patients."
In a randomized controlled trial, Muotri and colleagues involved 102 adult men and women diagnosed with panic disorder over 12 weeks. Participants were divided into two groups, each completing three sessions per week without medication:
- Experimental Group: Began with muscle stretching, followed by 15 minutes of walking, then one to six 30-second bouts of high-intensity running alternating with 4.5 minutes of active recovery, concluding with an additional 15 minutes of walking.
- Control Group: Performed segmental muscle contraction exercises in various body regions, followed by localized muscle relaxation.
Biometric monitoring devices were used for all participants during the exercises.
Outcomes
The primary outcome measured was the change in a patient's score on the Panic and Agoraphobia Scale (PAS) over 24 weeks. Secondary outcomes included changes in anxiety and depression questionnaire scores, and self-reported frequency and severity of panic attacks.
A psychiatrist, blinded to treatment allocation, assessed these outcomes.
Results and Conclusion
Both groups showed a decrease in average PAS scores, as well as anxiety and depression scores over time. However, these decreases were more pronounced in the brief intense intermittent exercise group.
Similarly, the frequency and severity of panic attacks reduced more significantly in the exercise group.
The authors concluded that brief, intense intermittent exercise serves as a more effective method for interoceptive exposure than relaxation therapy in treating panic disorder, with positive effects sustained for at least 24 weeks. Patients also reported greater enjoyment of the exercise method, which may contribute to higher treatment engagement and compliance.
Muotri summarized, "Healthcare professionals can adopt brief intermittent intense exercise as a natural and low-cost interoceptive exposure strategy. It doesn't need to take place in a clinical setting, so that exposure to the symptoms of a panic attack is brought closer to the patient's daily life. It could also be integrated into care models for anxiety and depression disorders."