NEW YORK, Feb 23, (RTRS): Does heart disease or another chronic illness have you anxiety-ridden? Starting an exercise program may help calm your nerves, according to a review of published studies.
The authors of the review say they found “solid evidence” that exercise can curb anxiety in patients dealing with a chronic illness, such as heart and circulatory problems, fibromyalgia, arthritis and other pain conditions, mental health problems, cancer, as well as the breathing disorder COPD.
Anxiety is common among people who are dealing with a chronic illness, yet it often goes unrecognized or untreated by doctors who may view it as an “unimportant response to a chronic illness,” Matthew P. Herring and colleagues from the University of Georgia in Athens note in the Archives of Internal Medicine. Yet, anxiety can have a negative impact on treatment, in part because anxious patients may be less apt to stick to their prescribed treatment regimen, they point out.
Anti-anxiety drugs can ease anxiety, but exercise is a good option for those who want a non-drug approach, Herring and colleagues found.
They searched the medical literature for relevant studies that tested the effects of exercise (versus no exercise) in sedentary adults with a chronic illness. The people included in the 40 selected studies were 50 years old on average, and 59 percent were women. Those assigned to exercise worked out three times per week for an average of 16 weeks, for an average of 42 minutes per session.
The types of exercises performed varied considerably, but that didn’t matter. Exercise reduced anxiety symptoms by approximately 20 percent, compared with no exercise.
“Even though the majority of these patient groups did not have extremely elevated anxiety symptom scores at the beginning of exercise training, anxiety symptoms were still reduced,” Herring noted in an email to Reuters Health.
Multiple sclerosis was the only illness for which exercise seemed to do little to curb anxiety.
The benefits of exercise on anxiety were similar whether or not the exercise regimen met recommendations for moderate or vigorous physical activity.
Exercise programs lasting between 3 and 12 weeks resulted in larger anxiety symptom reductions than programs longer than 12 weeks, while exercise sessions greater than 30 minutes elicited larger anxiety reductions compared to sessions less than 30 minutes. According to Herring, patients were more likely to stick with shorter duration exercise programs “which might account for larger anxiety reductions compared to longer program durations.” To put it another way, he said, “better participation rates likely will result in greater anxiety reductions.”
Although the role of exercise in alleviating depression symptoms has been well studied, the impact of exercise training on anxiety symptoms has received comparatively little attention, Herring told Reuters Health.
“The findings of our review add to the growing body of evidence that physical activities such as walking or weight lifting may be low-cost, effective treatments to help alleviate anxiety symptoms among patients.”
Exercise “may be especially useful” for patients with chronic illnesses who prefer non-drug approaches to dealing with anxiety, Herring and colleagues note in their report.
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Pregnancy: For pregnant women with depression, a couple months of acupuncture might help reduce the severity of their symptoms, a small study hints.
The study, which followed 150 pregnant women with major depression, tested “depression-specific” acupuncture against massage and acupuncture sessions that, according to traditional Chinese medicine, does not specifically target depression.
Researchers found that after eight weeks, women who received depression-specific acupuncture were more likely to have a treatment response — meaning the severity of their symptoms fell by at least half and they no longer met all of the criteria for diagnosing major depression.
Overall, 63 percent responded to the therapy, versus 37 percent of the “control” acupuncture group and half of the massage group, according to findings published in the medical journal Obstetrics & Gynecology.
But while the findings are promising, questions still remain — including whether acupuncture as practiced in the real world can reliably help women with depression.
“The acupuncture protocol we have tested appears effective,” lead researcher Dr Rachel Manber, of Stanford University in California, told Reuters Health in an email.
“However,” she added, “unlike a pill, which always has the same ingredients, acupuncture, like psychotherapy, varies from one provider to the other.”
So while the specific regimen used in this study appeared effective, Manber said, “I do not think we can say that our study proves that acupuncture is effective for depression during pregnancy.”
It’s estimated that 3 to 5 percent of pregnant women are diagnosed with depression, Manber and her colleagues note in their report. Antidepressant medications are one treatment option, but there are safety concerns.
One recent study, for example, found that pregnant women who started taking selective serotonin reuptake inhibitors (SSRIs) in the second or third trimester had a higher risk of preterm delivery than other women. SSRIs include drugs like sertraline (Zoloft), paroxetine (Paxil) and fluoxetine (Prozac).
Because of the potential for harm from medications, many pregnant women with depression may prefer psychotherapy or other non-drug options.
Acupuncture has been used for more than 2,000 years in Chinese medicine to treat a wide variety of ailments. According to traditional medicine, specific acupuncture points on the skin are connected to internal pathways that conduct energy, or qi (“chee”), and stimulating these points with a fine needle promotes the healthy flow of qi.
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Migraine: Women who suffer from migraine headaches appear to be at much higher risk of developing multiple sclerosis (MS) than women in the general population, according to research released in advance of the American Academy of Neurology Annual Meeting to be held in Toronto in April.
However, it remains unclear whether migraine is a risk factor for developing MS or if it is a condition that occurs at the same time as MS.
Moreover, in an email to Reuters Health, study investigator Dr Ilya Kister emphasized that “over 99% of migraineurs will not develop MS, since MS is a rare disease, while migraines are quite common; about one in 5 women in the US will have a migraine over the course of a year.”
The study involved over 116,000 women who were part of the Nurses’ Health Study II (NHS-II). At enrollment in 1989, about 18,000 women in the NHS-II had been diagnosed with migraine. During 16 years of follow up, 375 women in the study developed MS, including 82 in the group with physician-diagnosed migraine at the outset.
The study found that women with physician-diagnosed migraine at the beginning of the study were 47 percent more likely to develop MS than women without a diagnosis of migraine.
There are a number of reasons why migraine might be more common in people with MS. “One explanation is that migraine can, in some cases, be viewed as a symptom of MS,” said Kister who is with New York University School of Medicine. “Alternatively, higher frequency of migraine could be due to an intermediate variable, such as depression, as both migraine and MS are associated with higher rates of depression, or to an MS medication, (particularly interferons), which may have migraine as a side effect.”
However, it’s also possible that migraine is one of the factors that predispose a person to develop MS, the researcher added.
What causes MS is unknown, but research has revealed a number of possible genetic and environmental risk factors. “Our work suggests that migraine may be another risk factor for multiple sclerosis,” Kister told Reuters Health.
The researcher would like to see closer study of the relationship between migraine and MS. One outstanding question is whether migraine affects the course of MS, Kister said.
In the meantime, because migraine is common in MS patients, often disabling, overlooked and yet potentially treatable, Kister suggests that doctors elicit a “headache history” from all MS patients.


Modern research has most often focused on the effects of acupuncture on painful conditions, like chronic back pain and migraines. Researchers speculate that it may help ease pain by altering signals among nerve cells or affecting the release of various chemicals of the central nervous system.
It is unclear, Manber said, why acupuncture might help lessen the severity of depression.
For their study, she and her colleagues randomly assigned 52 women to receive depression-specific acupuncture twice a week for four weeks, then weekly for another four weeks. Another 49 women received control acupuncture and 49 received massage. All completed a standard measure of depression severity at the outset and again after four and eight weeks of treatment.
After eight weeks, patients in the depression-specific acupuncture group had a higher rate of response to treatment. They were not, however, more likely to see a complete remission in their depression; about 35 percent had a remission, versus 29.5 percent in the other two groups combined — a statistically insignificant difference.
Fourteen women who received depression-specific acupuncture reported pain during the needling, as did seven in the control-acupuncture group.
Overall, Manber’s team notes, the response to acupuncture in this study was comparable to what has been seen in studies of psychotherapy for depression during pregnancy.