Exercise, Anxiety and Beta Blockers

I've suffered from anxiety for quite a while now.  It's really unpleasant - aside form the emotional effects, he physical effects of feeling anxious can be completely overwhelming.  My heart races or feels irregular, my breathing becomes shallow and rapid, I fidget and feel like running away or hiding or crying.  I have had counselling and learnt a few mindfulness tricks to help manage it and get it under control and they certainly help.  Remembering that "this too shall pass" also really helps, as anxiety can feed itself.  For me, that leads to migraines and nausea.

If I go for a run before I get a headache, then my body deal with the hormones associated with anxiety in the way the body is designed to - after all, the feeling is the fig or flight response.  Unfortunately, during the day I cannot just get up and go for a run … I have a job to do and I'm pretty sure they'd not be happy with me popping on a pair of trainers and disappearing for an hour or so.

So a month or so ago I went to the doctors to talk about it.  I felt that I needed something that would enable me to stop the circle of anxiety, where the physical symptoms feed into themselves to make the feelings worse.  She suggested beta blockers.  During my various exercise courses I had heard of beta blockers.  "Ok" I thought "they cap my heart rate, so I'll not be able to work out so intensively.  I won't be able to rely on heart rate for an indicator of how hard I'm working".  I don't use heat rate monitors much anyway, so I wasn't that worried about their effects.

One day I was feeling particularly anxious and my heart was raving and my breathing shallow, so I decided that I needed to bring it under control and had one of the beta blockers.  Then I remembered that I'd arranged to meet some friends - so I jump on he Nike and frantically cycle up the hill.  I expected to get hot and bothered, but as well as those expected feelings I felt as though my chest was going to explode!  My legs were burning, my lungs felt as though they'd expanded in a vain effort to get as much oxygen into themselves as possible - while my heart just pottered on as though nothing was happening.  It was really confusing for my body.  At least I didn't feel anxious.  But i didn't like the feelings.  "Ok, so don't expect to do anything too intense after having one of them beta blockers" I said to myself.

Yesterday was a difficult day for me.  For no descernable reason I began to feel anxious.  Again my heart began to race and feel irregular and my breathing shallowed.  I had a few pills yesterday and by the evening the physical symptoms were under control and I felt better.  I had a decent nights sleep.

Today I went for my normal Sunday run.  I planned to run 10 miles.  So I start off up the hill.  I can tell early on that my heart was going to cooperate, so I slow right down.  My legs feel as though they were working really hard, but I was barley faster than a walk.  After about 2 miles I stopped.  I just couldn't keep going.  In the end, I resorted to doing intervals to get home - a recommended way of exercising with beta blockers, where you alternate periods of activity with periods of recovery.  I did get home and I felt as though I'd had a work out.  It took me 45 minutes to do 4 miles.  I was not pleased.  So I'll try again tomorrow.

I will probably get anxiety attacks again and I'll probably need to take a beta blocker again - and I will get used to them, but there's nothing quite like experiencing something for oneself to understand what it's like for others.  I don't know how many trainers have tried a beta blocker, but the experience will early help me appreciate and be supportive of others on medication.

Efficient Exercise

I'm finding that I am having to work my exercise routine around when I can fit it in, and at the moment, I'm having to fit some sessions into about 35 minutes.

Normally, when designing sessions for clients, I plan for about an hour, but you'll notice from my website that I offer sessions for 30 minutes. Primarily, these are targeted at beginners, but they could just as easily be for more experienced exercisers.

So what's squeezing my time right now? I'm having to do some exercise of a lunchtime and I get an hour for lunch. It takes about 15 minutes to get to and from the gym - I walk as fast as I can on the way so that I'm as warm as possible before I arrive. It takes a few minutes to change and then it's into a few minutes warm-up. Then I get into the main routine.

If its CV I want, then I know I can do a really effective 20 minute intervals workout that'll really challenge me … although I'll need to allow more time to cool down: I don't want to be still hot and sweaty when I get back to work (I will have a shower, but if I'm still hot, I'll be sweating ten minutes after I've stopped running).

If is a weights session, I'll do a really intense total body circuit, with only 30 seconds between sets. Or I might do an up body super-setting front and back exercises with minimal rest between sets to pack it all in!  Some days I might do two short sessions rather than one long session. 

My Favourite Form of Training

My favourite form of training is largely based around circuits - which is what most Boot Camps are based around. I'll design a set of circuits for myself and stick to them for four weeks; each week I up the volume (the amount of time) and at the end of the period I'll design a new set of exercises as a circuit with an increased intensity (heavier weights, more complex movements and higher heart-rate).

The key thing is having a plan and knowing what I'll do each session before I even get to the gym or studio. I find that if I go without a plan that I don't tend to work as hard as I should. If I have a plan and know exercise y follows exercise x, I can keep intensity as high as I need to and control my rest periods.

The other advantage is I know just has fast and far I should run or cycle and just how heavy and how many times I should lift a weight. I know that the first week of my plan shouldn't feel too tough, but the last week ought to be absolute murder! And all the while I am thinking about what the next four week period will contain.

Lastly, having a plan with consistent activities in it allows me to track progression over the weeks - and for some staple exercises to track progression over the months - and adapt accordingly when I plateaux. It can be incredibly useful to maintain some kind of diary of what you do, when, how much/long/fast/heavy and how you felt afterwards.

Weighing on your mind?

The problem with any weight loss strategy is that you cannot stop eating!

Obviously, this can cause problems when dieting, when trying to lose weight through never use or using a combination of the two. Often people over-compensate for the energy expended during exercise by eating too much ("I've earned this"). Many people also drink energy drinks while exercising - these are fatal to weight loss as they almost certainly have a calorie content greater than the energy expended and the calories ingested wont register on the brain's feeding centre … as a result you may feel even hungrier after exercise and drinking these sugary drinks than simply on exercise alone as they can spike insulin levels.

Many people become discouraged with weight loss if it doesn't happen quickly. Others abandon the process after losing a lot of weight initially and the plateauing. Those that do best are those that work to a gradual, sustainable weight management programme and gradually make behavioural changes.

That is why I partner with a professional counsellor to tackle the psychological aspects of diet and weight management to help tackle the mind as well as the body.

Is Exercise Failing You?

Are you in the gym everyday, sweating buckets and still not losing weight?

Have a good look at what you're doing outside of the gym:

• Do you drink lots of alcohol? The alcohol you don't burn immediately will be stored as fat. Alcohol will probably also inhibit your performance when exercising
• Do you smoke? This will reduce the effectiveness of your aerobic system (heart and lungs). It will also inhibit nutrient absorption.
• Do you feel you sleep well? Sleep is when your body repairs itself and builds muscle
• Do you have breakfast? All night you've been asleep and your metabolism drops; eating breakfast gives it a kick and gets you motoring. Skipping breakfast may be a false economy.
• Do you drive short distances? Or take the lift? Keeping active is more than getting hot in the gym - it involves raising your activity level throughout the day!
• Do you snack? Be honest! Sugars do horrible things to our energy systems - they encourage us to feel hungry, and then we eat more sugary things to fill us up.
• Do you drink sports drinks? These are full of sugar, and unless you are running marathons contain much, much more energy than you exert in the gym.

Try keeping a diary of what you eat, drink and all the activity you do in a day and how you feel about each thing.