{"id":25908,"date":"2025-05-06T14:53:01","date_gmt":"2025-05-06T14:53:01","guid":{"rendered":"https:\/\/lifestylemedicine.org\/?p=25908"},"modified":"2025-07-15T16:48:12","modified_gmt":"2025-07-15T16:48:12","slug":"how-to-use-physical-activity-to-address-unhealthy-stress","status":"publish","type":"post","link":"https:\/\/lifestylemedicine.org\/how-to-use-physical-activity-to-address-unhealthy-stress\/","title":{"rendered":"How to use physical activity to address unhealthy stress"},"content":{"rendered":"\n

How to use physical activity to address unhealthy stress<\/h1>\n\n\n\n
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Stress is an unavoidable part of life that can negatively impact health. But helping patients increase their physical activity can reduce harmful effects and improve resilience. May is National Physical Fitness & Sports Month.<\/p>\n<\/blockquote>\n\n\n\n

By Divya Hedgren, MD, DipABLM <\/strong><\/p>\n\n\n\n

May 8, 2025<\/p>\n\n\n\n

\"Runners<\/figure>\n\n\n\n

Physical activity is foundational to good health\u2014physically, cognitively, mentally, and socially.  It can serve as both a preventive and active management tool for chronic diseases, negative stress response, and mental health, as well as for maintaining a strong connection with the community. <\/p>\n\n\n\n

A reciprocal relationship exists between physical activity and stress. While individuals who experience chronic stress levels are more inactive, physical activity is a known intervention for the management of stress.  <\/p>\n\n\n\n

Stressors are an everyday part of our lives that cannot be avoided, and stress is a natural response to change. The World Health Organization<\/a> defines stress as “a state of worry or mental tension caused by a difficult situation. Stress is a natural human response that prompts us to address challenges and threats in our lives.\u201d Stressors are varied, ranging from positive to negative, acute to acute\/episodic, chronic, and mild to severe. Also, stressors can be categorized as environmental, psychological, physical, and\/or traumatic.<\/p>\n\n\n\n

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How our bodies respond to stress\u00a0<\/h2>\n\n\n\n

When stress occurs, the brain and body respond. Sometimes the response is positive, alerting the individual to be motivated and energized with positive emotion and mood. Other times, the response crosses a threshold becoming distressing, with physical manifestations such as headaches, gastrointestinal symptoms, heart palpitations, or sleep disruptions, or rises to the degree of being a significant risk factor for the development of mental health conditions such as anxiety and depression.  <\/p>\n\n\n\n

Physiologically, the stress response<\/a> occurs mainly as a function of the sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) axis.\u00a0 The instinctive, acute response occurs through the sympathetic nervous systems pathway, culminating into elevated heart and respiratory rate.\u00a0 The chronic response occurs through the HPA axis pathway triggering corticotropin releasing hormone (CRH) from the hypothalamus, then release of adrenocorticotropic hormone (ACTH) from the anterior pituitary, followed by release of cortisol, our \u201cstress hormone\u201d from the adrenal gland. Over time this can result in maladaptive changes, such as elevation in glucose, increase in sodium retention, and increase in immune suppression.<\/p>\n\n\n\n

The impact of physical activity on stress\u00a0<\/h2>\n\n\n\n

On a positive note, through hormonal responses, regular physical activity buffers<\/a> the chronic negative impact of stress and boosts resilience when faced with both psychological and physical stressors. When a person is more physically fit (aerobic), there is blunting of the responses through the HPA axis (lower cortisol response to stress) and optimization of the sympathetic nervous system (more rapid recovery when encountering stress). These effects contribute to a more positive emotional response and mood.\u00a0 Also, physical activity promotes an anti-inflammatory state and growth factor production influencing neuroplasticity and neurogenesis. More immediate exercise effects occur through release of hormones in the endocannabinoid system. Typically, regular activity contributes to better sleep, which helps maintain energy, alertness, and positive mood.\u00a0 In addition, there is a growing and promising body of research related to the benefits of strength\/resistance training as a tool for management of stress, depression, and anxiety, but more conclusive evidence is needed to fully understand this relationship. Mind-body practices including yoga and tai chi focus on balance, flexibility, meditative movements, and breathing regulation, which can foster relaxation and stress reduction.\u00a0<\/p>\n\n\n\n

Other beneficial psychological aspects of regular physical activity include experiencing a greater sense of self-esteem and competency through the progress made in stamina, endurance, function, quality of life, and chronic disease management.<\/p>\n\n\n\n

How physical activity affects anxiety and depression\u00a0<\/h2>\n\n\n\n

Similar to stress, there is a bidirectional relationship between physical activity and anxiety and depression, with these mental health conditions contributing to inactivity, and physical activity reducing risk of symptom onset and improving active symptoms.  <\/p>\n\n\n\n

Authors of this overview of systematic reviews<\/a> report that exercise improves symptoms related to psychological distress, anxiety, and depression and should be a mainstay part of the treatment plan for these situations and conditions. Similarly, this meta-analysis published in JAMA in 2024<\/a> revealed a variety of exercise from low- to high-intensity aerobic and resistance training may reduce depressive symptoms, with more intense activity leading to greater symptom relief.\u00a0 In addition, physical activity has been found to be a protective factor for the development of anxiety and depression. In a 2018 meta analysis that included 49 prospective cohort studies, the authors concluded that higher levels of physical activity reduced incidence of depression<\/a> across ages and geographical locations but an optimal dose of activity level was not established.<\/p>\n\n\n\n

How to assess a patient\u2019s physical activity\u00a0\u00a0<\/h2>\n\n\n\n

Physical activity is an important lifestyle medicine vital sign. The Physical Activity Vital Sign (PAVS)<\/a> resource from the American College of Sports Medicine is quick and easy to use and details the recommendations for adults for cardiovascular and strength training. The questions relate to type, frequency, intensity, and duration of the activity.\u00a0<\/p>\n\n\n\n

Potential questions to ask patients during physical activity assessment: <\/p>\n\n\n\n