Exercise-induced anxiety

Exercise Induced Anxiety AttacksWhile researching for another article, I happened upon a discussion thread about anxiety attacks and exercise. While science has shown that exercise generally lowers anxiety by producing endorphins in the brain, a number of individuals stated that as much as they want to exercise, doing so induces anxiety attacks for them. Obviously, this is a problem. We need to exercise for health, as well as to lower our stress, but how can we do that if the exercise itself produces anxiety attacks?

To be honest, I’ve noticed a similar problem sometimes when I exercise. It’s usually after I’ve been on the bike for about five minutes, right when I’ve gotten warmed up and have raised my resistance on whatever machine I’m on. My heart starts to pump even harder than I expected, and suddenly, distressing thoughts and images come to mind. Worst-case scenarios present themselves, and I feel a quick bout of near depression. My first instinct is to jump off the bike. If I started feeling that way while exercising, isn’t it best to separate myself from the situation?

It’s More Common than You Think

Summer Beretsky wrote about a similar experience in the article, “When Physical Exercise Feels Just Like A Panic Attack for Psychology Today. In it, she talks about how her doctors and friends told her over and over again how getting in shape and exercising regularly would help her lower her anxiety. There’s a Catch-22, however, she says, “exercising made me panic.” 

Livestrong.com’s article, “My Anxiety Gets Worse During Exercise,” also notes the struggle for some people who who have anxiety. The article notes that adults are often more aware of signs of anxiety attacks after they’ve had one, which means they’ll be on the lookout for anything that seems like an anxiety attack later on, even if it’s not.

Both articles note the same thing: Anxiety attacks and exercise share certain symptoms, the first being increased heart rate. This means faster breathing, as well as a rush of adrenaline. I’ve also read in online discussions that increased sweat production bothers some people. We can see how it’s easy to confuse the two. And honestly, if you’re trying to avoid anxiety attacks, the last thing you probably want to do is put yourself in a situation where it feels like you’re having another one.

So we know the symptoms match, and we know that it’s easy to confuse exercise and anxiety attack symptoms. The question is, what do we do about it?

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Guest blogger: Sophia and her TS

Sophia talks to Tourettes Action about her experiences of living with TS and what it means to her.

For me, Tourette’s made its appearance a little later than usual. I was 16 and had just been diagnosed with autism spectrum disorder, OCD and depression. Antidepressants were prescribed to help me manage my anxiety.

One morning, I woke up and was no longer in control of my body movements, my arms and legs were doing exactly what they wanted to, as if they were not a part of my body. I kept making noises, barking and meowing. I couldn’t stop. The inside of my body felt as if there were ants running inside me, combined with a strong burning sensation, a building tension that reduced ever so briefly, but only after a ‘tic’.

From that day, my tics became more complex and at one stage the movements were constant. I shouted things out and repeated other people’s words, phrases and actions. A constant feeling of unease, not knowing what was going to come out of my mouth until it had been said. Not only did I have to adjust to my new situation, I also had to accept the stares of onlookers, many of whom had only ever seen Tourette’s in the media.

Unfortunately, the media often has a tendency of over focusing on the ‘swearing tic’, known as coprolalia, which only affects a small number of those who have Tourette’s. “I wish I had Tourette’s so I could just swear all the time” is a phrase that I’ve heard more times than I would have liked to. Coprolalia is involuntary and certainly not something Tourette’s sufferers enjoy having, nor do they use it as an excuse to swear.

Tourette’s is more than just tics, many of us have multiple co-occurring conditions that have their own symptoms. Although Tourette’s is manifested outwardly, sometimes it is the symptoms people can’t see that cause us the most problems.

Two years passed, along with lots of hospital visits. Tourette Syndrome was mentioned throughout, but my official diagnosis was given to me at the age of 18. Now, I am studying Psychology at University. My tics change in frequency and severity, new tics emerge and old ones return. I have slowly learnt to accept my conditions and I am fortunate in that I am surrounded by wonderful people, who are incredibly supportive.

I think it is important to educate and challenge the stereotypes. To become your own advocate and to embrace what Tourette’s has taught you. To those reading this who have Tourette’s themselves:

“Keep Calm and Tic On!”

“Why do you let Tourette rule your life?”

This week I’m taking a week off from the “52 Weeks of TS” series that’s been posting here on the TSParentsOnline blog for the past 41 weeks. Today, I want to talk about one simple question that someone asked me:

Why do you let Tourette rule your life? 

What an interesting question. I don’t think my Tourette rules my life, it inspires me. I let my writing rule my life, and my ability to educate and inspire other people.

There are hundreds of thousands of kids and parents of kids that are dealing with complex disorders and syndromes, that they don’t understand. It’s even harder for the parents when the medical professionals don’t fully understand it.

These parents and children search for understanding, and I think through my writing (books and blogs) I have helped bring a little bit of understanding to the complexity of Tourette Syndrome. I have heard from hundreds of parents telling me how through my writing, they understand what their child is going through, and kids saying that I have wrote what they are trying to say. they feel like they are reading about themselves.

The most effective way to educate is opening your mouth, and that’s what I have done. we all have the ability to educate, but first we have to open up.

If children do not learn the way we teach them, then we must teach them the way they learn.

Tourette’s & Pregnancy: Trimester 3, Part 2

This post is all about the “secret weapons” I am using to combat the anxiety and everything else that comes with being pregnant and having Tourette Syndrome:

Exercise

I was thrilled to tell my physical therapist yesterday that I got a stationary bike for my house, the kind with the back support. An older patient chuckled and said I wouldn’t have to worry about using that after my little one comes. I smiled back to be polite, as I know he meant well, but deep down, I have to admit that it frustrated me.

People who don’t have chronic anxiety or tics often don’t understand why exercise is so important to me.

I know I shared this picture in my last post, but I'm just so stinkin' excited about my bike and balance ball!

I’m so stinkin’ excited about my bike and balance ball! To them, it might not mean a whole lot to stop exercising, but for me, it’s not just an activity – it’s a necessity. I’ve had to cancel at least half of my exercise plans during the second two trimesters because of back problems, nausea, and all the other fun things that pregnancy brings, but I could always tell when I’d cancelled too often. My tics would jump, and so would my stress.

Because simply getting to the gym can be a hassle (and will be even more after Jelly Bean arrives), I decided I needed to tackle my problem from another direction. I researched exercise bikes and then purchased a simple, somewhat inexpensive one for my home, along with a balance ball. Those, combined with the small sets of weights I already owned, made up my new home gym. It was pricey, but to me, keeping my stress levels down and my health up is worth it. That way, after Jelly Bean comes, I’ll be ready for some quick rounds of exercise whenever the time presents itself.

I’m not saying I’ll get in an hour every day, but from the first day I’m allowed back on that bike, I will be. Exercise will be a priority because I’m making it one. The only way I’m going to keep myself healthy and at peace enough to properly take care of my family is if I’m taking care of my own anxiety levels first.

Now about my diet …

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UPCOMING WEBINAR: February 25 on Sensory Issues at Home & at School

THIS WEEK’S WEBINAR

Making Sense of Sensory Issues – How to manage heightened senses at home and in the classroom

February 25, 2015

Presented by Dr. Michelle Miller, Psy.D., a New York State-licensed clinical psychologist who works at Therapy West, a group practice in Manhattan, and as post-doctoral fellow in the Tourette’s Syndrome Clinic at Rutgers University in Piscataway, N.J.

Over the years, parents and teachers have been increasingly attending to childrens’ sensory-related struggles; however, understanding and supporting sensory problems still remains unclear for so many people who work with children. Research also has suggested that 1 in 6 children are significantly impacted by sensory issues, further highlighting the need for this area to be addressed. This webinar is aimed at exploring what sensory issues are, how they look in different children and adults, and what can be done — both at home and at school — to help children with sensory issues thrive.

REGISTER FOR THIS WEBINAR »

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Tourette’s & Pregnancy: Trimester 3, Part 1

Fridays are always celebration days because they mean we’re another week closer to Jelly Bean’s arrival, and today marks our victory of 33 weeks! Between starting the nursery (which mean completely rearranging my house…which meant my husband completely rearranging the house), physical therapy for my back, a bit of substitute teaching, and a lot of writing, we’ve been pretty busy around here. I thought I’d take a few minutes and give you a report on how the Tourettes has been doing for Trimester 3.

(If you didn’t catch them the first time, here are my reports for Trimester 1 and Trimester 2.)

I’ll start off by saying that my tics have been noticeably more active this trimester, definitely more so than they were in the first two trimesters. I think this is for multiple reasons:

  • I had absolutely no energy with which to tic in Trimester 1.
  • I was still getting my energy back in Trimester 2.
  • I have a lot of great things going on in the coming weeks, but even good stress is still stress. And Stress=Tics.
  • Admittedly, my emotions are somewhat less balanced this trimester.

Now about that anxiety …

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What disabilities, disorders or conditions qualify for an IEP?

The following are listed as qualifying conditions, disabilities, or disorders for an Individualized Education Plan, or IEP.  The important thing to remember for any IEP is that the condition MUST affect a child’s educational outcome.  If they are brilliant and have no problems whatsoever with learning or adapting to a classroom environment affecting the ability to learn, chances are they may not qualify.

This is a very important thing for parents to remember.  Evaluations will be done to help determine disabilities, but parents should always find out ahead of time which ones are being done, and should also do some research to make sure they are the appropriate evaluations.

The federal criteria indicates a child must be impacted in the following areas to the point where they cannot perform at grade level when given instruction at that grade level. The term the federal government gives is “adversely affected”. The following are the educational areas where a child must be adversely affected:

  • Oral Expression
  • Listening Comprehension
  • Written Expression
  • Basic Reading Skills
  • Reading Fluency Skills
  • Reading Comprehension
  • Mathematics Calculation
  • Mathematics Problem Solving

The key to determining all of these criteria is is a history of assessments showing what areas a child may have struggled in, as well as a guarantee of appropriate professional instruction by an educator.  Once again, educational outcome must be affected!

The following are disabilities that can qualify a child for an IEP as long as they are adversely affected educationally:

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Clinical trial for new tic drug taking place in New Jersey

Tourette’s Syndrome is a neurological disease characterized by motor and vocal tics. It has been hypothesized that abnormal interactions of dopamine with its receptors may cause the tics. Right now, the Atlantic Center for Research in New Jersey is performing a study specific to this aspect of Tourette Syndrome.

The purpose of this study is to test the hypothesis that a drug named ecopipam can selectively block dopamine D1/D5 receptors and reduce the frequency and severity of the tics. The principal investigator of the study is Dr. Roger Kurlan, MD, and the sponsor is Psyadon Pharmaceuticals, Inc.

Inclusion & Exclusion Criteria:

  • Ages Eligible for Study: 7 Years to 17 Years
  • Genders Eligible for Study: Both
  • Accepts Healthy Volunteers: No

Inclusion Criteria: Subjects must have Tourette’s Syndrome (TS) based on the clinician-administered Diagnostic Confidence Index (DCI) for TS:

  • Subjects must exhibit both motor and vocal tics.
  • Subjects must have a minimum score of 20 at both Screening and Baseline (just prior to the first treatment) on the Yale Global Tic Severity Scale.
  • Subjects must be age (≥ 7 to < 18 years of age)
  • Subjects must weigh ≥ 20 kg (45 lbs)
  • Adolescent females of childbearing potential who are sexually active must be using effective contraception (i.e., oral contraceptives, intrauterine device, double barrier method of condom and spermicide) and agree to continue use of contraception for the duration of their participation in the study. They must also agree to use contraception for 30 days after their last dose of study drug.
  • Sexually active male subjects must use a barrier method of contraception during the study and agree to continue the use of male contraception for at least 30 days after the last dose of study drug.
  • Subject’s parent or legal guardian must execute a written informed consent.
  • Subject must execute a written informed assent.

Exclusion Criteria:

  • Subjects who have unstable medical illness or clinically significant abnormalities on laboratory tests, or ECG at Screening.
  • Subjects with a major depressive episode in the past 2 years
  • Subjects with a history of attempted suicide
  • Subjects with clinically significant suicidality (based on the Columbia Suicide Rating Scale (C-SSRS)
  • Subjects with a first-degree relative with a major depressive episode that resulted in any psychiatric hospitalization, or attempted/ completed suicide with the exception of a hospitalization for post-partum depression.
  • Subjects with a history of seizures (excluding febrile seizures that occurred >2 years in the past)
  • Subjects with a myocardial infarction within 6 months.
  • Girls who are currently pregnant or lactating.
  • Subjects who have a need for medication (other than ecopipam) with possible effects on TS symptoms (i.e., lithium, psychostimulants)
  • Subjects who have a need for medications which would have unfavorable interactions with ecopipam, e.g., dopamine antagonists or agonists [including bupropion], tetrabenazine, or monoamine oxidase inhibitors.
  • Subjects with a lifetime history of bipolar disorder type I or II, dementia, schizophrenia, or any psychotic disorder determined by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders – 4th Edition (DSM-IV) Axis-I Disorders (SCID).
  • Subjects with current or recent (past 3 months) DSM-IV substance abuse or dependence (with the exception of nicotine).
  • Subjects with positive urine drug screen (cocaine, amphetamine, methamphetamine, tetrahydrocannabinol (THC), benzodiazepines, barbiturates, phencyclidine (PCP), opiates) at Screening. Subjects with urine positive only for benzodiazepines and/or marijuana (i.e., a user but not an abuser as based on DSM-IV criteria) may be eligible.
  • Subjects who have had previous treatment with ecopipam.
  • Subjects who have had treatment with: investigational medication within 3 months of starting study; depot neuroleptics within 3 months of starting study; other psychotropics with possible effects on TS symptoms (i.e., lithium, tetrabenazine) within 2 weeks prior to Screening; oral neuroleptics within 4 weeks; selective serotonin reuptake inhibitors unless the dosage has been stable for a minimum of 4 weeks prior to study start and not prescribed to relieve the neurological signs of TS.

For more information or to sign up for the study, please call 908-522-5901 or send an e-mail to research@atlantichealth.org.

Ask questions … don’t be ignorant

As a mother of a child with Tourette’s Syndrome, I find myself asked questions a lot about Kane, his tics and methods that we use to help him. I love helping people to better understand Tourette’s; however, there is always someone who tries to disprove TS or to try and weigh in an opinion when they have not done their research.

Today, I was faced with this. I have been Kane’s mother for 10 years — I know this child better than anyone else in his life. I know what tics he has, how he acts when he is having a rough day and when he is being a total stink pot. To be approached by someone who tries to make me feel less educated than they are and throw out words they do not even understand about a disorder they know nothing about, really gets under my skin.

If you are not sure about the syndrome, ask questions, I would love to answer them the best I can. After all, I have done many hours of research, lived with an individual who is affected by TS and been to many sessions with my child. Please, don’t be rude! 🙂