PHYSICAL ACTIVITY AND ANXIETY DISORDERS: NEUROBIOLOGICAL MECHANISMS AND THERAPEUTIC EVIDENCE — NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6139Keywords:
Anxiety Disorders, Physical Activity, Exercise Therapy, Neurobiological Mechanisms, BDNF, Endocannabinoids, HPA Axis, Panic Disorder, PTSD, GADAbstract
Introduction: Anxiety disorders affect approximately 7.3% of the global population and remain undertreated. This narrative review synthesizes evidence on neurobiological mechanisms and therapeutic efficacy of physical activity (PA) in GAD, panic disorder, and PTSD.
Materials and Methods: A narrative review was conducted using PubMed, Scopus, and Google Scholar (2005–2026). Boolean strategies: ("physical activity" OR "exercise") AND ("anxiety disorder" OR "GAD" OR "panic disorder" OR "PTSD"); AND ("BDNF" OR "endocannabinoids" OR "neuroplasticity"); AND ("HPA axis" OR "cortisol" OR "serotonin") AND ("anxiety" OR "stress").
Results: Regular PA exerts anxiolytic effects through BDNF upregulation, HPA axis normalization, endocannabinoid system activation, and serotonergic adaptation. Aerobic exercise reduces anxiety symptoms (ES 0.34–0.66). Resistance training achieves GAD remission (NNT=3). HIIT produces rapid symptom reduction. Aerobic exercise attenuates CCK-4-induced panic attacks. Yoga demonstrates the greatest cortisol reduction among exercise modalities.
Conclusions: PA is an effective adjunct intervention for anxiety disorders, supporting integration into clinical protocols alongside pharmacotherapy and psychotherapy. Exercise prescription should consider modality, intensity, and patient characteristics.
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Copyright (c) 2026 Bartłomiej Błaszkowski, Roman Cemaga, Patryk Hebda, Maria Król, Przemysław Kołodziej, Mateusz Kubicki, Wiktoria Michnowska, Adam Wolski, Mieszko Czapliński, Mikołaj Patalong
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