The evidence base for the efficacy of physical exercise in reducing anxiety symptoms is smaller than that for depression; but nonetheless indicates that exercise is efficacious in alleviating symptoms of anxiety [1158, 1175, 1197]. In particular, exercise is thought to help manage the physical symptoms of anxiety by reducing overall arousal [1158]. Aerobic and non-aerobic exercise have been found to be as effective as CBT [1198], with reductions in anxiety, tension, and irritability observed among those with GAD who participated in resistance training and aerobics [1199, 1200]. Regular walking has also been found to enhance the efficacy of CBT across different anxiety disorders [1201]. Regular exercise has been found to produce greater reductions in anxiety than relaxation for those with panic disorder [1202], but is less effective than pharmacotherapy [1203] or group delivered CBT [1204]. The RANZCP guidelines recommend that people with anxiety disorders exercise three times a week, for 30 minutes at a time [1158].
Two reviews reporting secondary psychological outcomes of studies examining the effect of physical activity among people with AOD use found improvements in both AOD use and anxiety [272, 307]. Findings indicate that both aerobic and anaerobic training may be effective, over an optimal duration of nine weeks [1205]. An additional meta-analysis concluded that aerobic exercise effectively decreases AOD-related withdrawal symptoms and reduces anxiety among people with AOD use [305]. However, there is mixed evidence regarding the optimal intensity, with some studies finding support for light to moderate exercise, and others finding larger effects with higher intensity training [307].