Exercise as an Adjunctive Intervention for Anxiety Symptoms and Anxiety Disorders

A Narrative Review of Recent Evidence and Practical Implications

Abstract

Background. Anxiety disorders are common mental health conditions associated with impairment, avoidance behaviour and sensitivity to physiological arousal. Although treatment relies mainly on psychotherapy and pharmacotherapy, exercise is increasingly considered supportive.

Aim. This review analyses exercise as an adjunctive intervention for anxiety disorders, with emphasis on aerobic exercise, resistance training, mind-body practices and exercise combined with cognitive behavioural therapy.

Material and methods. Literature from 2017–2026 was prioritized using PubMed, Scopus, Web of Science and Google Scholar. Reviews, meta-analyses, randomized controlled trials, guidelines and observational studies on exercise and anxiety symptoms in adults were included.

Results. Exercise may reduce anxiety symptoms, although effects depend on activity type, patient characteristics, supervision and adherence. Aerobic exercise appears most applicable because it is accessible and adaptable. Exercise combined with cognitive behavioural therapy may support behavioural activation and exposure to bodily sensations, especially in panic symptoms or high anxiety sensitivity. Resistance training and mind-body exercise may be useful, although evidence is less consistent.

Conclusions. Exercise should not replace psychotherapy or pharmacotherapy but may serve as an adjunctive component of anxiety treatment. Further research should clarify optimal protocols, intensity, adherence and safety.