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If You’ve Had Panic Attacks While Running, You’re Not Alone

A mental health expert provides techniques to manage your brain and body’s reactions to anxiety.

For many people, running is the tool they use regularly to help alleviate symptoms of anxiety. But what happens when the activity that usually gives rise to a euphoric rush of endorphins seemingly begins to elicit a completely different response? 

The truth is when you’re going through a stressful period of time in your life, particularly one that prompts anxious feelings in sporadic intervals, running may not be enough to make you immune to intense moments of panic. In fact, you may even find yourself experiencing a panic attack while running. 

For longtime runner Ellen Isaac, panic attacks have just recently begun to occur while on runs—and often. As a former Division I athlete for Ohio University’s (OU) cross-country and track teams, Isaac is no stranger to stressful situations and is someone who genuinely looks forward to competition. However, it wasn’t until after she took her state board exam for physical therapy school this past April that she realized intense bouts of fear could immobilize her while running. 

She was on a run with her boyfriend, Nick, when she started feeling overwhelmed with thoughts about whether or not she passed her exam. 

“It got to the point where I literally just stopped in the middle of the towpath and was uncontrollably sobbing,” Isaac says. 

She was able to identify that she was having a panic attack, so she immediately found a rock to sit on so that she didn’t fall down. 

“Breathing while you’re running isn’t the easiest thing in the world, even when you’re running slow,” Isaac adds. “When you start to have those panic attacks, you’re short of breath from that, you’re short of breath from running, and it just completely spirals out of control. I just remember feeling totally out of control of what was going on in my life and out of control of what was happening with my body at that point in time.”

Michele Kerulis, Ed.C., L.C.P.C., who’s certified with the Association for Applied Sport Psychology and a professor of counseling at the Family Institute at Northwestern University, explains that panic attacks are caused by intense fears, concerns, or anxiety. And while these feelings are perpetrated by the mind, they can result in equally intense physical symptoms—like increased heart rate, breathing, and sweating—much like the ones Isaac experienced.

"Running in and of itself does not cause someone to slip into a panic attack—it’s more likely the runner’s thought process quickly snowballs from a small uncomfortable thought into a full-blown panic attack,” Kerulis tells Runner’s World. “For example, if someone has a fear of dogs and sees a dog on their running route, that person might have an automatic thought such as, ‘that dog is going to attack me,’ which leads to feeling intense fear, which can result in a panic attack.”

She points out that from a psychological perspective, when someone experiences a panic attack, it’s the body’s primitive response saying, “I feel like I really need to protect myself right now, I’m scared.” This reaction can then spearhead a physiological response that mimics the one that occurs while you’re running. 

“At that point, you experience increased respiration, you’re breathing harder, your heart rate goes up, you’re sweating, [you have] increased blood flow to your muscles—those are the exact same things that happen when you’re running. It’s the exact same physiological response as a panic attack,” says Kerulis. “So you’re having those same, almost ‘alert type’ of neurotransmitters in your brain, telling your body to accelerate. Even though the circumstances are very different, physiologically we’re experiencing those same things.”

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While Isaac says very few things will help her get out of a panic attack once one ensues, she has one method that seems to, at the very least, stabilize her symptoms and prevent them from exacerbating any further.

“When it happens, a lot of times what I end up doing is I usually end up counting all of the seconds until I calm down [while still running]. Sometimes I end up counting seconds for three miles. And then I’m like, okay, I’m fine now,” she says. “I do that during races, too. If I’m starting to freak out and get to that part of the race where I don’t know if I can keep going, I count seconds.” 

As Kerulis points out, running might reduce some symptoms of anxiety, but it won’t eliminate the thought process that triggers anxious reactions. Still, there are some elements that are learned from running that may soothe you in moments where you begin to feel frightened.

"Running has helped a lot of people develop skills to control their physiological symptoms, which can help them with body-to-mind relaxation techniques that are helpful when they feel as if they will experience a panic attack,” says Kerulis. 

Despite how terrifying these panic attacks are when they occur while running—not to mention the uncertainty of when they will happen during her run—Isaac remains grateful for the sport.

“If running kind of stirs up some anxiety for me, on one hand, yeah it’s unfortunate that it’s plaguing a part of my life that’s always been such a big stress relief for me,” she says. “But, if it takes some anxiety and panic attacks on runs for me to realize that there are things in my life that I need to address that I’m trying to shove under the rug, then I’m kind of okay with that.”

For those who experience regular bouts of anxiety, there are ways you can consciously restructure your own physiology while running so that you can better prevent slipping into that panicked state. Kerulis says that mental health providers often use mind-to-body as well as body-to-mind techniques to help people manage their cognitive (mind and thoughts) and physiological (body) reactions to anxiety. 

What is a mind-to-body technique?

“In the example above where a runner sees a dog on their route, once they notice their automatic thought, ‘that dog is going to attack me,’ they can work to stop the thought from snowballing by saying ‘stop!’ to themselves. Then [they can] rationalize the situation with a new, restructured thought like, ‘I know I’m scared right now, but that person seems to have control over their walk with their dog—I am safe,’” says Kerulis. “This will allow the person to slow down their thoughts and refocus on enjoying their run.”

She adds that picking up a meditation practice is another way you can gain control of your thought processes, as it can produce a calming effect. 

What is a body-to-mind technique?

Kerulis explains that this method encourages people to address their physiological symptoms of a panic attack head-on and allows them to focus on de-escalating those physical feelings. So, once someone can identify what they feel in their body—both when they're having a panic attack and when they’re running—they can begin to separate the two sensations and regain a sense of control.

“When someone is sprinting, for example, they will have heavy breathing and need to learn how to manage breath control to gain skills as a sprinter,” says Kerulis. “The same breath control can be used when someone feels a panic attack coming on. This way, people can focus more on their bodies and less on their minds at that moment. Once the wave of anxiety passes, they can re-evaluate the situation that triggered the anxious feelings.” 

The bottom line

Consciously employing both mind-to-body and body-to-mind techniques while running may be the answer to staving off the onset of a panic attack. As Kerulis notes, regular exercise can help you understand your body’s responses to stress. 

“Once you have a familiarity with your body’s responses, you can learn ways to slow down these responses, which will also help you gain a sense of control,” she says. 

posted Saturday September 25th
by Runner’s World