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Soldier exercising

PTSD and Exercise


Post-Traumatic Stress Disorder (PTSD) can develop after a highly stressful, or even life threatening event. PTSD is a mental health problem and is seen in many veterans. PTSD can lead to other major health problems to include impaired cognitive performance, diabetes, obesity, and metabolic syndrome. Exercise is one intervention that is low cost and could avoid some of the negative connotations that are associated with treatment approaches to these health issues. Exercise has also been shown to help with stress and anxiety, which are commonly seen in people experiencing PTSD.

Exercise is a way to treat ourselves when stress begins to have an effect on us. Below are ways to understand how to use exercise when dealing with stress.

Inoculate Yourself

  • Challenges are what allow us to strive and grow and learn. On the cellular level, stress sparks brain growth (assuming it’s not too severe and you’re given time to recover)
  • Connections become stronger and mental machinery works better
  • Stress is not a matter of good and bad; it’s a matter of necessity

The Alarm System

  • Purpose of the alarm system is to mobilize us to act; physical activity is the natural way to prevent the negative consequences of stress
  • Exercise in response to stress is what we have evolved to do

That Which Doesn’t Kill You…

  • Regular aerobic activity calms the body so that it can handle more stress before the serious response involving HR and stress hormones kicks in
  • It raises the trigger point of the physical reaction
  • In the brain, the mild stress of exercise fortifies the infrastructure of our nerve cells by activating genes to produce certain proteins that protect the cells against damage and disease; raises our neurons’ stress threshold
  • Resilience is the build-up of waste-disposing enzymes (neuroprotective factors) and proteins that prevent the naturally programmed death of cells
    • Best way to build them up is to bring mild stress on yourself—using the brain to learn, restricting calories, exercising, eating your vegetables
    • All these activities challenge the cells and create waste products that can be just stressful enough

The Science of Burning It Off

  • Exercise relaxes the resting tension of muscle spindles, which breaks the stress-feedback loop to the brain
  • If the body isn’t stressed, the brain figures maybe it can relax, too
  • The stress of exercise is predictable and controllable because you’re initiating the action; with exercise, you gain a sense of mastery as you develop awareness of your own ability to manage stress and not rely on negative coping mechanisms

Anxiety is something many people with PTSD experience. They grow nervous and fearful of situations that remind them of the experience that lead them to developing PTSD. If not controlled, anxiety can have a significant impact on someone’s life. Exercise can help by aiding in learning how to control fear and anxiety. Below are ways to understand how exercise helps someone learn to take control of their anxiety and fear.

The Evidence

  • When we increase our HR and breathing in the context of exercise, we learn that these physical signs don’t necessarily lead to an anxiety attack; we become more comfortable with the feeling of our body being aroused, and we don’t automatically assume that the arousal is noxious

Fear Itself

  • BDNF (brain-derived neurotrophic factor) might be an essential ingredient in combatting anxiety >> helps wire in positive memories that create a detour around the fear

The Missing Connection

  • ANP (atrial natriuretic peptide) is secreted by heart muscles when we exercise; directly tempers the body’s stress response by putting the brakes on the HPA axis and quelling noise in the brain; APA increases as the HR increases during exercise, which relieves the feeling of stress and the body’s response to it

Facing the Fear

  • Cannot erase the original fear memory, but we can drown it out by creating a new memory and reinforcing it
  • Brain creates a neutral alternative to the expected anxiety, weakening the typical response
  • Have people literally run toward their fear—reach the height of their fear in a state of full physical arousal, without the panic
    • Example: If you’re afraid of crowds, you should run toward a crowd of people so that you reach your peak physical arousal when you are close to the source of your fear. Yet, the reason for high arousal is due to exercise, not the crowd. Then walk back to where you started. Learn to associate stress response with exercise and a sense of control.

Outrunning the Fear

  • It provides distraction
  • It reduces muscle tension
  • It builds brain resources
  • It teaches a different outcome
  • It reroutes your circuits
  • It improves resilience
  1. Hegberg, N., Hayes, J., & Hayes, S. (2019). Exercise Intervention in PTSD: A Narrative Review and Rationale for Impelementation. Font Psychiatry Vol. 10. Retrieved from this link.
  2. Ratey, J., & Hagerman, E. (2008). Spark: The Revolutionary New Science of Exercise and the Brain. Little Brown Spark.