Dizziness, uncontrollable sweating, a rapid heartbeat and even a dead faint -- while still a teenager, *Jennifer (not her real name) experienced all the hallmarks of a stress-induced panic attack.
"My parents separated when I was in my late teens," recalls Jennifer, now a marketing executive in her early thirties.
Almost as soon as the split was announced, she recalls, the panic attacks hit.
"It was really frightening. I'd become severely dizzy, sweat uncontrollably and feel totally overcome.
"On some occasions I'd faint. It usually started with a dizzy feeling and a very rapid heartbeat."
The first time it happened, a major fear of a recurrence set in.
"In some way, even just the fear of having one seemed to bring on a panic attack.
"If I was in another stressful situation I'd start experiencing the same symptoms."
She didn't initially trace her panic attacks back to her parents' separation, but after consulting a therapist, the young woman started to make the right connections.
"Although I had a huge fear of having more panic attacks, I didn't want to go on any kind of anti-anxiety medication, so I looked into ways to help myself."
The therapist advised yoga, which helped enormously, while Jennifer also took up running/walking and gym-based resistance training.
These thrice-weekly exercise sessions transformed her life. The panic attacks have more or less disappeared.
"The yoga, for example, helped me to balance my life and gave me a mechanism to cope with my anxious feelings.
"It's all about breathing, so now when I feel myself getting stressed I'll stand back and try to do abdominal breathing -- when you breathe in a panic you breathe from your chest."
Jennifer's experience is underlined by scientific findings that show taking part in physical activity has a beneficial effect on mental health.
According to statistics, one-in-four of us will develop a mental health problem at some point in our life.
It can be triggered by events such as unemployment, bereavement, having a baby or being physically unwell -- and there is increasing evidence that physical exercise can help significantly.
In fact, as little as 25 minutes is enough to make a difference according to Jasper Smits, a psychologist at the University of Dallas.
"After just 25 minutes, your mood improves, you are less stressed, you have more energy -- and you'll be motivated to exercise again tomorrow. A bad mood is no longer a barrier to exercise -- it is the very reason to exercise," he says.
The 2010 'Cochrane Review' states that the benefits of exercise for people suffering from depression compare favourably to other therapies, while the 2009 'Moving On Up' report by the UK-based Mental Health Foundation found physical activity was positively associated with an improvement in mood and functioning for people experiencing mental stress.
Studies in Australia and the USA have also found clear links between physical activity and mental health.
"Panic attacks can affect your confidence because you are afraid of it happening in a social or work situation," says Jennifer.
"Running and resistance training not only build up your strength physically, they also build you up mentally -- you feel psychologically stronger.
"I don't have panic attacks any more and I feel a lot more confident in myself. The physical exercise and the yoga played a strong part in helping me control my panic attacks and anxious feelings.
"Learning to control my anxiety through deep breathing, which I learned through yoga, was very important.
"I was able to use the pent-up energy that was manifesting as anxiety, thereby triggering the production of endorphins and a feelgood feeling and they had a knock-on effect on my life -- I feel more in control now."
Sometimes, when she feels anxious or down, the thought of getting out and exercising is difficult, she says, but even a good, brisk walk generally does the trick.
The benefits of exercise on mental health have informed the way patients of all kinds are treated at St John of God's Hospital in Dublin, which provides services for the full range of mental health issues.
Here, senior occupational therapist Peter Connolly coordinates a hospital-wide exercise programme.
"The exercise therapy programme runs through every treatment programme in the hospital.
"It's provided to people who suffer from anxiety, stress, depression, psychosis and eating disorders as well as people on our addiction programmes."
The programme, which started off on a pilot basis in 2009 and now stretches right across the hospital, provides yoga, tai chi, stretching, gym, training for certain muscle groups, circuit training, interval training and a walking group.
"There is some form of physical exercise every day for about 45 minutes," says Connolly.
"Each special unit, eg eating disorders, has its own session at the gym and there are open gym sessions for the general hospital population."
Physical exercise is a very important part of the treatment received by patients, who range in age from teenagers to people over the age of 65, says the hospital's occupational therapy manager Orlaith Donoghue.
"We do it so that people are physically active. It helps them to develop a lifestyle that they can carry with them when they leave," she explains.
When the hospital did a recent survey of 86 patients on the benefits of its exercise regime -- the respondents suffered from everything from depression and anxiety to stress and psychosis -- the results were surprisingly positive.
"There was 100pc unanimity from those surveyed on the benefits of exercise -- the gym, circuit training, yoga," Connolly reports.
Patients found a noticeable difference in their well-being as a result of regular exercise, he says.
They felt more alert, experienced a reduction in stress, were less nervous, more confident more relaxed and had a better mood.
They also experienced better energy levels, reduced anxiety and the quality of their sleep improved.
The role and type of exercise in promoting mental health is evolving. In America and Canada, points out Connolly, some sports psychologists and psychiatrists are now going further and exploring and prescribing certain exercise for specific psychological states.
In the future, therapists may well suggest that a patient fight depression with a course of kick-boxing or follow a resistance programme if he or she wants to reduce stress.
However, whether they have a mental health problem or not, people of all ages should exercise at least three sessions a week, engaging in moderate to high intensity physical activity lasting about 45 minutes, advises Connolly.
"There is a cumulative benefit to it -- exercise has a real impact on well-being, it equips us to face the stresses of real life and it contributes to better sleep.
"When you're stressed your body recognises that you are stressed.
"We all need to exercise," says Connolly, who points out that in terms of finding something you enjoy doing, there's something from everyone -- just raise your heart rate and release the feelgood endorphins.
Health & Living