Anxiety is prevalent in both individuals with MDD as well as those with bipolar disorder, with over half of individuals with MDD and 88% of individuals with bipolar disorder having a lifetime comorbid anxiety disorder [2, 4, 63, 65, 66]. In individuals with primary MDD, comorbid anxiety disorders negatively impact treatment outcome and are related to increased impairment, symptom severity, and incidence of suicide [66]. In individuals with primary bipolar disorder, comorbid anxiety disorders are associated with lower quality of life, poorer functioning, and greater likelihood of suicide attempts [63]. Furthermore, panic disorder has been linked to a higher risk of cardiovascular events, thereby increasing mortality in this clinical population [67]. This increased risk is particularly concerning as only 14% of individuals in the general population report exercising regularly to reduce stress, highlighting the tendency for people to not exercise when anxious and further increasing cardiovascular risk in individuals with anxiety disorders [68].
