||During my years of training, I have worked with clients who have been through various traumatic events such as auto accidents, sexual abuse, kidnapping, and sudden loss of a loved one. Any of these events can cause anxiety, depression, phobia and self-blame. Treatment needs to address several fronts including clinical and exercise. The effects of exercise on PTSD symptoms have been the subject of many recent as well as long range studies. The United Kingdom has studied the effects of exercise on depression for decades, and literature on the subject is growing. Primary care in the United Kingdom prescribes exercise for depression.
There are three psychological theories as to how exercise may exert its antidepressant effects. First, it may serve as a distraction from stressful input. Second, exercise is a form of mastery or control, which allows a person to regain control over her/his body and life; it has been suggested that depression is a result of a perception of a loss of control over ones life. The third theory suggests the antidepressant effects are due to the psychological benefits derived from social interaction that accompanies group activity.
This according to Jeannie Patton, MS, CSCS (Personal Fitness Professional, 7/2002)
Sometimes we are unaware that we are depressed. Anxiety on the other hand, usually has clearer physical symptoms that are often physically manifested. It is difficult when you are depressed or anxious to motivate yourself to exercise; however, exercise will help to elevate your mood and reduce fear and anxiety. A client of mine gave me an acronym for FEAR that she read someplace: False Expectations Appearing Real. It isnt a bad thing to think about. In addition to elevating mood, reducing anxiety and fear, exercise can also help you have a better self-image, feel better, feel stronger, and look better.
Inactivity is associated with many chronic medical conditions, hypertension, heart disease, diabetes, obesity and osteoporosis. These conditions can add to your feelings of depression and helplessness. Helplessness is an often times expressed feeling of PTSD sufferers. Exercise can release endorphins into your bloodstream that act as the bodys natural painkillers and they make you feel GOOD.
It is advisable for anyone beginning an exercise program for the first time or after being sedentary for quite a while to consult with your physician. Make certain that it is safe for you to begin an exercise program. Start with moderate activity and pick something that you will stay with. Consistency is important because consistent exercise will help to keep your emotions more even. Your program can begin with something as simple as a 10 to 15 minute walk. Walking helps to clear your head. Sometimes it is difficult to clear our minds of thoughts. You can let the thought pass through your mind and then try to focus on the circularity of your breathing. Learning to breath from a deeper space in your body can be calming.
Ritual surrounding your exercise is helpful as well. You want exercise to be a pleasurable experience. Beginning an exercise program can be the most difficult part of exercise. So, after walking, taking an aerobics class, a cycling class, etc. try a few minutes of quiet meditation or meditation with soothing music or a warm bubble bath or arrange to meet a friend for coffee. Sometimes these little rewards help us to stay motivated to keep our exercise program consistent.
The majority of studies show that exercise has an antidepressant effect. It is important for fitness professionals to recognize and promote emotional and physical fitness as essential to the ability to take control of your life; this supports the current trend in exercise programming toward mind/body exercise. Goals should be focused on maintaining and/or increasing overall fitness, improving mood, self-concept and work behavior and decreasing depression and anxiety.
Tai Chi and Chi Kung (or Qigong) is a good example of a type of exercise that is mind/body based and can help with depression and anxiety. It is meditative movement, that has the ability to focus us, center us and bring us back into ourselves providing a safe space inside. One client who came to me was sent by a therapist because this client was frightened to leave home as a result of a serious trauma. This client needed to be in a place where it felt safe to be. The client found it difficult to interact with other people and was somewhat isolated in behavior. This particular client was not ready at the time the classes began to continue coming. The fear from the situation experienced was still too strong. This client came only a few times. We talked about it and concluded that perhaps, it would be best that a few weeks go by before he/she begins again. The therapist felt that the Tai Chi and Chi Kung would help the client to find her/his center again which is the way that Tai Chi and especially Chi Kung work. I highly recommend Chi Kung because it boosts your energy while it calms you.
Another client has been in one of my cardiovascular fitness classes for some time. This particular client was suffering from mild depression and anxiety due to childhood abuse. In addition to working with a mental health therapist, this client decided to start exercising for the first time in many years. Regular exercise really helps this client regulate depression and anxiety, however; there are times when the depression and anxiety come up, dont feel that this is the ultimate cure, but it really helps self-control.
Aerobic classes such as cycling classes are a very good way to experience increased endorphins, improve cardiovascular fitness and not worry about how coordinated you are. Cycling is an activity that you can self-regulate and that can range in intensity level from light to moderate to hard. It is easy on the joints, performed in a group setting with music that is stimulating and with an instructor choreographing the ride. While it is a group activity, you are still riding for yourself and not in competition with the other riders. Perhaps the most difficult aspect of beginning a cycling program is getting used to the seat
.invest in a gel seat if you havent spent much time on a bike.
We often try to hide our depression, anxiety or fears by gaining weight. Eating is a good source of nurturing. It is often an unconscious act. When we eat, our brain releases a chemical, dopamine that causes us to feel pleasure. However, in a recent study published in Lancet Magazine, PET scans were done on obese and non-obese people and researchers found that the availability of dopamine receptors were significantly lower in those who were obese (this can cause the obese person to eat more to get that good feeling). In a study published by HealthSource, the production of dopamine might also be linked to addictive-type behaviors.
One of my lifestyle and weight management clients suffered from morbid obesity as a result of losing both parents as a child. This client had tremendous guilt surrounding their death and that created the PTSD condition, (I am not a mental health professional, this condition was previously diagnosed by a therapist). We began a small group, 12-week program of lifestyle changes: including awareness of eating habits and regular exercise. Naturally, because of this clients physical condition, exercise was limited to gentle, seated strength training. We utilized tubing to work the muscles through a range of motion. On off days, this client agreed to perform 3-ten minute walking sessions on her own at least every other day. Sometimes this was not possible. However, this client felt changes in level of depression and self-control within the first three weeks of the program. In part, this client felt the program was designed in such a way as to be nonjudgmental and the facilitator and the group was very supportive. This particular client felt tools were given during the 12-week session to be able to continue along a more healthful path.
Exercise should be used as a healthful adjunct to working with a trained mental health professional. It is important that you take precautions when first beginning a fitness program. Wherever you go, need to feel comfortable to you, there should be a screening process including filling out a health and lifestyle questionnaire. Your medications, if any will need to be listed. Antidepressants can cause increased heart rate, insomnia, weight gain, dizziness, drowsiness or withdrawal. The fitness professional with which you are working will need to know this to be able to plan a safe and effective program for you. Unfortunately, some people feel there is a stigma attached to taking antidepressants and may be embarrassed to let the fitness trainer know this information. The information you provide is confidential and non-judgmental.
It has been found that general guidelines recommended for improving depression, anxiety, etc. is 30 to 40 minutes of aerobic activity 5 days per week. With that you want to perform a 5 to 10 minute warm-up and cool-down with stretching. Work at an intensity rate between 60 to 70% of maximum heart rate. If you are on medications that depress or increase heart rate or on diuretics or hypertension medications, have a fitness professional explain and make you familiar with the Rate of Perceived Exertion Chart so you can keep track of your intensity.
In order to increase your motivation and adherence to a program, make certain the program is fun, convenient, free of hassle and challenging. Group participation can promote social interaction. If social interaction is difficult for you at first, seek out the services of a certified personal trainer. It is important to exercise at a moderate level. Over-exercising can actually increase depression. Most of the studies, including The Influence of Exercise on Mental Health conducted by the Presidents Council on Physical Fitness and Sports Research state that exercise shows greater results when it lasts for more than 10-weeks. This study further states that exercise has more effect than casual recreation or relaxation training.
The 1996 Surgeon Generals Report on Physical Activity and Health reported that. Exercise helps depression, anxiety and stress in several ways. It releases endorphins, the bodys own mood-elevating, pain-relieving compounds, even as it reduces levels of the stress/depression hormone, cortisol found in the bloodstream. Exercise boosts self-esteem by providing positive feelings of accomplishment and autonomy. The prevailing hypothesis holds that the chief effect of regular physical activity, i.e., higher levels of cardio-respiratory fitness produces key, life coping psychological benefits such as enhanced mood, self-esteem, confidence and cognitive functioning.
There are sources for finding personal trainers in your area. You can go on the American Council on Exercise website, www.acefitness.org, American College of Sports Medicine website, www.acsm-healthfitness.org or the National Strength and Conditioning website www.nsca-lift.org. If you plan to use a personal trainer for a strength program, be sure to interview that trainer. Find out how long he/she has been training, what populations they work with, ask if they obtain medical clearance, can they interface with a physician/therapist if you would like, what type of medical questionnaire do they use, what sort of assessment do they use. Make certain the place where you go is a place that makes you feel comfortable and welcome. Whether it is for personal training or classes.
If you wish to read more about depression and other health conditions, you might like to look at these websites: the www.WebMD.org and Dr. Andrew Weil's Self Healing Newsletter at DrWeil.com Home Page. There are a number of Harvard Health Letters and Mayo Clinic Health Letters. Sometimes Health Magazine will have an interesting article. The American College of Sports Medicine produces a journal Health and Fitness but it is more geared to the professional. There are a number of good articles.
Carol Witham: Advanced Health & Fitness Specialist. Carol is a personal trainer and a certified T'ai Chi instructor. She is also a Level III Essentrics Apprentice Instructor, as well as a Reiki Master with eight years of training experience and 16-years of T'ai Chi experience. She operates two personal training studios called Optimum Performance on the coast of Maine, where in addition to personal training, she offers group strength classes, classes for seniors, T'ai Chi & Chi Kung, and cycle classes.