I have chosen again to use my blog as the format for another assignment. Please see below. As always I would love to hear your thoughts and opinions 🙂
How can the relationship between mental illness and physical activity and exercise be applied in real life settings and what might be the problems or weaknesses with this approach?
Staying active has long been associated with good physical health and overall wellbeing; and low activity levels have often been linked with diseases (such as diabetes or cardiovascular disease) and obesity. Now, more and more research is showing that exercise and physical activity (PA) may also benefit mental health. In this paper I will discuss two different types of mental illness: clinical depression and anorexia nervosa (AN) and how PA and exercise can be used as a form of treatment and what the problems and weaknesses with this type of approach could be.
| Mental Illness | Definition |
| Clinical Depression | A mental illness that causes feelings of sadness and loss of hope, changes in sleeping and eating habits, loss of interest in your usual activities, and pains that have no physical explanation. |
| Anorexia Nervosa | A serious illness often resulting in dangerous weight loss, in which a person does not eat, or eats too little, for psychological reasons. |
One of the most common Mental illnesses in today’s society is Clinical Depression. Depression is finally becoming acknowledged in every day society, and as such, research into non-drug treatment is becoming more common. According to S. He et al (2012) “The use of exercise to improve the symptoms of depression is an area of research focus.” Countless studies are being undertaken into the benefits of both aerobic and resistance training and the table below illustrates some examples of these studies and their outcomes.
| WHO | WHEN | PARTICIPANTS | FINDINGS |
| Blumenthal et al | 1999 | 156 depressed older patients in 3 groups
|
Walking/ jogging at 70-85% of max aerobic intensity as effective as medication in treating mild depression. |
| Backmand et al | 2003 | Former elite male athletes surveyed by questionnaire in both 1985 and 1995 | Low level of PA significantly increases risk of depression. Increase of 1 hr/day decreased risk of depression by 8% |
| Dunn et al | 2005 | 80 adults with mild-moderate depression in 3 groups with varying levels of exercise | Group given high dose of exercise showed greatest reduction in depression scores. |
These are just three examples of many studies showing a positive link between exercise and depression. However, there have been a number of articles and reviews criticising these studies, advising that they all have methodological weaknesses. For example “randomization was adequately concealed in only three studies and intention to treat analysis was undertaken in only two” (Lawlor & Hopker, 2001). Even with these methodological weaknesses, the results have consistently shown a drop in depressive symptoms and no studies have shown a negative outcome for using PA as a treatment. Of course, further studies need to be conducted, ensuring the methodology is corrected.
The idea of treating clinical depression with exercise is a great one in theory. What must be considered though is whether a depressed person would actually be willing to exercise. When depression causes an individual to lose interest in their usual activities, it is highly unlikely they will be willing to partake in PA, especially if it is not something they have any interest in to begin with. Also, if an individual suffering from clinical depression was being treated with PA and they became injured and were unable to undertake in the PA any longer, there is a possibility that this may upset them and cause them to either revert back to their previous levels of depression or become more depressed than they were originally.
Medication as a form of treatment for clinical depression is sometimes considered a “band aid” – as it can assist in improving an individual’s mental state enough that they are then able to work with a psychologist to treat some underlying issues. Perhaps this could also be an option: using a lower dosage of medication to assist in stabilizing the individual’s mental state and then using the PA as an additional form of treatment.
Moving on to anorexia nervosa (AN), research into exercise in relation to AN is still fairly new. According to Young et al (2013), it plays a detrimental role in the pathogenesis and maintenance of the illness. “A scarcity of research has focused on targeted exercise interventions in treatment and recovery (Young et al), with most research focusing on other aspects of the illness.
Although not mentioned in the earlier definition, it has been noted that in addition to starving themselves, many individuals suffering from AN may exercise excessively.
This excessive exercise has been “associated with an increased risk of overuse injuries, bones fractures, and osteoporosis”. It “tends to be seen in younger patients, in those with a lower percentage of body fat and BMI, in those with greater severity of eating disorder psychopathology and general psychopathology, and in those with specific personality features (e.g., perfectionism, high persistence, and low novelty seeking and reward dependence). It also seemed to play an important role in the development and maintenance of eating disorders and has been associated with longer inpatient treatment, quicker relapse and poor treatment outcome.” (Marta Alberti et al, 2013)
As this excessive exercising plays a large role in the development of the illness, more research will need to be carried out to fully understand the effects of using PA and exercise as a treatment. It has, however been used successfully in a study by Young et al, who advised that for a “subgroup of participants for whom exercise was a part of their identity pre-morbidly, [re- establishing] healthy exercise [is an] integral part of their recovery process.”
In conclusion, we can see that the relationship between PA and exercise and mental illness can be both negative and positive. Research has been quite successful in the studies with individuals with depression but in a real life setting it is difficult to know if individuals would actually be willing to co-operate. The problem could be actually getting the individuals to go and exercise. Whilst with an illness such as anorexia nervosa the individual could be exercising too much. Another problem is with recording information: for anorexia nervosa, many of these individuals will be in denial and so questionnaires may be an inaccurate way of recording results. Individuals with depression may be unmotivated and unwilling to participate in questionnaires or even just in trailing something “that involves more work” than medication. Although at this stage further research still needs to be completed, exercise has been shown to benefit individuals suffering both Clinical Depression and Anorexia Nervosa. Close monitoring would of course be required due to exact outcomes still fairly unknown.
References:
Keegan, R. (2014, September 16). YouTube. Exercise, PA and Depression – YouTube. Retrieved October 5, 2014, from http://www.youtube.com/watch?v=qOcFNmIMyfA&list=UU7BHTk00vYUAC7DvJ2-n6QA
(2013). Australian Institute of Health and Welfare. Physical inactivity (AIHW). Retrieved October 10, 2014, from http://www.aihw.gov.au/risk-factors-physical-inactivity
(2014,). Cambridge Free English Dictionary and Thesaurus. Home page for British English Dictionary and Thesaurus – Cambridge Dictionaries Online. Retrieved October 10, 2014, from http://dictionary.cambridge.org/dictionary/british/
Weir, K. (2011, December). American Psychological Association (APA). The exercise effect. Retrieved October 11, 2014, from http://www.apa.org/monitor/2011/12/exercise.aspx
He, S., Tang, W., Tang, W., Kao, X., Zhang, C., & Wong, X. (2012). Exercise intervention may prevent depression. International Journal of Sports Medicine, 33(7), 525-530. doi:http://dx.doi.org/10.1055/s-0032-1306325
Taylor, C., Sallis, J., & Needle, R. (1985). The relation of physical activity and exercise to mental health. Public Health Reports, 100(2), 195-202. Retrieved October 11, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1424736/
Blumenthal, J. A., & Ong, L. (2009). A commentary on ‘Exercise and depression’ (): And the verdict is…. Mental Health and Physical Activity, 2(2), 97-99. doi:http://dx.doi.org/10.1016/j.mhpa.2009.08.001
Lawlor, D., & Hopker, S. (2001, March 31). BMJ. The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials | The BMJ. Retrieved October 15, 2014, from http://www.bmj.com/content/322/7289/763?linkType=FULL&resid=322/7289/763&journalCode=bmj
(2010, May). Eating Disorders Review – Eating Disorders Articles. Excessive Exercise Among Anorexia Nervosa Patients. Retrieved October 15, 2014, from http://eatingdisordersreview.com/nl/nl_edr_21_3_7.html
(2012, January 5). Mayo Clinic – Mayo Clinic. Anorexia nervosa Definition – Diseases and Conditions – Mayo Clinic. Retrieved October 14, 2014, from http://www.mayoclinic.org/diseases-conditions/anorexia/basics/definition/con-20033002
Davis, C., & Kaptein, S. (2006). Anorexia nervosa with excessive exercise: A phenotype with close links to obsessive-compulsive disorder. Psychiatry Research, 142(2–3), 209-217. doi:http://dx.doi.org/10.1016/j.psychres.2005.11.006
Young et al (2013). The role of exercise in the treatment and recovery process of anorexia nervosa. Journal of Eating Disorders 1(Suppl 1):O8. doi:10.1186/2050-2974-1-S1-O8
Alberti, Marta et al (2013). Assessment of Physical Activity in Anorexia Nervosa and Treatment Outcome. Medicine and science in sports and exercise, 45 (9), 1643-1648. doi:10.1249/MSS.0b013e31828e8f07
Danielsson, L., Papoulias, I., Petersson, E., Carlsson, J., & Waern, M. (2014). Exercise or basic body awareness therapy as add-on treatment for major depression: A controlled study. Journal of Affective Disorders, 168(0), 98-106. doi:http://dx.doi.org/10.1016/j.jad.2014.06.049
Progression of me 
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