Wednesday, June 3, 2009

Exercise


Many studies have shown positive results for the treatment and prevention of depression and anxiety (BP depression still needs to be evaluated though I believe exercise is one of those generic activities which can help anybody feel better) with an effectiveness comparable to pharmacotherapy and CBT. Not that exercise should replace other therapies, but rather should be used in conjunction with your current treatment plan.

The exercise can be either aerobic or strength training allowing for a lot of flexibility in an exercise routine. According to one study examining dose response of exercise, the benefits for alleviating and preventing depressive and anxious symptoms are obtained when one engages in physical activity according to the public health dose which is roughly 1200 calories burned per week (roughly 1/2hr of moderate activity per day) and exercise is performed at least 3 days per week.

With a psychiatric illness, finding the motivation to start any project can be extra difficult. It is recommended to not jump into the routine at full speed. Start small. Begin adding exercise into your daily routine with short durations of activity a couple of days a week and build on that as you adjust to having a new activity in your life. Think of exercise as a medication; you start at a small dose and increase that dose in appropriate increments until you reach therapeutic levels. Eventually, according to myself, exercise, like medications, should be something you give yourself everyday.

Once you have started, some tips for maintaining your routine include having a support system with your therapist, individualise your routine (type of exercise, time of day, listening to music, indoor vs. outdoor activities…), vary the types of exercises you do, and be creative in your selections. You may also find it helpful to keep an exercise diary where you note your activity, day and time, duration, and mood. I also think it can be very beneficial to practice mindfulness techniques during this time, even if only for a few minutes, you will begin to notice how your body responds to different stimuli which is especially important for feelings of anxiousness and other somatic symptoms.

For more motivation techniques, see my post on motivation techniques.

Some of the benefits of a regular exercise routine are increased self-esteem, community building (try incorporating at least one group physical activity), movement, and practice with goal setting.

Some ideas for different exercises (for a more extensive list including caloric output see this site):

• Morning walks – This might not be as vigorous as the others, but early morning is a great time for mindful walking. If you can get up at around sunrise, it’s a cheap light therapy which can improve your mood and help establish more regular sleep cycles. You don’t even have to change out of your pyjamas, just put on a jacket and some shoes.

• Rebounder – It’s like jumping on the bed for adults. Weights can be included in the routine. A note of caution, this may not be the most appropriate activity if you live in a basement with low ceilings, even if you’re short.

• Sledding – Some people like the snow. Run, instead of walk, back up the hill for extra exercise.

• Hair-dryer squats – I learned this from a colleague. Do squats while you’re drying your hair. It doesn’t cost any extra time from your day.

• Walk backwards and sideways on the treadmill - Because walking forwards is so passé. Also, it will work different muscle groups and improve balance.

• DDR (Dance Dance Revolution) – Put it on competition mode and press as many buttons as fast as you can.

• Sex.

• Tightrope walking – There is actually a product you can buy for your home. You can also go to an outdoor sports store and ask them what you need for zip-lining and set up the line between some trees or whatever.

• Balance beam – Turn a 2x4 on its side.

• Kitten fishing – Run around the house with a piece of string.

• Kitten chasing – Like kitten fishing, but there’s no string and the cat is running away from, instead of towards, you.

• Substitute cycling for driving or bussing once in awhile.

• Climb a tree.

• Chin-ups – There are bars you can install in your home. Or, you can see how many areas in your house you can do pull-ups off of without ripping of the moulding.

• Grocery weights – Carry your groceries with your arms fully extended. It looks funny, but is a great strengthening exercise.

• Free weights – You can pick these up cheap anywhere, but I find the Physician’s Desk Reference is a particularly effective object. Cats work well too, but you may want to feed them extra food as you get stronger.

• Hacky-sac – Old school yo.

• Ballet – Because Summer Glau does it.



References: 1, 2, 3, 4

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