Fw: Exercise for depression

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Exercise for depression

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|| Exercise eases symptoms of anxiety and depression

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|| By MayoClinic.com

|| More on this in Health & Fitness

|| a.. Psychotherapy: Improve your mental health through talk therapy

|| b.. Mental health providers: Making the right choice

|| c.. Medical Encyclopedia

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|| If you have depression or anxiety, you might find your doctor prescribing

| a regular dose of exercise in addition to medication or talk therapy.

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|| " There's substantial evidence that exercise can enhance mood and reduce

| symptoms of depression, " says Vickers-, Ph.D., a

psychologist

| at Mayo Clinic, Rochester, Minn. " It's not a magic bullet, but increasing

| physical activity is a positive and active strategy to help manage

| depression. "

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|| Exercise has long been touted as a way to maintain physical fitness and

| stave off high blood pressure, diabetes, obesity and other diseases. A

| growing volume of research shows that exercise also can help alleviate

| symptoms of certain mental disorders, such as depression and anxiety, and

| help prevent a relapse after treatment.

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|| Before you think, " Yeah, right, " and move on, consider this: Exercise

| doesn't have to come in large doses to offer psychological benefits. Even

as

| little as 10 minutes of low-intensity walking helps. Your goal doesn't

have

| to be losing 20 pounds, being able to run five miles nonstop or hitting

the

| gym at 6 a.m. three days a week for a sweat-drenched workout.

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|| Rather, the idea is to do something active in order to trigger the

| mechanisms that reduce negative moods and improve positive moods. And with

a

| little planning and some practical tips - after all, it's not a matter of

| sheer willpower - adding exercise to your treatment program won't seem so

| daunting, even if you experience severe symptoms of depression or anxiety.

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|| Despite ongoing research, just how exercise reduces symptoms isn't clear.

| There are plenty of theories, though, about both the physiological and

| psychological pathways that can improve symptoms related to depression and

| anxiety disorders, including sadness, anxiety, stress, fatigue, anger,

| self-doubt and hopelessness.

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|| One of the physiological mechanisms that may be at work is an increase in

| levels of certain mood-enhancing neurotransmitters in the brain. In

| addition, exercise may boost feel-good endorphins, release tension in

| muscles, diminish sleep abnormalities, reduce levels of the stress hormone

| cortisol and even increase body temperature, which has calming effects.

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|| Psychological benefits

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|| Psychologically, exercise can work in numerous ways, Dr. Vickers-

| says. Among them:

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|| a.. Improved accomplishments and confidence. Engaging in physical

| activity affords a sense of accomplishment and can provide a boost in

| self-confidence - you've met a goal or challenge.

|| " Having confidence in our ability to make positive change is strongly

| associated with actually taking steps to make that change happen, " Dr.

| Vickers- explains. " However, people with depression often feel

| ineffective in taking care of themselves and their responsibilities. They

| may lack confidence in their ability to manage themselves and their

| depression. Achieving physical activity goals, no matter how small, can

| boost self-confidence and a sense of accomplishment, which makes it easier

| to take the next positive step. "

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|| a.. Positive distraction. When you have depression or anxiety, it's easy

| to repeatedly focus your attention on yourself, your symptoms and the

| consequences of your symptoms - to ruminate. But that kind of dwelling

| interferes with your ability to problem solve and engage in more active

| coping strategies. It can also make depression more severe and longer

| lasting.

|| " Physical activity can help shift attention away from unpleasant or

| unhelpful thoughts and instead direct attention toward neutral or pleasant

| thoughts and activities, " Dr. Vickers- says. Exercise provides a

| positive shift in focus - to your surroundings, to the music you listen

to,

| to other people.

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|| a.. Improved self-esteem. With anxiety and depression, self-esteem can

| take a hit. Getting exercise, even small amounts, can reshape how you

think

| about your appearance and your own self-worth. Doing something for

yourself

| means granting yourself more value.

|| a.. Positive pairings. The physical experience of physical activity -

| breathing changes, sweating, increased pulse - can mimic the signs and

| symptoms of anxiety or panic disorder. But in the case of physical

activity,

| these symptoms occur without emotional distress. In that way, exercise can

| help disconnect the pairing of physical symptoms with distress, Dr.

| Vickers- says. For people with panic disorder, it's the symptoms

| themselves that come to be feared. Associating something positive with

those

| symptoms, instead of a panic attack, for instance, can help you learn how

to

| manage the symptoms and not live in fear of them, she says.

|| a.. Environmental reinforcement. Exercise also gives you an opportunity

| to experience positive social or environmental reinforcement. " Depression

| often makes people want to isolate themselves, " Dr. Vickers-

| explains. " But by doing so, they miss out on experiencing positive

| interactions with others or their environment, such as a smile or kind

word

| from a passerby, or the sights and sounds of nature. "

|| a.. Positive coping skills. Doing something beneficial to manage your

| depression or anxiety is a positive and active coping strategy. Trying to

| manage your moods through excessive alcohol consumption or dwelling on the

| consequences of your negative mood are unhelpful coping strategies. Rather

| than waiting passively for depression or anxiety to change, taking active

| steps, such as increasing physical activity, can help you gain confidence

in

| your ability to manage your symptoms, Dr. Vickers- says.

|| It's likely that no one single biological or psychological factor

| associated with physical activity is responsible for improving depression

| and anxiety. Just as mental disorders often have many different causes,

| exercise acts in many different ways.

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|| " There's plenty of evidence to suggest that exercise is important for

| emotional well-being and is helpful in reducing symptoms of depression, "

Dr.

| Vickers- says. " It's true that less is known about how exercise

| affects mood. But there's no reason to wait until the direct, indirect and

| interactive influences of physical activity on mental health are fully

| understood. You can start taking advantage of the benefits of physical

| activity now. "

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|| Overcoming the inertia of depression

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|| Of course, knowing that something's good for you doesn't make it any

| easier to actually do it. Most people in the general population don't

engage

| in any regular physical activity or quit shortly after starting an

exercise

| program. Depression and anxiety can make it even more difficult to get

| active. By its nature, depression means that you don't enjoy activities,

| that you're often fatigued or sedentary, that you just don't feel like it,

| that you lack motivation, or that you don't stick to treatment regimens

very

| well.

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|| You may have a hard enough time doing the dishes, showering or going to

| work. How can you possibly consider adding exercise to the mix?

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|| Overcoming that inertia can be daunting. Another challenge is

maintaining,

| or adhering to, an activity program. Setting realistic goals, doing some

| problem solving, and recognizing that exercise won't always be fun or easy

| can help.

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|| a.. Talk to your doctor. Although not all mental health professionals

| have adopted exercise as a part of their treatment regimen, talk to your

| doctor or therapist for guidance and support. Jointly assess your issues

and

| concerns about an exercise program and how it fits into your overall

| treatment strategy.

|| a.. Identify what you enjoy. Figure out what type of exercise or

| activities you're more likely and less likely to do, as well as where,

when

| and how often. For instance, would you rather garden in the evenings, jog

in

| the pre-dawn hours, go for a brief walk in the woods or play basketball

with

| your children after school?

|| a.. Set reasonable goals. Your mission doesn't have to be to walk for an

| hour five days a week. Even a 10-minute walk can help lift your mood, get

| you into a more positive environment and refocus your thoughts, even

| temporarily, away from negative or self-critical thinking patterns.

| Custom-tailor your plan to your own needs and abilities.

|| a.. Break it down. It might be good to have an overall exercise

strategy.

| But focusing on the perfect plan or an ideal rather than what's realistic

| for you can sabotage your efforts. Don't start with the ideal and work

| backward. Start with the realistic and work forward. Break your program

down

| into smaller parts. If you can't fathom walking for 45 minutes, what is

| possible? Fifteen minutes? Five minutes? Start there, and build on that

| foundation.

|| " For many of us, just getting our shoes on and getting out the door is

| the majority of our effort. That's the hardest part, " Dr. Vickers-

| notes. " Once we're moving, though, it's often easier to keep moving. So

put

| your energy into the front end - into just getting started. "

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|| a.. Have short-term coping strategies. You may have a structured

exercise

| program that calls for activity several times a week at the local gym. But

| plan for active ways to cope immediately and quickly with unexpected

| negative moods, depression, anxiety or other issues. For instance, even if

| it's your day off from exercise, taking a 10-minute walk may quickly help

| lift your mood if you're sad or anxious or find yourself focusing on

| negative thoughts. " Try to respond to a negative mood with physical

| activity, " Dr. Vickers- says.

|| a.. Don't think of exercise as a burden. If exercise is just another

| " should " in your life that you don't think you're living up to, you'll

| associate it with failure. Rather, look at your exercise schedule the same

| way you look at your therapy sessions or antidepressant medication - as

one

| of the tools to help your treatment. " Reframe the way you think about

| physical activity, " Dr. Vickers- says. " Don't think of it as just

| another thing that you should be doing, but can't because of all of the

| demands in your life. Instead, think of it as something positive that you

| can do now to help you meet your goals, including feeling better

physically

| and emotionally. "

|| a.. Address your barriers. Identify your individual barriers to

launching

| a program. If you're self-conscious, for instance, you might not want to

| exercise in public.

|| If depression makes you feel like you're carrying a heavy weight around,

| the idea of moving on purpose, doing something active, can seem absurd.

The

| barriers may feel overwhelming. But when you have depression, it's easy to

| overestimate difficulty. Instead, develop a strategy to overcome or get

| around those barriers. If you don't want to go to a crowded gym, perhaps

you

| can go to a quiet park or use a home treadmill or bike. If you're put off

by

| the thought of spending 30 minutes jogging, aim for five minutes of

walking

| instead of just doing nothing. If five minutes seems daunting, try two

| minutes.

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|| a.. Prepare for setbacks and obstacles. Exercise isn't always easy or

| fun. And it's tempting to blame yourself for that. People with depression

| are especially likely to feel shame over perceived failures. Don't fall

into

| that trap. Give yourself credit for every step in the right direction, no

| matter how small, Dr. Vickers- says.

|| " Chances are, you're going to come to a time when it gets really hard, "

| she says. " If you say that you're a failure, that you blew it, that you

have

| to start all over, you're more likely to quit altogether. Recognize that

| change is hard and setbacks are part of the change process. By learning

how

| to cope with setbacks, you'll learn skills that will help you stay active

| over the long term. "

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|| Sticking with the program

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|| Launching an exercise program is hard. Maintaining it can be even harder.

| " In the general population, most people who start an exercise program quit

| after a few months, " Dr. Vickers- says. " For people with

depression,

| making change and sticking to it can be even more difficult. "

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|| A key to exercise maintenance is problem solving. " What would happen if

| you went out to your car and it wouldn't start? " Dr. Vickers- asks.

| " You'd probably be able to very quickly list several strategies for

dealing

| with that barrier, such as calling an auto service, taking the bus, or

| calling your spouse or friend for help. You instantly start problem

| solving. "

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|| But most people don't approach exercise that way. What happens if you

want

| to go for a walk but it's raining? Most people decide against the walk and

| don't even try to explore alternatives. " With exercise, we often hit a

| barrier and say, 'That's it. I can't do it, forget it,' " Dr.

| Vickers- says.

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|| Instead, problem-solve your way through the exercise barrier, just as you

| would other obstacles in your life. Figure out your options - walking in

the

| rain, going to a gym, exercising indoors, for instance.

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|| " Some people have the idea that being physically active is supposed to be

| easy and natural, " Dr. Vickers- says. " Some think of it as just

| having enough willpower. But that really oversimplifies it and can make us

| feel like failures. You can't just rely on willpower. Identify your

| strengths and skills and apply those to exercise. Change isn't simple, but

| taking a series of simple steps in the right direction can be very

| effective. Just figure out what is the very first step for you. "

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|| In the end, the psychological payoffs can make that effort worthwhile.

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|| " I really believe in empowering people to take an active role in their

| treatment, " Dr. Vickers- says. " And physical activity can be an

| important part of that. "

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