Fitness and Mental Health
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Transcript of Fitness and Mental Health
Fitness and Mental Health: Exploring the Mind-Body Connection
Objectives The student will learn about:
The benefits of sunlight, oxygen, movement and endorphins on mood
How exercise can help mitigate depression, anxiety, bipolar disorder, postpartum depression, hyperactivity, bulimia/binge eating and addiction
Common mental health issues in the “average” population and their frequency
Common psychotropic medications and their side effects which may affect balance, coordination, reaction time and stamina
Objectives Cont...
Dehydration and the effectiveness of certain medications Special concerns when working with clients/students
with eating disorders The benefits of exercise in the elderly with regard to
depression and suicide The benefits of teaching children to love exercise
including prevention of many physical and mental health problems in later life
The interaction between hormone shifts, sleep deprivation and postpartum depression
S.O.M.E.
Gotta getcha S.O.M.E. Sunlight Oxygen Movement Endorphins
Sunlight
Benefits Vitamin D Stonger Bones Improved Rest Improved Mood
Ways to incorporate Go outside Sunlight spectrum bulbs
How much? 20 minutes per day
Oxygen
Signs of too little in a healthy person Yawning Feeling tired
Benefits Energy Increased blood flow Relaxation
Movement
Signs of too little (or too much) Tiredness Depression Aches/Stiffness Weight problems Muscular atrophy Sleep problems
Movement cont…
Benefits Increase bloodflow Strengthen muscles and bones Improve sleep Reduce aches and pains Improve weight Improve self-esteem Eliminate toxins Relieve constipation
Movement cont…
Types Fitness classes---provide levels of workout Encourage movement bewteen classes—walking,
house cleaning, gardening, tennis...
Endorphins
Happy chemicals Finding the happy medium
Stress
What is it: Fear? Anger? Both? How common is it (15 per day) 6 Basic Stressors
Fear of Death Loss of Control The Unknown Rejection Failure Isolation
* Discussion Forum *
How prevalent is stress in your life? In your work? What would you identify are the primary sources of your stress? How does stress affect you physically? What activities reduce your stress? We would love for you to share your responses in the discussion forum. Thank you.
Stress Chemicals Adrenaline
Function Mental Health Side Effects Physical Side Effects And Exercise
Cortisol Function Mental Health Side Effects Physical Side Effects And Exercise
http://www.heartcenter.com/billett.html
Prevalence of Mental Health Disorders
Anxiety: 18% Depression: 8-9% (not including situational or
postpartum) Bipolar Disorder: 3% Eating Disorders: 8% Alcohol and Drug Addiction: 7%
According to the National Institute of Mental Health “The Numbers Count: Mental Disorders in America”
Psychotropic Medications
Antidepressants
MAOIs Side effects: Drowsiness, Dizziness, Weakness,
Shakiness, Fatigue, Weight Gain SSRIs
Side effects: Weakness, Dizziness, Shakes Usually remit within one to two weeks Often recur if client misses a dose
Antianxiety / Sedatives / Anticonvulsants
Benzodiazepines, Barbiturates, Anticonvulsants Examples: Xanax, Valium, Restoril, Librium,
Ativan, Phenobarbital, Pentobarbital, GHB Side effects: Drowsiness, Coordination Loss,
Dizziness, Occaisional Hypotension, Reduced Reaction time
Mood Stabilizers and Side Effects Lithium
Dizziness Weight Gain
Tegretol/Carbamazepine Sleep Problems
Depakote/Valproate Weight Gain Drowsiness
Seroquel/Quetiapine Drowsiness Antianxiety properties
Mood Stabilizers Cont...
Geodon/Ziprasidone Risperdal/Risperidone
Drowsiness Clozapine
Major weight gain Zyprexa/Olanzapine
Weight Gain
Medications in italics have evidence of both anitdepressant and anti-manic properties
Medications in yellow are classified as Atypical Antipsychotics http://www.psycheducation.org/depression/meds/moodstabilizers.htm
* Discussion Forum *
There are many new treatment medications available today compared to 20 or even 10 years ago. What differences have you noted regarding treatment effectiveness with the newer medications? Which area of psychopharmacology would you like to see researched and developed more? We would love for you to share your responses in the discussion forum. Thank you.
Common Types of Mental Health Issues that Benefit from Exercise as an Adjunct Therapy
Anger
Benefits of exercise Channels energy to positive activity Burns up stress chemicals and free-floating fatty
acids Can be cathartic
Medication Generally not medicated unless patient is a
danger Possibly barbiturates Tendancy towards alcohol or marijuana abuse
Anxiety Cluster of disorders (GAD, PTSD, Phobias) Generally referred to as fear, stress, worry or
tension Affects 18 percent of the population Benefits of Exercise
Helps clients clear their mind/focus on something other than their fear
Burns up stress chemicals helping to relieve the fight or flight response
Provides clients with venue for social support/interaction
Anxiety Medications
Benzodiazepines Barbiturates SSRIs/Antidepressants Busiperone
Bipolar Disorder
Formerly called manic depression Occurs in 3 percent of the population Benefits of Exercise
Improves mood during depressive phases May provide an appropriate outlet during manic
phases Clients can be reckless during manic phases so
adequate supervision is essential
Medications for Bipolar
Mood Stabilizers are the drugs of choice Many mood stabilizers
Cause weight gain Increase fatigue May demonstrate alterations in effectiveness if
patients become dehydrated (A. Fariborzian, M.D. (2006), personal communication)
Depression
Major Situational Seasonal Affective Disorder (SAD) Premenstrual Dysphoric Disorder (PMDD) Postpartum
Depression Treatment
Major Antidepressants, MAOIs Behavioral—nutrition, exercise, social support,
sunlight Situational / SAD / PMDD
Anitdepressants (Short course) Behavioral as above
Postpartum Depression (PPD)
Crucial to be aware of statements of harm or obsessions
Often occurs during major hormone or schedule shifts 1-2 weeks after birth 1-2 weeks after stopping breast feeding Periods of sleeplessness Can occur up to 1 year after birth Might be associated with hypothyroid
http://www.med.umich.edu/depression/postpartum.htm
PPD Cont...
Mothers at higher risk (controversial) Mothers with pre-existing eating disorders Mothers with pre-existing depression or anxiety
disorders Mothers with little social/family support
PPD Treatment/Exercise
Medications Antidepressants Antipsychotics Antianxiety Anticonvulsants
Sunlight and Exercise To improve mood and regulate sleep schedule Some evidence indicates exercise can help mitigate the negative
interaction between hormones and neurotranmitters Can help mom relax and have positive effects on baby
Exercise & PMS By: Carol Krucoff http://yourtotalhealth.ivillage.com/diet-fitness/exercise-amp-pms.html?pageNum=1
Behavioral Issues and Exercise
Addictions
Most people with addictions have co-occurring depression and anxiety.
Addictions are often self-medicating. Exercise can help relieve stress, improve self
esteem, improve energy and increase positive neurochemicals: norepinepherine, endorphins.
Eating Disorders—Bulimia, Binge Eating
Approximately 8% of the population can be diagnosed with anorexia or bulimia.
5.5%-11% of the population can be diagnosed with binge eating disorder.
What can we do?
Providing a healthy exercise environment models positive behaviors for clients with EDs.
Teach that moderate exercise is a vital component to reducing depression, anxiety and bingeing.
Be aware that overuse of vomiting, laxatives and diuretics may make this population weak and can lead to heart attack, fainting, stroke.
* Discussion Forum *
Do you see a difference in response to treatment for those clients who exercise as suggested versus those who do not exercise? How are their outcomes different? Please share your responses in our discussion forum. Thank you.
Eating Disorders: Anorexia
They are driven by an obsession with perfection and control.
Fitness Instructors: Use extreme caution working with this population. They are often emaciated and in uncertain physical condition.
Hyperactivity
Home grown 7-year old hyperactivity, not AD/HD
Group fitness classes right after school can provide positive outlets for pent up energy
Exercise in the morning for adults who have excess nervous energy
Special Populations
Children Elderly Law Enforcement
Children
Develop self esteem and motor skills through exercise
May reduce oppositionality Provide daily opportunities for success and
challenge Early exercise habits prevent later life obesity
etc. Early exercise habits also improve self-esteem
and self confidence which buffer against later mental health problems.
Kids continued...
Make it FUN! http://kidshealth.org/parent/nutrition_fit/fitness/exercise.html Theodore Ganley, MD, and Carl Sherman, “Exercise and
Children’s Health," The Physician and Sports Medicine Journal, (February, 2000).
Elderly
18 % of elderly persons are depressed (National Alliance on Mental Illness, 2008)
Persons over 65 have the highest rates of suicide of any age group
Social interaction is the number one buffer against elder suicide
Elderly cont...
Exercise provides Social Interaction Reduced depression Improved Sleep
Have classes that target the over 65 group Use music appropriate to their genre For counselors: Many elderly patients have
trouble opening up in a counseling office, but not on the walking track
Many elders will confide in each other, but believe “counseling” is taboo.
Law Enforcement/ER Physicians and Nurses
Constantly experience chronic low-grade stress with bursts of extreme stress
LEO have heart disease now listed as a work related disability due to chronic stress levels
(D. Snipes (2002) Gender differences in the perception of stressors among law enforcement officers”)
Can reduce some of the negative impact through exercise
Shift workers
Have classes/appointments at 2 or 3 in the afternoon for midnight shifters
Keep the room bright 12-hour shifts
Showing up after a long shift, coordination and energy levels may be down, but cortisol may still be high
Encourage mild to moderate exercise
•Summary
Exercise can mitigate many mental health and behavioral problems through S.O.M.E.
Many class participants/clients are probably taking psychotropic medications
Side effects of medications can include reduced reaction time, impaired judgement, dizziness and impaired coordination
Some medications effectiveness is drastically changed based upon the hydration level of the patients (esp. antipsychotics)
Summary cont...
Getting children to love exercise early helps prevent a host of later-life physical and mental health problems
Fitness programs targeting the elderly help reduce depression and possibly suicide