Writing Samples

Exercising to improve mental health
By Kevin Dowler

The world wasn't crumbling around Mireille Lavoie but it was spinning pretty fast.

As a producer of the CBC French language morning radio program she has a lot to manage: finding what's hot in the news for that day, finding a local angle, finding a local source who speaks French; and all this before six o'clock every morning. And once that's done it starts all over again - a work schedule that would drive most of us overboard. To help keep herself above water Lavoie decided to stay on the boat and start rowing.

“Even after the worst day, there's nothing like a good row,” Lavoie says about her escape from her stressful workday. “I feel rowing has helped me better deal with pressure. Through rowing, I don't feel as overwhelmed.”

The link between physical activity and an individual's ability to deal with stress is something the medical field has seen a connection between and is continually trying to learn more about.

“There have been enough studies done that we can confidently say that working to develop a lean body, strong muscles and a strong heart will benefit more than your cardiovascular system,” says Dr. Kent Kowalski an associate professor of the University of Saskatoon's College of Kinesiology. “We can't ignore the mind/body link; they do have an influence over one another,” Kowalski says. “Fitness generally leads to a person taking all around better care of themself and the studies have shown that physical activity also helps to develop mental fitness too.”

Dr. Wayne Schlapkohl, a psychologist with the Prairie North Health Region's Adult Community Support Program at the Battlefords Mental Health Centre, says there have been a series of studies on depression and physical activity that have concluded that regular exercise promotes wellness and mental health.

One report from Duke University studied people suffering from depression and found that 60 per cent of the participants who exercised for 30 minutes, three times a week overcame their depression without using antidepressant medication.

Another study found that short workouts of eight minutes in length could help lower sadness, tension and anger along with improving resistance to disease in healthy people. Many people exercise to boost confidence along with reducing anxiety and stress, all of which contribute to psychological health and well-being.

Schlapkohl says there have been studies that have shown that patients who were exercising and no longer showing signs of depression showed the same results as for those who only used medication in their depression treatment. In a Mayo Clinic study, scores showed that depression worsened in a control group that did not exercise.

Another positive but hard to measure effect from physical activity is improved self-esteem.

“Because the typical traits improved through exercise relate to the main characteristics of self-esteem - attractiveness, strength and athletic skills - it is hard to tell exactly what is causing the feeling of self improvement,” Kowalski says.

But the improvement is there. It's the fitness that helped to develop those key self-esteem components and those traits that then help to improve how people feel about themselves, Kowalski says.

As well as an improvement in her physical fitness, Lavoie says she has a stronger sense of self-confidence and focus since starting rowing two years ago.

“In a race I don't have time to think about what went wrong on the last stroke; I'm thinking about what I can do right on the next one,” she says. “I can see myself doing the same thing at work. I'll take time later, after (the show) to analyze what I can do better or change the next time.”

Lavoie's selection of rowing as a sport is a reflection of her daily work. There is a similarity in the cyclic repetition of the oar stroke when compared to the cyclic repetition of producing a daily radio show. Each oar's stroke is followed by another, to keep the boat moving forward by working closely with her teammates, with the stroke's end only to be replaced with another. Much like her work day, where each radio show is followed by another, finishing one show only begins the cycle to be repeated again tomorrow.

“When you're rowing you have to think about a lot of different things while trying to relax and not to panic if something goes wrong. The same thing happens at work,” she says. “Rowing is a positive thing for me. It doesn't matter how bad of a day it is at work, I always look forward to getting on the lake.”

Schlapkohl notes the feeling of well-being generated during and after exercise is also a reaction to the body's natural release of endorphins during exertion. Endorphins are the body's opiate-like chemical released by the brain. The release of endorphins creates an increased feeling of happiness, Schlapkohl says.

“One of the interesting things currently being studied about endorphins is that it's not really how hard you work that determines how much endorphins are released,” Schlapkohl says. “Studies are now showing that it is not just aerobic activity that enhance mood but any activity can do it. The good news from this is that almost any amount of exercise seems to work (to release endorphins).”

The studies have shown the better shape you are in the less effect you get from the endorphins.

“The evidence suggests those people who are not fit will notice the mood elevations more than those who are fit,” Schlapkohl adds. But no matter what kind of shape you are in you can still exercise to feel better. Now that the link between mind and body has been clearly established, Schlapkohl says, the next question that is being studied is to determine what the optimal “dose of exercise” is needed to have an effect. Another factor that seems to work into the equation of improving mood through physical activity is distraction.

When people are exercising, they are forced to think about that activity rather than the concerns in their lives that may be contributing to their low mental condition. A new runner will be focused on running - where their legs are or getting their kick right rather than what's going on in their life, Schlapkohl uses as an example.

And the same goes for rowing, Lavoie adds. There are so many technical aspects in rowing: where your hands are, how you are sitting, how high you are lifting your oars, how you are using your oarlocks and how the rest of your team is working.

“It is a very technical sport so when I'm out there that's all I am thinking of,” Lavoie says. In his practice, Schlapkohl has used physical activity in his treatment for patients showing signs of depression.

“As an example, if I knew a patient used to swim I would say I want them to go for a swim this week and I'm going to ask about it next week,” Schlapkohl says. “Almost everyone who has done this has said the exercise was helpful but it was hard.”

It's difficult to do on a physical level and while fitting it into a busy schedule. This is where you start to see individuality coming into play, he says. Some people like to create a social aspect of exercise while others like to exercise alone. There are some people who would rather exercise in a group for the social aspects of joining a group. Today, running is a popular form of group exercise.

“For some people part of the appeal is that it is nice to be in a group without the pressure to talk. A running group is one of the few places where you can be in a group without feeling the need to talk,” Schlapkohl says.

In general, exercise leads to an increase in energy and to better sleeping patterns, which may also explain why exercise is so helpful to people with depression. A series of studies by the Mayo Clinic found sleep patterns were improved in the people using exercise. One of the Mayo Clinic studies found that regular physical activity is a natural sleep-enhancer and that a daily walk or exercise class can help a person sleep more soundly at night. From these studies, exercise can be viewed as a preventative or wellness activity that may actually help prevent physical and emotional conditions. The studies have shown that even short bursts of activity will help individuals feel better, which means that you don't have to spend hours at the gym or on the track to gain real mental health benefits.

Both Schlapkohl and Kowalski note studies that found that exercise has been demonstrated to be as effective as some medications in treating depression. If you find you have lost the ability to experience joy from things that you used to enjoy you may be experiencing depression. Schlapkohl says he has people experiencing depression gauge on a scale from one to 10 how much they enjoy doing something they would have enjoyed before the depression and they gauge how much enjoyment they get out of the activity while they are being treated for depression. As their mood improves the number should go up.

When you are in the midst of depression you are not going to be able to quickly jump back up to the level where you enjoyed things before, but there should be a gradual improvement, he says. It's a slow process to come out of depression. Schlapkohl says it can take as long as 12 weeks for people to recover from a bout of depression. Even when using physical exercise as part of a recovery program he wants to remind people that recovery is a slow process when using either medication or physical exercise as part of the treatment program.

“It's too difficult to judge for ourselves if and when we are better” Kowalski says. “You need to know yourself very well; but, as with all sciences, you should seek the advice of experts to do the final measurements.”

Keeping a physician involved in your physical and mental health is important. Exercise can reduce the symptoms of depression, anxiety and sadness - but only the symptoms, not what is causing the problem. The symptoms you are battling with are just that - symptoms of something else, possibly more serious that you realize - and going to the gym can't replace a visit to a doctor, Schlapkohl says.