Physical Activity and Improved Well-Being - Essay Example

EFFECT OF PHYSICAL ACTIVITY IN THE PREVENTION AND TREATMENT OF ANXIETY PATIENTS 12TH JANUARY, 2009 RATIONALE FOR THE ROLE OF PHYSICAL ACTIVITY IN THE DEVELOPMENT OF PSYCHOLOGICAL WELL-BEING Mental illness is a growing issue which has affected a major chunk of population in the past and is still advancing at a rapid pace. In some countries it is as severe as the soaring presence of high blood pressure and hence, becomes a major public health concern. WHO has predicted that depression and other similar mental disorders like anxiety will create the greatest burden of disease by coming year 2020. ‘Anxiety’ is a type of disorder that causes emotional discomfort associated with "stress" while ‘Depression’ indicates a wide range of disorders affecting many aspects of human physiology, and can be triggered through various psychological , biophysical and social stressors (Sarbadhikari N S, Saha K A, 2006). Though extensive research has been carried out to explore the relationship between depression and physical activity but very little study is conducted to find out how exercise acts as a catalyst to prevent clinical anxiety disorders. In the current scenario, anxiety and depressive disorders are considered to be the critical health problems, and desirable changes in lifestyle, such as physical exercise, have been considered the major remedial measures in prevention and treatment of such chronic disorders. There are numerous evidences (Aroa T, 2000: Martinsen W E, 2008) which reveal the essence of the physical activities in reducing the risk of developing depression and anxiety. The exercise interventions are now associated with remarkable benefits for patients suffering from varied levels and intensity of depression from mild to moderate as well as in reducing anxiety. The supported facts of the researches have led to the proposal that exercise may serve as an alternative or a supplement to conventional forms of medical therapies and there certainly exists as a potential association between exercise and reduction in anxiety symptoms. ADVANTAGES AND STRATEGIES FOR PROMOTING PHYSICAL ACTIVITY AND REDUCING ANXIETY Regular physical activity is taken to be one of the effective nonpharmacological therapies desirable to integrate physical activity in the routine treatment (Volker K, 2006). The most common physiological explanations regarding the effect of exercise on anxiety involve the action of endorphins within the central nervous system, the increase of the body (Salmon P, 2001)and the brain temperatures which produces calming effects, the distraction hypothesis which states that “ time out from the worry can trigger relief from depression and anxiety “and the mastery hypothesis states that “completion of an important and crucial task brings a sense of well being” (Dishman K R, 1995). Apart from the above , exercise also raises the levels of certain mood-enhancing neurotransmitters in the brain, which further release muscle tension, and help in attaining sound sleep. Physical exercise and anxiety result in advantageous outcomes as being physically active is in itself a sense of accomplishment. Exercise helps in diverting the focus from unpleasant thoughts to something more pleasant. Physical activity helps in building up a socialized environment and inculcating health coping strategies. To add on, regular physical activities help in improving cardiovascular and cognitive functions. To promote exercising it is important to adopt strategies for encouraging and spreading the role of physical activities which could also be initiated in numerous ways such as launch of awareness campaigns, involvement of different media etc. Small increases in physical activity can lead to greater levels of physical and psychological wellbeing. Some of the skills and strategies that have been explored by Reynolds F (2001) can prove to be quite effective in supporting individuals to adopt a more active lifestyle. Such strategies can be imbibed in form of educational interventions, exploring barriers to physical activity, promoting self-efficacy for exercise, maximising rewards, encouraging goal setting, enhancing resistance to relapse, building social support and providing reminders or cues to action (Reynolds F, 2001). The above mentioned strategies can extend an occupational therapy to patients suffering from varied levels of anxiety and can be applicable in both physical health and mental health settings. EVIDENCE AND SUPPORT FROM RECENT THEORY AND RESEARCH Physical activity is regarded as a primary means of preventing chronic diseases and helping in rehabilitating the patient. Physical activity has many positive impacts on an individual’s health and well being. To support the fact and provide evidences that physical activity/exercise is quintessential for reducing the negative consequences of anxiety and emotional stress, various researches and studies have been undertaken. The recent evidence on physical activity or exercise and reduction of chronic mental disorders like depression, emotional stress, anxiety etc, incidences just replicate the results as marked in the past findings. The current evidence confirms previous findings that exercise is one of the determinants for physical and psychological well-being (Kruk J, 2007). In adults with mental affective disorders, physical activity has a positive effect on symptoms of depression and anxiety. The research conducted on animals revealed that exercise stimulates the growth of new brain cells and improvement memory and learning which are greatly affected by the ill effects of anxiety levels (Williams & Willkins, 1996). McAuley E, Marquez DX, Jerome GJ, Blissmer B, Katula J (2002) in his study identified the extent to which the positive changes in the social physical anxiety were attained due to the regular physical activity participation and exercise programs. In the study intervened, six months of physical activity and six month follow up on reduction in SPA was ascertained whereby changes in behavioral, physiological and psychological attributes were taken into consideration. Positive results were observed from 174 participants where physical activity intervention indicated improvements in self efficiency and overall fitness. Bowden RG, Rust DM, Dunsmore S, Briggs J (2005), also conducted a research regarding social physique anxiety where the relationship between anxiety and different physical activity course for 16 week duration. 315 undergraduates were entailed in either physical activity courses or an emergency care conducted via a fitness course which had higher anxiety scores. The results supported that scores showed improvement between 8 and 16 wk Landers (1997) also proved that exercise produced the greatest positive benefits in cases of aerobics lasting for more than 10 weeks and in situation where subjects had lower level of fitness or higher levels of anxiety. In relation to aerobics in specific, the preliminary or the initial research studies dealt with the influence of the intensity of exercise, as lower power outputs were not related with the reduction in state anxiety whereas higher power outputs indicated reduced anxiety levels. Hence the past researches concluded that physical activity should be of atleast moderate intensity to show the signs of anxiety reduction but the recent works just ignored and ruled out the effects of intensity (Morgan P W, 1997). It is also suggested that aerobic exercise leads to improvements only in anxiety however aerobic exercise as well as anaerobic exercise are linked with lowered levels of depression. Evidences from various sources confirm that proper physical activity exercises mitigates the levels of anxiety and depression in patients with various diseases such as cancer etc and also that untreated depression is one of the visible causes of impaired cognitive functions. (Midtgaard J et al., 2005). Lower depression and increased well-being, after aerobic exercise, was observed in the normal population, specifically in the older people (Antuneset H K et al., 2005). Moderate exercise is almost equivalent and effective as walking in older people (Motl R W et al, 2005). Moreover, adult people with mild or moderate depression respond better to exercise of higher intensity (15,5 kcal/kg/week) than low intensity exercise (7 kcal/kg/week) (Dunn, 2005).   A study has also found out that increase of participation in the physical activities, helps the students to enhance their self esteem and reduces anxiety and stress levels (Key Note 1). In relation to mental health, physical activity is also found to augment the student’s capacity to learn. Infact in one such study, prolonged two year participation in the physical education program helped in attaining several favorable effects on academic achievement due to reduced anxiety and stress levels (Sallis JF, McKenzie TL, Kolody B, Lewis M, Marshall S, Rosengaurd P, 1999). In a study conducted by Dishman K R, (1995), a central shortcoming is highlighted relating to an absence of hard core evidence of physiological mechanisms coherent with biological or cognitive theory about the causes and cure of anxiety. The need for further research on the specific area is clearly shown. In another study conducted by Dunn A L,Trivedi M H, O’Neal H A (2001), the identification of the scientific evidence for a dose-response relation of physical activity to mental disorders comprising of depression and anxiety disorders were undertaken. The observational studies conducted indicated that greater amounts of occupational and leisure time physical activity are directly linked with the reduction of symptoms of depression and anxiety. Quasi-experimental studies also highlighted that light-moderate, and vigorous-intensity exercise can help in mitigating the symptoms of mental disorder. No RCTs are found to have different frequency or fluctuating time durations of exercise in relation to the studies of depression or anxiety. Quasi-experimental and RCTs reflected that both resistance training and aerobic exercise carried immense potential to trim down the symptoms of depression. The results of the experiment show that all evidence for dose-response affects of physical activity and exercise remain reasonable. Studies have also brought in hard facts which state that increased temperatures during exercises contribute towards reduction in anxiety levels but body warming is not the only reason for the reduction of anxiety levels or improved mood (Dishman K R, Washburn A R, Heath G, 2004). Further endorphins are also related with reduced anxiety levels after extreme physical activities but still there is no supportive evidence in the related context. Studies conducted on human elements which used opioid blocking drugs during the exercise, still found out that there were people who reported, reduction in anxiety or feelings of tension. Researchers have also found that acute and chronic exercise can help in muscle relaxation but they have not been able to relate whether reduced muscle tension (Dishman K R, Washburn A R, Heath G, 2004) after exercise is a part of reduced anxiety or is a response after exercise which is independent of anxiety. A different key point was also brought forward whereby a reduced rate in startle response was considered to be effective in reducing the self rating of state anxiety in conditions of post quiet rest and moderate intensity cycling exercise(Dishman K R, Washburn A R, Heath G, 2004). Many studies have also concentrated on results which reveal that high end exercises help in the reduction of self rated anxiety while regular exercises help in lessening trait anxiety in young to middle aged adults who have no signs of anxiety disorders, yet there is no such population based evidence that relates to the prevention of future anxiety disorder ((Dishman K R, Washburn A R, Heath G, 2004). Clear evidences exists supporitng links between physical activity and reduced anxiety and depression levels. The strongest link is related with the treatment of clinical depression both from the long term as well as the short term benefits. People who are in ahabit of exercising regularly report that they feel better following a programme of physical activity. In a survey conducted by the Mental Health Charity Mind, it was found that 59 percent of the surveyors believed that physical activities could help in prevention of mental health problems such as depression and over 60 percent of the respondents said exercise helped in reducing stress and anxiety . Further evidences were revealed by Fox (1999) who stated that exercises were a resonable mode of psychotherapeutic interventions in the treatment of depression and anxiety (Jones et al, 2004). THE KEY ISSUES, LIMITATIONS AND RECOMMENDATIONS Physical activity is considered as an important public health tool utilized for the treatment and prevention of various psychiatric diseases such as depressive and anxiety disorders. However, the current findings have clearly shown have that despite of the positive consequences , physical activity can also be associated with impaired mental health specifically related to negative impacts like "excessive exercise" and "overtraining syndrome" (Peluso MA, Guerra de Andrade LH, 2005). Though many researchers have tried to establish a link between physical activities on mental health, still these studies have not been able to reflect on the mechanisms that are involved in the benefits and dangers to mental health associated with exercise (Peluso MA, Guerra de Andrade LH, 2005). Apart from this , a substantial evidence relates to the development and implementation of new technologies in the workplace which might be useful for enhancing the organization’s productivity and efficiency but in the recent years the psycho–social implications comprising of cognitive, behavioral and affective perspectives are regarded to be a major growing concern on individuals mental health and psychological well being. Negative outcomes generate experiences related to higher anxiety levels (Driscoll P M, Driscoll C E, 2008). The main limitation of physical activity in relation to anxiety area lies in the fact that sometimes excessive exercise results in a psychopathological disorder but the occurrence of such disorder is very rare. There also exist positive and negative motivational level and degree of centrality of exercise in each individual’s life for instance some exercise is a means to reduce weight and for some it is a strict disciplinary act helping them to live life healthy. On the whole , physical activity and mental health still remains an under researched and under-invested area in comparison to the other fields of health service research. There is a need to focus more on the evidence based health principles in the specific area. More research is needed on health service interventions especially related to people who avoid physical activity programmes so that the future research may be concentrated on factors that prevent mental health outcomes. Evidence of physiological effects of exercise on anxiety is available but the emotional effects still remain an area to be focused upon. The clinical applications for the use of antidepressants and anxiolytic effects still remain unexploited. CONCLUSION The research confirms that a lot needs to be done in the area of exploring relationship between anxiety and physical activity or exercise. The National Institute of Mental Health and other researches are still in process of studying whether greater exercise levels result in more anxiety symptom improvement and whether regular physical activity appears to enhance well being. However it cannot be denied that sufficient evidences now exists as stated in the report above for the effectiveness of exercise in the moderate reduction effect on state and trait anxiety and improvement in physical self-perceptions and global self-esteem. Aerobic and resistance exercise enhances the cognitive function in older adults. In culmination of the impact of the research conducted it can be suggested that regular exercise should be considered as a practical and feasible means of treating anxiety and improving mental well-being in the general public. REFERENCES Arao T. (2000). Effect of physical activity on the prevention and treatment of hypertension: a brief reviews of cohort study and meta-analysis. Nippon Rinsho.   58 Suppl:360-5 Bowden RG, Rust DM, Dunsmore S & Briggs J. Changes in social physique anxiety during 16-week physical activity courses. Psychol Rep. 96(3 Pt 1):690-2  Dishman K R. (1995). Physical activity and public health: Mental Health. Quest: 47 ; 362-85 Dishman K R, Washburn A R & Heath G.( 2004). Physical Activity Epidemilogy. Published by Human Kinetics Dunn AL, Trivedi MH &O'Neal HA. (2001). Physical activity dose-response effects on outcomes of depression and anxiety. Med Sci Sports Exerc.  33(6 Suppl):S587-97 Driscoll P M &Driscoll C E. ( 2008). Mental capital and wellbeing: Making the most of ourselves in the 21st century, State-of-Science Review: SR-C5 the Impact of New Technology in the Workplace on Mental Wellbeing, http://www.foresight.gov.uk/Mental%20Capital/SR-C5_MCW.pdf Jones , Martin, O’Beney & Carol. (2004). Promoting mental health through physical activity: examples from practice. Journal of mental Health promotion,http://findarticles.com/p/articles/mi_qa4122/is_200403/ai_n9465303 Key Note 1: US Department of Health and Human Services. (1996) Physical activity and Health: a report of the Surgeon General. Atlanta, GA: US department of Health and Human services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. Kruk J. Physical activity in the prevention of the most frequent chronic diseases: an analysis of the recent evidence. Asian Pac J Cancer Prev.   8(3):325-38 . Landers D M. (1997). The influence of exercise on mental health. President’s council on physical fitness and sports research digest 2(12) Morgan P W. (1997). Physical activity and mental health. Published By Taylor & Francis. McAuley E, Marquez DX, Jerome GJ, Blissmer B & Katula J. (2002). Physical activity and physique anxiety in older adults: fitness, and efficacy influences. Aging Ment Health.  6(3):222-30  Martinsen W E.(2008). Physical activity in the prevention and treatment of anxiety and depression. Nordic Journal of Psychiatry, Volume 62 (47): 25 - 29 Peluso MA& Guerra de Andrade LH. (2005). Physical activity and mental health: the association between exercise and mood. Clinics.  ; 60(1):61-70 Reynolds F. (2001). Strategies for facilitating physical activity and wellbeing: A Health Promotion Perspective . The British Journal of Occupational Therapy, 64 (7): 330-336(7) Sarbadhikari N S & Saha K A.( 2006). Moderate exercise and chronic stress produce counteractive effects on different areas of the brain by acting through various neurotransmitter receptor subtypes: A hypothesis. Theor Biol Med Model. ; 3: 33. Sallis JF, McKenzie TL, Kolody B, Lewis M, Marshall S &Rosengaurd P.1999. Effects of health-related physical education on academic achievement: project SPARK. Research quarterly for Exercise and Sport 70(2): 127-34. Salmon P. (2001). Effects of physical exercise on anxiety, depression, and sensitivity to stress: A unifying theory. Clinical Psychology Review , 21 (1) :33-61 Völker K.( 2006). Physical activity, hypertension, and cardiac and circulatory system. Med Klin (Munich).  2006; 101 Suppl 1:61-5 William & Wilkins. (1996). U.S Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd Edition. Baltimore, pages 611-624 Read More