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Basic InformationLatest NewsBPA Levels in Humans Are Underestimated: StudyHow Well Are You Aging? A Blood Test Might TellDistracted by Their Smartphones, Pedestrians Are Landing in the ERAntarctic Study Shows Isolation, Monotony May Change the Human BrainAre E-Scooters a Quick Ticket to the ER?Sleep Deprivation a Big Drain on the BrainLife Expectancy Shrinks for America's Working-Age AdultsHitting the Highway This Holiday Season? Buckle Up in Front and BackAHA News: Regular Fasting Could Lead to Longer, Healthier LifeHealth Tip: Avoiding Cabin Fever This WinterKeep Stress Under Control as Holiday Season StartsThree Tips for Getting Your Zzzzzz'sHealth Tip: Creating a Healthy RoutineDon't Let Salmonella Make Your Thanksgiving a TurkeyMusic Integral to All Cultures, in Similar Ways: StudyAHA News: Eating Mindfully Through the Holidays – and All YearProtect Yourself From Frigid-Weather EmergenciesNot Getting Enough Shut-Eye? 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The Answer May Affect Your HealthYour Furry Best Friend Might Extend Your LifeWhen Income Drops, Young Adults' Brains May Suffer Blog EntriesYoga For Mental HealthHow Technology is Changing How We RelateThe Realm of Giving and GenerosityMindfulness for Busy PeopleEffective Listening in Small GroupsBelieve It’s Possible3 Ways to Know If You’re Saying Yes Too MuchWords of WisdomWarm Up This Winter By Embracing MistakesHelping Yourself Speak Your TruthWhat is Toxic Shame?What's YOUR Biggest Challenge for the New Year?Navigating Life's ChallengesImproving the Quality of Life as We AgeThe Third Noble Truth – The Noble Truth of the End of SufferingThe Second Noble Truth – The Noble Truth of the Cause of SufferingWhy Are We So Busy?The First Noble Truth – The Noble Truth of SufferingDiscovering Your Best Personal-Professional Energy: Reconnecting with Your Spiritual Homeland - Part IIDiscovering Your Best Personal-Professional Energy: In the Context of Health, Aging & Time - Part IGive Yourself a Break!Get a Better Night's SleepChanging the Machinery of UpsetWhy We Lie to OurselvesToo Much PretendingExcuses, ExcusesA Mistake Is but an Error: An Ironic-Poetic Odyssey for Human Authenticity and Audacity 9 Clever Ways to Gain ConfidenceUnderstanding Human BehaviorEmotional Needs - More Subtle and Sensible Than You Think Thought Versus RealityLife Goals and the Perception of Time: Do It Now!The Myth of Emotional SecurityHow Emotionally Intelligent Are You?Being at Peace with the Pain of OthersCelebrating Transitions in This Season of ChangeThinking and BeliefsWhat Will You Do With the Rest of Your Life? 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Both Can Make Us Feel BetterDeveloping a “Buddha Brain” Through GratitudeTickets To Paradise: A Good-Hearted TaleDo FreelyOrthorexia Nervosa on the Rise in the Quest to Eat HealthyWholesome Intentions – The Neurology of IntentionDeveloping An Inner Protector"Hope Dealers" Inspire Youth to Achieve True WellbeingLearned OptimismKey Points of AwarenessIt's Far Too Simple: An Adapted Zen ParablePerfectionism's Trap: Matthew McConaughey's Impossible ChaseThe Secrets of PersuasionRelax Needless Fear Around OthersEveryman's Dance Troupe Teaches Lessons about How to Live WellIncessant Drip, Drip, Drip — A Universal StoryYour Opinion is the One That Counts!How the Three Pillars of Exercise Benefit Mental HealthCore Beliefs and HappinessDo Life Challenges Make Us More Creative?A Meditation on GratitudeStop "Shoulding" All Over Yourself and Others-Everything in Life is a ChoiceA Caring, Joyful HeartThe Secrets of People That "Get It"How Socrates' Students Chose Themselves Helping Adult Children Affects Well-Being of Older ParentsAnticipation Versus Doing10 Secrets of Successful PeopleBinge TV Watching on the RiseMind Changing Brain Changing MindBeing Sedentary Changes the Brain (And Not for the Better)Are Workplace Wellness Programs Worth It?The Fun House of Mirrors — Seeing Light in EveryoneWhy Do We Fail to See Beauty? 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A One-In-Several-Billion ShotLet Things ChangeQuestions To Live ByFive Ways to See a Problem in a New LightAccept Them as They AreThree Components of a Commitment: A Universal ToolThe Long Term Consequences of Being BulliedBe Smarter than Your SmartphoneAccept ItHistory Shows that Exercise Boosts MoodMake a Difference Grow Inner StrengthsMeaning Depends Upon Context, Egos Make Up All the Meanings & the Context of All That's Real is Being Aware of Awareness ItselfPossible Direct Control - Staying on the Playing FieldMust You Win an Argument and Lose a Friend?Enjoy Four Kinds of PeaceLive Longer By Believing You WillWhat Do You "Have To" Do in Life?Posture and How it Changes Your FeelingsThe Five Businesses and an Inner Meter on Manipulation What You Look for Is What You Get: Learn 5 Ways To Change Your LookingOffending Rules, Bending Rules and Upending Rulers While Defending the Rule of LifeFree Yourself from Self SabotageIntroversion Gaining the Respect It DeservesEmbrace Your Introverted SelfTo Escape the Box, Embrace ParadoxA Better Way to Get Healthy Habits to StickTaming Our Inner DialogueSeeing Three Domains - Illusory, Empirical World, and AbsoluteThe Pros and the Cons of Cosmetic Surgery from a Psychologist's ViewpointHow to Cultivate GratitudeMotivation: What to do When You Don't Feel ItWhen Nostalgia is a Good ThingBeing Presence Itself - Enliven the Quality of Your LifeRelationships and the Meaning of CourageThe Power of Witnessing: How Would a Fish Know It is in Water?The Visionary Emperor EncounterSeeing Through the Unreal, Reveals Purely What is RealGet Out of the War10 Ways to Stick to an Exercise ProgramDealing with LiarsWant to Change Careers? 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Recognize Suffering in OthersThe Sixteen Laws of Emotions: Recognizing Moods and Emotions to Return to Healthy Feeling ProcessingWhy Time Management is So YesterdayTo Stabilize Weight and Improve your Self-Esteem, Research Shows the HAES Approach Is a Winner! “Let’s Just Wait and Watch It” — Let’s NOT! 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Empathy: It's About Happiness, TooBelieve It Or Not: Skeptics Brains Are DifferentSee Deep WantsLife Cannot Be Reduced To NumbersWant to Feel More Peace? Look at Your ExpectationsThe Anatomy of a Poker FaceThanksgiving and Gratitude in Hard TimesEmbarrassment: Powerful and PuzzlingDon't Rain on the ParadeHow to Make an Anti-Bullying Program a Bad Thing (Do Not Try This at Home)Community Development: An Untapped Resource in Mental Health TreatmentWant to Get Tougher in Life? Be Vulnerable.Regret: How You Can Reshape the Past See Good IntentionsShame: The Core of Addiction and CodependencyShould Doctors Prescribe Lifestyle Changes?We Don't Need to Wait for ThanksgivingNow and Then, Stress Is a Good ThingDon't Let Waiting Become RegretSee ProgressThree Errors in Judgment We are All Too Inclined to MakeTo Caffeinate or Not to Caffeinate? Making Personal Health Decisions Must Remain PersonalPurpose, Purpose, PurposeSpeak WiselyBe Sure to Taste Your WordsFeeling Bad about Being SadCultivating Patience in Everyday LifeUnexpected Causes of TirednessSee Life from an Infant's EyesNew and Old Friendships Alike Help Us Age Successfully6 Ways Mindfulness Can Improve Your Daily Life Drop the "Shoulds"If You're Happy and You Know It…Wag Your Tail?How to be Wise About FearLet It R.A.I.N.Why I Love Rock 'n' Roll: Healing Music for the SoulThe Art of RoutineWays We Think That Can Make or Break Us - Part 2Insisting on Fairness & Justice is a Recipe For Conflict, Misery & SufferingAre You Blind? He Said...Put the "I" in IndependenceWays We Think That Can Make or Break Us - Part 1Find Your Own WayThe Brain in Your GutHow Our Brains Adapt to Trust and BetrayalTech Support to Help Us Count Our BlessingsThe Risk and Reward of Emotional Agility: How to Know When to Let GoChoose Beginner’s MindAre Compassion and Pride Mutually Exclusive?Garbage Detection and Brilliance SpottingCan You Predict Your Emotional Future?What You Need to Know About Generation XhaustedWake Up to Good NewsWhat We Can Learn from Our KidsBehold the SuperAgers!Change the ChannelMental Health First Aid: A New Concept Helping CommunitiesFind ConnectionBottom-Up or Top-Down? How We Generate EmotionsFind StillnessThe Thoughts that Hold Us Back - And What to Do About Them"Off With Their Heads!"—Danger! Danger! Guillotiners Ahead! - Identifying and Protecting Yourself From Expediency-Driven Guillotiners4 Steps to ForgivenessForgiveEnjoy the Little ThingsAn Interview with Margaret Moore, B.S., M.B.A., on Organize Your Mind, Organize Your LifeCultivating Everyday Spiritual ExperiencesMinimize Painful ExperiencesConscientiousness and a Happier, Longer LifeTraining the Self-Care HabitFriends And MarriageRelax, You've ArrivedHow to Be Emotionally Aware - No Cat Ears RequiredHappiness, Sandwiches and George CarlinPeeling the Onion—Uncovering Our Wounds in TherapyHugging is Good MedicineHold Wants LightlySelf-Advocacy vs. Hypochondria: Where Do We Draw the Line?Trust Yourself and Take Some Baby StepsA Unified Theory of Happiness: Interview with Andrea Polard Psy.D.Why Support is Important for Dealing with Food, Weight + Body Image Issues Let It GoRule-Bound Adjustment is Deadening - Rule-Flexible Adaptiveness is EnliveningRest Your Weary HeadInclining Your Mind to Happiness: Just 5 ThingsThe Importance of Family Pets, Grieving the Loss of my Best Friend, Bonnie Exercise: Building the "Can Do" MuscleOur Obsession with "More"When Does Vicarious Trauma (VT) Become a Sign of Codependency? - Part IIGenerativity as a Path to WellnessWhy You Just Can't Stop Texting and DrivingGift YourselfWhen Does Vicarious Trauma (VT) Become a Sign of Codependency? - Part ICultivating Resilience before Mental Health Problems BeginA Mindful and Compassionate Approach to Anger in RelationshipsThe Essence of Healing, Governing, Service, Judgment and ContributionCreate Peace in YourselfThe Protective Effect of Having a Purpose in LifeEnjoy NowAre Mental Health Apps the New Generation of Self-Help Books?The Downside of ExpectationsIs Hating Someone Because They are Different a Mental Illness?Find What's SacredThich Nhat Hanh Shares Some Good NewsComplacency, Apathy and Resignation Be Banished and TransformedSuccessfully Negotiating the Crisis-Trauma, Grief-Transition Passage: Six Emo-Existential Questions The Benefits of Self-Questioning Part OneClean Air = Clear Thinking (Or How Pollution Undermines Cognitive Health)Having Trouble Exercising? Cultivate a Mindful HabitAvoid the RushMore Evidence That Staying Active is Good for the BrainSpring Cleaning for Your Social NetworkLessons Learned from Almost Dying: A Personal JourneySteps Back are Not Setbacks: Finding Solid Ground Can Be EssentialBridging the International Corporate Geo-Cultural Divide or Presenter Beware and Buyer Be AwareDefining Your Own Spiritual PathBeing Kind to Your Body is Healing to the MindTo Trust or Mistrust - Part IFind Your North StarChange Your Body, Change Your Mind Being Positional, Non-Positional and Taking a StandMen are from Earth and so are WomenMultidimensional Wellness: Powerful Concept and Practical ToolCling Less, Love MoreFollow Your Dreams Start Feeling Joy Now!What Can I Do? The Seven Options Available For You In Any SituationBe Grateful for the Good and Graceful During the BadIn Challenging Times, No More “Inner Child”: Boldly Bring Your Inner ChutzpahPay AttentionThree Components of a Commitment: A Universal ToolWhen Calmness is a Trigger for Fear and How to Change itRetraining Your Brain Toward Greater FreedomThe Grammar of Committed Action: Speaking That Brings Forth BeingThe Strength and Stamina of Your Willpower Make a Valentine's ResolutionAn Interview with Gerti Schoen on The Gentle SelfThe Secret Ingredient to Making Change StickBe BenevolentWhen is Compassion Idiotic?Inspiring Power and Partnership: An Interactive and Interdependent PerspectiveCatch A "Wild Pitch?" You Must Be Kidding!Breaking Bad Habits Using The Now EffectDon't Beat Yourself UpAre Reasons Complete Nonsense? A Three-Minute Course Admit Fault and Move OnPositivity in Relationships is ContagiousA Simple Life Lesson for Us All: The Late Shirley LevineAn Interview with Brenda Knight on The Gratitude Power WorkbookPut Yourself on Your Priority ListCan You Live Without the Internet?It's Shocking How Little People Settle For, How Much They Put Up With and How Much Better They Deserve5 Tips on How to Keep New Years' ResolutionsElisha Goldstein’s Top 10 2011 Mental Help PostsBe the BodyA Tip for Happiness: Turn Routine into WonderHoliday Blues and Depression Single and Alone for the Holidays? 6 Strategies for Surviving and Even Thriving the Holidays AloneWithdraw Attention, Interest and Feeding Unhappy Thoughts,and Natural Happiness Arises and BlossomsBack to BasicsKnowledge is an Obstacle to KnowledgeEnjoy Every Last SandwichThe Impact of Exercise on Your Mental HealthSee the Good in OthersThis Thanksgiving Try the Mindful Gratitude PracticeWant a Healthier Life? 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The Answer is YesThe Architecture of All Change ProcessesSee Beings, Not BodiesDrop Tart ToneThe Top Seven Sources of Stress and Their RemediesLower the PressureReceive GenerosityBasics of Living: Breathing, Standing, Walking and Sitting: Safeguards of Well Being and Listening WithinAn Acronym that Guides us to Mental HealthBalancing Joining and Separation Keeping It Real — Do You Get It?You Can Feel Safer: Is There Really a Tiger in Those Bushes?Your Primary Spiritual Relationship - Love for YourselfAn Interview with Lama Tsering Everest21 Ways To Turn Ill Will to Good WillGROKKED: Being Seen, Heard and Known For Who You AreA Phrase to Save Your DayHow Did Humans Become Empathetic?Am I Normal?Dreams: More Than Fantasies and WishesThe Wolf of Hate7 Mindfulness and Psychotherapy Posts You Might Find InterestingSelf-Responsibility/Self-Accountability Qualifies You as an AdultTaking in The GoodAcknowledgment Transcends Pride and HumilityAltruism: The Power of Social MediaHealthy FriendshipCan you Improve Life Satisfaction by Changing Your Focus?Video Blog: Confidence3 Steps to Say Goodbye to Old Beliefs that Keep You StuckThe Brain in a Bucket Developing An Inner Meter on Manipulation — A Critical Life SkillFacebook: A Cold Hard LookLife: Bringing Back the Missing Puzzle PiecesWhy Do Smart and Successful People Do Dumb and Self-Sabotaging Things?What's Your 500 Year Plan for Humanity's Mental Health?My Beef with the "Secret"Beliefs, Roles and Stories Can Be Useful At Times or Create Suffering: Recognition, Disillusionment, Disidentification & Surrender is Freedom Itself Want to Make Change? 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Consider this Strategy TodayPrime Your Mind for GoodDid You Know? Some Surprising Data about Stress Can Increased Light Make You Fat? Your Mind: A Blessing and a CurseAn Expert Interview with Darrin Zeer on Managing Work Stress Lessons Learned: Like Bridges Burned?Can How you Eat Change What you Eat and What you Weigh?9 Ways Mindfulness Can Change Your LifeHow Lucky Are You?Musical Inspiration to Open to the Possibilities of Life 10 Ways To Finish The Race With The Bear On Your Back!"So What's the Point?" Help with Finding the Answers... New Research: Mindfulness and Adolescent Boys Change Your Mind, Your Brain and Your Life! 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by Brendon Stubbs and Simon Rosenbaum (Editors) Academic Press, 2018 Review by Roy Sugarman, PhD on Dec 11th 2018 
It has been known for some time that exercise was more likely to benefit brain health and neuronal connectivity than sitting on a computer playing brain games. For more than a decade, authors such as John Ratey (a psychiatrist) alongside these authors have recognized that various growth factors are released by robust exercise, including BDNF and other brain-trophic chemistry (Simon is in fact a colleague in my faculty at UNSW in Sydney).
Other conditions, such as chronic pain are now known to be classed as 'neuroplasticity gone wild' and we have known since 2011 and earlier that this was not only the case, but that mental illness, even in adolescence, was accompanied by cortical changes that were not in the right direction in these developing brains.
Add to this the effect of being sedentary and adding 10 000 hours to the average school kid's sitting time before middle school has come and gone, and these and other modern life threats have been laid out in my own book, "Saving your life one day at a time: seven ways to survive the modern world" which I published n early 2013.
Cumulative evidence has therefore emerged over multiple years that exercise is not only good for you, it actually can act to rehabilitate brain and body following the onset of mental illness, and even may act as a resilient-building preservative. Studies of TaiChi and other meditative forms of exercise, or complex movement rather, have been shown to reduce the incidence of Alzheimer's and other dementias both sides of the Pacific.
Working with the folks at United Health Group more than a decade ago, we found that principal care practitioners in the USA were far more likely to diagnose and treat mental illness with medication up front, whereas general practitioners in the UK were more likely to prescribe activity. Behavioural Activation, a part of 3rd-generation CBT is in fact likely to assist mood and include activities including those leading to better fitness and cognitive reserve.
There is no surprise that Brendon and Simon were thus able to cover a gamut of the DSM in their chapters by inviting mostly UK-Europe based practitioners to submit their take on the subject.
First up, predictably, are Meyer and Schuch on Depression, Herring on Anxiety and Stress, Vancampfort and Goldstein on Bipolar Disorder, Suitani and Vancampfort on Schizophrenia, Hallgren for Alcohol abuse, and then essential to this argument, Smith and colleagues on sedentary behaviour and mental health. Older people are always going to be a focus, so Chen and partners look at older patients with mental health issues, and on the flip side, Aussie gal Parker and Alan Bailey investigate the effects on adolescents and young people with mental illness. We all know that eating disorders are often associated with frenetic exercise, sport, ballet, and so Michel looks at this aspect of exercise-mental illness in eating disorders where this can be excessively used to control weight and appetite. We also know, from ourselves and everyone else that behavioural activation is not easy in normal and patients with mental health issues, and often this is the first thing that gets left behind as people lose motivation and the gumption to create self-volition in initiating or maintaining exercise and eating hygiene, and so Romain and Bernard tackle behavioural and psychological approaches to igniting interest in movement again.
Stubbs and Rosenbaum then re-emerge to tackle forensic settings and Carney and Firth introduce the concept of mHealth as a method of increasing physical activity, with Stanton then introducing the methodology of integrating exercise professionals, as I do, into the multi-D treating team.
There is the elephant in the room, dealt with by Rethorst, who looks at the mechanisms of action in these disorders, and suggests the need to go beyond the neurotransmitters and endocrine systems he mentions here, and how to scaffold the neurohumeral response. The editors re-emerge once more with Davy Vancampfort mentioned in a few chapters earlier, on research and evaluation in exercise and mental health, and interestingly in these chapters, the changes noted on neuropsychological testing are minimal compared to say, evaluation questionnaires or inventories which do show improvements. Finally, a chapter is devoted to Gorczynski and colleagues discussing various aspects of getting research into the field with a few case studies.
So very exciting to start. One aspect I wondered about up front was that if exercise and the damage it does to the muscles in order to get lactic acid etc replaced by growth hormones, and these were added to the brain soup, how was the brain to know what to scaffold with this 'miracle-grow' for the neurons? Surely, as with say movement-meditative practices like ChiQong and TaiChi, some guidance is necessary to tell the brain what to do with these factors in order to effect change in the neuronal architecture?
The editors note right up front that modern medication might have a role to play in depleting the health of patients, often producing metabolic syndromes and cardiac issues in the same way being sedentary does, and what I targeted in my own book in terms of the modern world. Satiety issues for instance in antipsychotics or dental caries in anticonvulsant are all side effects which create health issues for patients. Diabetes might accompany many medications, or loss of sexual drive with others. Every action of a drug usually disrupts some other function of the body or brain. The loss of life expectancy? Ignoring opioids for now, the answer is 15-20 years. In some cases, death by medication exceeds other causes in some countries.
And we are slow to catch up. It takes 17 years to turn 14% of findings into applied clinical care. Woefully slow.
As with medication efficacy studies, the heterogeneity of the term 'depression' makes studying the outcomes of exercise on Major Depression quite complex, especially in meta-analytical studies. Two things do emerge though: firstly, the intensity and duration of the exercise don't really matter, but certainly giving the person the right to decide what exercise they do and how long and how intensely they train, is critical to the outcome for them, in a personalized way. A menu of choices, in the Motivational Interviewing sense of the phrase, is key. Finding a way to specifically hone in on MDD is the task here. For instance, an overall improvement in fitness was NOT a necessary element in the treatment via exercise, compared to psychotherapy, so aerobic fitness elements might not be a critical element in the outcomes or necessary for reduction in symptoms. In this way, resistance training and a concomitant increase in strength likewise diminished symptoms in the same was a aerobic exercise did. Later studies designed to now compare to medication effects, found that all exercise was effect, but in terms of a bang for your buck, dose-response effect, more was better and that better outcomes attended greater frequency of exercise, and finally that this could augment treatment in patients resistant to medication or psychotherapy, even to remission rather than just symptom reduction. 3-5 sessions a week, 45-60mins, at 50-85% of maximum heart rate, and if we know the maximum weight we can lift, three sets of 8 repetitions at 80% of the max lift, would suffice, over 10 weeks of compliance.
So clearly a few elements are at play. First of all, there is a slight increase in inflammation after exercise, to which the body responds by reducing inflammation, targeting perhaps this issue in depression. Balancing out neurotrophins has been mentioned above, and normalizing the HPA axis is also an element, as would be monoamines as referenced above. As Gordon Parker has noted (one of the editors works with his group), the heterogeneity of Major Depressive Disorder means drug companies have largely given up on new drug research, the DSM tells us nothing of what goes wrong and leads to depression, and so 1000 people in a room with depression would have come to it in different ways, so we need treatments with heterogenous actions: our first antidepressants were 'accidently dirty' as Stephen Stahls termed them, and worked well, with unfortunate side effects to their heterogenous actions on the brain and body. Finally, these authors will note that autonomy should be preserved and respected: barriers to increasing or resuming physical activity may depend on intrinsic motivation, and this is both unique to the individual and rooted in their values, many of which have been eroded in depression, as ACT based therapies have noted. I addressed these issues for PT's in my 2014 work, "Client-centered training: A trainer and coach's guide to motivating clients" which dealt with just this challenge.
Matt Herring says much the same about anxiety, and gives us an excellent primer into anxiety disorders to start. Nine meta-analytic studies have supported the effects of exercise on anxiety in a positive way, with small to moderate effect sizes. Although we will hear about younger patients later in the book, Herring notes there is little evidence in this set of conditions, but a single bout of exercise knocks off ¼ to ½ a sd in this population. As with medication in depression, the worse your mood or anxiety is, the more the exercise is able to improve the symptoms, even after a single bout. This includes patients with other chronic illnesses comorbid. He discusses each form of anxiety disorder, and then the probably mechanisms of change, including placebo effect, GABA, Ne, 5-HT and so on. Again, the idea of motivational compliance vs adoption is a necessary key discussion. As with the neuroscience model I have promoted elsewhere, self-efficacy is a major issues, and predicts both adoption and adherence, as well as social support as a strong influence.
Bipolar Disorder is one of the most catastrophic mental illnesses alongside Schizophrenia, and physical health issues account for a 10 year reduction in lifespan. They sit more in a day on average than older people. More needs to be done in investigating the benefits here.
Schizophrenia likewise is a difficult disorder. The stats are similar to BAD above in that people who suffer in this way are remarkably inactive and sedentary. Positive, negative and cognitive symptoms all are improved by supervised professionally-guided exercise. Even if weight does not improve, fitness does, with apparent attendant benefits.
Alcohol misuse is rife in my country and many others. New information is pointing out dangers beyond liver and brain disease, to now include cancer, and so excess mortality rates in this group are twice normal, and mental health impact gives them 1.5 times the risk of non-users. Intervention studies around exercise are cited and are compelling, despite the issue of users being demotivated to seek help in the first place, let alone comply with treatment.
The elephant in the room so often here and anywhere today is the added risk to both body and brain of being sedentary, and increasingly so in younger groups. I note the recommended sitting time for kids and adolescents in Australia is so far exceeded by schools here that it would be laughable if it were not tragic, and adding homework and mobile time to it, it becomes too awful to contemplate. If there is an elephant in the room, he is sitting down and deconditioned, and likely to become mentally ill. If we consider the increase in insulin resistance this causes, the loss of muscle tone in the triple-flexed position, the added load on the neck by extending the head forward, doubling the torque every one inch of peering closer to the device, the release of inflammatory cytokines such as Interleukin 6 with the risks of depression and metabolic syndromes soaring, there is no wonder we need to intervene at regular intervals, not just at home time or before work sessions in the gym. In those who sat more, the rate is 25% higher than more active people. Worse, the association between depression and sedentary time is likely to be bi-directional. Add to this increased triglyceride levels the longer you sit, and we have a problem. The mortality rates in woman sitting less than 3 hours a day vs more than 6 are astonishing, and men are not immune: 11 hours in a car, 24 hours sitting overall, especially let's say in front of the TV instead of the computer, is deadly. The trick is that continuous sitting is the issue, and breaking this up, say by moving around for 3 mins in 60, helps a lot.
Disappointingly, as I noted above, in older adults although there are great benefits, none is shown on formal neuropsychological assessment. Let us pause here. We know from Snowden's teaching nun's studies that even though these women had lesions that mimicked dementia to a high degree, they showed no signs of it clinically, or on neuropsych testing. The reasons here for this failure, which Chen and colleagues do not discuss, goes back to Parker as I mentioned above. The heterogeneity of the conditions and of the interventions needed. Snowden's group were teachers, nuns, homogenous in their eating, sleeping, education, sedentary, social support, spirituality, never married or bore children. As with the continuing studies into cholesterol, the same longitudinal studies point to a declining incidence of dementia with increased attention to education, socialization, movement, and care applied to managing blood sugar and heart health. One would expect that excluding brain training programs on computers, the multifactorial approach of exercise needs additional input to change cognitive status: use the BDNF by putting it to good use, studying Spanish or another language while combining this with scaffolding exercise, diet, socializing, moving more, eating clean, and managing your stress. Then, I believe, we will see gains in cognition when exercise is not standalone.
Mention of the paucity of research in younger people is noted above, but here Parker (Alexandra, not Gordon) addresses this. She struggles to find advantages of treatment as usual over exercise, assuming TAU is more robust, but notes that the longer term advantage is at the hands of exercise. She finds this difficult to compute. However, having seen this, I have an idea why. The trial lasted 6 weeks. I have found exercise has its major advantage at 12 weeks as the BDNF and other hormones take their time to rebuild hippocampal and related connectedness over that time. Shock treatment likewise fades in value over about 3 months or so, as the brain adapts. So I found sustained effects of treatment would do something like psychotherapy beats medication in the long run, exercise beats both if sustained, which is often isn't, and a combination of the three gives us the best of all three worlds: Just Sayin'. In terms of self-efficacy, Prof Alex, I think both meds and CBT require some level of passive-active stance, but the self-efficacy gains in exercise, Motivational Interviewing, Self-Determination and ACT-values directed, seems to work better for me and my clients, and they continue to activate these behaviours long after seeing me for the last time. Again, that is my sample of a few thousand patients, elite military, athletes, corporates and others, not a research per se, but naturalistic. Parker's research is methodological, and she notes, there is not a lot of evidence otherwise, and the studies she reviews here in anxiety disorders are underpowered, and thus not giving us much evidence despite the direction. With substance misuse there are the inevitable dropouts, and with psychosis, something more promising. Frustratingly, once again, the research is not dealing with the heterogeneity of the conditions or multiple presentations, mimicking the failures of drug studies in these cases. The following chapter dealing with eating disorders deals with an even more complex set of scenarios, as here exercise can be excessive and used for a different purpose.
The book continues on to deal with severe and complex issues, and I am gratified to see the field, especially psychiatry, robustly taking on the challenge of incorporating the body into its most obvious manifestation, the brain and attendant mind. Some wags have commented that Doctors leave medicine to enter psychiatry, and this may in some cases be close to the truth. On the other hand, regulatory bodies have taken political, almost guild-like views and for instance, censured an Orthopaedic Surgeon for recommending a patient go on diet to address diabetes. It is clear that a multi-D team is the best way to go, and rehabilitation companies need to address these issues rather than allow a siloed approach to treatment.
An excellent anthology with multiple values to multiple readers and an essential read for all mental health professionals.
© 2018 Roy Sugarman
Roy Sugarman PhD. Director: Applied Neuroscience in the Performance Innovation Team, Team EXOS, Az USA; Conjoint Senior Lecturer in Psychiatry, Medical School, University of New South Wales, Australia |