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Importance of
exercise for mentally ill
is emphasized
(May 2006
Issue)
By Jennifer Chase Esposito
If we don't move our bodies and fuel them with good foods, we will
die younger than we need to. It's a sad and scary fact, yet the
prognosis is even worse for people suffering from mental illness.
According to a 1999 U.S. Surgeon General's report, people with mental
illnesses lose nearly 15-and-a-half-years in their life expectancy
because of "lifestyle issues" like being too sedentary, poor diet
choices and medication-induced weight gain.
Where more than half of U.S. adults don't engage in exercise that's
recommended by public health organizations like the Centers for
Disease Control, hospitals and programs responsible for the well
being of their patients are helping people with mental illness take
better control of their lives through exercise and nutrition programs
that will hopefully add back on the years that their diseases may
take off, making exercise an important component for well-being
along with medication and therapy.
The Center for Psychiatric Rehabilitation is a nationally, federally
funded treatment center affiliated with Boston University. Founded
in 1979, the center was at the forefront of a movement that began
investigating this question: What is the importance of physical
training for people with mental illness?
With high incidences of diabetes, a tendency toward smoking and
sedentary behavior it wasn't too difficult to figure out exercise's
importance or why people should want to work out.
"We've been doing this for a long time," says Dori Hutchinson,
Sc.D., director of services at the center, "... [and] people who
live with a disability need their physical health as a resource.
They want to go back to work, they want to go to school. [They]
need good health."
A closer look at the "why," according to Hutchinson, brings up
complex issues like poverty and lacking self-esteem - two things
that can keep even the clearest mind on the couch instead of on
a treadmill.
But it's really the poverty issue that can unhinge the best intentions
of people with mental illness to improve their physical health.
Hutchinson is adamant that programs have to be provided for the
vast majority of people who can't afford the $100 per month that
even an average YMCA charges to swim or use equipment.
"People just don't have that kind of cash," she says. "My whole
take is we're in the business of rehabilitation and recovery. We
need to take programmatic responsibility to do something."
At the Center for Psychiatric Rehabilitation, patients can use
exercise facilities, take nutrition classes and learn about cooking.
But the center has also taken the role of consultant, helping nearby
McLean Hospital in Belmont, Mass. expand its physical health programs
by helping open a fitness room that's accessible to all inpatients
and outpatients.
Center House Day Treatment in downtown Boston, Arbour-Fuller Hospital
in Attleboro, Mass. and Genesis Clubhouse in Worcester are additional
Massachusetts facilities offering programs to help keep patients
physically fit.
What's the patient reaction when they learn they can have access
to healthy options for breaking a sweat? "Oh people love it!" says
Hutchinson. "They feel like they've lost their health and they're
just regular people like you and me. They feel better, lose weight
and look better" when they're exercising.
In Keene, N.H., people with mental illness have access to a unique
exercise program called "In Shape" at Modnanock Family Services,
a 100-year-old mental health center that helps support people with
mental illness and their families.
According to its Web site, participants of the "In Shape" wellness
program work with a training "mentor" to create a workout plan comprising
good eating and workout habits. Positive reinforcement is received
every six weeks at a "celebration" honoring their progress. Clients
exercise in group activities like yoga, swimming, and weight lifting,
and all of that good moving seems to be working.
Seventy-eight percent of the program's 200-person member pool have
stayed in the program and done things like quit smoking, lower their
cholesterol and decrease their blood pressure, weight and mood swings.
This rise in exercise programs with an emphasis on physical health
co-mingles with what researchers, dieticians and doctors have long
known about exercise and its effects on reducing even mild depression.
In an article "Working off depression," published in the December
2005 issue of Harvard Mental Health Letter - the Harvard Medical
School publication that for 20 years has informed on and debated
mental health issues that concern both mental health professionals
and laymen - it was reported that "hundreds of studies now show
that [exercise] can help" severe depression, anxiety or chronic
mental illness" by improving body image; the social support from
group exercise helps keep everyday worries at bay; and there's a
chemical benefit from changing the circulation of neurotransmitters
like serotonin and endorphins in your body.
Citing 31 different articles, the article stated "many reviews
and meta-analyses show that … people who become or remain physically
fit or active are less likely to develop clinical depression," and
that exercise had "also been found equivalent to cognitive behavioral
therapy and antidepressants in direct comparisons." One study showed
that after 16 weeks of prescribed aerobic exercise, antidepressant
drugs or a combination of both, 60-70 percent of patients in a trial
had recovered from depressive episodes; but the exercise effects
may have lasted longer.
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