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Exercise as a Treatment for Disease
October 5, 2009
We are all aware of many of the beneficial results of regular physical exercise, including protective effects against the increasingly widespread heart disease and obesity problems in the United States. Regular exercise, though, can be just as effective a measure for promoting mental health and alleviating symptoms associated with depression, attention-deficit disorder (ADD), and addiction. Positive mental benefits are also indicated in generally mentally healthy individuals, with improvements in memory and general capacity. However, it is still somewhat unclear by which mechanisms these benefits are achieved, and which specific types of exercise are most effective for particular disorders. Is it possible that the positive response in the mentally ill to exercise is simply a placebo effect? I was able to track down a few studies which held the purpose of discovering at least a baseline of data in the continuing process of uncovering the answers behind exercise’s effect on mental health.
In researching exercise and its effect on particular mental diseases, I searched both general and scholarly journal articles on the ProQuest database. There is indeed a plethora of information and a number of studies available on the subject, and I was able to track down some very informative studies regarding exercise’s effect on cases ranging from depression in the elderly to attention-deficit disorder in children. I made the decision to draw mainly from scholarly journal articles given that, in general, the internet is rife with untrustworthy information and product salesmanship (more than a few endorsed by Hugh Downs) that is of little use. The scholarly journal articles also provide the benefit of a purely clinical and scientific purpose, so we do not have to worry about bias or hidden intent on the part of the authors.
A Randomized Controlled Trial of High Versus Low Intensity Weight Training Versus General Practitioner Care for Clinical Depression in Older Adults (2005): This study, published in The Journals of Gerontology, attempted to isolate exercise as a treatment for depression in Seniors, and compare these results to those of Seniors being treated for depression by General Practitioners. Three different programs based on low, medium, and high levels of resistance-training exercise were assigned randomly to the participants, and the results were indeed significant. The patients in the “High” groups, in particular, provided “more than double the relative response (% change) of GP care participants,” in two critical measures, while participants in the low groups provided intermediate improvements mostly in line with the results of the GP-cared groups. (Singh, Stavrinos, Scarbek, Galambos, 2005) Thus, the conclusion was that high-intensity resistance training is more effective than low-intensity, and that the mechanism of action is likely to be biological as opposed to a “placebo effect.” Participants in the “High” group also showed much larger gains in muscle strength and quality of life, with an emphasis on markedly better sleep. (Singh, Stavrinos, Scarbek, Galambos, 2005)
Physical Activity as Reinforcement for Classroom Calmness of ADHD Children: A Preliminary Study: This study successfully attempted to reinforce the hypothesis that physical activity could contribute to classroom attentiveness in ADHD subjects with other possible mental incapacities. The study focused on two adolescents who suffered from both mild retardation and severe ADHD, who had been receiving consistently poor performance reviews from their teachers at a school for the mentally disabled. The results were quite profound, with the two boys each improving from baseline respective attentiveness (measured in 1 minute intervals) of 5 and 10% to 100% (Azrin, Vinas, Ehle 2007). The graph below highlights this marked response, with the y axis indicating percentage of attentiveness ranging from 0 to 100, and the x axis displaying the untreated results on the left versus the treated results to the right. The authors concluded that the improvements may have been attributable to both the praise given to the children during the exercise sessions as well as the effective “burning” of energy during these sessions, but that the main factor indeed seems to be the exercise itself.
(Azrin, Vinas, Ehle 2007)
Exercise-related activities are associated with positive outcome in contingency management treatment for substance use disorders:
This study, focusing on the effect of participation in exercise activities on abstention from substance abuse, showed that there was a positive link between the two. The participants in the study were patients in an intensive outpatient treatment group for ongoing substance abuse issues. The results were as hypothesized, and it was found that, “Those who completed an exercise-related activity had significantly longer durations of abstinence compared to participants who did not complete any exercise-related activities, even after accounting for other relevant factors that may have influenced treatment outcome, such as baseline toxicology result. Therefore, participation in exercise may have a positive impact upon SUD treatment outcome.” (Weinstock, Barry, Petry 2008) The study did not name a likely mechanism of action which may have brought about the results, but the results clearly indicate that whether purely mental or biological, exercise may be an effective treatment for yet another mental disorder.
Although the internet is often a questionable source when researching scientific topics, there are still a number of informative and accurate sources available. According to an article titled, “Depression and Anxiety, Exercise Eases Symptoms,” published on Mayoclinic.com, exercise may be biologically effective in treating mental disorders through the enhanced production of neurotransmitters and endorphins, but even these widely held hypotheses are still unproven. It is also possible that exercise works as a coping mechanism, effectively replacing other potentially harmful coping mechanisms with healthy activity (Depression and Anxiety). The National Institute of Mental Health mentions that, “There is preliminary evidence that aerobic exercise may have a calming effect,” on its website, but does not appear to advocate or indicate any exercise programs as a major treatment for many mental disorders. (NIMH, Anxiety Disorders). Such findings indicate that research into the effect of exercise as a treatment for mental disorders is still very much in the preliminary stages.
Conclusion: Even in the modern age of science when a huge number of studies have been successfully completed in order to identify the specific cause and effect relationships between exercise and its positive treatment effect on a number of different mental illnesses, it is still quite unclear which specific mechanisms are responsible for the benefits. However, it is clear that exercise is becoming a more and more prominent addition or substitute for more traditional counseling and pharmaceutical treatments in many cases of mental illness, and that in many cases its benefits to overall quality of life as well as effectiveness against acute illness are not simply a “placebo effect.”
Nalin A Singh, Theodora M Stavrinos, Yvonne Scarbek, Garry Galambos, & et al. (2005). A Randomized Controlled Trial of High Versus Low Intensity Weight Training Versus General Practitioner Care for Clinical Depression in Older Adults. The Journals of Gerontology: Series A Biological sciences and medical sciences, 60A(6), 768-76. Retrieved October 6, 2009, from Health Module. (Document ID: 864648231).
Weinstock, J., Barry, D., & Petry, N.. (2008). Exercise-related activities are associated with positive outcome in contingency management treatment for substance use disorders. Addictive Behaviors, 33(8), 1072. Retrieved October 7, 2009, from Health Module. (Document ID: 1496624501).
Nathan H Azrin, Veronica Vinas, & Christopher T Ehle. (2007). Physical Activity as Reinforcement for Classroom Calmness of ADHD Children: A Preliminary Study. Child & Family Behavior Therapy, 29(2), 1-8. Retrieved October 7, 2009, from Psychology Module. (Document ID: 1296811561).
Mayo Clinic Staff. “Depression and Anxiety: Exercise eases Symptoms.” http://www.mayoclinic.com/health/depression-and-exercise/MH00043. 2009.
National Institute of Mental Health. “How to Get Help for Anxiety Disorders”. http://www.nimh.nih.gov/health/publications/anxiety-disorders/how-to-get-help-for-anxiety-disorders.shtml. 2009.
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