Exercise and Mental Health

• McNair identified 6 dimensions of mood: tension-anxiety, depression, anger, fatigue, vigour and confusion. These are measured by the Profile of Mood States (POMS) and the scores for all categories are added (except vigour which is subtracted) to give a total score, called the Total Mood Disturbance (TMD).
• Steinberg and Sykes developed the endorphin hypothesis which says that sustained physical activity releases endorphins which acts as a natural opioid to produce a feel good effect. This is why people feel good after exercise.
• Henning Boecker used PET scans on 10 distance runners before and after a 2 hour run and found that endorphins were released during the run.
• De Moor completed a questionnaire on 19000 Dutch adults about their exercise patterns and mental health and found that exercisers were significantly lower in symptoms of anxiety and depression.
• Peluso and de Andrades identified 3 psychological explanations for the benefits of exercise:

  • Distraction hypothesis - exercise shifts attention away from the origin of the symptoms providing cognitive relief.
  • Self-efficacy hypothesis - exercise provides a challenge for the patient to successfully take on to feel better about themselves.
  • Social interaction hypothesis - social interaction during exercise builds positive relationships that improves coping capacity.
• Lewis et al aimed to investigate the effect of dance on mood in the elderly and specifically those with Parkinson's (PD) across a long and short period of time. He studied 37 participants (Mean age = 65.5 years) and 22 with PD. The participants were age matched controls and selected through local PD support groups. All participants gave informed consent.
• In Lewis et al, participants filled out a demographics questionnaire and the POMS about how they felt in the past month. They then attended a weekly 50 minute dance class for 10 weeks - the dances had a variety of styles and levels of intensity (Standing or sitting). In the 9th week, participants were asked to complete the BRUMS (shorter version of POMS) before and after the class. They then completed the POMS again in week 12.
• Lewis et al found that TMD scores were significantly lower following the 10 week dance classes - specifically anger had significantly reduced. Those with higher depression reported less fatigue following the dance classes. The effect did not differ between those with PD and those without.

  Over one dance class, all participants reported an improvement in mood - anxiety and vigor significantly improved.
• Encourage dance

  • Encourage dance as a form of exercise to improve mood and relieve feelings of anxiety and depression.
  • Give POMS before and after to find TMD then take part in weekly dance classes of different intensity and styles. Do POMS again to see if TMD is reduced. BRUMS for those with limited time.
  • Lewis illustrated how effective dance classes can be on mental health (especially symptoms of depression and anxiety) on those with and without PD.
• Encourage exercise

  • Encourage an exercise regime for people to practice raising heart rate and improving well being.
  • Set up an exercise regime (when, where and how), should include aerobic exercise and social interaction.
  • Talk about the endorphin hypothesis, distraction hypothesis, self-efficacy hypothesis and social interaction hypothesis.