Running, jumping, flying, and swimming are always worth doing—but in the right doses. How much movement is just right? Psychotherapist Anna Cichoń speaks with Kamila Kielar.
Physical activity aids circulation, stimulates metabolism, and improves sleep quality. Regular physical exertion has a major positive impact on mental health. But where do you even start? The simplest and most advantageous sort of movement is simply walking. And, as it turns out, for many people that’s good enough.
Kamila Kielar: The British Journal of Sports Medicine has published research showing that physical exercise is more effective than previously supposed in preventing and treating depression and states of anxiety.
Anna Cichoń: Really there’s no sickness where it’s advisable to be sedentary, even when you’ve broken bones. Movement increases the flow of blood to the brain, which has a positive impact on its cognitive functions: memory, concentration, and information processing speed. It regulates the nervous system and stimulates the excretion of hormones, primarily endorphins and serotonin, which is why it is vital when it comes to mental illness. The European Psychotherapy Society recommends adding physical exercise to therapy for people with moderate and mild depression. It is also recommended for those suffering from schizophrenia, whose cognitive functions are significantly impaired and for whom the risk of cardiovascular disease (in part because of the sedentary lifestyle that come with this ailment) is three times greater than average.
One kind of pleasant exercise, one that is useful in that it requires movement, responsibility, and consistency, is caring for animals.
As far back as the late eighteenth century it was observed that work with animals, such as walking and tending to dogs, is helpful in treating people whom we would now likely diagnose with Post-Traumatic Stress Disorder (PTSD). Mental difficulties have various sources and can be complex, sometimes they cannot be treated with psychotherapy or pharmacotherapy alone. A combination of the two methods may also be insufficient. It is good to join psychotherapy with some form of physical activity: physiotherapy, breathing exercises, social support, or animal therapy. That kind of interdisciplinary approach can work wonders. In people with PTSD, the nervous system often gets “frozen”; this often happens from situations where they were helpless and unable to act—neither to defend themselves nor assist others. This means they might need a sense of agency, such as a “mandatory” walk with their animal companion.
Some stressed people need to be constantly on the move.
Some people are constantly hyperactive and do not give themselves a moment’s rest. Although keeping up this pace is bad for their health, they are unable to proceed any differently—they feel anxious when resting or left with no definable task. I often tell my clients that they need not give 150 percent—100 really is enough! Studies show that moderate exercise is best for the nervous system, so in most cases, walking is better than running. This is well illustrated by an outstanding psychiatrist, Professor Daniel Siegel, who spoke of the window of tolerance, or the zone of optimal stimulation. When we find ourselves above or below that value and are in a state of hyperstimulation (commonly found, for instance, in those living in chronic stress or trauma) or hypostimulation (found in people with depression, for instance), we begin functioning less effectively. People who have experienced trauma often fall out of the window of tolerance and operate with either too much or too little stimulation; or they may lurch from one extreme to the other. Meanwhile, a simple stroll can soothe hyperstimulation—we might say it takes it down a notch—or help people who feel frozen rise back up. This twin regulatory function of walking is also effective for bipolar disorder (ChAD). If a person alternates between mania and depression, they always feel disjointed. And if in such a state of stress they add even more activity to their daily lives, they release added layers of cortisol and adrenaline, which could raise their stress level. This is why patients with PTSD need gentle movement, and not revving up their adrenaline through hyperexertion, as many are prone to do. Shoveling tons of coal, running marathons, and pushing the limits of their bodies are probably self-destructive here.
So why is this behavior so common among PTSD patients?
People with PTSD might not want to, or are unable to, alleviate a state of hyperstimulation, as this would mean added anxiety. Victims of years of violence may not enjoy safety and calm, because these sensations might be unfamiliar, and thus, disquieting. In chronic trauma sufferers, the body is so used to such a heightened level of adrenaline and cortisol that when it drops, they feel ill at ease and want to return to their previous state at once. This can also be a way of punishing themselves, of destroying their bodies. Then marathons are not a source of pleasure, just a way of cranking up the effort.
When is exertion too much?
People increasingly tie their value to productivity. Their thinking is, “I’m worth how much I do.” When these people feel worse and fail to meet their expectations, mainly their own, they begin to think they have no right to exist. So, in therapy, I ask them if they can imagine an event, such as an illness, that could reduce their productivity, or even eliminate it. And I ask if they imagine that they would still be valuable just because they exist, and not for what they do. Some have made an effort on the basis of their sense of their own worth, which collapses when they no longer have strength, and they give up on activities they have planned. There are people for whom effort is an outer scaffolding that supports an empty shell.
Might running a marathon also help support that shell?
There are various reasons for running. You might run a marathon just because you like it. Or you might run to prove something to yourself or because you think you’re no one if you can’t beat the record. That’s a dangerous motivation. It’s just as dangerous when you train to give yourself a thrashing and hurt yourself or you do it compulsively, which has all the signs of a behavioral dependency. Excessive effort can also be a form of self-destruction, though it is less visible than when a person destroys their body through alcohol, for instance. Patients who compulsively exert themselves are always active and incapable of resting. People with depressive mood disorders, in turn, see any effort as a challenge. In such cases, I look for the smallest activity my client can manage. For someone with severe depression, it can be a major effort to wash or make a cup of tea.
Does the regulatory function of movement work in all anxiety disorders? Is it also helpful when it comes to social phobias?
Movement does not eliminate anxiety, but it can temper it. Taking on (gradual) challenges is an important part of therapy. You cannot cope with social phobia or other anxiety disorders without confronting life. Thinking something like: “Now I’ll sit in a therapist’s office for a few years, I won’t step out into the world, and then I’ll go out to a party, just like nothing ever happened,” makes no sense. That’s not how it works—therapy has to happen gradually. It also takes attempts to understand if the social phobia doesn’t hold a painful experience: an injury or trauma. When it comes to physical exertion, for people with social phobias certain forms of athletic activity are fairly safe, ones where you can spend time with others and yet focus on your individual actions. These include wall climbing or bike trips, during which you don’t have to talk much, but you can safely get used to other people’s company.
Just being out in the fresh air is good. The Ottawa University campus has built underground tunnels so students needn’t face Canada’s extreme weather. But it turns out that the moods of those walking “up above,” along the river and trees, were much better than those who took the lower corridors.
We tend to overlook the obvious things. And then it turns out that what’s obvious works. Dr. Katarzyna Simonienko, who promotes laser therapy in Poland, stresses that aerobiological factors are at work when we stroll through the greenery, like the things we inhale, such as essential oils. Microbiological factors are also important, such as the Mycobacterium vaccae, or “happiness bacteria,” living in the soil, which have proven antidepressive and anti-anxiety effects, and stimulate the brain to excrete serotonin. Small wonder that so many people feel good after they’ve been collecting mushrooms. Perceptual factors as well—straining the ears, sight, touch, or smell—can effectively take us to the “here and now” and free us from negative thoughts. There is plenty of research that says that “forest bathing” activates the parasympathetic and lower sympathetic, so it calms overstimulated people. When we plant a garden as part of horticultural therapy, we do so together with others, or there is a relational aspect. And we’re spending time in the sun, and UV rays have an antidepressant effect. The therapeutic value of physical activity in nature comes from a combination of all these favorable elements.
Apart from the biological factors, there is a sense of agency and a real result, such as the mushrooms you gather, which promotes self-esteem and a sense of well-being.
Actively getting involved to improve your self-esteem is key, I believe. Even if we make a small effort, such as going to the store, we have more of a sense of agency than if we swallow a pill. That pill works on the body, of course, but it doesn’t give us a sense of agency. This understanding of effort is close to what we mean when we speak of supporting seniors. A task so basic as watering plants or caring for a dog or cat, can extend a senior’s life. And it certainly improves its quality and provides satisfaction that we should seek out every day.
Read similar:
