About 30% of all Americans that go to the doctor are instructed to begin an exercise program. This has increased from 23% from just a few years prior. Approximately one third of all Americans are obese. Clearly, there are a whole lot more calories being taken in than burned. Despite the improvements that are associated with introducing exercise into patient care, exercise is a frequently neglected intervention in mental health care.
There is evidence that physical health is tied to mental health. People with mental illness have an associated medical condition 68% of the time, accounting for a large portion of healthcare costs. As Dr. Jay Reeve and Sue Conger identified in a previous Grapevine Article people with mental illness have a life expectancy 20 – 25 years less than the general population. The shortened lifespan is correlated with the significant medical conditions that are often untreated.
The Center for Disease Control identified that cardiovascular diseases, cancer, type II diabetes mellitus, osteoarthritis, osteoporosis, obesity, and mental health can be influenced and improved by exercise. Physical interventions are associated with improvements in mental health; yet are rarely utilized in treatment of psychological disorders. A common intervention to start an exercise program often consists of little more than a statement to the patient that they need to get some exercise, with little direction or guidance being offered.
There is significant support that exercising to treat mental health disorders is effective, particularly in regards to anxiety disorder such as generalized anxiety disorder and mood disorders such as depression. Exercise can reduce anxiety, depression, and negative mood, while enhancing self-esteem and cognitive functioning. Medical and mental health professionals should work together not only to recommend exercise, but to follow up and continue to ask about it. A group of scientists identified nine key health benefits that they claim should be emphasized to every patient, particularly those with mental health disorders:
• Improved duration and quality of sleep
• Enhanced libido
• Increased endurance
• Stress relief
• Improvement of mood
• Increased energy and stamina
• A reduction of tiredness that is associated with increased mental alertness
• Weight reduction
• Reduced cholesterol
• An overall improvement in cardiovascular fitness
Although 70-90% of people with mental illness are usually successfully treated with medications, physical exercise can reduce symptoms of mental illness.
Many patients receiving psychiatric medications do experience side effects; especially increased appetite. Given the readily available, convenient, and calorie dense foods available, it is no surprise that two thirds of Americans with mental health disorders are obese which can be linked to shortened lifespan. Despite the side effect of increased appetite, all is not lost; food is fuel for the body and each calorie represents the potential for successful exercise.
It is the role of all healthcare professionals to work together to improve a patient’s understanding of exercise. It is not enough to tell people to exercise. If there is no guidance or accountability, then people are less likely to actually participate in exercise.
Some doctors have found that writing a prescription for exercise, just like any other medication, has helped improve compliance with exercise as an intervention. The more specific and achievable a plan to exercise becomes, the more likely the patient is to follow through with it. For example, instructing a patient to walk 20 minutes a day 3 days per week has more meaning than you need to go work out.
If people with mental illness get the right assistance, we can help not only reduce their increased obesity and early mortality rates, but enhance their quality of life.
Jon Williams is a clinical supervisor at Apalachee Center, Inc and earned his Master’s Degree from Slippery Rock University of Pennsylvania. He is working toward his PhD. at Florida State University focusing on PTSD. He has been a clinician for the past 16 years in a variety of settings.
by Jon Williams
Dr. Jay Reeve,
Clinical Supervisor, Apalachee Center