1 Best Kept Secret In Mental Health: Exercise

 

“Go Big Or Go Home” Is NOT The Solution

How Exercise Can Help A Stressed Out Workforce

Virtually any form of physical exercise can act as a stress reliever. And stressed we are! 83% of US workers suffer from work-related stress, with 25% saying their job is the number one stressor in their lives. About one million Americans miss work each day because of stress. 76% of US workers report that workplace stress affects their personal relationships. Time to dig deeper into the science behind exercise and stress with Prof. Dr. Jasper Smits.

Jasper is Professor of Psychology and Director of the Anxiety & Stress Clinic at The University of Texas at Austin. He is the author of  several books and scientific papers on mood disorders, cognitive behavioral therapy, the efficacy of exposure and much more.

He also maintains that one of the best kept secrets in the treatment of mood disorders is the proven efficacy of exercise, a topic we want to dig deeper into during this podcast episode. His research shows that relatively short periods of exercise, lasting as little as 2 weeks, were associated with reductions in anxiety equivalent to 12 weeks of cognitive-behavioral therapy (CBT) and that high-intensity exercise helps people with anxiety quit smoking.

Check out the Earkick podcast episode #10 with Jasper and the transcript below:

Exercise And Mental Health: A Key Relationship 

KS: Tell me why is exercise so important for mental health? 

JS: You know, I think when it comes to mental health, health behaviors like exercise are just an important part of the picture. I think most people who think of themselves as doing well and they’re wellbeing will also point to certain health behaviors as being important to that picture.

Health behaviors are critical to our wellbeing. When you think of smoking, nutrition, physical activity, they’re all part of a picture of living better and feeling better in general. You know, if  you ask people, there’s exercise associated with a better mood. I think most people will say:” Yes, I feel better when I’m physically active.” So that’s pretty straight. The question obviously when it comes to exercise for depressed mood or for anxiety is how do you get people to engage in physical activity such that it becomes a habit and that they can get an experience of long-term benefits.

KS: Is there any sense in telling people what happens if they ignore exercising?

JS: I think ignoring exercise is more common than not. 

A lot of people have good intentions to be physically active. 

A lot of people have times in their lives when they’re more active, followed by times in their lives when they’re not active. And so it’s hard for people to create a habit that is really stable and for them to see themselves as someone who, on a daily, weekly basis is adhering to physical activity guidelines. People know often that the times when they’re more physically active are the times that they feel better, and the times that they’re not physically active are the times that they don’t feel as well. And that relationship tends to be sort of bidirectional, right?

I mean, we tend to feel better when we are physically active and when we don’t feel well, we’re also less likely to be physically active. For most people, that relationship they can see as one that applies to them. And so telling people:”Hey, it’s a good idea to exercise!” is something that people have probably heard, that they believe in, but it doesn’t necessarily get them to also do it. To adopt a level of activity or a regimen that’s really going to help and work for them.

Always work towards successes first

KS: How do you get people motivated to at least give it a try? Is there any best practice around getting people to make those first steps? 

JS: One thing that we know that doesn’t work is to  just tell people:” Here is the physical activity guideline. Make sure that you get 150 minutes of moderate intensity exercise a week or 75 minutes of vigorous intensity exercise a week.” If you just tell people to do that, people are not gonna do it because that’s overwhelming. It doesn’t generate a picture yet of what that looks like for people.

I find it essential, when I work with my patients, to get into it and truly start thinking about specific types of activities that are feasible for people. 

The most common activity is something that people can do when they walk outside the home.

Like they can maybe go for a walk or they can run or they can bike or something that’s sort of easily accessible for most people. But it isn’t necessarily the activity that’s feasible because running isn’t an activity that’s exciting or interesting or associated with good memories for many people. A lot of people don’t have a good relationship with running, so I think we have to be creative and start thinking together with people about an activity that works for them. That requires brainstorming and thinking about all kinds of physical activity, whether it is taking a class at a gym, whether it’s playing tennis, whether it’s swimming, or whether it’s skiing.

Depending on where you live, there are lots of possibilities, but it requires a conversation with someone about what’s an activity that you’re interested in that seems one, that maybe you would like and enjoy, and what’s an activity that’s also feasible? Like something that you could actually do if, let’s say you were planning on doing this in the next week or so. So that I think is a critical part of the conversation and looking initially for feasible and enjoyable activities. And then it is a question of dosing in terms of figuring out a pattern, a prescription of physical activity that is feasible for the person. Do you start slow? Let’s say for the next week you just go out once and do this particular activity, see how it feels, how did it go? What were some of the barriers or things that sort of got in the way? And then you build from that, because in the beginning I think it’s helpful with people to always work towards successes first.

Can we have some initial access? Some activities that you feel like:” Hey, that worked well. I liked it, and that’s a good starting point to start building from that.”

I think one of the mistakes that people make often is to start too big. 

And to say:” Hey, let’s do this for next week.” You go out on Sunday, Monday and again on Wednesday. And then a person gets into their week is not able to do that and might feel sort of discouraged around physical activity. Success can be much more easily achieved if you start slow. If you start with a really specific, doable, feasible activity, that the respective person can actually complete that week. And that’s a nice activity or a nice success to build on for a future prescription that you establish with the patient. 

KS: Do you encourage your patients to keep track in any way so that they can see that those five minutes walk or those 10 minutes jogging are doable and that they can discuss it with you?

JS: Yes! I like tracking. But I first check with the patient. Some patients actually like journaling, like writing things down, like reviewing what they’ve written down later as a way to keep motivated to do a particular activity or to learn more from it, to help them troubleshoot. So I think that’s the first conversation: Can tracking be helpful around this?

And then the second conversation is if it is helpful? What do we want to track?  Do we want to just track what you are doing so that you can sort of see at the end of the day, the end of the week, what you’ve done and have the potential to feel good about that? Sort of:

“I’ve accomplished a goal. I feel like I’ve been successful!”

I think that can be helpful for a lot of people. A lot of people like looking at their steps at the end of the day, looking at their mood at the end of the day or the next day and comparing it to previous days as a way to get a sense if they are on track. But I think you can extend this type of tracking around exercise to other elements, such as: How do you feel during exercise? How do you feel after exercise? 

I have found it helpful that we ask people to indicate their mood or their tension, or their anxiety or their stress levels before exercise and again, after exercise and just make a habit of that. And then review those patterns over the course of, let’s say a week, that it can be helpful for them to see those relationships:” Hey, I feel better after exercise relative to how I feel before the exercise” as a way to increase their motivation to stay with a habit over time. 

It’s All About Making The Transition Easier

KS: What are the biggest barriers when people try to really get into exercise and just can’t? What are typical stumble stones in their way?

JS: You know, people talk about motivation. A lot of people are not necessarily motivated to exercise. It’s like you don’t always necessarily wake up and feel like:” Oh , I want to go outside and go for my walk.” Or when you come home after a long workday and you had planned to do some sort of workout, to immediately feel like you need to jump into that. There are other things that seem way more appealing when you come home and you’re tired. It might be much nicer to maybe watch TV or read a book or do something that’s much easier and doesn’t require that kind of effort. And I think that’s real for most people. So the conversation is:” How can we make these kinds of transitions easier for you?

What can we arrange in your environment that helps you, such that you can make that transition easier, which is: You’ve just worked or you’ve just woken and now you’re transitioned to physical activity. So let’s say for example, in the morning, you wake up, you’re kind of tired and sleepy, but you wake up because you had set the alarm because you were gonna go out for a walk before you would have breakfast and before you go to work. How can you make that transition when you wake up?

Well, there are certain things that you can do. Like maybe in the beginning what you do is say:” Hey, I’m gonna make sure that I’m gonna do that walk with a friend. I know that I’m gonna meet that friend in about 10 minutes and that makes it easier for me to jump out of bed, put on my clothes, and actually go there.” In fact, it might also be easier if you already have your clothes set out. You might keep your clothes closer to your bed rather than hidden away somewhere.

Sometimes people need to set multiple alarms, or maybe have their friend call them to get them going.

And I think these kinds of things may be helpful, particularly early on when a person hasn’t established a habit, hasn’t sort of felt naturally motivated to do this. They may not necessarily see the reward of exercise yet and this helps them make that transition from waking up to actually engaging in the activity.

The Dark Side Of Exercise

KS: Is there such a thing as too much exercise? 

JS: The concern that exercise can also be problematic is real. It’s there for a smaller population. A lot of people, as we know, are not sufficiently active, but there are also people who are overly active or exercise too much to where it can really cause harm physically, or it can obviously cause harm also emotionally. Sometimes exercise is used as a compensatory strategy for eating, and so when we work with people who have body image issues and body image concerns, exercise can be used excessively. Such that it might help them meet a particular goal like:” I need to exercise so much to feel well.” But it’s not necessarily helpful to them in the sense that it might, you know, continue to feed that negative cycle of keeping body image concerns, fears and negative emotions alive. And so it’s in those situations where we wanna talk to people about:

” How can you use exercise in a way that’s more helpful to you, such that it doesn’t continue to reinforce this negative cycle?”

So that’s one example. Certainly exercise can also be problematic for people who have certain physical vulnerabilities. And we want to be careful to prescribe an intense exercise regimen for people who have cardiovascular problems. And it doesn’t mean that exercise cannot play a role in their wellbeing prescription, obviously it it does and it has to, but you wanna collaborate more carefully with their healthcare providers to come up with a prescription that’s safe.

And so I think those are two examples where we do want to personalize exercise prescriptions, but tie it again to what are their specific goals and what also are their specific vulnerabilities so that exercise doesn’t become a problem, but exercise actually is part of the solution. 

Exercise And Workplace Mental Health

KS: We spend a lot of time at work and many, many people complain about being stressed at work, about experiencing burnout or depressive phases. I imagine that exercise during work time or around work time also comes with benefits. Given that so many of those employees feel stressed at work, what can the workplace do to help? For example to incorporate exercising habits for the workforce?

JS: Yeah, I like that question. I mean much of it is about your environment, people around you, the expectations, the talk about exercise. How do people around you view exercise as part of the bigger picture of productivity and wellbeing? One of the things that we know about exercise is that it generates a nice buffer for stress.

Always think about exercise as helping you be more persistent and more resilient to stressors. Many of my experiences with patients have actually centered on coming up with exercise routines that actually facilitate their productivity at work. So let’s take for example, someone who points to stressful meetings that occur on a Tuesday and find that those become sort of the center of their concerns around work.

It’s like:” I like my work, but my Tuesday is just particularly hard because I have this set of meetings and I feel like I don’t function as well during these meetings or the anticipation of the meeting. I feel more anxiety, more stressed following those meetings. I feel particularly wiped out on my Tuesday evenings – not like the other evenings.”

I might work with that person and say :” Is there something that you can do Tuesday morning in terms of a physical activity bout?” Let’s say you can go for a walk or you do your spin class or whatever it is that you find appealing on Tuesday mornings before work. I find that if people are able to implement that and are able to adhere to that kind of prescription, their Tuesday actually can be much easier. Because if you come into work after a physical activity bout like that, you do feel differently.

Research has shown that if we experience and participate in a relatively intense or moderate to vigorous intensity exercise bout before a stressor – in this case a work meeting- that stressor has less of an impact. 

Both physiologically – so your heart rate reactivity is a little bit less – as well as psychologically. That stress reaction that you experience tends to be less intense following that physical activity bout. So I like that prescription and certainly that’s something that an employer could also facilitate. If, let’s say at work there is easy access to a gym. Or if at work, management employees think about exercise as part of the workday, as in “it’s okay.”

Let’s say someone participates in a sports class during a lunch hour, during a coffee break or whatever. I think all of those things can actually come back positively, not just for the individual at work, but by extension also to the employer: That person is going to function better, perhaps be more efficient, and also more productive. It’s a win-win both for the individual as well as for the workplace.

KS: I hear a lot when I ask someone:” Oh , you wanna join me for a walk?” They say:” Oh , I only have five minutes. That’s not gonna be worth it.” What does science say?

JS: Yeah, I think it depends on what your goal is. Say I really want to see a nice boost in my mood. Sometimes five minutes of a walk isn’t necessarily enough. But five minutes of walking can actually provide a nice opportunity for people to shift their attention away from something else that they were engaged in, which can be really positive. That is the ability for us to disengage from something that’s really stressful to then later re-enter with a new perspective. Perhaps with a little bit of a refresher behind you, this can really help people do better in that next segment of their day.

It often feels for people that short bouts are not sufficient. But they can be. The key really is for people to try it.

And so if you’re not sure about it, my recommendation is: why don’t you test it? Why don’t you see for yourself whether if you go for a five minute walk, you actually get some benefit from that? Whether that’s a lift in your mood, whether that’s a lift in your productivity. 

If people are concerned that it might take away from their productivity – test that too! Did it really make a difference that you took a five minute break there? Those are all questions that can be asked if people just put them to a test and track it, write it down, and then review it afterwards.

Exercise And Exposure

KS: How can we think of exercise as some kind of exposure? And how does exposure make us more resilient towards the stressors of our daily lives?

JS: One of the more effective strategies for helping people feel more safe around intense bodily sensations that are often associated with fear and panic, is to bring on those bodily sensations on purpose. And not just once, but you do it repeatedly. We find, and research has shown this, that if you get people in that situation, experience that kind of activation and help them relate to that differently, people report fewer panic attacks. Rather than pushing it away they try to embrace it and start to feel more safe around it. They report less anxiety around these kinds of stressors. And that’s a really nice outcome. So in the clinical psychologist office, you apply something that’s called interoceptive exposure, which is to bring these bodily sensations on with all kinds of exercises where it’s hyperventilation on purpose, whether it’s spinning or breathing through a straw.

Those are the kind of exercises that we typically apply. Physical activity – particularly if it’s a more intense exercise valve- brings people a lot of these physical sensations. Therefore it can be used effectively as an interoceptive exposure procedure. We have found in multiple studies now that if we apply it as such, we get the kind of effects that we also see with these more cognitive behavioral therapy methods.

As such,  exercise can be applied as a method of exposure therapy and yield the kind of effects that are comparable to CBT (Cognitive Behavioral Therapy).

Ready to start your journey to better mental health and mental readiness? The free Earkick self care companion is there for you at every step of the way.