W3 - Evidence linking physical activity, sedentary behaviour and mental health Flashcards
Define mental health
“a state of wellbeing in which the individual realises his or her abilities, can cope with the normal stresses of life, work productively and fruitfully, and is able to make a contribution to his or her community”
What is mental illness?
- changes in emotion, thinking or behaviour (or a combination of these)
- Associated with distress and/or problems functioning in social, work or family activities
- 1 in 4 people will experience a mental health problem each year in England. Mixed anxiety and depression is the most common mental illness in Britain, 7.8% people meet the criteria for diagnosis
- Distinguish between severe and common mental illnesses, e.g.: bipolar
How common are problems with mental health worldwide?
- Mental health problems are one of the main causes of the overall disease burden worldwide
- Major depression is thought to be the second leading cause of disability worldwide
- Mental illness causes almost 1/4 of our burden of disease (22.8%), yet receives only 11% of NHS funding
- More than 1/3rd of GP consultations are related to mental health (approximately 150 million consultations per year)
What are the NHS’s 5 steps to mental well-being?
- Connect
- Be active
- Take notice
- Learn new skills
- Give to others (makes us happier in ourselves)
Speaking to people and meeting them can help our mental state
What are the evidence based benefits of PA on mental health?
- Reduced risk of anxiety and depression
- Improvements in mood/reduction of negative mood
- Improvements in self-esteem and self confidence
- Improved sleep
- Increased energy and concentration levels
- Managing stress or intrusive thoughts
- Increasing ‘connectedness’
How did Covid-19 impact peoples mental health?
What relationship was shown between mental health and PA?
- 23 March (2020) – UK lockdown
- Social distancing measures impacted mental health
- Large body of work evidencing mental health benefits of PA
Results:
* 902 adults (64% women, 50% people aged 35-64)
* Negative association between MVPA and MH (after adjusting for covariates)
* Higher levels of PA associated with a better MH status
* Limitations?
What is the difference in psychological and physiological mental health mechanisms?
psychological:
- activity enhances self-efficacy
- social interaction hypothesis
- distraction hypothesis
Physiological:
- monoamine hypothesis
- endorphin hypothesis
Describe the association between sedentary behaviour and mental illness
Sedentary behaviour is defined as: any waking behaviour characterized by an energy expenditure ≤1.5 metabolic equivalents (METs), while in a sitting, reclining or lying position
* Those who are most sedentary have poorer mental health (Hamer et al., 2016)
* Linked with increased risk of anxiety (Teychenne, 2015)
* Linked to sleep disorders, comorbid with mental health problems (Kline et al., 2016)
What are some mechanisms where sedentary behaviour and mental illness are correlated?
- cardiometabolic risk factors
- Passive sedentary activities may encourage social isolation
- Inflammatory process with C-reactive protein (Hamer et al., 2013) - linked to depression
- Displace time spent in more important activities → stress
- Increased CNS involvement → anxiety
How does physical activity impact severe mental illness?
- Severe mental illness (SMI) → 23% of disease burden
- People with SMI engage in less PA than general population
- Variety of benefits of PA for SMI include:
- Improvements in BMI, weight and cardiovascular fitness
- Improvements in quality of life and social/cognitive functioning (PA has been shown to improve cognitive function in people with schizophrenia)
- Reduction in depressive and psychotic symptoms
- EPA guidance for physical activity as a treatment for SMI
What are the EPA research and practise recommended
- Research Recommendations
○ focus on ways to promote PA
○ controlled trials needed to determine optimal ‘dose’ - Practice Recommendations
○ Requirement for qualified exercise professionals to lead PA
○ Beneficial as an adjunctive treatment to improve cognition/QoL
○ Should be used to improve physical health in people with severe mental illness
Name some barriers to exercise
Low mood
Stress
Lack of support
Tiredness/lack of energy
Poor physical health
Low motivation
What are some reasons to exercise?
Lose weight /maintain fitness
Managing mood
Reducing stress
Improve physical health
Improved sleep
Overall mental health management
How does PA impact eating disorders?
- Weight and shape control common reasons for PA participation
- The ‘thin ideal’ and problematic physical activity
- Problematic physical activity (PPA) and eating disorders
- Abnormally high levels of PA shown in many patients → detrimental health consequences
- PA actively discouraged in eating disorders, especially in hospitals → BUT, PA easier to monitor in hospitals
What effect does exercise have on bipolar disorder?
Why is it important that different exercise intensities are recommended for different episodes?
- Bipolar disorder – mania and depressive episodes
- Physical activity appropriate to reduce/manage depressive symptoms
- Activity may be a double edged sword for bi-polar due to potentially exaggerating symptoms of mania(may cause people to take part in high risk behaviours)
- Type of activity may be more important here
○ Manic episode –> need for low intensity exercise
○ Depressive episode –> need for high intensity exercise - As always, we need more research
