Healing Through Exercise: Scientifically Proven Ways to Prevent and Overcome Illness and Lengthen Your Life (15 page)

Although this relationship has been known since the 1980s, psychiatrists and psychologists have just started to use the healing power of exercise in the treatment of mental disorders. In contrast to cardiologists, they largely disregarded the influence of regular exercise on mental well-being.
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Some psychiatrists believe it is high time to alter this attitude: “The clinical psychiatry of the recent past and present with its focus on psychotherapy and pharmacotherapy regards sports and games rather as simply a fine pastime and doesn’t so far attribute any specific therapeutic effectiveness to it.”
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The reservations shown by many psychologists and psychiatrists in this regard are even more astonishing given that there is now a wealth of data indicating specifically that people suffering from depression and anxiety disorders benefit from physical exercise. Multiple studies also show that more than just psychiatric impairments can be successfully treated with training. Neurodegenerative disorders like Alzheimer’s disease, characterized by dramatic losses of brain mass and nerve cells, are being studied in relation to physical activity. These diseases, once they develop, are curable with neither tablets nor training. Yet exercise appears to be one of the best means to prevent them from developing in the first place.

FROM THE COUCH TO THE TREADMILL

Only a few patients who suffer from depression become healthy again by taking drugs. About 65 to 75 percent of those patients who do so are not cured and have to face recurring depressive episodes: they are sad, easily agitated, and have problems sleeping and concentrating. This is due not only to the fact that drugs have little effect, but it is also because up to 60 percent of patients are believed to stop following their prescriptions after three weeks. Others refuse to take antidepressants in the first place for fear of being stigmatized.

In the face of all these problems, some doctors started to wonder whether there might be a better alternative. Ideally this would be a remedy that is effective, has no adverse side effects, and is socially accepted. Older studies among healthy subjects had indicated that physical exercise is an ideal candidate to fit this description. Endurance training had been found to lighten moods, reduce fears, and increase the capacity to cope with stress. In one study, groups of active and sedentary people were followed for eight years, with the conclusion being that inactive people developed a depression rate twice that of their active counterparts.

Other trials included patients suffering from mild to severe depression. In one study, 40 patients were encouraged either to participate in a running program for eight weeks or to try strength training for eight weeks. Tests before and after the program revealed improved symptoms in both groups.
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Does that mean exercise beats pharmaceuticals in terms of effectiveness? The research group of James Blumenthal at Duke Medical Center in Durham, North Carolina, set out to answer this question.
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They randomly assigned 156 elderly patients, who suffered from major depression, into three groups: those exercising, those taking antidepressants (in this case sertraline hydrochloride, which is an antidepressant of the selective serotonin reuptake inhibitor class), and those trying both. The exercise session lasted for 30 minutes, three days per week.

After 16 weeks, the participants were reexamined. In all three groups, the patients’ health had significantly improved, and about 60 percent of each group were no longer depressed.

Therefore the program relying solely on physical activity was as effective as state-of-the-art antidepressants.

Over time, the effect of exercise became more pronounced. The participants were examined after six months, and those on exercise regimens had significantly fewer relapses than the drug-takers. The long-lasting effect of activity can be explained by the fact that many of the participants liked exercising so much that they continued to be active even after the official end of the study. That way, they overcame their depressions. Knowing that they were capable of fighting their illnesses might have further enhanced their success. Blumenthal concludes: “Simply taking a pill is very passive. Patients who exercised may have felt a greater sense of mastery over their condition and gained a greater sense of accomplishment. They felt more self-confident and had better self-esteem because they were able to do it themselves, and attributed their improvement to their ability to exercise.”
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As impressive as this result seems, the study could not completely determine if the results were simply a consequence of the social aspect of the workouts because the participants exercised together. During these sessions, everyday worries seemed to be forgotten, and people made small talk and laughed. Perhaps the new friendships and the collective experience were the main reasons for the improved mood.

In order to exclude this possibility, researchers at the Cooper Institute’s Science Research Center in Golden, Colorado, initiated a further study.
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They encouraged 80 men and women who were sedentary, depressive, and not on medication to participate in a sports program that lasted eight weeks, with three to five sessions per week. They either walked on a treadmill or pedaled on a stationary bike, and were alone (except for gruff assistants who checked on them to make sure nobody was secretly resting).

Half the participants tried an easy program and in one week burned just three kilocalories per pound of bodyweight. Though their symptoms improved, the effect was small and thus could have been a chance finding.

The members of the second group burned eight kilocalories per pound. This consumption corresponds to moderate exercise, like a brisk 30-minute walk on most days of the week. The symptoms in this group decreased by 47 percent, and in 42 percent of the patients the symptoms disappeared completely. This confirms that physical exercise is as effective as antidepressants and psychotherapy. Interestingly, it did not matter if the patients worked out for three or five days per week. Burning the recommended amount of kilocalories in a week is the main objective.

PLAYING AGAINST PANIC

Psychiatrists report regularly on patients and cases in which physical training was found to help people suffering from anxiety. Yet only a few trials have been initiated to look into this phenomenon. In one study, 46 individuals with claustrophobia, affective panic disorder, or both participated in a ten-week program and were asked to jog a distance of 3.1 to 3.7 miles on three or four days of the week. The patients of a second group were inactive and received either standard medication (the antidepressant clomipramine) or a placebo. Compared to the placebo, the medication significantly improved the symptoms. Exercise was also better than placebo, though not as effective as the medication.

In the treatment of alcoholics and drug addicts, moderate training programs are by now quite widespread in Germany, although there are few studies about whether this actually affects the addiction. On the contrary, members of soccer and handball clubs often consume amazing numbers of cigarettes as well as alcoholic beverages like beer and schnapps. It might shock American readers, but in lower-level German soccer leagues, it is not too uncommon for substitute players to smoke while watching their peers play. After the game, players and their families often gather and open a keg of beer. People with addiction problems might do better to avoid such crowds and pick up healthy ways of exercising like walking and jogging. Andreas Broocks of Helios Kliniken in Schwerin, Germany, is among the leaders in the field of sports therapy in psychiatry, and he concludes: “Regular endurance training substantially improves the self-confidence and self esteem of addicted patients and thus could help them to stay abstinent.”
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Individuals with schizophrenia are also often in a condition for which physical exercise is much needed. Many such patients are heavy smokers, have an unhealthy diet, and hardly move their bodies. A training regimen would not only improve their physical shape but also help work against the psychiatric disorders that can accompany schizophrenia. According to one study, about 50 percent of all schizophrenic people also have symptoms of panic, obsessive-compulsive disorder, and depression. Although the possible benefit of exercise has not been studied until now, some physicians are discovering its potential. Inspired by good experiences with patients, many clinics are now trying to treat patients with schizophrenia with exercise as therapy.
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SOUND BODY FOR A SOUND MIND

It is thanks to the Roman poet Juvenal that we believe a sound mind (
mens sana
) resides in a sound body (
corpore sano
).
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This proverb has spread for centuries, but it was not until recent times that neuroscientists have found enough evidence to reassure us that the ancient claim can be taken literally. Researchers have now accumulated evidence showing that exercise can stave off mental decline and the onset of widespread Alzheimer’s disease, which leads to the loss of critical brain functions.

Alzheimer’s is a disease that strikes with age. Among people aged 70 to 74, it is estimated that fewer than 3 percent are affected; among those older than 90, about one-third are affected. And because people in the United States and other industrialized nations live longer and longer, Alzheimer’s is considered one of the most pressing health-care problems of the near future. An estimated 4.5 million Americans have Alzheimer’s disease. That number has more than doubled since 1980 and is projected to reach 11.3 to 16 million by the year 2050.

Besides age, there are other risk factors. It may not be a good omen when family members have suffered from Alzheimer’s because that suggests a genetic preposition to it. Alzheimer’s also relatively frequently afflicts people with low education levels. These factors are hard to change once a person has reached adulthood, but there is another way to postpone the onset of the disease or to prevent it altogether: activities such as brisk walking or bicycle riding.

Results from lab trials indicate that exercise can protect the brain.
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Mice held in cages with treadmills accumulate fewer harmful molecules in their brains than sedentary animals. These peptides, called amyloid beta, are usually found in demented mice and lead to plaque formation.

Even when this peptide is already spreading in the brain, exercise appears to help stall the progression of dementia. In a study published in the
Journal of Neuroscience
, researchers at the Institute for Brain Aging and Dementia at the University of California, Irvine, took mice that were predisposed to develop Alzheimer’s disease and gave them running wheels for exercise. After several months of exercise, the mice showed improved cognitive behaviors and less amyloid-beta plaque. “What we found is that levels of the amyloid in these exercising mice went down,” said the principal investigator, Carl Cotman. “Instead of a drug, it was a natural behavior that translated to a reduction of Alzheimer’s-like pathology developing in the brain.”
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A similar picture emerges when researchers try to correlate the lifestyles of people and their risk of developing Alzheimer’s disease. Chinese researchers studied more than 1,000 elderly inhabitants of Beijing for three years. Those who hardly left their apartments developed dementia more often than was average.

Japanese researchers conducted a diligent study in which they monitored 828 citizens older than age 65 for seven years and inspected their brains using CT scans and other methods. More than 200 participants died in the course of the study, but most of their brains were examined after death. And the result showed again that sedentary seniors were more prone to become ill with Alzheimer’s disease.
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Fortunately, there is no need for strenuous activities to stave off this notorious atrophy of the brain. Older men aged 71 to 93 who walk at least two miles every day cut the risk of Alzheimer’s in half, compared to people the same age who walk only a quarter of a mile per day.
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The more intense the dose of exercise, the bigger the effect against dementia. This direct correlation was revealed by a five-year trial of elderly women. The most active women had a risk reduction by 50 percent, and a 60 percent reduction specifically for Alzheimer’s.

One of the most extensive studies has been carried out by researchers at the Aging Research Center of the Karolinska Institute in Stockholm. In 1972 they began studying the leisure-time exercise habits of nearly 1,500 people.
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Those who exercised at least two days per week during midlife lowered their risk of developing Alzheimer’s by 50 percent.

For people around age 40, this implies that if they start now on moderate exercise programs, like bicycling and walking, they might be rewarded on some not-too-distant day. The neurologist Miia Kivipelto, senior author of the study, said: “These findings may have wide implications for preventive healthcare; if an individual adopts an active lifestyle in youth and at midlife, this may increase their probability of enjoying both physically and cognitively vital years later in life.”

Apart from these epidemiological findings, brain-imaging studies also indicate that exercise influences the risk for Alzheimer’s disease. These images show that physical activity slows down the type of brain atrophy that usually comes with age. Between our 30th and 90th birthdays, approximately 15 to 25 percent of the brain’s gray matter is lost, and the areas in charge of learning and memorizing shrink the most.