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Role of the exercise in management of mental health

Smith PJ, Merwin RM. The Role of Exercise in Management of Mental Health Disorders: An Integrative Review. Annu Rev Med. 2021 Jan 27;72:45-62.

Numerous epidemiological studies have demonstrated that lower amounts of physical activity (PA) or greater amounts of time spent in sedentary behaviors are associated with greater risk of poor mental health. In a recent study of 1.2 million US adults, in which participants were matched across numerous background and demographic factors, individuals who exercised reported better mental health functioning compared to non-exercisers.

Prospective studies focusing on specific mental health conditions have reported similar findings, suggesting that greater habitual PA may protect against the development of various mental health conditions. For example, a recent meta-analysis of 49 prospective studies across nearly 267,000 individuals demonstrated that higher levels of PA associated with reduced odds of developing depression across age groups.

PA also prospectively associated with lower odds of developing elevated anxiety symptoms and anxiety disorders in a recent meta-analysis of more than 80,000 individuals.

Examination of the literature linking exercise to mental health suggests that exercise training is beneficial for a broad array of mental health outcomes, although the strength of treatment benefit appears to vary across populations and training modalities. The present literature base could be characterized as having three overarching mechanistic hypotheses, which are useful in framing hypotheses regarding treatment improvements:

  • mental health is improved in association with physical/hedonic effects of exercise,
  • exercise improves mental health via neurobiological mechanisms,
  •  exercise is a vehicle for cultivating behavioral mechanisms of change (e.g., self-regulatory skills and self-efficacy).

We contend that exercise training likely improves mental health through synergistic influences of both neurobiological and behavioral learning mechanisms. Within this framework, training improves neurobiological systems critical for adaptive learning, as well as affective and cognitive control processes, resulting in synergistic improvements in the regulation of both cognitive and affective responses through a “virtuous circle” of reinforcement.

Measuring well-being in sport performance

Giles S, Fletcher D, Arnold R, Ashfield A, Harrison J. Measuring Well-Being in Sport Performers: Where are We Now and How do we Progress? Sports Med. 2020 Jul;50(7):1255-1270.

Despite the lack of a universally agreed definition of wellbeing, it is principally understood to encompass a combination of both hedonic and eudaimonic components, which are crucial to thriving across multiple life domains.

The hedonic perspective is typically defined in terms of happiness which is achieved through the striving for rewarding and pleasurable experiences that reinforce positive feelings and satisfaction. The eudaimonic perspective, as proposed by Aristotle (350 BC), focuses more broadly on the personal qualities and ways of life that promote living well. A central tenet to this perspective is the enactment of personal qualities that enable a person to live up to one’s personal potential in a manner that is consistent with their daimon (or ‘true self’).

Grounded in eudaimonic principles, scholars have defined a variety of components (e.g. autonomy, personal growth, and purpose in life) that are used to study psychological well-being and states of flourishing.

Debate remains, however, regarding the extent to which particular components correspond to eudaimonia as articulated in the original philosophical works, as well as the extent to which these are empirically distinguishable from hedonic conceptions of wellbeing. While a comprehensive review of the conceptual and theoretical discussion on this topic is beyond the scope of this paper, it is worth noting that this issue has provided a continual source of debate in the works of contemporary philosophers, and eminent humanistic, clinical, and developmental psychologists. The study of hedonic well-being is often broadly equated with Diener’s model of subjective well-being (SWB). With regards to measurement, there is general agreement that SWB comprises an affective component (i.e. the presence of positive emotions and the absence of negative emotions) and a cognitive component (i.e. evaluations of life satisfaction).

Turning to eudaimonic well-being, numerous conceptual models of measurement have been proposed that combine various components of psychological and social functioning and extend the notion of well-being beyond ‘feeling good’ as emphasised in the hedonic perspective.

To illustrate the conceptual variance that existsdepicts how various domains and components of well-being have been combined in prominent approaches to measurement. While there remains a lack of consensus regarding the conceptual structure of eudaimonic well-being, most scholars accept that measures of eudaimonic well-being are important because they provide an insight into the subjective experiences of individuals beyond that captured through assessments of life satisfaction and affect.

Athletes victimized by stereotypes about mental illness

Petersen, B., Schinke, R.J., Giffin, C.E., Larivière, M. (2023). The Breadth of Mental Ill-Health Stigma Research in Sport: A Scoping ReviewInternational Journal of Sport Psychology, 54(1), 67-90.

Mental ill-health affects athletes at prevalence rates similar to the general population, despite beliefs that athletes are protected by highly physically active lifestyles. Though discussions of stigma are ubiquitous within sport, the research landscape on mental ill-health stigma in sport is unclear. Consequently, we conducted a scoping review overviewing the extant literature and researchers’ approaches to stigma in sport. We collated data from 68 articles and provided interpretations of the emergent trends. Researchers have primarily focused on athlete help-seeking and mental health literacy in relation to stigma. Additionally, future research should clarify the type of stigma under study and explore structural stigma, which remains a significant literature gap. Finally, shifting toward open-ended and inclusive research methodologies can centralize participants’ involvement, incorporating their experiences and leading to progressive understand- ing of mental ill-health stigma. Our findings present future research directions and research suggestions to expand mental ill-health stigma in sport research.

Stigma isthe devaluation of an individual based on a characteristic they possess or are believed to possess.

As a result, athletes indicate that stigma attached to mental ill-health is one of the biggest barriers to help-seeking behaviours, inhibiting athletes’ utilization of mental health services as they seek to prevent any stigma-related repercussions. Athletes’ unwillingness to access mental health 230 services to avoid stigma may lead to ongoing performance detriments or exacerbation of mental ill-health; subsequently, the effects of stigma on help-seeking behaviours feature prominently in sport psychology stigma research.

The wellbeing secrets: movement and interpersonal relationship

Xu X., Mishra G.D., Holt-Lunstad J., et al. Social relationship satisfaction and accumulation of chronic conditions and multimorbidity: a national cohort of Australian women General Psychiatry 2023;36.

Background Social relationships are associated with mortality and chronic conditions. However, little is known about the effects of social relationship satisfaction on multiple chronic conditions (multimorbidity).

Aims To examine whether social relationship satisfaction is associated with the accumulation of multimorbidity.

Methods Data from 7 694 Australian women who were free from 11 chronic conditions at 45–50 years of age in 1996 were analysed. Five types of social relationship satisfaction (partner, family members, friends, work and social activities) were measured approximately every 3 years and scored from 0 (very dissatisfied) to 3 (very satisfied). Scores from each relationship type were summed to provide an overall satisfaction score (range: ≤5–15). The outcome of interest was the accumulation of multimorbidity in 11 chronic conditions.

Results Over a 20-year period, 4 484 (58.3%) women reported multimorbidities. Overall, the level of social relationship satisfaction had a dose–response relationship with the accumulation of multimorbidities. Compared with women reporting the highest satisfaction (score 15), women with the lowest satisfaction (score ≤5) had the highest odds of accumulating multimorbidity (odds ratio (OR)= 2.35, 95% confidence interval (CI): 1.94 to 2.83) in the adjusted model. Similar results were observed for each social relationship type. Other risk factors, such as socioeconomic, behavioural and menopausal status, together explained 22.72% of the association.

Conclusions Social relationship satisfaction is associated with the accumulation of multimorbidity, and the relationship is only partly explained by socioeconomic, behavioural and reproductive factors. Social connections (eg, satisfaction with social relationships) should be considered a public health priority in chronic disease prevention and intervention.

Meditation is for all

When we think of meditation we usually picture a monk in a faraway country in Asia or some privileged person like u actor who has time to do practice at dawn. Most of us don’t meditate because we consider it useless, because we think we don’t have the time, because we are so stressed that meditating would be an added stress, because we would rather sleep an extra half hour and then we are always late, because we have other things to think about, because we don’t need to, because you have kids or the house to fix before you go out, because if he/she doesn’t know anyone who does it there must be a good reason, because at home he/she would think he/she is crazy, because he/she tried it but it’s not for him/her, because he/she doesn’t even have time to eat breakfast in the morning, because he/she thinks it doesn’t do any good, because it doesn’t help solve problems, and so on.

They are not aware that meditating is a way to take care of ourselves and to guide our thoughts on a path that improves our well-being.

In that sense, meditating is taking a thought that we like and developing it, expanding it until it uniquely and totally occupies our mind. Meditating allows us to be focused on one thought at a time with the goal of promoting well-being.

Research has shown that the positive effects of meditation show up clearly after adding up 30 hours of practice. So if a person practiced for 15 minutes for 6 days a week, after 3 months he or she would see the first improvements in his or her mood and psychological condition, which would stabilize over the following months. Of course, this activity is suggested for people who do not suffer from psychological disorders and who, instead, should follow a psychotherapeutic course with a professional.

Walking keeps death away

Association of Daily Step Count and Step Intensity With Mortality Among US Adults

JAMA. 2020; 323(12):1151-1160.

Question  What are the associations between daily step counts and step intensity with mortality among US adults?

Findings  In this observational study that included 4840 participants, a greater number of steps per day was significantly associated with lower all-cause mortality (adjusted hazard ratio for 8000 steps/d vs 4000 steps/d, 0.49). There was no significant association between step intensity and all-cause mortality after adjusting for the total number of steps per day.

Meaning  Greater numbers of steps per day were associated with lower risk of all-cause mortality.

At this time of year, plans are always being made to improve our lives in the coming year. This research provides us with an opportunity to make an important and meaningful choice for our well-being. It’s free and affordable for everyone. It involves walking, an activity that many of us do on an extremely limited basis. It does not matter the speed, to obtain benefits it is enough to move with our pace, however, it is necessary to do 8,000 a day to obtain this positive result that will make us live better and longer.

It’s time to promote the athletes’ and coaches’ mental health

The NGO of Athletic in UK are working with Believe Perform to create new online resources for athletes, coaches and parents around mental health and performance.

Great news!



The mindset of the people who do not respect the rules

As long as I breathe I hope,” Cicero said, today we could translate it into “as long as there is life there is hope,” more brutal but equally true. The coronavirus affects precisely this capacity that is at the basis of the physiological and psychological needs of living beings. You may not drink or eat for a few days, but you can’t breath for a few minutes if you are not a champion of underwater apnea. Correct breathing is at the base of self-control and the stresses of our daily life determine as a first negative effect our own breathing problems. Fear makes us block our breath, anger hates it to allow us to scream at someone, sadness reduces it to a trickle of air that goes in and out and anxiety makes us breathe in a shallow and superficial way. Breathing reflects our level of physical fitness and well-being and one of the effects of this new virus is to block it, making assisted breathing necessary in many cases. Mario Garattini, founder of the Mario Negri Pharmacological Research Institute, MIlano, said that “everything will depend on us, on our ability to avoid contagion. Let’s adhere to the dispositions. If everyone had adequate lifestyles and there was adequate prevention, perhaps we would be more resistant”.

This awareness, combined with the worldwide spread of the coronavirus and its devastating effects, should have frightened people enough to never leave their homes again, motivating them to respect the rules that have been spread and whose implementation is mandatory. Nevertheless, thousands of people have continued to travel throughout our country and the police have fined more than 2000 people for violating the restrictive rules of the government decree. What are the reasons for this behaviour? Superficiality, too positive approach to the problem, anxiety and a lack of habit of following the rules. Superficiality is a kind of magic thought, in which people think that the coronavirus is a problem that affects others, such as the elderly and sick, is a way to protect themselves from feelings of sadness in the short term. These people deny the existence of the problem and, therefore, engage in behaviour to escape from their reality. A second type of attitude is people who have an approach not mediated by reality and that is too positive, such as those who thought at the beginning of the spread that it was little more than a flu. They are individuals who live under the illusion of positive short-term solutions. A bit like those who start a diet or want to quit smoking and are confident that they will succeed just because they have made this decision, they are illusory forms of thinking so that at the first obstacles people give up following the new rules they have given themselves because it is too difficult. In the case of the coronavirus the problem manifests itself in the difficulty in maintaining the rules of physical distancing from other people and then they go out, take a walk with friends and take their children to play in the gardens. Similar for the effects but different in reasons is the approach of those who feel angst in staying at home. They perceive themselves as prisoners, feel violated in their freedom of movement and live this condition in a claustrophobic way. To overcome it the only solution in going outside. Finally, there are those who live reactively to the rules, have an attitude of eternal adolescents fighting against the norms of the adult world. They find it difficult to make the rules their own, which in this case are mandatory, and to develop a pluralistic concept of social coexistence, based not only on their rights but also on their duties towards the community.

These are some possible interpretations of behaviours that in a period of world crisis like the one we are experiencing and of upheaval of our daily life can explain the actions of the many who seem not to want to adapt to the new rules.

Move and think

Why Your Brain Needs Exercise

The evolutionary history of humans explains why physical activity is important for brain health

David A. Reichlen and Gene E. Alexander, Scientific American, January 1, 2020

Brief synthesis

“Why does exercise affect the brain at all?

Physical activity improves the function of many organ systems in the body, but the effects are usually linked to better athletic performance.

Instead exercise seems to be as much a cognitive activity as a physical one. In fact, this link between physical activity and brain health may trace back millions of years to the origin of hallmark traits of humankind. If we can better understand why and how exercise engages the brain, perhaps we can leverage the relevant physiological pathways to design novel exercise routines that will boost people’s cognition as they age—work that we have begun to undertake.

… we demonstrated that people who spent more time engaged in moderate to vigorous physical activity had larger hippocampal volumes.

Researchers have also documented clear links between aerobic exercise and benefits to other parts of the brain, including expansion of the prefrontal cortex, which sits just behind the forehead. Such augmentation of this region has been tied to sharper executive cognitive functions, which involve aspects of planning, decision-making and multitasking—abilities that, like memory, tend to decline with healthy aging and are further degraded in the presence of Alzheimer’s. Scientists suspect that increased connections between existing neurons, rather than the birth of new neurons, are responsible for the beneficial effects of exercise on the prefrontal cortex and other brain regions outside the hippocampus.

If we can augment the effects of exercise by including a cognitively demanding activity, then perhaps we can increase the efficacy of exercise regimens aimed at boosting cognition during aging and potentially even alter the course of neurodegenerative diseases such as Alzheimer’s.

They found an additive effect: exercise alone was good for the hippocampus, but combining physical activity with cognitive demands in a stimulating environment was even better, leading to even more new neurons. Using the brain during and after exercise seemed to trigger enhanced neuron survival.”

… we recently showed that collegiate cross-country runners who train extensively on outdoor trails have increased connectivity among brain regions associated with executive cognitive functions compared with healthy but more sedentary young adults. Future work will help us understand whether these benefits are also greater than those seen in runners who train in less complex settings—on a treadmill, for instance.

10 reasons to walk everyday

Knowledge takes place through movement: start walking again at least half an hour every day.

  1. Walking awakens every muscle in the body, not just the legs.
  2. Walking is a time to spend with other people but also in solitude
  3. Walking improves our mood
  4. Walking is just for all ages
  5. Walking is the only activity in common with every human being from thousands of years
  6. Walking has been and is the primary activity to know and expand our territory
  7. Walking on one’s own legs is what parents teach their children
  8. Walking is the basis of running, jumping, throwing and any other form of movement.
  9. Walking into the nature stimulates watching, smelling and the sound of one’s own footsteps
  10. Walking is a free activity

How  do  you  want  to  be?


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