HBO Vitality management en Tourism:

Exercise & MENTAL HEALTH

23 April 2013

INTRODUCTION:

Irene van de Giessen•Expert by Experience at the psychiatric department of the Admiral De Ruyter Hospital•Freelance Expert by Experience Molemann Mental Health

• Owner Convalescent Talent

Me

HealthHealthSicknessSickness

CHRONIC health conditions and WAY OF LIFE:

Some GROUPS are more at risk for chronic health conditions:

LACK of physical activity and chronic health conditions:

Fysical activity (mixed model of MOTIVATION):

Physical activityPhysical activity

Mental functionsMental functions

Brain functionsBrain functions

Mental well-being

Mental well-being

Fysical fitnessFysical fitness

Motivational on alternative behaviour targeted interventions

Motivational on alternative behaviour targeted interventions

Health care policy

Health care policy

Policy Government

Policy Government

Interventions aimed at change of living conditions and way of life

Interventions aimed at change of living conditions and way of life

We are going to talk ABOUT:

1. The backgrounds of motion poverty because of the sedentary way of life we live now a days

2. The consequences of the sedentary way of life for physical and mental health

3. How does physical activity work positive for the psyche

4. How can mental health services promote that its clients are going to exercise more

PHYSICAL activity in EVOLUTIONARY and HISTORICAL perspective:

The WAY genesbehave themselves:

Genes express themselves in a BALANCED way:• Balanced diet• Intensive exercise for at least half an hour a day

Medical ATTENTION for PHYSICAL ACTIVITY in mental health services:

The GAIN of PHYSICAL exercise for mental health:

‘Brain cells grow, like other parts of the body by exercise. The sensory cells can be exercised only by use of the senses. In like manner the motor cells can be exercised and developed only by making them contract the muscles.’

T.M. Balliet

Since the 19th century physical exercise was used on and of as a therapeutic method in mental health services

‘A chain of empty Sundays'

http://youtu.be/VaDlLD97CLM

The GAIN of PHYSICAL exercise for mental health:• In the Netherlands there’s not much research for the

relation of physical exercise and mental health• There’s no direct link between the dose of physical

activity and mental wellbeing. • Besides de diminishing of symptoms of certain mental

disorders, physical exercise is also good for:

1. Improved self-esteem, 2. Learning social skills, 3. Improved cognitive functioning, 4. The decline of fear en de diminishing of - for heart

and blood vascular system – the risky way of reacting on stressors.

http://youtu.be/bwYj0crnsuo

SLEEPINGPROBLEMS and FATIGUE:

Fatigue is only than a problem, and can only be diagnosed as a disorder, when the fatigue become more chronic

Sleep 1.The average time for sleeping is diminished2.A lot of adults, especially elderly, have sleeping problems

Sleeping problems and depression•Sleeping problems are not only symptoms of depression and symptomatic for elderly but can also be symptoms of other disorders and can be a signee for new depression. •Negative effects of antidepressants can lead to insomnia•The development of a pattern of physical activity and social interaction protects the elderly against incidental and chronic insomnia.

COGNITION:

• Short term results • Long term results

Positive effects:1. Improvement of reactive power and response time2. Improvement the powers of concentration3. Improvement attention4. Improvement problem solving behaviour5. Improvement social psychological functioning

‘Physical activity for children is to be discussed in the light of ‘normal’ development’

http://youtu.be/WxhqjbI7aKc

MECHANISMS that improve COGNITIVE function after exercising:

1. Neurobiological mechanism a)BDNF (challenging environment)b)More oxygen in the brainc) The circulation of glucose

2. Physiological mechanism3. Psychological explanations for the benefit of

physical activity for the psyche include:• Improved self-esteem• Feelings of control of the own life• It offers social support• the activity reduces the feeling of ill-being

4. Relaxation of the parasympathetic nervous system

LACK of activity, physical problems, diseases and disorders:

Many people with psychiatric disorders have a moderate to poor physical health

1.Clients in mental health care, just like any other people, have to do with the risk of somatic diseases such as lung diseases or cancer 2.There are somatic diseases which, due to biological or social psychological mechanisms, occur more than average in people with certain mental illnesses.

CO-MORBIDITY:

1. Various disorders have the same risk factors and physiological processes

2. Undesirable effects of prescribed medication (bigger risk of somatic disorders)

3. A pattern of abuse of psychoactive substances is associated with somatic damage

4. The mental disorder is related to an unhealthy lifestyle in which abuse of substances, poor diet, too much stress and too little exercise are linked together and raise the risk of a somatic disorder

DUBBEL PROBLEMS in MENTAL HEALT CARE

METABOLIC SYNDROM

– central obesity: appel– high bloodpressure – insuline resistence – high cholesterol

COGNITIVE PROBLEMS

Problems with:• planning• concentration • memory

Prevalence: General population20% (and rising!)Mental Health Care: 30-40%People who stay in a psychiatric hospital50% (PHAMOUS)

•Use of antipsychotics

•Not enough Exercise

•Smoking, drugs, alcohol

•Unhealthy food

•Bad self-care

•Stress

•Genetics: link schizophrenia MS

Comon CO-MORBID disorders:

1. Obesity2. Metabolic Syndrome3. Heart- en blood vessel disease4. Diabetes

Diabetes and schizophrenia1. Chronic stress2. Eating wrong and too much 3. Inactivity4. Smoking

Relation between RISK FACTORS and DISORDERS:

Mental disordersMental

disorders Heart diseaseHeart disease

DiabetesDiabetesObesityObesity

Chronic stressChronic stress

Eating too much and wrong

Eating too much and wrong

Smoking/ abuse of alcohol

Smoking/ abuse of alcohol

InactivityInactivity

RECOVERY:

‘Recovery is a way of living a satisfying, hopeful, and contributing life even with the limitations caused by illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness' (Anthony, 1994)

From NO activity to MORE activity:

Casually active!! (cheap, additive)

Nature•helps in recovery from stress and attention fatigue (the way people feel, discipline, concentration, self discipline and physiological stress)•It stimulates to move (one moves in a natural environment and performs better)•facilitates social contact•promotes the development of children (children: the function of attention, self discipline and mental toughness, cognitive-, motor-and social emotional development, social contact)• promotes personal development and spiritual meaning

What can aid workers DO (in mental health care):1. Work together with exercise physiologists, physical

therapists, motion scientist and sports doctors to figure out what their clients want and need when it comes to movement

2. Talking to clients about the usefulness of moving (in conjunction with diet, stop smoking, drink less alcohol, or making changes to the way of life that result in less stress and more relaxation /courses).

3. Pioneering in order to make it possible clients participate in sports clubs outside Mental Health Services (affordability, stigma)

4. Stimulate research

https://www.health4u.nu/ove

r-health4u/3http://youtu.be/SL_xegIIIzM

Techniques for BEHAVIORAL CHANGE:

1. Identify the characteristics of the problem2. Searching for realistic goals and reach agreement on that3. Determining small sub-goals, like this clients can

experience success with their efforts4. Self monitoring and self control

No well-intentioned advice.....

Preparation of an EXERCISE PROGRAM:

1. Research the history of the client in the field of physical activity

2. Work out together in the beginning as a counsellor (role model)

3. Inform the client on the possible physical and mental health effects of exercise

4. Go after what options there are to workout as functional as possible

5. Use the possibilities offered by the environment of the client

6. Let the client choose from wide offer7. Take into account the physical condition of someone

in the type of activity you choose8. Let the exercises take place in an positive

environment9. Behavioural self-control strategies10. make use of strategies for relapse prevention

Mental health care ‘in motion’:

1. Implementation of available knowledge on effectively treating mental disorders, effective organisation of work processes and intelligent use of ICT

2. Market mechanism3. Futuristic biomedical technologies

4. search for disease mechanisms of mental disorders5. Drug delivery

Take home MESSAGE:

1. Sedentary lifestyle increases risk of chronic disease2. The health effects of exercise are undeniable3. (In)activity plays an important role in the course of mental

disorders and brain development 4. Activity must go hand in hand with an enriched

environment5. Physical activity is good for all people with mental

problems and knows hardly any side effects6. Influencing behaviour is difficult, but not impossible7. There is more than enough knowledge available to act8. Questions remain, further investigation is needed9. The care sector for sure, but maybe you too, need to get

started

Thank you very much for listening!