Stress is part of our daily lives, and more Americans Stress is part of our daily lives, and more Americans than ever are feeling its ill effects. Exercise may than ever are feeling its ill effects. Exercise may

positively influence feelings positively influence feelings of well-being.of well-being.

►Hectic pace of westernized, Hectic pace of westernized, technological society.technological society.

►16+ million Americans suffer 16+ million Americans suffer from depression.from depression.

►12 to 14 million Americans suffer from 12 to 14 million Americans suffer from anxiety or stress reactions.anxiety or stress reactions.►Epidemiological data: Physical activity Epidemiological data: Physical activity is positively associated with good is positively associated with good mental health in the U.S. and Canadian populations.mental health in the U.S. and Canadian populations.

Short-term or burst activities not Short-term or burst activities not involving the transportation of involving the transportation of oxygen (e.g., weight lifting, oxygen (e.g., weight lifting, baseball).baseball).

AnaerobicAnaerobic

Longer-term activities that Longer-term activities that increase pulmonary and increase pulmonary and cardiovascular system activity cardiovascular system activity (e.g., cycling, running).(e.g., cycling, running).

AerobicAerobic

High-intensity aerobic activity is not the High-intensity aerobic activity is not the only way to produce positive effects, but only way to produce positive effects, but compared with other activities (e.g., compared with other activities (e.g., strength training, yoga), it seems to strength training, yoga), it seems to maximizemaximize positive effects. positive effects.

►Exercise intensity of at least 70% of Exercise intensity of at least 70% of maximal heart rate appears to be maximal heart rate appears to be associated with the greatest reduction in associated with the greatest reduction in postexercise state anxiety.**postexercise state anxiety.**

►Postexercise reductions in state anxiety Postexercise reductions in state anxiety return to preexercise anxiety levels within return to preexercise anxiety levels within 24 hours.24 hours.

“Acute” Effects of Exercise

►Typical program to study chronic Typical program to study chronic effects lasts 2–4 months, with effects lasts 2–4 months, with 2–4 sessions per week.2–4 sessions per week.

►Exercise is associated with reductions Exercise is associated with reductions in state anxiety, and the reductions are in state anxiety, and the reductions are maintained for up to 15 weeks.maintained for up to 15 weeks.

♦““Chronic” Effects of ExerciseChronic” Effects of Exercise

►Greater physiological gain does Greater physiological gain does not necessarily lead to greater not necessarily lead to greater psychological gain.psychological gain.

►Although consistent reductions in state anxiety occur Although consistent reductions in state anxiety occur with both aerobic and anaerobic exercise, most research with both aerobic and anaerobic exercise, most research has focused on aerobic exercise to reduce anxiety.has focused on aerobic exercise to reduce anxiety.

►Exercise is associated with moderate Exercise is associated with moderate reductions in both state and reductions in both state and traittrait anxiety. anxiety.►Exercise is associated with reductions Exercise is associated with reductions in muscle tension.in muscle tension.

►Longer training programs (sessions conducted over Longer training programs (sessions conducted over weeks, rather than hours or days) are more effective than weeks, rather than hours or days) are more effective than shorter ones in producing positive changes in well-being.shorter ones in producing positive changes in well-being.

►Reductions in state anxiety after exercise Reductions in state anxiety after exercise may be due less to the physical activity than to may be due less to the physical activity than to the “time-out” from daily stresses and hassles.the “time-out” from daily stresses and hassles.

(continued)(continued)

►Reductions in anxiety after exercise occur Reductions in anxiety after exercise occur independently of age and health status.independently of age and health status.

►Exercise training is particularly Exercise training is particularly effective for effective for individuals who have elevated levels of individuals who have elevated levels of stress.stress.

►All durations of exercise significantly All durations of exercise significantly reduced anxiety, although larger effects reduced anxiety, although larger effects were found for periods up to 30 minutes.were found for periods up to 30 minutes.

Extremely Depressed Mood– Lasting at Least 2 Weeks

Cognitive Symptoms Anhedonia Vegetative Symptoms Single or Recurrent Episode– No Manic or Hypomanic Episodes

Extremely Depressed Mood– Lasting at Least 2 Weeks

Cognitive Symptoms Anhedonia Vegetative Symptoms Single or Recurrent Episode– No Manic or Hypomanic Episodes

Clinical Description Clinical Description

Clinical Description Clinical Description

2 Weeks or More2 Weeks or More

Facts and Statistics Facts and Statistics Mean Age of Onset is 25 Years Nearly 70% are women Length of Episode Varies Remission is Common Risk of Suicide

Mean Age of Onset is 25 Years Nearly 70% are women Length of Episode Varies Remission is Common Risk of Suicide

►Possible depression treatments include Possible depression treatments include prescription drugs, psychotherapy, and exercise.prescription drugs, psychotherapy, and exercise.

►Exercise appears most helpful in relieving Exercise appears most helpful in relieving depression for people who are actually depression for people who are actually depressed.depressed.

►All modes of exercise are effective, but the All modes of exercise are effective, but the greater the duration of the exercise program, greater the duration of the exercise program, the greater the antidepressant effect.the greater the antidepressant effect.

►Exercise Exercise intensityintensity is not related to changes is not related to changes in depression.in depression.

►A pleasing and enjoyable activityA pleasing and enjoyable activity

►Aerobic or rhythmic breathingAerobic or rhythmic breathing

►An absence of interpersonal competitionAn absence of interpersonal competition

►A closed, predictable, and spatially A closed, predictable, and spatially certain environment (e.g., running)certain environment (e.g., running)►Moderate intensity and duration of at least Moderate intensity and duration of at least 20 to 30 minutes20 to 30 minutes►Regular inclusion in the weekly scheduleRegular inclusion in the weekly schedule

►Physically active individuals report a Physically active individuals report a better quality of life.better quality of life.

►College students participating in an endurance-College students participating in an endurance-conditioning program report a significantly higher conditioning program report a significantly higher quality of life than do non-exercisers.quality of life than do non-exercisers.

►Older adults who are physically active Older adults who are physically active report greater life satisfaction.report greater life satisfaction.

The effects of exercise on enhancing The effects of exercise on enhancing sleep are not as compelling or large as sleep are not as compelling or large as commonly believed.commonly believed.

►The effects are small, but they The effects are small, but they are noteworthy.are noteworthy.

IncreasesIncreases DecreasesDecreases

ConfidenceConfidence

AssertivenessAssertiveness

MemoryMemory

Self-controlSelf-control

Well-beingWell-being

DepressionDepression

AngerAnger

HeadachesHeadaches

Psychotic behaviorPsychotic behavior

Work errorsWork errors

►Increases in cerebral Increases in cerebral blood flowblood flow

PhysiologicalPhysiologicalexplanationsexplanations

►Changes in brain Changes in brain neurotransmitters (e.g., neurotransmitters (e.g., norepinephrine, endorphins, norepinephrine, endorphins, seratonin)seratonin)

►Increases in maximum Increases in maximum oxygen consumption and oxygen consumption and delivery of oxygen to delivery of oxygen to cerebral tissuecerebral tissue

(continued)(continued)

PhysiologicalPhysiologicalexplanationsexplanations

►Reductions in muscle Reductions in muscle tensiontension

►Structural changes in Structural changes in the brainthe brain

►““Time-out” or distraction Time-out” or distraction hypothesishypothesis

PsychologicalPsychologicalexplanationsexplanations

►Enhanced feelings of controlEnhanced feelings of control

►Feelings of competence Feelings of competence and self-efficacyand self-efficacy

►Positive social interactionsPositive social interactions

►Improved self-concept Improved self-concept and self-esteemand self-esteem

““The Runner’s High”The Runner’s High”The runner’s high is a euphoric sensation, usually The runner’s high is a euphoric sensation, usually unexpected, of heightened well-being, an enhanced unexpected, of heightened well-being, an enhanced appreciation of nature and transcendence of time and appreciation of nature and transcendence of time and space.space.

►60% of adults are sedentary.60% of adults are sedentary.

►50% of youth (ages 12-21) 50% of youth (ages 12-21) do notdo not participate in regular physical activity.participate in regular physical activity.

►25% of children and adults report 25% of children and adults report doing doing nono physical activity. physical activity.►Only 15% of adults participate in Only 15% of adults participate in vigorous and frequent activity.vigorous and frequent activity.

►Only 10% of sedentary adults are Only 10% of sedentary adults are likely to begin a program of regular likely to begin a program of regular exercise within a year.exercise within a year.

(continued)(continued)

►Weight controlWeight control

►Reduced risk of cardiovascular diseaseReduced risk of cardiovascular disease

►Reduction in stress and depressionReduction in stress and depression

►EnjoymentEnjoyment

►Building self-esteemBuilding self-esteem

►SocializingSocializing

►Lack of time, energy, or motivationLack of time, energy, or motivation

►Excessive costExcessive cost

►Illness/injuryIllness/injury

►Feeling uncomfortableFeeling uncomfortable

►Lack of skillLack of skill

►Fear of injuryFear of injury

►Match the intervention to the Match the intervention to the participant’s stage of change.participant’s stage of change.

►Provide cues for exercises Provide cues for exercises (signs, posters, cartoons).(signs, posters, cartoons).

►Make the exercises enjoyable.Make the exercises enjoyable.

►Tailor the intensity, duration, Tailor the intensity, duration, and frequency of the exercises.and frequency of the exercises.

(continued)(continued)

►Promote exercising with a group Promote exercising with a group or friend.or friend.►Have participants sign a contract or statement Have participants sign a contract or statement of intent to comply with the exercise program.of intent to comply with the exercise program.

►Offer a choice of activities.Offer a choice of activities.

►Provide rewards for attendance Provide rewards for attendance and participation.and participation.

(continued)(continued)►Give individualized feedback.Give individualized feedback.

►Find a convenient place for exercising.Find a convenient place for exercising.

►Have participants reward themselves Have participants reward themselves for achieving certain goals.for achieving certain goals.

►Encourage goals to be self-set, Encourage goals to be self-set, flexible, and time-based (rather flexible, and time-based (rather than distance-based).than distance-based).

►Suggest keeping daily exercise logs.Suggest keeping daily exercise logs.Have participants complete a decision balance Have participants complete a decision balance sheet before starting the exercise program.sheet before starting the exercise program.

Psychological and/or physical Psychological and/or physical dependence on a regular regime of dependence on a regular regime of exercise, characterized by withdrawal exercise, characterized by withdrawal symptoms after 24 to 36 hours pass symptoms after 24 to 36 hours pass without exercise. Withdrawal symptoms without exercise. Withdrawal symptoms include anxiety, irritability, guilt, and include anxiety, irritability, guilt, and muscle twitching.muscle twitching.

What is What is exercise addiction?exercise addiction?

Stereotyped pattern of exercise, Stereotyped pattern of exercise, with a regular schedule of once or more daily.with a regular schedule of once or more daily.1.1.

Giving exercise increasing priority over Giving exercise increasing priority over other activities to maintain the pattern.other activities to maintain the pattern.

2.2.

Increased tolerance to the amount of Increased tolerance to the amount of exercise performed.exercise performed.

3.3.

Withdrawal symptoms related to Withdrawal symptoms related to mood disorder following cessation mood disorder following cessation of exercise.of exercise.

4.4.

(continued)(continued)

Relief of withdrawal symptoms by further exercise.Relief of withdrawal symptoms by further exercise.5.5.

Subjective awareness of a compulsion to Subjective awareness of a compulsion to exercise.exercise.

6.6.

Rapid reinstatement of the previous pattern of exercise Rapid reinstatement of the previous pattern of exercise and withdrawal symptoms after a period of abstinence.and withdrawal symptoms after a period of abstinence.

7.7.