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Treating depression with exercise: what does an accredited exercise physiologist do?

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With depression being hailed the third highest cause of disease burden worldwide, often overlapping with other chronic conditions, the media is full of news about the latest mental health treatments.

Anti-depressants have been proved to work. So has talk therapy. Exercise is a known lifestyle change that can improve mental health, but often people don’t know where to start and they can be dealing with other problems caused by their depression such as weight gain, social anxiety and withdrawal.

So how does exercise help?
A study conducted by Guszkowska, 2004 found that improvements in mood are proposed to be caused by exercise-induced increase in blood circulation to the brain and by an influence on the hypothalamic-pituitary-adrenal (HPA) axis and, thus, on the physiologic reactivity to stress.
Other studies have found that it is the self-efficacy, distraction and social interaction that exercise can bring that is actually beneficial. The brain learns to be too busy concentrating on the exercise that it forgets to generate stress and fear, which lead to anxiety and depression.

Group exercise is often encouraged, but doesn’t work for everyone – which is where an exercise physiologist can be a great help. The presence of a highly specialised professional coach can provide the same motivation as the fear of letting down teammates.

Accredited exercise physiologists who specialise in mental health are able to identify and respond to behaviours arising from mental illness, being aware of the side effects from any medications the patient may be on (such as dizziness or elevated blood pressure). They understand how their work fits into the multi-disciplinary mental health team of GP, psychologist and chronic health educator to produce a client-centred standard of care.

Techniques include motivational and goal-setting strategies, physical activity and healthy eating education and assistance in reducing the stigma of participating in mental health services; one of many barriers for those resisting exercise.

Exercise to treat mental illness has been shown to decrease symptoms of depression, anxiety, stress and schizophrenia. It improves sleep quality and social engagement; and reduces cravings and withdrawal in substance use disorders and alcohol addiction (ESSA consensus on role of AEP in treatment of mental disorders, 2015).

People who have ongoing mental health conditions such as depression are able to receive Medicare rebates for up to five sessions per year with an Exercise Physiologist under the Chronic Disease Management Plan. Private psychologists/psychiatrists are also able to refer to accredited exercise physiologists, which most health funds recognise under allied health cover.

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Sharon Smith

Sharon Smith writes freelance articles as a medical, science and technology specialist. She is researching health journalism at Griffith University and lives mostly on Twitter @smsmithwriter (and would love to hear from you).