Ex­er­cise helps when you need it most

Re­search finds work­ing out can play a valu­able role in adapt­ing to loss

The Hamilton Spectator - - HEALTH - AMANDA LOUDIN Wash­ing­ton Post

Twenty months ago, Ta­mara Grand ex­pe­ri­enced every mother’s great­est fear: the loss of a child. Strug­gling with her grief, the 49-year-old per­sonal trainer turned to what has al­ways been her first line of de­fence when deal­ing with stress: ex­er­cise. While noth­ing could fill the hole in Grand’s heart, she has found that move­ment makes it easier to face her grief.

Robert Neimeyer, a pro­fes­sor of psy­chol­ogy at the Univer­sity of Mem­phis whose re­search and prac­tice fo­cuses on be­reave­ment, says that while ex­er­cise is by no means a panacea, it can play a valu­able role in adapt­ing to loss.

“It pro­vides both di­rect ben­e­fits to mood and health, and in­di­rect ben­e­fits as it forces you out of iso­la­tion and into the world,” he says.

Al­li­son Gil­bert, a New York-based grief ex­pert and au­thor of “Passed and Present,” says that what grief takes away — en­ergy, joy, fo­cus — ex­er­cise can give back. “Death of a loved one in­volves so many emo­tional drains,” she ex­plains. “Ex­er­cise al­lows you to come into a space where you can fo­cus on your­self, and helps de­crease the pulls on your en­ergy. It re­stores some of your buoy­ancy.”

The link be­tween ex­er­cise and de­pres­sion, of­ten a hall­mark of grief, is well doc­u­mented. Ge­orge Mam­men, a Univer­sity of Toronto PhD can­di­date, re­viewed 25 pieces of re­search and con­cluded that mod­er­ate ex­er­cise can boost mood and help ward off de­pres­sion in the long term. “Many stud­ies have demon­strated the ef­fec­tive­ness of ex­er­cise reg­i­mens in im­prov­ing mood for peo­ple who are mod­er­ately de­pressed, ef­fects that are ob­served within a few weeks of be­gin­ning a fit­ness pro­gram,” Neimeyer says.

It doesn’t end with the emo­tional ben­e­fits, ei­ther. Neimeyer points out that fit­ness “pushes back” against the phys­i­cal health risks of be­reave­ment.

Nu­mer­ous stud­ies have looked at ex­er­cise as a method for treat­ing de­pres­sion. Patrick Smith, an as­so­ciate pro­fes­sor of psy­chi­a­try at Duke Univer­sity and coau­thor of sev­eral stud­ies on the topic in­clud­ing “Is Ex­er­cise a Vi­able Treat­ment for De­pres­sion?,” says, “The short story is that in most head-to-head stud­ies, ex­er­cise is equally as ef­fec­tive as an­tide­pres­sants.”

What Smith and others have not de­ter­mined is the amount of ex­er­cise re­quired to de­liver mood ben­e­fits. “We used stan­dard car­diac re­hab pro­to­cols (three times per week at 70-85 per cent max heart rate) in our stud­ies, but the jury is out on what cer­tain thresh­old is nec­es­sary for ben­e­fits,” he wrote in the ab­stract of one of his stud­ies. “We do know that neu­ro­trans­mit­ters [brain chem­i­cals] are mod­i­fied via ex­er­cise, lead­ing to im­proved mood.”

That ef­fect is tran­sient, as peo­ple ex­pe­ri­ence an ex­er­cise-in­duced surge in brain chem­i­cals as­so­ci­ated with im­proved mood, Smith says. But “once they feel the ef­fects, they are more likely to re­turn for more,” he says, “and that can lead to last­ing changes and im­pacts.”

Over time, though, Smith says, “these same changes ap­pear to have more en­dur­ing, sys­temic ef­fects,” pos­si­bly even caus­ing the growth of neu­rons in a part of the brain that of­ten at­ro­phies in de­pressed peo­ple.

“The key is for pa­tients to find some­thing con­ve­nient and en­joy­able enough that they will keep at it for the long term,” he ex­plained in an email. “It’s dif­fi­cult to quan­tify how long the long-term an­tide­pres­sant ef­fects of ex­er­cise are, but ... one of the best pre­dic­tors of con­tin­ued re­mis­sion from de­pres­sion is whether or not par­tic­i­pants kept ex­er­cis­ing. In al­most every study I’ve been a part of, re­gard­less of their ini­tial treat­ment (med­i­ca­tion, ex­er­cise, or placebo), when we eval­u­ated par­tic­i­pants again six months to a year af­ter end­ing the in­ter­ven­tion, those who ei­ther con­tin­ued or started ex­er­cis­ing reg­u­larly had the low­est risk of re­laps­ing into de­pres­sion.”

Just two weeks af­ter los­ing her 13-yearold daugh­ter to com­pli­ca­tions from a ge­netic heart con­di­tion, Grand, of Bri­tish Columbia, forced her­self back to the gym. “As a fit­ness pro­fes­sional, my brain knew that move­ment would be an im­por­tant part of my griev­ing process,” she says.

While ex­er­cise was the right idea, do­ing it in her reg­u­lar gym where she was well known wasn’t, Grand says. “It was dif­fi­cult and awk­ward, and I felt like I was on show,” she says. “Peo­ple con­stantly in­ter­rupted my work­outs to of­fer con­do­lences and ask ques­tions,” which was emo­tion­ally drain­ing.

This was more than Grand was ready for. “Af­ter about six weeks of try­ing this, a friend sug­gested a change of scenery might be in order,” she says.

She signed on for a small-group strength and con­di­tion­ing pro­gram at an­other fa­cil­ity. “This worked won­ders for me,” she says. “Not only was I anony­mous, but all I had to do was show up and do the work.”

Grand spent eight months as part of this group. “At the end of that time, I felt ready to go back to my reg­u­lar gym and take charge of my own work­outs again,” she says. “I also re­turned to teach­ing group ex­er­cise about two months af­ter Clara’s death. The fan­tas­tic en­ergy I get from my morn­ing classes has of­ten spilled over and sus­tained me for the rest of the day.”

Adri­enne Lan­ge­lier, a li­censed pro­fes­sional coun­sel­lor from The Wood­lands, Texas, says that emo­tional stress can make it hard to push your­self phys­i­cally, but do­ing so should be seen as an im­por­tant part of self-care. “I was sched­uled to run a marathon when my grand­mother was in the hos­pi­tal dy­ing,” she says. “I wres­tled with run­ning it, but in the end, push­ing through al­lowed me to be more present for my fam­ily.”

Her pas­sion for run­ning and abil­ity to get out and do it helped with the in­tense grief she felt when her grand­mother died, Lan­ge­lier says. “Run­ning filled my well in­stead of emp­ty­ing it.”

Gil­bert says that ide­ally, ex­er­cise is trans­for­ma­tional dur­ing grief. “It’s an op­por­tu­nity to re­move stress and gain the ca­pac­ity to build re­silience and make your­self happy.”

In the early stages of grief, it is easy to be pas­sive and let others take care of you. “Through my own per­sonal loss, I learned that it was up to me to move for­ward and find joy and hap­pi­ness,” Gil­bert says. “As the sup­port goes away, it’s cru­cial to take the reins and take care of your­self.”

Grand says that in the early stages of grief, all she wanted from ex­er­cise was es­cape — “from my house, my fam­ily, my friends, ac­quain­tances and my own thoughts. Lift­ing weights did that for me, and it still does. At the 18-month mark, I’m back to my old rou­tine of teach­ing and train­ing.”


“Passed and Present: Keep­ing Mem­o­ries of Loved Ones Alive,” by Al­li­son Gil­bert

Ta­mara Grand lost her 13-year-old daugh­ter Clara to com­pli­ca­tions from a ge­netic heart con­di­tion. A per­sonal trainer, she found ex­er­cise “worked won­ders” for her as she moved through her grief.

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