Let’s get physical
Exercise can improve mental health, writes Aznim Ruhana Md Yusup
THE human body is complex in its functionality. We are made up of skin and bones, of blood and neurons, and of cells and chemicals. We may have a better idea of how things work now compared to 1,000 years ago but there are still many aspects that we need to unravel and discover.
Connected with the tangible side of things are those less so, such as our thoughts, emotions and memories. We are defined by our mental cognisance, and we pride ourselves on being able to control our physical self with our conscious thoughts.
This makes the struggles of mental illnesses such as depression and anxiety doubly unpleasant because it’s a malady that destroys the sense of self while pulling the person into a downward spiral of not recognising that the destruction is happening.
If they do recognise it, they sometimes think: “Is this me or is this my illness? Where do I begin, and at what point do I no longer have control over my thoughts and actions?”
Like a person with autoimmune disease, you wonder why your body is working against you.
To tell a depressed or anxious person to “snap out of it” is an unkindness to their struggles, and shows a lack of respect to the aforementioned complexity of the human body. Of course they want to be able to snap out of it but nothing is as simple as that.
BRAIN WIRING
Shankar Thirulchelvam is a counselling psychologist at the Mind Faculty psychiatric clinic in Kuala Lumpur.
His approach is to look at his client’s lifestyle in order to get them on the path to recovery. There’s traditional psychotherapy and medication, but also advice on nutrition and exercise.
He’s especially keen on the latter. Shankar is known to send his clients to personal trainers for workout sessions, although he only picks trainers who have the sensitivity to deal with the issue. But why is exercise important in the recovery of mental illness?
“The first thing is to understand that the body is biological,” he says. “When you exert yourself physically, whether you’re running or lifting weights, it releases certain chemicals in the brain, especially chemicals dealing with dopamine, which is basically the feel-good hormone. Then you have an increase in the release of serotonin, a mood stabiliser.
“And if you do certain types of exercises, it enhances the brain’s ability to form new neural pathways or brain plasticity.”
Brain plasticity is what gives us the capacity to learn, change and adapt throughout our lives. Commonly speaking, it’s the way in which we can change the wiring in our brain.
People with mental illness are wired differently. To treat it, some rewiring may be required. Traditionally, this is done through talk therapy and medication such as antidepressants. A lot of antidepressants
work on increasing serotonin levels but exercise can help as well.
The key aspect of what exercise does in the treatment of mental illness is the release of chemicals and hormones such as dopamine and serotonin.
Shankar explains: “After you finish a workout, you generally feel good and that’s because these chemicals improve mood. If mood is improved, it also improves cognitive functioning, which is how you see the world at large and how you process things.
“People who go through depression and anxiety often have a bleak or negative outlook on life and the world. So if exercise enhances mood and thereby enhances your outlook on life — even by seven to 10 per cent, just to put a measurable figure — it’s still an improvement.”
As the individual begins to exercise consistently, they start making progress. They can run longer and farther. Perhaps they can lift heavier weights or finish their circuit training routine quicker. There’s a sense of accomplishment, and also camaraderie with their fellow runners or gym-goers.
“When the workout becomes a lifestyle, which means it’s something you do a certain number of times a week, you allocate time for it. You’re driven and motivated in the activity and it starts to shift the brain plasticity. The brain has evolved differently,” says Shankar.
He recommends working out four times a week for 45 minutes each session, doing an intense activity that get the heart rate up for 25 to 40 minutes. This includes high intensity interval training (HIIT) and full body floor exercises such as burpees, planks and lunges.
“The rule of thumb is that your workout days should be more than your rest days. If the body has too much rest between workouts, you don’t really improve, proficiency-wise. But I also create workouts for just 12 minutes because that’s what my clients say they can manage. That’s fine too because it still creates that chemical effect.” TURN TO PAGE 4
When you exert yourself physically, whether you’re running or lifting weights, it releases certain chemicals in the brain, especially chemicals dealing with dopamine, which is basically the feel-good hormone.
Shankar Thirulchelvam