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Exercise as a form of treatment for mental illness

Introduction

My name is Joe and I’ve just begun the 2nd year of my PhD in Medicine. I am researching how we can use physical exercise to improve people’s mental health. Specifically, I work with young people (from 18 years onwards), who are experiencing serious mental health problems for the first time in their lives – a condition which is referred to as “First Episode Psychosis”. I am investigating whether specially designed physical exercise routines can help people with First Episode Psychosis to feel healthier; in the body, and also in the mind. 


In Depth

What is First Episode Psychosis

First Episode Psychosis is the first 5 years of any ‘psychotic disorder’, such as Schizophrenia. This affects around 1 in 100 people, and most often starts around the age of 18. The most recognisable symptoms of first-episode psychosis are hearing voices, seeing things which other people cannot see (hallucinations), delusional beliefs and paranoia. Along with these, there are often less obvious symptoms of people severely lacking in motivation, feeling depressed, withdrawing from society and becoming reclusive.

Current Treatment

The most common treatment for first-episode psychosis is antipsychotic medications: There are tablets that sufferers can take which greatly reduce the symptoms of hearing voices, delusions etc. However, people taking these tablets often relapse within a few years, or need higher and higher doses overtime for them to remain effective. Furthermore, antipsychotics do not help with the symptoms of social withdrawal and inability to feel motivated. Unfortunately, it is these unseen symptoms which can really prevent people from living a happy and fulfilling life.

What do I Investigate?

I am investigating whether we can use physical exercise for first-episode psychosis, as an extra treatment for all the different types of symptoms so that they need fewer medications and feel better overall in life. To do this, people with first-episode psychosis are sent to me from their mental health service. I design them a special exercise routine and then take them to the gym twice-per-week for 10 weeks to train with them. In the exercise sessions, we do running, rowing and cycling to work on their fitness, and also weight training to work on the muscles. Past research has shown that these sorts of training can make people feel better, happier and more motivated – even in normal healthy people. It has never been tried for First Episode Psychosis (even though these are the people who may need it most!).

To see if it has worked, we score peoples’ mental health using a psychiatric interview before they start the 10 weeks of training, and then score them again after the 10 weeks to check if they have improved. I also look at peoples’ physical health, fitness, social life and brain functioning, as exercise is known to be able to help with these things too. If proven effective, exercise may eventually become part of NHS treatment programs for first-episode psychosis, and be available to any young person who is in need of treatment, like a new form of therapy! 


Going Further

If you want to know more about first-episode psychosis in general, such as what causes it, what it does, here is a great place to start: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/psychosis/first_episode_psychosis_information_guide/Pages/first_episode_psychosis_information_guide.aspx

For more information about my specific experiment, you can find the full details of the clinical trial here: http://www.controlled-trials.com/ISRCTN09150095/

If you’re interested in which physical exercise can improve mental health, this article goes through many different ways in which it may do this:
http://www.huffingtonpost.com/2013/03/27/mental-health-benefits-exercise_n_2956099.html