0 Need a New Year’s Resolution? Try Exercise!

By Ahmed Raza Khan, MD, MPH

Follow@AhmedRazaKhanMD

Child and Adolescent Psychiatry Physician at Stanford University
School of Medicine



Most people know that exercise is beneficial for cardiac health and is prescribed by physicians for the prevention and alleviation of various medical complications. But what if I told you exercise can also significantly benefit your mental health in more ways than one? Let’s take a look at some of the ways exercise can improve mental health and how to incorporate this into your new year’s resolution list!

Exercise and Depression Prevention:More than 350 million people in the world suffer from depression and it is the leading
cause of disability worldwide.  Exercise
has often been considered as a supplemental tool in treating depression, but
recent evidence points to exercise playing a role in the prevention of future
depressive episodes. These recent findings show that even low levels of
physical activity (e.g., walking less than 150 minutes a week) can prevent
future depression. There has been significant research in the last few years
that links cardiovascular health’s role in the origin of depression. This would
certainly be a plausible explanation for why exercise may prevent depression.



Alzheimer’s Disease Prevention:Alzheimer’s
disease is a chronic, degenerative disease of the brain that affects over
25 million people in the world. This illness leads to a progressive mental
decline, steering its victims to dependence on caregivers and, eventually,
death. Amyloid plaques are abnormal clusters of protein fragments that are
found in the brains of patients with Alzheimer’s disease and are thought to
play a major role in its progression. Recent studies have found that people who
exercised at or above the levels recommended by the American Heart Association
had significantly lower numbers of amyloid plaques than those who exercised
less. This was the case for even those who carried the APOE-e4 gene
variant, which is an established risk factor for Alzheimer’s disease. When
people with the APOE-e4 gene variant were compared, those with higher levels of
exercise had lower levels of amyloid plaques.



Improving Cognitive Functioning:Exercise has been shown
to increase cognitive functioning in rats. As rats get older, their memory
tends to diminish and this appears to be due to a drop of nerve synapses in the
hippocampus, the memory center of the brain. But after 12 weeks of voluntary
running, both memory and hippocampus nerve synapses were restored in these
rats.



Consistency in Exercise:Recent neuroscientific
studies have shown that the cognitive benefit of exercise may have a window of
time. In fact, rats that improved their cognitive functioning by exercise, had
this improvement dissipate in 3-6 weeks of inactivity. This is similar to what
is seen with muscle mass or heart rate when exercise is withdrawn. This
evidence intimates that exercise is beneficial for the brain and should be
performed consistently.



The American Heart Association is a great
resource for planning the amount and type of exercise one needs. They recommend
at least 30 minutes of moderate-intensity aerobic activity at least 5 days a
week for a total of 150 minutes or at least 25 minutes of vigorous aerobic
activity 3 days a week for a total of 75 minutes. An easy target to remember:
30 minutes a day, 5 days a week.

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0 Keeping Your New Year's Resolution with Mindfulness

By Brandon Cornejo M.D., Ph.D.

How many of you are trying to get yourselves back into a regular gym and exercise routine for your New Year's resolution? When it comes to exercise, one of the biggest challenges is staying motivated and consistent. I hope I can help you with this two-part blog post on "Mindfulness."

What is Mindfulness?

• Mindfulness is a nonjudgmental, present-centered awareness in which each thought, feeling, or sensation that arises is acknowledged and accepted.

Mindfulness as a Therapeutic Approach

• Mindfulness based stress reduction means to focus your attention on the "now."

• People practicing mindfulness work on not judging or evaluating the present moment but focus on simply “being” present.

• People in a formal mindfulness class engage in daily meditation along with skill-building homework that ties them to the “here and now.” 

 How Does Mindfulness Work?

• Mindfulness allows a person to pause calmly and reflectively before reacting to things.

• Mindfulness may prevent relapse of clinical depression by allowing a person to have some “space” between who they are and their emotions.

• Mindfulness based cognitive therapy (MBCT), a form of therapy that combines elements of mindfulness with cognitive based approaches to treatment, can be an effective approach for the treatment of anxiety or depressive disorders.

• Mindfulness may enhance mood as well as help eliminate negative thoughts associated with depressive states.

So why is "mindfulness" important to keeping that New Year's resolution of daily exercise? Next week, I will post part two with my tips for staying in the present moment while exercising. Happy New Year's!

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0 Towards A Healthier View of Happiness: Human Fulfillment

By Roberto A. Blanco, M.D. 

I believe that mistaking what one would call pleasure or joy with happiness is causing people a lot of unnecessary pain.  In popular culture and the media, “happiness” is the feeling when you open a brand new bottle of soda, when you have a party with your friends, or when you get a new car.  Consumer culture has subtle but noticeable effects on people’s beliefs to the point where most people buy into these images or ideals consciously or unconsciously to some extent.  

But, this is not the meaning of happiness for which we should be striving.  This is because pleasure, while it may be fun, is superficial and impossible to sustain.  Even for people who live a “charmed life," it is impossible to find pleasure or joy in all events in life.  In fact, unless there is some larger or longer-lasting definition of happiness such as human satisfaction that fills our lives, it is likely that we won’t be able to find joy in anything.  Events that should provide joy will lose their effect eventually without some deeper meaning.

This may be why many people become depressed.  A lot of us put pressure on ourselves to be “happy” all of the time.  Because we confuse pleasure for happiness at times, the fact that we are not “happy” all of the time can lead to more dissatisfaction with life or lack of fulfillment.  If happiness equates with pleasure or joy, how can we be happy and happy with ourselves when we are going through difficult but worthwhile transitions?  What about during periods of grief? 

It is often very difficult to sustain superficial happiness especially when the inevitable thoughts of ‘why am I feeling bad?’ or ‘why am I not happy?’ creep into the mind.  These thoughts often cause people to feel guilt and then as if they are failures.  To be joyful and smiling all of the time is just an unrealistic goal and we should not feel bad about ourselves if we happen to be in a difficult stage of life.  We need to keep in mind that it is all part of a larger plan or goal of development, human fulfillment or self-actualization.

The search for a good definition of happiness is not a new idea and certainly not one that I thought of.  Over 300 years before Christ and in his book entitled NicomacheanEthics, Aristotle proposed his definition of happiness to the ancient Greek people and laid out his arguments for the meaning of happiness.  He argued that having true happiness is the best and final aim for human activity.  Aristotle called true happiness “eudaimonia” which was a type of long-lasting happiness more consistent with human fulfillment or satisfaction.  Aristotle also believed that happiness should be human fulfillment and not confused with joy or pleasure when he wrote:



For one swallow does not make a spring, nor does one sunny day;

similarly, one day or a short time does not make a man blessed and happy.

I agree that human fulfillment is a loftier goal than joy because when someone is having a difficult time or fallen on hard times, they can still be working towards human fulfillment. During these formative or growing experiences, we can still feel as we are fulfilled or fulfilling our own self-actualization even if we aren’t joyous.  When we take into consideration human fulfillment, we no longer need to feel guilty or as failures during difficult times, transitional periods, or episodes of grief.  We begin to see life from the wide angle of human fulfillment rather than from the small picture of pleasure.

Kahlil Gibran, the famous Christian mystic poet from the early 20th century, also believed in eudomainia.  When Almustafa, the all-knowing visitor in the poem The Prophet, answers a woman’s question on pain, he exemplifies this belief in the beauty of human fulfillment and long-lasting satisfaction despite these painful episodes:

And could you keep your heart in wonder at the daily miracles of your life, your pain would not seem less wondrous than your joy;

And you would accept the seasons of your heart, even as you have always accepted the seasons that pass over your fields.

And you would watch with serenity through the winters of your grief.

As people living in a society where mental illness is so common, we must seek to understand happiness and human fulfillment.  In the hopes of making happiness something more meaningful and sustainable, what we should be striving for is an eternal, longer-lasting form of happiness which is known as human fulfillment or as the Greeks called it eudaimonia.  This is because human fulfillment rather than joy or pleasure allows for the different stages of our lives and growth without having to feel guilt or as if something is wrong.  If we make human fulfillment the goal, we will live happier and more satisfying lives.  Now the obvious question becomes, how do we achieve it?

1.  Aristotle (1999).  Nicomachean Ethics. (Martin Ostwald Trans.)  Upper Saddle River, New Jersey: Prentice Hall, Inc.

2. Gibran, Kahlil (1964).  The Prophet .  New York: Alfred A. Knopf.

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0 Making Resolutions You Can Keep

By Gina Newsome Duncan, M.D.

Happy New Year! If you’re like most people, you’ve made some resolutions for 2010. How are you doing with keeping them? Losing weight and improving finances are probably two of the most common resolutions people make. Unfortunately, for many of us, our resolutions have often been broken before February starts.

When making resolutions or setting goals in general, think SMART. Goals should be:

Specific

Measurable

Achievable

Realistic

Time-bound



You can always ramp up your efforts. But if your expectations are too high at the beginning you'll get discouraged and give up.



Set yourself up for success!

Detail: Making Resolutions You Can Keep

0 Live 2010 Like You Want To

By Bill Callahan, M.D. 




It’s that time again.  Big balls dropping, toasts given, resolutions given and many broken.  We are on the eve of a New Year. I look at a resolution for change, whether on January 1 or on any anniversary, as a battle between the healthy part of me that is for change and courage, and the destructive part of me that wallows in ruts and familiar patterns.




A careful review of our behavior over the past year allows us to see the thoughts, actions, and fear that causes us to retreat into familiar patterns with known results.  We can predict, if we are honest with ourselves, how we talk ourselves out of change, and perhaps berate ourselves after we get disappointed.  This hopeless pattern does not need to continue.




I find when I set out for my three mile run in the dark at the end of the day, that there is a point just before a mile where my mind and body scream out with every reason to give it up (just for today they tell me) with all kinds of legitimate reasons to postpone, and yet when I make myself persevere there is a powerful euphoria related to the genuine side of me winning over the part that wants to quit and postpone.  We all have the chance to strengthen our healthy side and weaken the self destructive parts of us.

A few ideas that I use to keep resolutions for change, at New Year’s or any anniversary that matters to me:

1.      1. Do set goals.  The focus of our minds makes a huge difference.  Take a look at the movie What the Bleep Do We Know to get a glimpse into the untapped potential of the human mind and spirit.

2.      2.  Catalogue the ways you talk yourself out of change, postpone and procrastinate so that you know the enemy parts of yourself and their maneuvers.  Every time you stop one of them it’s another win for you.

3.     3. Pat yourself on the back for successes, but don’t reward yourself by undoing your gain (spending money if you are reigning that in, eating excessively when you wish to lose weight).  Speak honestly to yourself when you have given in to your destructive side but without berating yourself.

4.     4. Learn to talk in terms of what you want and will do.  Remove the words should, need, have to, can and can’t from your vocabulary.  This language reinforces obligation, which can cause a  knee-jerk stubbornness, and the helpless part of our character.  These parts are not our friends.

5.     5. Remember, when waging war for your independence, there will be many battles.  You simply need to win more than you lose, and you can do that.

Detail: Live 2010 Like You Want To