Keeping the pace
Imagine a pill that would dramatically lower your risk of heart disease, diabetes, and certain cancers. Now imagine that same pill could help you lose weight, improve your mood, and boost self-esteem. Would you take it? Sure, you would. Who wouldn’t?
As it so happens, all those benefits are associated with exercise. Unfortunately, scientists haven’t found a way to put them into a pill; to take advantage, you still have to get up and get moving.
Now that the summer’s over and the cold weather is settling into many places, finding ways to be active becomes even more of a challenge. “But that’s no excuse for being sedentary,” says Ruth Ann Carpenter, MS, RD, a registered dietitian and healthy eating and active living consultant who is co-author of Active Living Every Day (Human Kinetics, 2001). “No matter where you live or what the weather is like, there are opportunities for physical activity.” At any time of year, being active on a regular basis poses special challenges for people with schizophrenia. The illness itself can cause apathy and lack of energy, and some psychiatric drugs also cause fatigue, as well as weight gain. The combination leads many people to be almost completely sedentary. A 2009 study by researchers at the University of California–San Diego found that people with schizophrenia typically do less than half as much physical activity and expend fewer than half the calories that people in the general population do.
If getting motivated to be more active is tough, sticking with it can be even harder. “Among the general population, about half of people who start an exercise program drop out within six months,” says Lora Humphrey Beebe, PhD, an associate professor at the University of Tennessee–Knoxville, who studies physical activity among people with severe mental illness. “For people with schizophrenia, the drop out rate is 90 percent.”
But not all the news is discouraging. Beebe and her colleagues recently completed a study funded by the National Institute of Mental Health in which a group of people with schizophrenia took part in four weekly sessions designed to motivate them to become more active, followed by a 16-week program of treadmill walking.
The results were striking. “Our volunteers reduced body fat, improved fitness levels, and reduced psychiatric symptoms such as hallucinations and delusions,” says Beebe.
Other benefits surprised even the research team. “Some of the things people said were most important to them weren’t even things we set out to measure, such as flexibility,” says Beebe. “One man said he couldn’t tie his shoes before he started the program. Now he could tie them easily. Another was stamina. One woman said she was able to run to catch a bus, something she’d never been able to do before.”
Almost everyone can benefit from being more physically active, experts say. But some of the benefits of exercise are particularly important for people with schizophrenia. Bein physically active on a regular basis can help prevent weight gain associated with psychiatric medications. It can also improve self-confidence.
Physical activity has the important benefit of being recovery focused, says Beebe, providing a great opportunity for people with schizophrenia to be part of an activity that isn’t about being sick.
Other researchers have found similar improvements. Several years ago, researchers at Canada’s Foothills Medical Centre in Calgary, Alberta, started a Personal Empowerment Program with weekly health education sessions and an exercise program for people with serious mental illness. One member of the research team reported in the May 2006 issue of NurseWeek that clients had gone “from passive to active learning….They question information they hear—taking an active role in their own wellness.”
The same good news is showing up around the world. In a 2007 report by researchers at the National Institute of Mental Health and Neuro Sciences in Bangalore, India, people with schizophrenia were assigned either to a physical activity or a yoga therapy program. Both groups enjoyed a reduction in psychiatric symptoms and improvements in social functioning and quality of life. The yoga group actually did a little better overall.
Yoga is certainly one activity you can do when the weather outside is frightful. There are many others; walking is by far the preferred activity for many people with schizophrenia. And fortunately, when it’s icy or cold outside, it’s easy to walk at indoor shopping malls, which are usually accessible by public transportation. (And you can window-shop as an added bonus!) If you live in a building with stairs, you can set a goal to walk up and down the stairs several times—enough to get your heart beating a little faster and your lungs working harder.
Some communities have recreation centers or fitness clubs where you can swim, participate in aerobics classes, or use exercise cycles, walking treadmills, or stair machines indoors.
To get the full range of health benefits, experts recommend engaging in moderate physical activity for at least 30 minutes a day, five days a week. Moderate activities include brisk walking, bicycling, low-impact aerobics, raking the lawn, vacuuming, and pushing a power mower.
“It isn’t necessary to find time for a single 30-minute session,” says Carpenter. “You can piece together several sessions of activity.” But it is important to do bouts of at least 10 minutes of uninterrupted activity.
If even that sounds like a lot, Beebe’s advice is to start slow. “In our program, we started with five-minute walks. Then we extended to 10 minutes, then 15 minutes, and finally 30 minutes.” When the participants got the hang of it, she says, “some of them positively blossomed. They were helping stragglers along, showing others how to do stretching exercises, and showing real leadership. Even the people on our research team were surprised at how much they got into it.”
| Article Author: |
Peter Jaret |
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