All blog posts from Dr. Allott are provided for educational and informational purposes only. As Dr. Allott is also a licensed medical practitioner, we must make it clear that nothing on the blog is intended to constitute medical advice, consultation, recommendation, diagnosis, or treatment. If you are concerned about your health, please seek appropriate care in your area.


Minimal Metrics for Exercise

In 2018, my blog focused primarily on anxiety. This year I am thinking more about movement and mental health. A good starting place is identifying the minimal metrics for movement and how achieving these metrics can support mental health.

So, I spent some time reviewing the most recent studies for exercise.

What is definitive?

Exercise reduces dementia and reduces all causes of death. For mental health in general, cognitive functioning exercises in studies don’t always show that it is helpful. They have not shown that they decline cognitive functioning. Ok. Exercise dose not always helps to be smarter. But for depression, the research is clear: exercise is an excellent therapy on its own and in conjunction with other therapies. Exercise increases neuroplasticity, improves how the autonomic and endocrine systems respond to stress, improves sleep, improves self-esteem, …the list goes on. So, we can definitely say now that exercise is good for both the brain and body.

How much movement do the studies say is needed?

When people exercise three times a week for 12 to 24 weeks, there is a dramatic reduction of depression, and if the exercise continues, there is a reduction in recurrence. That sounds great! And… those people were selected and paid to be in the studies.

Beyond the studies and in my office

When people can feel that movement improves how they feel, then it becomes a useful tool for treating energy and mental clarity in the moment. I believe that part of treating depression, mental health, pain, and other diseased states, is to provide people with tools that move them towards resilience moment to moment. If a person has a tool that can help them feel better now, today, or later today, we can build experiences that move us away from depression, fatigue, low self-esteem, anxiety, pain, or whatever their points of suffering are. Why does this work? When people can experience change that they are in control of, and learn the value of the process, they have a model of change that can then apply to other things in their life.

But how do you actually get someone who is depressed moving?

At my last PESI training in Richmond, VA, I posed this question to the group of around 90. I like to start with the smallest possible metric, in large part because it is doable. And since I am all about being able to feel what’s going on in the body, I first asked everyone to do an experiment. You, the reader, can do the same experiment now.

The Minimal Movement Experiment

1. Check-in and rate your energy level at this moment, using the scale below.

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Now stand up. Choose one of the three possible movements that you will do four times. Here is a video of me squatting, marching and flapping my hands, in case you want to see what I am talking about.

  • Chair squats – have a chair behind you and sit down as though you are going to take a seat. Just as the chair touches you, stand back up;

  • March in place – with your knees coming up as high as it is comfortable; or

  • Overhead hand clap – raise both arms in the air and bring your hands together comfortably over your head. Clap your hands together if that sounds like fun.

Remember one of these, just four times.

3.  Sit back down and re-rate your energy level.

The majority of people in my training reported feeling at least 10% better. So, if you were initially at 6 (out of 10), you might now be at 7… in less than 30 seconds! What could you do with 10% more energy? Do you get up to snack or drink coffee at work when you might just need to move your body a little bit to get some energy and mental clarity?

Where can the experiment be done?

Certainly, YOU can do this experiment anywhere: at the office, in the bathroom, when you get off the couch from watching TV. Additionally, you can try this experiment with clients who present with fatigue or who are kinesics learners. I offer it as a mindfulness exercise for people with childhood history of trauma, as a way got them to learn to listen to their bodies. It is a small enough dose that it is unlikely to make fatigue worse. Maybe nothing is noticed, but they tried something new. I also like to give it to my clients as homework (“Since the exercise was helpful in my office, I would like you to try it when you have been sitting for more than three hours.”)

Throughout the year, I will write more about how to use movement as a way to improve energy and mental clarity.

References:

Medina JL, Jacquart J, Smits JAJ. Optimizing the Exercise Prescription for Depression: The Search for Biomarkers of Response. Curr Opin Psychol. 2015;4:43-47. doi:10.1016/j.copsyc.2015.02.003. Link to study.

Belvederi Murri M, Ekkekakis P, Magagnoli M, et al. Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes. Front psychiatry. 2018;9:762. doi:10.3389/fpsyt.2018.00762. Link to Study.

Short Cuts: Experiments to feeling better

We often think that feeling better takes a lot of time and energy. This idea is certainly supported and promoted by the weight loss industry! But there is a difference between feeling better today, next week, and weight loss. It’s also important to understand that sustained weight loss is very complicated. However, what if our goal is just to have 10 to 15% more energy and mental clarity? This is very possible right now, with a little experimentation.

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I like doing experiments for my health. It allows me to evaluate if a new behavior is worth continuing and also when to use it most effectively. There are lots of little experiments that can improve how you feel, in as little as 10 minutes or just a few days. And this means you might then have the energy to do more to feel even better.

For example, years ago I discovered that if I exercised in the morning my dyslexic brain worked better. With more experiments I discovered that it takes about 20 minutes of walking or 15 minutes of stretching, weight lifting and balance exercises to see a benefit at the end of the day. When it is beautiful out, I go for a walk; when it is raining I work out in my living room.

Every experiment has to have a definable benefit. Not just “because I should”. For me, when I work out in the morning, I can get my clinical notes done with the patient in the room or in the time before my next patient. When I don’t exercise, I spend 45-60 minutes charting at the end of the day. On my non-clinical days, I spend less time wondering around the internet looking for heartwarming videos and more time on my own passions. It took a month of morning work outs for me to see the correlation. Now that I see it, I can see that the benefit is immediate.

Here is a pdf that outlines some short cuts to feeling better. I invite you to choose one to experiment with. Let me know how it goes, or share your own short cuts, by commenting below.

How to help your brain recover more quickly

Have you ever thought about how important our brain is for getting through our day? Our brain is involved in everything we do: sensing, breathing, thinking, walking, speaking, interacting, choosing… to name a few. Research is showing that movement/exercise is one of the best activities we can do to support and heal our brains. Exercise prevents and improves brain-related diseases such as:

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  • addiction
  • ADHD
  • major depression
  • Alzheimer's disease
  • plus most physical health diseases such as cardiovascular disease, diabetes, and cancers.

When we sit and think all day we are using just a small part of our brains. What if when we are tired and unclear mentally, it is because the part of our brains we have been using at work is just tired and the other parts are just waiting to be used?

I have recently been introduced to this idea. A few years ago, I was in a motor vehicle accident that disrupted my vision and balance. Now, when I over-use those nerves beyond their current capacities, I get symptoms of fatigue, visual changes, nausea, neck pain and tinnitus. For a while, it was recommended that I stop and do nothing when this happens, because everything is related to vision and balance. When I had to spend a long time in a car, for example, it would take days to recover.

Another idea is that I can switch and use non-tired parts of my brain. My Z-health trainer, Jennifer Nerio at TAISO Fitness, has shown me over and over again that if I use other parts of my brain that are not tired my symptoms resolve faster. Now, doing movement on the ground can help me recover in minutes rather than days.

This reminded me that I used this same concept when I was in medical school.  I would study, study, study and when I could not study any more, I would do 10 pushup or sit ups. By doing movement that I was familiar with - most importantly movement that I was not seeking improvement with, I was able to rest the neuro-nets that I was using for studying.  By the end of the set of muscle movement, I could go do more reps of mental movement on gross anatomy.

Where can you do cross training for the brain when you are intellectually or emotionally tired, remembering that the movement should be something that feels safe and comfortable?

If you are curious and want to glance through more science about the overlap of cognition, emotions and movement, I suggest the Wikipedia article on the “Neurobiological effects of physical exercise”. If you want to get more in depth, I recommend the book Spark: the revolutionary new science of exercise and the brain.