" Exercise and self confidence "

It is a common fact among exercise professionals that exercise will not only improve the body but the mind as well. This is more than just in appearance and self-confidence from a mental prospective. Obviously if the scale is going “ south” and your clothes are looser this will raise your level over well-being and self esteem. It is only natural that your prospective of your self will improve as well. Especially when peers and co-workers start noticing how good you look. However there is a lot more going on here than just fitting into your skinny jeans or being able to take your shirt off at the beach. The body produces natural hormones and chemicals that are known to boost your mood and change it for the positive. The further this point the increase blood flow to working muscles and the brain has a positive impact as well. Below are some of the findings from an Arizona State University study.

ANXIETY REDUCTION FOLLOWING EXERCISE

It is estimated that in the United States approximately 7.3% of the adult population has an anxiety disorder that necessitates some form of treatment (Regier et al., 1988). In addition, stress-related emotions, such as anxiety, are common among healthy individuals (Cohen, Tyrell, & Smith, 1991). The current interest in prevention has heightened interest in exercise as an alternative or adjunct to traditional interventions such as psychotherapy or drug therapies.

     Anxiety is associated with the emergence of a negative form of cognitive appraisal typified by worry, self-doubt, and apprehension. According to Lazarus and Cohen (1977), it usually arises “...in the face of demands that tax or exceed the resources of the system or ... demands to which there are no readily available or automatic adaptive responses” (p. 109). Anxiety is a cognitive phenomenon and is usually measured by questionnaire instruments. These questionnaires are sometimes accompanied by physiological measures that are associated with heightened arousal/anxiety (e.g., heart rate, blood pressure, skin conductance, muscle tension). A common distinction in this literature is between state and trait questionnaire measures of anxiety. Trait anxiety is the general predisposition to respond across many situations with high levels of anxiety. State anxiety, on the other hand, is much more specific and refers to the person’s anxiety at a particular moment. Although “trait” and “state” aspects of anxiety are conceptually distinct, the available operational measures show a considerable amount of overlap among these subcomponents of anxiety (Smith, 1989).

     Landers and Petruzzello (1994) examined the results of 27 narrative reviews that had been conducted between 1960 and 1991 and found that in 81% of them the authors had concluded that physical activity/fitness was related to anxiety reduction following exercise and there was little or no conflicting data presented in these reviews. For the other 19%, the authors had concluded that most of the findings were supportive of exercise being related to a reduction in anxiety, but there were some divergent results. None of these narrative reviews concluded that there was no relationship.

          In addition to these general effects, some of these meta-analyses (Landers & Petruzzello, 1994; Petruzzello et al., 1991) that examined more studies and therefore had more findings to consider were able to identify several variables that moderated the relationship between exercise and anxiety reduction. Compared to the overall conclusion noted above, which is based on hundreds of studies involving thousands of subjects, the findings for the moderating variables are based on a much smaller database. More research, therefore, is warranted to examine further the conclusions derived from the following moderating variables. The meta-analyses show that the larger effects of exercise on anxiety reduction are shown when: (a) the exercise is “aerobic” (e.g., running, swimming, cycling) as opposed to nonaerobic (e.g., handball, strength-flexibility training), (b) the length of the aerobic training program is at least 10 weeks and preferably greater than 15 weeks, and (c) subjects have initially lower levels of fitness or higher levels of anxiety. The “higher levels of anxiety” includes coronary (Kugler et al., 1994) and panic disorder patients (Meyer, Broocks, Hillmer-Vogel, Bandelow, & Rüther, 1997). In addition, there is limited evidence which suggests that the anxiety reduction is not an artifact “due more to the cessation of a potentially threatening activity than to the exercise itself” (Petruzzello, 1995, p. 109), and the time course for postexercise anxiety reduction is somewhere between four to six hours before anxiety returns to pre-exercise levels (Landers & Petruzzello, 1994). It also appears that although exercise differs from no treatment control groups, it is usually not shown to differ from other known anxiety-reducing treatments (e.g., relaxation training). The finding that exercise can produce an anxiety reduction similar in magnitude to other commonly employed anxiety treatments is noteworthy since exercise can be considered at least as good as these techniques, but in addition, it has many other physical benefits.

EXERCISE AND DEPRESSION

Depression is a prevalent problem in today’s society. Clinical depression affects 2–5% of Americans each year (Kessler et al., 1994) and it is estimated that patients suffering from clinical depression make up 6–8% of general medical practices (Katon & Schulberg, 1992). Depression is also costly to the health care system in that depressed individuals annually spend 1.5 times more on health care than nondepressed individuals, and those being treated with antidepressants spend three times more on outpatient pharmacy costs than those not on drug therapy (Simon, VonKorff, & Barlow, 1995). These costs have led to increased governmental pressure to reduce health care costs in America. If available and effective, alternative low-cost therapies that do not have negative side effects need to be incorporated into treatment plans. Exercise has been proposed as an alternative or adjunct to more traditional approaches for treating depression (Hales & Travis, 1987; Martinsen, 1987, 1990).

     The research on exercise and depression has a long history of investigators (Franz & Hamilton, 1905; Vaux, 1926) suggesting a relationship between exercise and decreased depression. Since the early 1900s, there have been over 100 studies examining this relationship, and many narrative reviews on this topic have also been conducted. During the 1990s there have been at least five meta-analytic reviews (Craft, 1997; Calfas & Taylor, 1994; Kugler et al., 1994; McDonald & Hodgdon, 1991; North, McCullagh, & Tran, 1990) that have examined studies ranging from as few as nine (Calfas & Taylor, 1994) to as many as 80 (North et al., 1990). Across these five meta-analytic reviews, the results consistently show that both acute and chronic exercise are related to a significant reduction in depression. These effects are generally “moderate” in magnitude (i.e., larger than the anxiety-reducing effects noted earlier) and occur for subjects who were classified as nondepressed, clinically depressed, or mentally ill. The findings indicate that the antidepressant effect of exercise begins as early as the first session of exercise and persists beyond the end of the exercise program (Craft, 1997; North et al., 1990). These effects are also consistent across age, gender, exercise group size, and type of depression inventory.

     Exercise was shown to produce larger antidepressant effects when: (a) the exercise training program was longer than nine weeks and involved more sessions (Craft, 1997; North et al., 1990); (b) exercise was of longer duration, higher intensity, and performed a greater number of days per week (Craft, 1997); and (c) subjects were classified as medical rehabilitation patients (North et al., 1991) and, based on questionnaire instruments, were classified as moderately/severely depressed compared to mildly/moderately depressed (Craft, 1997). The latter effect is limited since only one study used individuals who were classified as severely depressed and only two studies used individuals who were classified as moderately to severely depressed. Although limited at this time, this finding calls into question the conclusions of several narrative reviews (Gleser & Mendelberg, 1990; Martinsen, 1987, 1993, 1994), which indicate that exercise has antidepressant effects only for those who are initially mild to moderately depressed.

          That exercise is at least as effective as more traditional therapies is encouraging, especially considering the time and cost involved with treatments like psychotherapy. Exercise may be a positive adjunct for the treatment of depression since exercise provides additional health benefits (e.g., increase in muscle tone and decreased incidence of heart disease and obesity) that behavioral interventions do not. Thus, since exercise is cost effective, has positive health benefits, and is effective in alleviating depression, it is a viable adjunct or alternative to many of the more traditional therapies. Future research also needs to examine the possibility of systematically lowering antidepressant medication dosages while concurrently supplementing treatment with exercise.

OTHER VARIABLES ASSOCIATED WITH MENTAL HEALTH

Positive mood. The Surgeon General’s Report also mentions the possibility of exercise improving mood. Unfortunately the area of increased positive mood as a result of acute and chronic exercise has only recently been investigated and therefore there are no meta-analytic reviews in this area. Many investigators are currently examining this subject and many of the preliminary results have been encouraging. It remains to be seen if the additive effects of these studies will result in conclusions that are as encouraging as the relationship between exercise and the alleviation of negative mood states like anxiety and depression.

Self-esteem. Related to the area of positive mood states is the area of physical activity and self-esteem. Although narrative reviews exist in the area of physical activity and enhancement of self-esteem, there are currently four meta-analytic reviews on this topic (Calfas & Taylor, 1994; Gruber, 1986; McDonald & Hodgdon, 1991; Spence, Poon, & Dyck, 1997). The number of studies in these meta-analyses ranged from 10 studies (Calfas & Taylor, 1994) to 51 studies (Spence et al., 1997). All four of the reviews found that physical activity/exercise brought about small, but statistically significant, increases in physical self-concept or self-esteem. These effects generalized across gender and age groups. In comparing self-esteem scores in children, Gruber (1986) found that aerobic fitness produced much larger effects on self-esteem scores than other types of physical education class activities (e.g., learning sports skills or perceptual-motor skills). Gruber (1986) also found that the effect of physical activity was larger for handicapped compared to nonhandicapped children.

Restful sleep . Another area associated with positive mental health is the relationship between exercise and restful sleep. Two meta-analyses have been conducted on this topic (Kubitz, Landers, Petruzzello, & Han, 1996; O’Connor & Youngstedt, 1995). The studies reviewed have primarily examined sleep duration and total sleep time as well as measures derived from electroencephalographic (EEG) activity while subjects are in various stages of sleep. Operationally, sleep researchers have predicted that sleep duration, total sleep time, and the amount of high amplitude, slow wave EEG activity would be higher in physically fit individuals than those who are unfit (i.e., chronic effect) and higher on nights following exercise (i.e., acute effect). This prediction is based on the “compensatory” position, which posits that “fatiguing daytime activity (e.g., exercise) would probably result in a compensatory increase in the need for and depth of nighttime sleep, thereby facilitating recuperative, restorative and/or energy conservation processes” (Kubitz et al., p. 278).

     The sleep meta-analyses by O’Connor and Youngstedt (1995) and Kubitz et al. (1996) show support for this prediction. Both reviews show that exercise significantly increases total sleep time and aerobic exercise decreases rapid eye movement (REM) sleep. REM sleep is a paradoxical form in that it is a deep sleep, but it is not as restful as slow wave sleep (i.e., stages 3 and 4 sleep). Kubitz et al. (1996) found that acute and chronic exercise was related to an increase in slow wave sleep and total sleep time, but was also related to a decrease in sleep onset latency and REM sleep. These findings support the compensatory position in that trained subjects and those engaging in an acute bout of exercise went to sleep more quickly, slept longer, and had a more restful sleep than untrained subjects or subjects who did not exercise. There were moderating variables influencing these results. Exercise had the biggest impact on sleep when: (a) the individuals were female, low fit, or older; (b) the exercise was longer in duration; and (c) the exercise was completed earlier in the day (Kubitz et al., 1996).

As someone who has first hand knowledge from being the “ last picked” for sports teams in the neighborhood , I would not be here today unless I found my Solis in martial arts and exercise world. At the age of 12 I lost my father to Alcoholism and felt lost and alone. Without the encouragement of a close uncle who talked me into taking karate and then lifting weights, I probably would have chosen a different path. Fortunately for me I found my way out and up through exercise and nutrition. Coach Kevin Kearns 

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