Excercise for Body and Mind

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Physical effects of exercise

            Physical activity is defined as energy that is burned from the body doing any numerous amount activities (Marks, Murray & Evans, 2011). Physical fitness allows the body systems to move more naturally and helps organs, muscles, and skeletal systems work at their best. Staying active and exercising is important for meeting biological drives and energy needs in the body. According to Warburton (2006), regular physical activity, burning around 2,000 calories per week, was associated with an increase in life expectancy of 1-2 years by the age of 80 years-old. Those who are disabled or physically fragile saw benefits even when completing lower amounts of exercise that were consistent over time. Working to meet weekly energy expenditure goals could help individuals improve their current physical health and also offset possible future disabilities or illnesses. With TV, video games, fast food, and social networking websites and Apps a reduction in physical activity can impact overall health. Only one-third of American youth receive the appropriate amount of exercise (Plante, Gores, Brecht, Carrow, Imbs, & Willemsen, 2007). A larger majority of people in the US are staying more sedentary in their daily lives and their intake of fatty/oily foods is increasing. Half of American adults do not get their recommended amount of exercise and about one-fourth of this population does not exercise at all (Plante et. al, 2007). When people sit and remain inactive, taking in more energy than they expend, they are putting themselves at an increased risk for both short-term and long-term health dangers.

Imbalance in exercise and food intake can create health problems such as obesity, cardiovascular disease, colon cancer, type 2 diabetes, stroke and breast cancer (Marks, Murray & Evans, 2011). Cardiovascular disease is a growing problem in the US, but exercise has demonstrated a positive impact in creating healthier lifestyles. Staying physically active can be related with a 50% or higher risk reduction for cardiovascular disease (Warburton, 2006). Individuals who exercise can live longer, have healthier hearts and circulatory systems. The research that has been conducted demonstrates that obesity rates decline with exercise and even a small amount of activity change can drastically impact a persons overall health. Comparatively, a physically inactive, middle-aged woman (less than 1 hour per week), experienced a 52% increase in overall mortality, a doubling of cardio-vascular related mortality and a 29% increase cancer-related mortality compared with physically active women (Warburton, 2006). Different types of exercise have been shown to improve certain health risk potentials. Using weight-bearing exercises can help improve osteoporosis. Aerobic and resistance workouts can help improve risk for type II diabetes. A consistent, moderate, workout plan can help reduce the risk for all cancer types but particularly, breast and colon cancers.

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Psychological effects of exercise

            The amount of beneficial impacts the body feels from exercise also translates to psychological wellness. Exercise ranging from 5-30 minutes has been found linked with psychological well-being and positive affective responses (Hogan, Maata & Carstensen, 2013). Endorphins and other “feel good” chemicals get released in the brain allowing a person to feel elated after exercise. Physical activity can aid in reducing rates of depression, anxiety, and stress-related disorders. Feeling good after exercise can help individuals feel motivated to continue being active or do things they find pleasure in. According to Mata, Hogan, Joormann, Waugh and Gotlib (2013), exercise has been shown to improve positive affect in individuals with major depression when compared with individuals who have more sedentary lives. Individuals suffering from major depression have a difficult time finding pleasure in activities and continuing with hobbies they use to enjoy. Exercise can break the cycle of depression by allowing the natural endorphins to help them “feel good” while aiding them in moving out of their depressive cycle. According to Plante et. al (2007), many of the benefits of mood improvement are linked with socialization during physical activity. Individuals who join groups, classes or weight loss programs can help improve affect, overall physical health and feelings of “belonging”.

Gender and the benefits of exercise

            Men and women have different impacts on their physical and psychological health from exercise. The physical effects of exercise is beneficial for both men and women but how bodies process this energy may be different. Women commonly wonder why their husband or boyfriend can eat just as much as them or more but not gain weight. Men have higher muscle mass that burns intake quicker and more effectively than women. Due to gender differences in body composition between fat and muscle, women often have to search and find weight loss programs or groups to meet their desired goals. Many of these visually slim goals have high standards set by society and media. Some women, and men as well, struggle with high expectations and have a hard time finding a supportive environment to exercise. According to Plante et. al (2007), women get the most psychological benefits from exercise that is conducted in social groups, such as gyms instead of at home in isolated settings. Men may also receive similar benefits of social exercise but they have less of an initial to push to improve their health in the first place. Men receive less educational information about health and exercise from practitioners and other health providers (Hatchell, Bassett-Gunter, Clarke, Kimura & Latimer-Cheung, 2013). Men may not exercise as frequently as women, due to a lack of information, about the need for certain amounts of exercise a week/day.

References

Plante, T. G., Gores, C., Brecht, C., Carrow, J., Imbs, A., & Willemsen, E. (2007). Does exercise environment enhance the psychological benefits of exercise for women?. International Journal Of Stress Management, 14(1), 88-98. doi:10.1037/1072-5245.14.1.88

Hatchell, A. C., Bassett-Gunter, R. L., Clarke, M., Kimura, S., & Latimer-Cheung, A. E. (2013). Messages for men: The efficacy of EPPM-based messages targeting men’s physical activity. Health Psychology, 32(1), 24-32. doi:10.1037/a0030108

Mata, J., Hogan, C. L., Joormann, J., Waugh, C. E., & Gotlib, I. H. (2013). Acute exercise attenuates negative affect following repeated sad mood inductions in persons who have recovered from depression. Journal Of Abnormal Psychology, 122(1), 45-50. doi:10.1037/a0029881

Marks, D. F., Murray, M., Evans, B., Esttacio, E. V. (2011). Health psychology: Theory, research, and practice, 3rd ed.). London: Sage.

Warburton, D. E. (2006). Health Benefits Of Physical Activity: The Evidence. Canadian Medical Association Journal, 174(6), 801-809.

Demystifying the Diagnosis

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What do clinicians diagnose with?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) was originally released by the American Psychiatric Association, when it changed its name in 1921. The DSM-IV-TR and the new DSM 5 are the currently used editions. The DSM 5 is now active, released in 2013, but some agencies, including my own will not be transitioning until later 2015. The DSM is a very large book that uses number coding and criteria to help clinicians and clients classify mental health disorders. The DSM is purely for diagnosing purposes and is not a guide for treatment, nor does it specify guidance for ethical decision making in practice.

Differences between DSM-IV-TR and DSM 5-
1) Change from roman numerals to standard numbers in an attempt to make the DSM 5 more accessible and easy to understand internationally and not just in the US.
2) The last DSM-IV was published in 1992, and had yet to be updated with current terminology, so a revised edition was published but a full DSM rewrite was not started until 1999. Very important to stay current!
3)The DSM-IV-TR was written from a medical model, by medical and psychiatric professionals, and did not include counseling professionals feedback. The DSM 5 was written from a variety of outlooks with professionals from many fields contributing to the contents.

What is a diagnosis?
The numerical diagnosis code, for example 300.,  is given for ease of categorizing, and is not as intimidating as it appears. For example, the diagnosis that associates with the code 300.00 is Anxiety Disorder NOS. NOS meaning=not otherwise specified (it doesn’t fit the criteria for a more specific anxiety disorder). Addition .XX numbers can be added as specifers for things like mild, moderate, and severe. Additional specifiers can be added for acute or chronic, these depend on the specific diagnosis.

So is it good or bad?
Simple answer…..it depends.
A diagnosis is often the most associated stigma within mental health counseling. Over-diagnosing, poor diagnostics, and lack of client psychoeducation leads to stigma in the field and anxiety from both clients and clinicians. A diagnosis is given to help classify and standardize the assignment of clinical treatment. The diagnosis can be helpful to ensure that standards and criteria are being followed in order to diagnose accurately. Tricky part is that diagnosis, unfortunately, is subjective so what applies for one client and one clinician can be different from one therapy setting to the next. For example, a substance abuse clinic will most like place the chemical dependency or abuse diagnosis as the primary, while a mental health agency might place it as a secondary diagnosis, or may fail to address it at all. Subjectivity can be a good thing however, for those who understand their clients well and may know more details than the criteria can cover itself.

What were your experiences with being assigned a diagnosis?

 

My professional opinion?

Although I feel I just started to understand the last DSM coding structure, I believe the new DSM 5 is more suitable for working with people in a counseling vs. a clinical setting. The DSM 5 is more user friendly and takes into account the social and environmental factors that influence behaviors. I view diagnosing as a requirement for insurance that is not necessarily needed to understand symptoms, or have effective treatment. It is helpful to be able to collaborate with others in the field, have a specialty area, and understand similarities between clients. I do however, find it is equally important to value diversity, individuality, and having a fresh perspective for each client without get “swept away” trying to make someone fit into a diagnosis category.

People are people. period. It is important to be present and be with the client, not checking boxes in your mind.

Some Additional Information

I included a link to a PDF outline with some of the basic changes made to the new DSM, and a link to more information on the detailed history of the DSM, hope you find it helpful. Any questions please feel free to ask.

Links:

http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf

http://www.psychiatry.org/practice/dsm/dsm-history-of-the-manual