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A new clinical trial among patients with heart failure shows that regular exercise helps alleviate depressive symptoms and prevent hospitalizations and death
It’s no surprise that upbeat, motivated people find it easier to get out and exercise. But exercise itself can actually improve mood and motivation as well, particularly for people with heart failure, a new study shows.
The finding is exciting not only because depression is very common and can be deeply debilitating among people with heart failure — up to 40% are clinically depressed and three-quarters score higher than average on tests of depressive symptoms, according to background information in the study — but it’s also consistent with previous research suggesting that exercise may be effective as a treatment for depression more widely.
“This study shows that exercise is associated not only with physical health benefits, but important mental health benefits as well,” lead study author James Blumenthal told reporters. The findings are published this week in the Journal of the American Medical Association (JAMA).
For the new study, more than 2,000 patients with heart failure across the U.S., Canada and France were tested for possible depression and then were randomly assigned to receive either usual care for their heart condition, or usual care plus a program of aerobic exercise — either riding a stationary bike or using a treadmill. After three months and again after 12 months, the study participants were followed up for depressive symptoms. The exercise group saw modest but statistically unambiguous reductions in depressive symptoms compared with the group that didn’t exercise.
After 30 months, when the study concluded, the exercise group was also found to have a very slightly lower risk of hospitalization and of death. This difference, although small, was also statistically unambiguous, in that there was a large enough number of people in the trial that it’s unlikely the finding was due to chance alone.
Blumenthal, a psychology professor at Duke University Medical Center, added that exercise has been shown to be safe for people with heart failure, and that exercise does not need to be strenuous or a huge time commitment for patients to see a difference.
“It doesn’t require intensive training for a marathon to derive benefits,” he said. “We’re talking about three, 30-minute sessions for an accumulated 90 minutes a week. And the results are significant improvements in mental health, reduced hospitalizations and fewer deaths.”
This latest experiment in JAMA is not the first to test the effects of exercise on depression, either. In 1999, in fact, Blumenthal and other colleagues published results from a trial of people who suffered from major depressive disorder, without heart failure. There too, the researchers found that aerobic exercise helped to alleviate depressive symptoms somewhat — working just as well as front-line antidepressant drugs.
With the new findings among heart-failure patients, the clinical investigators write that they can “confirm and extend previous research,” by showing the benefits of exercise in a vulnerable population, where the burden of depression is very large.
In their JAMA article, the study authors warn that the difference between patients assigned to exercise and those assigned to usual care was still “modest” and that “the clinical significance of this small improvement is not known.” However, they add, because the effects did seem to persist over a full year of follow-up, there’s cause for optimism. This difference, they write, “is likely to be associated with better social functioning and higher quality of life.”
Start With a Better Morning Routine
If your days are stressful and rushed, consider a fresh, new approach to your morning routine. Start with a healthy breakfast and morning exercise, and you will set a positive tone for the rest of your day. The way you start the morning can have a big impact on the rest of your day. If you begin every day feeling harried and rushed instead of productive and streamlined, it may be time to revamp your morning routine. Start by getting into action with simple activities like taking a walk, going to the gym, or practicing an invigorating morning exercise, such as tai chi or yoga. These activities can help you feel focused and ready to meet the challenges of your day. Be sure to power up with a healthy breakfast to give your body the fuel it needs.
What is good emotional health?
People who have good emotional health are aware of their thoughts, feelings and behaviors. They have learned healthy ways to cope with the stress and problems that are a normal part of life. They feel good about themselves and have healthy relationships.
However, many things that happen in your life can disrupt your emotional health and lead to strong feelings of sadness, stress or anxiety. These things include:
- Being laid off from your job
- Having a child leave or return home
- Dealing with the death of a loved one
- Getting divorced or married
- Suffering an illness or an injury
- Getting a job promotion
- Experiencing money problems
- Moving to a new home
- Having a baby
“Good” changes can be just as stressful as “bad” changes.
How can my emotions affect my health?
Your body responds to the way you think, feel and act. This is often called the “mind/body connection.” When you are stressed, anxious or upset, your body tries to tell you that something isn’t right. For example, high blood pressure or a stomach ulcer might develop after a particularly stressful event, such as the death of a loved one. The following can be physical signs that your emotional health is out of balance:
- Back pain
- Change in appetite
- Chest pain
- Constipation or diarrhea
- Dry mouth
- Extreme tiredness
- General aches and pains
- High blood pressure
- Insomnia (trouble sleeping)
- Palpitations (the feeling that your heart is racing)
- Sexual problems
- Shortness of breath
- Stiff neck
- Upset stomach
- Weight gain or loss
Poor emotional health can weaken your body’s immune system, making you more likely to get colds and other infections during emotionally difficult times. Also, when you are feeling stressed, anxious or upset, you may not take care of your health as well as you should. You may not feel like exercising, eating nutritious foods or taking medicine that your doctor prescribes. Abuse of alcohol, tobacco or other drugs may also be a sign of poor emotional health.
Why does my doctor need to know about my emotions?
You may not be used to talking to your doctor about your feelings or problems in your personal life. But remember, he or she can’t always tell that you’re feeling stressed, anxious or upset just by looking at you. It’s important to be honest with your doctor if you are having these feelings.
First, he or she will need to make sure that other health problems aren’t causing your physical symptoms. If your symptoms aren’t caused by other health problems, you and your doctor can address the emotional causes of your symptoms. Your doctor may suggest ways to treat your physical symptoms while you work together to improve your emotional health.
If your negative feelings don’t go away and are so strong that they keep you from enjoying life, it’s especially important for you to talk to your doctor. You may have what doctors call “major depression.” Depression is a medical illness that can be treated with individualized counseling, medicine or with both.
How can I improve my emotional health?
First, try to recognize your emotions and understand why you are having them. Sorting out the causes of sadness, stress and anxiety in your life can help you manage your emotional health. The following are some other helpful tips.
Express your feelings in appropriate ways. If feelings of stress, sadness or anxiety are causing physical problems, keeping these feelings inside can make you feel worse. It’s OK to let your loved ones know when something is bothering you. However, keep in mind that your family and friends may not be able to help you deal with your feelings appropriately. At these times, ask someone outside the situation—such as your family doctor, a counselor or a religious advisor—for advice and support to help you improve your emotional health.
Live a balanced life. Try not to obsess about the problems at work, school or home that lead to negative feelings. This doesn’t mean you have to pretend to be happy when you feel stressed, anxious or upset. It’s important to deal with these negative feelings, but try to focus on the positive things in your life too. You may want to use a journal to keep track of things that make you feel happy or peaceful. Some research has shown that having a positive outlook can improve your quality of life and give your health a boost. You may also need to find ways to let go of some things in your life that make you feel stressed and overwhelmed. Make time for things you enjoy.
Develop resilience. People with resilience are able to cope with stress in a healthy way. Resilience can be learned and strengthened with different strategies. These include having social support, keeping a positive view of yourself, accepting change and keeping things in perspective.
Calm your mind and body. Relaxation methods, such as meditation, are useful ways to bring your emotions into balance. Meditation is a form of guided thought. It can take many forms. For example, you may do it by exercising, stretching or breathing deeply. Ask your family doctor for advice about relaxation methods.
Take care of yourself. To have good emotional health, it’s important to take care of your body by having a regular routine for eating healthy meals, getting enough sleep and exercising to relieve pent-up tension. Avoid overeating and don’t abuse drugs or alcohol. Using drugs or alcohol just causes other problems, such as family and health problems.
DESTRESS YOURSELF! GET HAPPIER NOW, TODAY IS YOUR DAY!
Stress is the body’s reaction to any change that requires an adjustment or response. The body reacts to these changes with physical, mental, and emotional responses. Stress is a normal part of life. Many events that happen to you and around you, and many things that you do yourself, put stress on your body.
Stress that continues without relief can lead to a condition called distress — a negative stress reaction. Distress can lead to physical symptoms including headaches, upset stomach, elevated blood pressure, chest pain, and problems sleeping. Research suggests that stress also can bring on or worsen certain symptoms or diseases.
-43% of all adults suffer adverse health effects from stress.
-75%- 90% of all doctor’s office visits are for stress-related ailments and complaints.
-Stress can play a part in problems such as headaches, high blood pressure, heart problems, diabetes, skin conditions, asthma, arthritis, depression, and anxiety.
-The Occupational Safety and Health Administration (OSHA) declared stress a hazard of the workplace. Stress costs American industry more than $300 billion annually.
-The lifetime prevalence of an emotional disorder is more than 50%, often due to chronic, untreated stress reactions.
Jerome F. Kiffer, MA, Department of Health Psychology and Applied Psychophysiology, The Cleveland Clinic Foundation.
Reviewed by Amal Chakraburtty, MD on March 08, 2010
© 2010 WebMD, LLC. All rights reserved.
24 Ways to Brighten Your Morning
The morning is probably no one’s favorite part of the day, particularly if you stayed up the night before to watch Leno or Jaws for the seventeenth time. Remember: Stress and anxiety wreak havoc on your immunity. Enter your day happy and relaxed, and you greatly increase your chances of a healthy, productive day…..