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Exercise & Mental Health The National Institute of Mental Health recognizes exercise as a valid treatment for anxiety and depression. Levels of neurotransmitters such as serotonin, dopamine, and norepinephrine are higher in those who exercise. These, in turn, may elevate mood, reduce depression, and improve mental focus. Exercise or physical activity assists the psycho-physiological adaptation of emotional stress. Weight training, in particular, has shown to raise body image and global self-esteem. Exercise has been shown to improve mental function and is speculated to enhance creativity and problem solving ability. Exercise can be seen as one of the components essential for physical and mental health in today's society. Importance of Recess in School Surveys and studies indicate multiple trend toward recess: Reducing recess to accommodate additional time for academic subjects. Withdrawal of recess for punitive or behavioral reasons. Decreased recess time as student ages Less abundant recess among children in urban settings and of lower socioeconomical status. American Academy of Pediatrics released a policy statement stating that recess should not be withheld for punitive or academic reasons since it is a crucial and necessary component of a child's development. Just as physical education and physical fitness have well recognized benefits, recess offer its own unique benefits and is complimentary to physical fitness - not a substitute for it. Recess offers both cognitive, social, emotional, and physical benefits. For example, periodic recesses have been shown to make children more attentive and more productive in the class room. It also offers a necessary break from the academic challenges and rigors of concentration. Also see PE Cutbacks. American Academy of Pediatrics, Council on School Health (2013). The Crucial Role of Recess in School. Pediatrics. 131(1): 183 -188. Positive Peer Pressure Not all peer pressure is bad thing. Giving into group pressure can be beneficial particularly when you purposely join a group or exercise with a training partner with similar goals as yours. Positive peer pressure can be used introduce and reinforce positive behaviors until they become a normal part of your life. Salvy SJ et al (2007) questioned 10 boys and 10 girls between ages 12 and 14 for one week about their activities and whether they were alone or with others. The presence of peers turned out to be the only significant predictor of the children’s activity intensity. Overweight children reported greater physical activity when in the presence of peers as compared to lean children. Unfortunately overweight children also reported more time spent alone. Salvy SJ, Bowker JW, Roemmich JN, Romero N, Kieffer E, Paluch R, Epsein LH (2008). Peer Influence on Children's Physical Activity: An Experience Sampling Study. J Pediatr Psychol 33 (1): 39-49. Adherence verses Compliance Compliance (old medical model) indicates client obeying prescription given by professional as an authority. Adherence (newer model) indicates client following plan arrived at by both the professional and client as a team. There should be a compromise between what may be recommended for a client and what they are willing to do. Expecting a client to do exactly what you prescribe risks alienating them to the point of having less of a positive influence on their future behaviors. Barriers to change Cost Embarrassment Family Responsibilities Fatigue Inconvenience Lack of family support Lack of proper equipment Facilities not available Other people Pain or discomfort Time Transportation Weather Work Responsibility

Improving Program Adherence Dropout from a fitness program is more likely if 3 factors are characteristic of that program are not meet: Fun high intense exercise is related to higher drop out rates Convenient Time of day Other obligation and goals out side of exercise must be considered Frequency Some may do better with 2 or 3 days a week Others may prefer the routine of exercising every day Duration Long workouts will have less adherence Safe length of lay off after injury may be indefinite More moderate or progressive changes in diet and exercise may encourage more permanent behavioral changes. Simplistic Behavior Change Model A) Antecedents: what cues precede behavior B) Behavior C) Consequences: what are the consequences Body Dismorphic Disorder Body Dismorphic Disorder (BDD) is a compulsive obsessive ailment characterized by a preoccupation with an imagined physical defect in appearance or a vastly exaggerated concern about a minimal defect. The preoccupation causes significant impairment in the individuals life. Body Dysmorphic Disorder affects 1 in 50 people. Brain Growth It was once thought that you were born with a set number of brain cells and they just decreased as you got older. Researchers at Salk Institute for Biological Studies discovered walking three hours per week for three month increased many new neurons to grow causing a measurable increase to the size of the participant's brains. The new neurons tended to grow around areas with well established existing connection and replaced ones that where nonfunctioning. The structure of the brain that grew the most was the hippocampus, the area most involved with memory and cognition. A Pereira, D Huddleston, Brickman A, et al. (2007). An in vivo correlated of exercise-induced neurogenesis in the adult dentate gyrus. PNAS 104(13): 5638-43. S Colcombe, K Erickson, P Scalf, et al. (2006). Aerobic exercise training increases brain volume in aging humans. J Geron: Med Sci 61A(11) 1166-70. Exercise and Dementia Vergese (2003) found no association between physical activity and the risk of dementia. Voluntary exercise can increase levels of brain-derived neurotrophic factor (BDNF) and other growth factors, stimulate neurogenesis, increase resistance to brain insult, and improve learning and mental performance (Cotman 2002). Cognitive and physical activities overlap so it is not surprising that previous studies have disagreed on the role of physical activities. Although physical activities is important in promoting overall health, its protective effect against dementia remains uncertain. Cotman CW, Berchtold NC (2002). Exercise: a behavioral intervention to enhance brain health and plasticity. Trends Neurosci; 25(6):295-301. Verghese J, Lipton RB, Katz MJ, et al. (2003). Leisure Activities and the Risk of Dementia in the Elderly. N Engl J Med;348(25):2508-16. Hedonic Psychology Hedonic psychology is the study of what makes experiences and life pleasant or unpleasant. It is concerned with feelings of pleasure and pain, of interest and boredom, of joy and sorrow, and of satisfaction and dissatisfaction. See following studies and paradigm therories: Remembered Utility Grant and Glueck Longitudinal Studies Optimal Mental State Challenge and Skills Effect on Mental State Kahneman D, Diener E, & Schwarz N. (1999). Well-being: The foundations of hedonic psychology. New York: Russell Sage Foundation., p. ix