Exercise & Mood Part III — From Science to Action

There is probably no one word that can sum up what people want in terms of emotional or mental health. Whether it be clients I meet in the clinic with a mood or anxiety disorder or a friend or acquaintance asking for an opinion in a social setting, the theme of the question is common but each one is different. However I think there is one common thread that joins the questions and ONE word that captures 99% of what is ideally sought STABILITY.

Those with recurring depressive episodes or mood swings want mood stability. Others with anxiety, nervousness or worry want calm stability. The frazzled, stressed, workaholics want relaxed stability. For many achieving stability would make them happier, more productive, more sociable and have a better quality of life. I don’t claim that exercise is the only way to achieve stability. There is no panacea. The correct treatment of all of the above situations is an individually tailored combination that could include medications, talk-therapy, lifestyle changes and other components but should ALWAYS include exercise.

Now let’s make the leap from the science we reviewed in the previous blog posts to action. How do we “dose” exercise? What kind of exercise? What time should I exercise? For how long? How do I start and how do keep going?

For an easy reference I will summarize the answer in one sentence then explain the details and the fine tuning will come later. Remember here we are talking about the ‘dosing’ of exercise that changes the biology of the brain and not the number of packs in your Abs! Although that might be a welcome side effect — if you are trying to achieve that talk to a personal trainer. Here we are treating the brain and going after STABILITY.

Exercise for 30 minutes 6 days a week at a high-impact level.

That’s it simple, right? Ok ok I know it is not that easy. So let me explain further by breaking it down into 3 rules.

Rule #1 — Exercise: For brain health exercise can be any type that suits you. It does NOT have to be weight-lifting or running on a treadmill. You do NOT have to go to a gym or use a workout DVD. Do any exercise that you enjoy. Swim, run, hike, climb, lift weights, tennis, basketball, soccer, yoga, cycling and on and on. Adapt the exercise to your body if your capacity is limited by physical needs or injuries, but anyone can do some sort of exercise unless you are fully paralyzed.

Rule #2–30 minutes 6 days a week: The bottom-line is that the research shows this is the average of the dose needed for the brain to adapt. Now let’s break this rule down. First reactions are usually — 6 days?! That’s a lot! Yes it is, but we are only asking for 30 minutes. Think about it, how many hours a day do you sit at the internet or TV? 30 minutes is very short. In fact, DON’T do more than 30 minutes (unless you have a routine and have been doing this for years). Doing more will lead to inconsistency and skipping workout days. The science shows it is far better (at least for the brain) to be consistent in exercising most days of the week rather than spending an hour exercising 2 or 3 days a week. In fact, for you gym-goers if you think about it (and research also supports this) if you are spending more than 30 minutes at the gym then your are chatting and resting too much. Thirty minutes makes it harder to come up with excuses such as: There is no time! or I’m too busy! If you work a lot or travel find 30 minutes to do some stretches, pushups, air-squats, jumping jacks etc. 30 focused minutes is all you need, Done! Six days too much? Fine five days is the absolute minimum, but better to aim for 6 so that if you fall short then you have a day to save for later.

Rule # 3 — High Impact: For the scientists reading this that is 16 kcal/kg/week. What?? English please! Ok so here is how I explain high-impact to people: For most of the 30 minutes you are exercising you should be sweating and it should be difficult to speak in complete sentences without needing to catch your breath. This means you work hard for 30 minutes then you are done. Walking doesn’t count unless it meets the criteria above. Commuting does not count! That is your normal energy expenditure. Remember we are trying to change the brain and you can’t do that without effort.

Last few tips:

  • You can exercise anytime in the day that fits your schedule. I find first thing in the morning works best because it is the time of day with the least demands on your schedule. Plus there is evidence this timing may have a more efficient effect than other timings. If it means you have to wake up 30 minutes earlier then do it and just sleep 30 minutes earlier at night. No big deal. But if it doesn’t work just exercise at any time that’s the most important thing. Get it done.
  • You can either start slow and build up to 6 days a week over a number of weeks or just pick a week and start. If you have started and stopped exercise routines in the past you will find this one is easier to maintain because it is more flexible. You can do anything as long as you break a sweat. Jumping rope is great if you don’t have a lot of equipment and can’t go to a gym. Keep telling yourself it’s only 30 minutes and just get up and do it.
  • If you skip days and don’t exercise at least 5 days in a week don’t be discouraged and go back down to zero. Just start again. It is normal to stumble. I do all the time. The important thing is to keep the 30 minutes 6 days a week in your head and keep as close to that as you can. But the closer you are to that ‘dose’ the better the result will be.
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Dr. Mohammad Alsuwaidan is a specialist psychiatrist at Mubarak Al-Kabeer Hospital in Kuwait and an Assisstant Professor of Psychiatry at both Kuwait University and the University of Toronto. He has trained at the University of Toronto, Stanford University and Johns Hopkins University. He is a Fellow of the Royal College of Physicians of Canada and a Diplomate of the American Board of Psychiatry and Neurology. More information at www.AlsuwaidanClinic.com