How Muay Thai & Ju-Jitsu Can Transform Traumatized & Addicted Young Men.

A blog by Alastair Mordey.

Muay Thai is Thailand’s traditional martial art. It is often called the art of eight limbs because it uses not just the fists, but also elbows, knees and shins to deliver blows. I have used Muay Thai as part of a treatment system for addicted young men for some years now. People have commented on the wisdom of using such a brutal martial art to help addicted young men climb out of their self-defeating lifestyles. And when you consider the fact that many of the men we treat have significant traumas – this is a salient point. But what we are starting to learn about trauma has changed our understanding of how we work with it. 

In our Muay Thai programme we build young men up very slowly. Very few of them have ever fought in the ring, and most of them never will. They train hard, and they spar lightly. If talented, then of course, they can test themselves against the Thai instructors and learn exactly what defeat tastes like without being seriously injured in the process. A very few (three so far) have gone on to have amateur fights after discharging from our facility. But most don’t. They don’t ring fight because they don’t want to. And this is an important point. 

In today’s world, particularly in the UK, young men are being increasingly sucked into violence that they have no previous experience of and which quickly overwhelms them with tragic consequences. Knife crime is now epidemic in the UK’s inner cities and in the US guns have long since replaced fists as the most effective way to settle disputes in many neighbourhoods. The fact is, a physical test which confirms one’s physical limits and abilities in very black and white way – such as sparring – can serve as a potent reality check. The young man can then say, “OK, this is how far I can go – and no further”. In other words – this is not a computer game. Small, manageable doses of pain go a long way to building a real understanding of the effects and ramifications of worse violence. 

But Muay Thai and other martial arts such as wrestling, jui-jitsu, boxing and judo, are not just effective as a reality check. They also have significant potential as a modality for treating trauma and addiction. In early sobriety, martial arts like Muay Thai can help addicted young people learn about discipline, delayed gratification, the facing of fear and above all – how to mount some kind of successful challenge against a ‘stuck’ position. This external fight mirrors an internal fight which has been raging for a long time in most addicted people, but which has now been forgotten. To understand this fully we must delve into what trauma is, how it works, how it is linked to addiction.

Our knowledge of traumatic stress has been greatly increased over the last twenty years by a number of writers. Peter Levine first outlined the role that the body’s ‘freeze’ response plays in the causation of trauma, and wrote about it in his 1997 book Waking the Tiger. DrGabor Maté, an addiction physician, also wrote specifically about how addiction is a self-medication for childhood trauma in his 2009 book, In the Realm of Hungry Ghosts. More recently the psychiatrist Besel Van Der Kolk wrote The Body Keeps The Score, a book whichinvestigated the role of the fight-flight response still further. Multiple studies, most notably the ACE study conducted by the Center for Disease Control, have also found strong links between an adverse childhood and addiction in adolescence and early adulthood. 

All of these writers and researchers have also emphasized the necessity of going beyond traditional talk therapy in treating trauma and addiction, and outlined the importance of somatic work. Somatic work or body-based therapy is where we work directly on the body, or more specifically, on the nervous system, in order to ameliorate the symptoms of trauma – rather than relying solely on talk therapy. The reason they suggest this, is because traumatic stress is highly physical in its manifestations.

According to Levine, trauma is caused by the body’s freeze response, which is technically known as the immobility response. This response is controlled by the autonomic nervous system, which is divided into the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS). The SNS is so-called because it works with the emotions. Van der Kolk describes it as ‘the accelerator’. It regulates the release of hormones like adrenaline which can make us temporarily superhuman in moments of need, and capable of fighting or fleeing very effectively. The PNS, in contrast, works as the brake. It regulates the release of acetylcholine and puts things back together again after the abnormal levels of arousal that terrifying encounters inevitably produce. As Levine points out, when encountering horrors, sometimes we don’t fight or flee – we freeze. This immobility response is completely involuntary and occurs when we are absolutely sure we are going to die or be seriously harmed (or if we are witnessing the same thing happening to others). This traumatized state can be induced by a surprising number of scenarios that people might not necessarily assume are traumatic, like invasive surgery for example. Ultimately, it depends on how the individual perceives what is happening to them. 

The evolutionary purpose of this ancient function of the mammalian and reptilian brain areas is two-fold. Firstly, it makes our impending death less painful by helping us to completely disassociate ourselves from our own body. Secondly, if there is any possibility at all of evading death or injury by keeping very still (what Levine calls ‘playing possum’) then this is probably the best bet once fight or flight have been judged as utterly hopeless. Upon surviving a near-death experience or a perceived near-death experience, some people don’t come out of their ‘deep freeze’ but remain stuck. Their physiology is ramped up into overdrive because their hyper aroused SNS was firing on all cylinders at the moment that they became frozen. 

This model does not see trauma as a purely mental phenomenon but rather, as a highly visceral experience. Alarming messages that are registered by the brain are carried back and forth across the whole body by the polyvagal nerve, which links the brain with the stomach, the intestines, the heart, and the lungs. All of these body parts are intricately involved in regulating our feelings of danger and safety. And as anyone who has experienced a traumatic betrayal will tell you, a broken heart really does feel like a broken heart. And being ‘gutted’ is also a very accurate description of what it feels like to be horrendously let down. So trauma is not just a mental ‘dis-ease’ but a very somatic experience as well. It’s ‘encoded in the viscera’, in the guts, so to speak. 

Besel Van der Kolk’s work has showed us that trauma can be exacerbated or healed respectively, by the way that we relate to others and the way we perceive ourselves in relation to others. Our mirror neurons can read the malevolence in other people’s faces and in their body language. It is this ability to read the motivations of other human beings in such a complex and nuanced way that really compounds traumatic physiology in humans. When we find that someone has acted in a deliberately evil manner it becomes more than just a temporary threat. It is an ongoing existential threat. It destroys our sense of trust in the world because now we are cursed with the practical knowledge of good and evil and we know full well that it could happen again. When it comes to treating trauma then, we are dealing with someone who is stuck in a confrontation they feel they cannot win, and one in which their relation to others is key. And this brings us back to the boxing.

Muay Thai, and other full contact martial arts, are mildly to moderately stressful. They are ‘real’, to use a clichéd term. And with regard to young men in particular, this is no bad thing. In fact, it is therapeutic. Research on young male rats suggests that group exposure to mild to moderate stress levels increases pro-social behaviour. It seems that mild stress actually brings young male rats closer together. They learn to cooperate more than they would in an overly harmonious or unstressed environment. This is also reflected in their brains, which display elevated levels of oxytocin (the ‘bonding’ chemical) when they are placed in moderately stressful situations with a group of their fellows.

When we consider the fact that re-visiting the trauma (through talk therapy) is often counter-productive – something Van der Kolk, Levine and others agree on, then we can start to appreciate the tonic effect that using your body, whilst being in a group, and whilst being moderately stressed and challenged – can have on our mental health. In short, done correctly, this kind of stimulating environment is more therapeutic for young men than sitting around emoting.

Whereas traditional talk therapy often lunges around in the dark, emphasizing the need to talk about or verbalize an event in order to achieve ‘closure’, Levine realized that, if anything, this did more harm than good. Talking about a traumatic event does nothing but re-live it in imagistic terms. What we must do instead (according to Levine) is confront the dragon by a side-door. We must re-visit a replica, or symbolic representation of it. Like the Greek hero Perseus who slayed the Gorgon Medusa, we must attack it while looking at it in a mirror. If we remember that trauma is an unsatisfactory conclusion, a failure to complete the body’s natural fight-flight response, then we can appreciate the fact that those who manage to effectively fight back, or even to effectively run away, are to some extent executing a successful response to that life threatening event. They are completing the gestalt, going full circle, or bringing the process to a close, as Van der Kolk explains in The Body keeps the Score;

“Being able to move and do something to protect oneself is a critical factor in determining whether or not a horrible experience will leave long lasting scars.” 

People mummified in the glacier of ongoing traumatic stress continue to vibrate with the nervous energy of ‘unfinished business’. Regardless of whether this freeze is the result of trauma that is self-imposed, or trauma visited upon them by external malevolence, they become helpless and resigned to their fate and enter a frozen state. All of this necessitates a response because, in the language of the famous psychologist Carl Jung, ‘whatever we run from grows bigger’. A Jungian solution, therefore, would be to confront the dragon. The young man who was beaten, must pick up the gloves once more. The man who came home to find his wife and kids gone without so much as a note, must learn to be a father again. And the veteran who cannot resign himself to the fact that he could not save his comrade must rescue somebody else instead. In assuming such responsibilities, ironically, we come back to our selves. In facing the dragon, we are coming home. In developing others, we are developing ourselves. In the words of the notoriously hard-core Thai monk of the forest meditation tradition – Ajarn Man; “right where our suffering arises, is where the suffering will cease.” 

Whilst physical confrontation is not for everybody, the analogy of creating inner strength through manageable doses of stress – preferably in groups – still holds. This principle is known as hormetic growth. The more we stress an object the more resilient it becomes. Actually, resilience is a somewhat limited way of describing this growth. Exposure to stress actually has the potential to make us anti-fragile – a concept developed by the writer and philosopher Naseem Nicholas Taleb. Things which are anti-fragile are not merely resilient or robust, they are the opposite of fragile. They don’t just survive stressors, they become stronger and better after being exposed to stressors. Muscle tearing and subsequent growth after weight lifting is the obvious example. But there are also mental, emotional, social and psychological muscles we can develop. As long as the stress is manageable, and performed within the support network of a brotherhood (or sisterhood) with a common purpose – deliberately imposed stress can leave us more expanded than we were before. In this light we have to honestly ask ourselves as psychological professionals – “have we been using a fragility model?”

Nevertheless, there are of course, young men who are not inclined or well-suited to such rough and tumble. But the same principles of anti-fragility still apply, even when you shift the focus to another kind of challenge. With this in mind we also pioneered a triathlon training programme which provided an equal (if not greater) challenge. Like Muay Thai, triathlon provided an intense but manageable crucible of suffering for our young men. It provided the opportunity to test themselves…against themselves (but within the support network of a recovery group). 

Serious physical challenge, adventure and odyssey are things that are almost entirely missing in society today. Triathlon and combat sports do something to put this back. Swimming in the sea is daunting when the sea is rough, even if it’s only for one kilometre. Or try jumping into the Mekong river at 6.30am. It’s an experience you won’t forget. It’s surprising how few people (including young men) can actually do this, and being able to deal with such arduous feats of athleticism is life-affirming – and frankly – what young men should be doing.

Nevertheless, some addiction ‘experts’ continue to deny the efficacy of this type of physically oriented treatment programme. “What about exercise addiction?” they groan. Well, let’s weigh it up. A compulsive need to over-exercise versus death by opiate overdose or a life sentence for murder earned during a three-day meth bender. I know which one I’m opting for. “Well what about issues with body image then?” they chunter on. “What about becoming obsessed with their own body?” This is a better question, and there is a very good response to it.

A little bit of body awareness goes a long way for young men who have been marooned in a sedentary life. It goes a long way to boosting confidence, of a very limited and basic type admittedly, but at least it’s something. Self-esteem comes from achievements which have been earned, not through being gassed up with unrealistic ideas of how ‘special’ you are, by weak willed adults who want to curry favour with you. Often, the completion of exacting physical tasks provides a basic level of achievement for young men in a way that it doesn’t for other people. For young men with no discipline, physical achievements are perhaps the easiest way to learn discipline. And don’t underestimate the power of physical discipline to serve as a blue print for other, more complex forms of delayed gratification.

We have found that our intense activity-based programme has yielded results. By 2018 we produced five ironman triathletes, with dozens of others going on to complete shorter races, as well as producing several amateur Muay Thai fighters. Our sobriety rates at one year have been good. In the ‘revolving door’ publicly funded London services I once worked in, the sobriety rates at 12 months were less than one per cent. Here, they are over twenty-five per cent, which, as anyone who has been in the field of addiction treatment for any length of time will tell you – is very high.

Recently, we began a tract in our treatment programme which mandates participation in Brazilian Jui-Jitsu (BJJ) classes. In our view Jui-Jitsu’s philosophy offers an even greater expansion on this general methodology of using physical challenge to overcome adversity, bond the group, and increase feelings of belonging, purpose, self-efficacy and stress management. Jui-Jitsu, like Muay Thai, brings people into close physical contact with one another. Instead of strikes (which can be confronting to say the least) BJJ focuses on grappling technique and skill. This has the effect of neutralizing the strength differences between individuals, genders, and age groups to a considerable degree. It is our belief that this modality will go on to have even greater success than our Muay Thai and triathlon programmes. We will test the data as we go along. 

One thing we can say for sure is that if young men do not find the challenge they need within their wider culture then they will find it in a subculture – or act it out with a psycho-pathology. We’re not going to eradicate knife crime with talk therapy, and I have come to believe that we will not make serious in-roads into treating trauma and addiction with talk therapy either. All of these conditions require radical action to be reduced, and they need the powerful effects of a motivated ‘tribal group’ to prevent against their return. Once again, Besel Van der Kolk has some wise words regarding this, which summarizes the philosophy I live by quite nicely;

“Our culture teaches us to focus on personal uniqueness, but at a deeper level we barely exist as individual organisms. Our brains are built to function as members of a tribe.”

Alastair Mordey is a pioneer of addiction treatment centres in Asia. He was the co-founder and chief clinical architect of The Cabin Group, and is current programme director of The Beach, Thailand. In 2020 Alastair will be opening Alpha (Thailand) a men’s addiction treatment programme focused on Brazilian Jui-Jitsu and body-based therapies.

Self Esteem, Self Compassion and Their Role in Recovery from Addiction.

It is common to hear among recovering addicts that they suffer with low self esteem. They talk of having low self-esteem before using a substance or behaviour and often their behaviours whilst in active addiction serve to compound this feeling of low self worth. When treating addiction, we often look at ways we can raise an individuals feeling of self esteem in the hope that feeling better about themselves will prevent them from self destructive behaviours. However this article seeks to discuss the idea that it is not raising self esteem that is necessarily needed in the treatment of addictions, rather the learning and understanding of self compassion. 

What is self esteem? 

Self esteem is a judgement we put on ourselves. Whether we are worthy as individuals. Are we good and valuable and do we do estimable things? William James, an influential U.S. philosopher and leading thinker who is also known as the “Father of American psychology”, believed that self-esteem was a vital component of mental health. He stated that self-esteem was created by a person’s ‘perceived competence in domains of importance’[1] James, W. (1890). Principles of Psychology. Chicago: Encyclopedia Britannica discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd . Early sociologist Charles Horton Cooley suggested that self esteem was also influenced by ‘the ‘looking glass self’ – our perceptions of how we appear in the eyes of others’[2] Cooley, C. H. (1902). Human Nature and the Social Order. New York: Charles Scribner discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd . In a 1999 study conducted by Susan Harter looking at how individuals assess their overall worth, she found that self esteem is often ‘impacted more powerfully by the opinions of acquaintances than close others’[3]Harter, S. (1999). The Construction of the Self: A Developmental Perspective. New York: Guilford Press discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd Considering that acquaintances are less likely to know us as well as close family and friends, this surprisingly suggests that our basis for self esteem may be mistaken and ill informed. 

Pursuing self-esteem in order to achieve better mental health.

Although self esteem in and of itself is perhaps a necessary component for our overall sense of wellbeing, the pursuit of it can be problematic. For example ‘the need to feel superior in order to feel okay about oneself means that the pursuit of high self esteem may involve puffing the self up while putting others down’[4]Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd. As well as an over-emphasised sense of importance and superiority, self esteem may also pose other issues. In an assessment of ‘7 sources of self esteem in college students: academics, appearance, approval from others, competition, family support, God’s love, and virtue’, Crocker, Luhtanen, Cooper, and Bouvrette found that problems can also arise when self esteem is contingent on particular outcomes[5]Crocker, J., Luhtanen, R. K., Cooper, M. L., & Bouvrette, S. (2003). Contingencies of self-worth in college students: Theory and measurement. Journal of Personality and Social Psychology, 85, 894–908.. As Harter discovered, global self esteem assesses itself in specific domains such as ‘appearance, academic ⁄work performance, or social approval'[6]Harter, S. (1999). The Construction of the Self: A Developmental Perspective. New York: Guilford Press discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd. Because we evaluate our self esteem within categories defined by society, this may result in us neglecting certain other important skills which are necessary for success. Because often self esteem is reliant on specific outcomes, it will therefore shift and vary being intrinsically unstable. In 2005 Michel Kernis looked at the importance of stability of self esteem in psychological functioning and concluded that when self esteem was unstable it drove people ‘to obsess about the implications of negative events for self-worth, making them more vulnerable to depression and reduced self-concept clarity’[7]Kernis, M. (2005). Measuring self-esteem in context: The importance of stability of self-esteem in psychological functioning. Journal of Personality, 73, 1–37.

If not self esteem, then what? 

How can we feel worthy, valuable and good about ourselves if not by inflating our self-esteem? Before you panic and think that we are all doomed to feeling worthless and ashamed of ourselves, rest assured that research has been done into another concept that can be used to raise our feelings of worth and pride and has similar benefits to self esteem but without the problems of ‘self-evaluation, ego-defensiveness, and self-enhancement’[8]Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd. This is the idea of self compassion. ‘Whereas self esteem entails evaluating oneself positively and often involves the need to be special and above average, self compassion does not entail self evaluation or comparisons with others. Rather, it is a kind, connected, and clear-sighted way of relating to ourselves even in instances of failure, perceived inadequacy, and imperfection’[9]ibid.

How can self compassion over self esteem help in recovery from addiction?

Both self compassion and self esteem are sources of positive self regard (although one is conditional and the other unconditional), which is something that, though difficult to achieve in recovery, is vitally important to develop if we are to maintain long lasting freedom from addiction. One theory as to why self compassion is more helpful for people in recovery stems from work done by Paul Gilbert and Chris Irons when looking at whether compassionate mind training would work with people suffering with shame. Within their study they theorised that some of the differences we have been attributing to self-compassion and self-esteem could potentially be down to the fact that each one affected different physiological systems. They suggested that ‘self-compassion deactivates the threat system’[10]Gilbert, P., & Irons, C. (2005). Therapies for shame and self-attacking, using cognitive, behavioural, emotional imagery and compassionate mind training. In P. Gilbert (Ed.), Compassion: Conceptualisations, research and use in psychotherapy (pp. 263–325). London: Routledge.. In general every addict has suffered some form of trauma, either before addiction, during addiction or both. Trauma dysregulates the nervous system and causes the threat system to be on continuous high alert. If, as suggested by Gilbert and Irons, self compassion is able to deactivate this and instead activate the self-soothing system which brings feelings of secure attachment and safety, it would be a vital tool for those in recovery to have. 

If, as Kirstin Neff says, self compassion is made up of three components: self kindness, connection through our shared humanity and mindfulness, it’s easy to see how well it could be used to help those in recovery from addiction: 

Self-Kindness – this is about the ability to be understanding and caring towards ourselves instead of judging or criticising. When you are being kind to yourself, you look upon your personal flaws and inadequacies gently and attempt to understand them instead of criticise. It’s about accepting the fact that you, just like everyone else, are imperfect.

Connection in our shared humanity: this is arguably the most vital component when relating it to recovery from addiction because addicts feel isolated. Addicts, in fact, are isolated from the community and from society. Recognising that everyone fails, makes mistakes and feels inadequate from time to time can connect us to one another. In journalist Johann Hari’s widely known and referred to TED Talk titled “Everything You Think You Know About Addiction is Wrong,” he concludes, in a concise and wonderfully true way, that ‘the opposite of addiction is not sobriety, it’s connection’.‘Self-compassion sees imperfection as part of the shared human condition, so that the self’s weaknesses are seen from a broad, inclusive perspective. Similarly, difficult life circumstances are framed in light of the shared human experience, so that one feels connected to rather than disconnected from others when experiencing suffering’[11]Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd

Mindfulness: mindfulness and meditation are well known and crucial elements of most people’s recovery from addiction. They are also equally as important as the third component of self compassion. Kabat Zinn, the “Godfather of modern mindfulness” and author of the book “Wherever you go, there you are”, says “Mindfulness means paying attention in a particular way: on purpose, in the present moment, and non-judgmentally. This kind of attention nurtures greater awareness, clarity, and acceptance of the present-moment reality. It wakes you up to the fact that our lives unfold only in moments. If we are not fully present for many of those moments, we may not only miss what is most valuable in our lives but also fail to realise the richness and the depth of our possibilities for growth and transformation.” Eckart Tolle is another of today’s best known authors and thinkers around mindfulness. In his book, The Power of Now he firmly states, “Realise deeply that the present moment is all you have. Make the NOW the primary focus of your life.” It is this idea of being present in the moment that is so important in recovery from addiction. In order to be able to be kind, understanding and gentle towards yourself in a moment of suffering, you first need to acknowledge and be present in that suffering. That might sound obvious but you may be surprised as to how many people don’t actually take the time to feel their own pain because they are too busy self criticising, judging or, like all addicts, trying to figure out a way not to feel the pain. 

In conclusion it seems that when related to recovery from addiction, it would appear that striving for high self-esteem may in some instances be harmful and counterproductive, whereas self compassion could offer a healthier way to feel valuable, safe, accepted and secure and a valuable tool in maintaining long lasting recovery.  


References   [ + ]

1. James, W. (1890). Principles of Psychology. Chicago: Encyclopedia Britannica discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd
2.  Cooley, C. H. (1902). Human Nature and the Social Order. New York: Charles Scribner discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd
3, 6. Harter, S. (1999). The Construction of the Self: A Developmental Perspective. New York: Guilford Press discussed in Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd
4. Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd.
5. Crocker, J., Luhtanen, R. K., Cooper, M. L., & Bouvrette, S. (2003). Contingencies of self-worth in college students: Theory and measurement. Journal of Personality and Social Psychology, 85, 894–908.
7. Kernis, M. (2005). Measuring self-esteem in context: The importance of stability of self-esteem in psychological functioning. Journal of Personality, 73, 1–37.
8, 11. Neff, K (2011) Self‐Compassion, Self‐Esteem, and Well‐Being. Social and Personality Psychology Compass © 2011 Blackwell Publishing Ltd
9. ibid
10. Gilbert, P., & Irons, C. (2005). Therapies for shame and self-attacking, using cognitive, behavioural, emotional imagery and compassionate mind training. In P. Gilbert (Ed.), Compassion: Conceptualisations, research and use in psychotherapy (pp. 263–325). London: Routledge.

The Antidepressant Power of Exercise

Depression is the most predominant mental health problem worldwide. According to the World Health Organisation (WHO) more than 350 million people suffer with depression globally. In Europe, data shows that 27% adults in the EU have mental issues, which have contributed to 55,000 people who die yearly from suicide. Twice as many people are dying from suicide compared to car accidents. [1]Vos, T., Barber, RM., Bell, B., Bertozzi-Villa, A., Biruyukov, S., Bollinger, I., …Murray, CJ.. (2013). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease study. The Lancet, 386(9995), 743-800.

In 2013, depression was the second leading cause of years lived with a disability worldwide, behind lower back pain. In 26 countries, depression was the primary driver of disability. In 2014 almost 20% of people in the UK aged over 16 showed symptoms of anxiety or depression – a 1.5% increase from 2013. 

The most common way globally to treat depression is with antidepressant medication. However, this is not the only way. In recent years there has been more and more interest directed towards understanding the effects physical exercise could have on the wellbeing of people with mental health disorders. Although this concept isn’t as new as we may think. Back in the 80s, researchers  suggested that  physical  fitness training could lead to an improved mood, self-concept, and work behaviour.

Today more and more research is indicating that exercise can also be used to treat depression. According to Dr Michael Craig Miller, assistant professor of psychiatry at Harvard Medical School, exercise can work for some people just as well as antidepressants. Although for those with severe depression exercise may not be enough on its own, it can certainly help in conjunction with medication where medication is necessary. 

The effect of exercise:

Exercise has a biological impact on our bodies that contributes to many health benefits including heart disease, diabetes, reducing blood pressure levels and helping us get better quality sleep. When you participate in any form of high intensity exercise such as running, circuits, boxing etc you may have noticed that you feel great afterwards. This is due to the release of endorphins this kind of exercise stimulates. However, it’s not only high intensity exercise that can be beneficial. Low intensity exercise, when sustained over a consistent period of time, encourages the release of proteins call neurotrophic or growth factors. These neurotrophic proteins stimulate nerve cell growth which then make new connections within your brain chemistry resulting in an improved sense of wellbeing. According to Dr Miller, neuroscientists have discovered that depressed people have a smaller area of hippocampus in their brains. The hippocampus is the region of the brain that regulate mood. If this area is smaller, it is understood that mood is potentially harder to regulate. Therefore if exercise can result in growing the connections between the nerve cells within the hippocampus region of a depressed person, it stands to reason that it could help relieve their depression. 

How to use exercise to treat depression:

Depressed people often lack motivation to do even the most simple of daily tasks. This is because depression causes reduced energy levels, poor quality sleep, pain and changes in appetite. Exercising can then be thought of as an impossibility for many people suffering with depression. It doesn’t have to be that way though. As little as ten minutes of exercise a day can may a difference. The better you start to feel, the more likely you will increase the amount of time you spend exercising a day. Make sure that you pick something that’s sustainable and fits in with your daily routine as exercise as a treatment for depression is not a quick fix. You need to be able to commit fully to it as part of a long term treatment plan. The goal is to find something you enjoy doing and keep it up. 

References:

  1. Monica Stănescu, Luciela Vasile. Using Physical Exercises to Improve Mental Health Procedia – Social and Behavioral Sciences, Volume 149, 2014, pp. 921-926
  2. Ferrari, A.J., Charlson, F.J., Norman, R.E., Patten, S.B., Freedman, G., Murray, C.J.L., … & Whiteford, H.A., (2013). Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease study 2010. PLOS Medicine, 10(11).
  3. Evans, J., Macrory, I., & Randall, C. (2016). Measuring national wellbeing: Life in the UK, 2016. ONS. Retreived from https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/measuringnationalwellbeing/2016#how-good-is-our-health.
  4. McManus S, Bebbington P, Jenkins R, Brugha T. (eds.) (2016). Mental health and wellbeing in England: Adult psychiatric morbidity survey 2014. Leeds: NHS digital.
  5. Monica Stănescu, Luciela Vasile. Using Physical Exercises to Improve Mental Health. Procedia – Social and Behavioral Sciences, Volume 149, 2014, pp. 921-926

References   [ + ]

1. Vos, T., Barber, RM., Bell, B., Bertozzi-Villa, A., Biruyukov, S., Bollinger, I., …Murray, CJ.. (2013). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease study. The Lancet, 386(9995), 743-800.