If you live in Sydney then there has been much to tempt you: a running festival (choose your torture), a ride to Central Australia with hundreds of bikers, a swimming event ominously called 100 x 100s, and lots more….

For those less inclined to pound the pavement, there was a short film competition on exercise and mood.

Here is the winning film, a stop-motion starring Buddy.
(If you can’t see it in the RSS feed then view it on YouTube.)

Stewart Bishop, winner of the competition (and son of yours truly), described his film:
“It’s about a small dog named Buddy, who wakes up in a bad mood. For him it seems like nothing is going right, until he uses simple odds and ends to devise an ingenious exercise routine. It helps him cheer up and he can go back to his home cheerful and feeling refreshed.”

Unfortunately the staff entry has disappeared from the winners and grinners page, but visit the site to view the other highly commended entries. And exercise your mood, of course.

One of the best things a depressed person can do is step out the front door. Natural light is very beneficial, especially early in the day. Exercise has proven benefits. Something as simple as taking a walk or gardening can lift your mood.

I wrote about ecotherapy a few years ago, following a major report by Mind UK. According to the report there are four main reasons why “green exercise” is beneficial for mental health:

• Natural and social connections: watching wildlife, evoking good memories, spiritual feelings
• Sensory stimulation: colors and sounds, fresh air, enjoyment, escape from pollution, contrasts with urban life, being exposed to the weather
• Activity: using manual skills, physically challenging activities such as digging or cycling
• Escape from modern life: time to think and reflect, clear the head, get away from pressures and stress.

Visit Mind UK to read or download the full report: Ecotherapy – the Green Agenda for Mental Health.

During the week the excellent Mind Hacks blog pointed to an article in ScienceLine on the same topic. The article reviews the state of play in ecopsychology, and research into ecotherapy. While it’s not as gung-ho as the Mind UK report it still makes a pretty good read.

My key takeaway from the article was not about the science of ecotherapy, but that a whole genre of therapy has flown right under my radar. Wilderness therapy, adventure therapy, outdoor behavioral healthcare and extreme ecotherapy^TM. (Actually this last one is mine).

By the way, I’m a die-hard fan of Man vs Wild. It’s my only weekly TV commitment and watching it equips me with good survival skills. In my mind adventure, wilderness and therapy are made for each other. Even without a mid-life crisis this is something I can embrace. Later.

During the week author and friend Graeme Cowan added a post on his site, also on exercise and mental health. It lists a dozen websites that help with motivation and cater to different life scenarios. Graeme also referred me to Spark People a while back. I can’t stand their website (sorry Spark People), but I get their daily exercise tips by email and find them very helpful. They are always small, simple exercises that can integrate easily into a normal daily routine. Exactly where I’m at right now.

There is one other web service that I’m using called HassleMe. I receive 2 emails that I worded myself, at irregular intervals. The first one tells me that I have lousy posture – which makes me instantly sit up straight. The other tells me to take just one step outside. (The second step is always easier.)

Do you use online reminders or social websites to help motivate you? I’m interested to hear which ones help, so please share your experiences below.

Just to note, I’m not a certified trainer. I’m just sharing stuff that’s worked for me. Also, some of this stuff is contradictory. That’s because you’re not supposed to implement all of them – just pick the ones you think will work for you, and give them a try. Good luck!

Top 42 Exercise Hacks

1. Start slow.The biggest mistake that people make when starting an exercise plan is starting too fast or too hard. Trust me, I’ve done it many times. I’ve learned to take it easy, start as small as possible, and worry about endurance or intensity later. The key in the beginning is to make it enjoyable and accomplishable. That’s probably not a word, but it should be. And it is now. Zen Habits are ones that are accomplishable.
2. Increase but gradually.After getting used to a certain level of exercise, you’ll want to increase it. Don’t just run two miles or walk 20 minutes three times a week for a year. Your body adjusts to the stress you’re giving it, so you need to increase the level once you’ve adjusted. But do it gradually, and only every two weeks or so.
3. Crank it up.Once you’ve gotten used to exercise, you’ll want to do some higher intensity ones for better fitness and fat-burning. For example, instead of running slowly and steadily, for a long time, try doing shorter bursts of fast running, with periods of rest in between. You can do this for any exercise. Higher intensity increases the calorie burn, and improves performance. But you can’t do it as long, and you shouldn’t do it every workout. Mix it in with endurance workouts.
4. Schedule workouts. Make appointments with yourself to workout, at a specific time and place, just as you would with any other appointment. And make it the most important appointment on your calendar – more important than a doctor’s visit or even the manicurist.
5. Make it a habit. If you can do exercise at the same time, every single day for a month, you are more likely to make it a habit. Consistency makes habits more ingrained. Once it’s a habit (and start easy in the beginning!), then you can step up the intensity a bit.
6. Forget about weight loss. Yeah, many of us would like to lose some weight. But if you’re motivated solely by weight loss, exercise will be a tough proposition. The reason is that you might not lose weight right away. Oh, it’ll come, if you can keep it up over time, but in the beginning you might be disappointed (especially if you haven’t changed your eating habits). Just get into the habit of exercise, and worry about the weight later. First things first.
7. Forget the gym. The gym can be horribly convenient, but it can also be intimidating for beginners, and confusing if you don’t know how to use the equipment. Sure, you can get a trainer to teach you, but if the cost or the confusion stops you from exercising – well, skip the gym and do it at home or at the park or somewhere less intimidating. You can do pushups and crunches and dumb bell exercises at home very easily, workout to a DVD, or go walking or jogging in your neighborhood. Cheap and simple is my motto.
8. Reward yourself. Self-explanatory, but rewards are best if they are frequent in the beginning. Be self-indulgent! Even sweets are good rewards – remember, get into the habit of exercise, and you can worry about weight loss later.
9. Do a 30-day Challenge. Challenge yourself, and see if you can rise to the occasion. Do it with a group or your significant other. Put in rewards. Tell everyone you’re doing it. Motivate the hell out of yourself.
10. Join an online group. One of the best motivators is having to report successes and failures to a group of people. Check out some online groups (there are groups for every type of exercise), introduce yourself, see which ones you’re comfortable with. Once you’ve gotten established (after a couple of days) see if you can post your results every day – you won’t go wrong once you start doing that.
11. Post your results on your blog. There’s nothing more motivating than positive public pressure (short of a gun to your head). Step it up by making a promise to your blog readers that you will commit to this goal for a month, and post your results every day. Even if your mom is your only blog reader, it’ll really help.
12. Do a journal. If you don’t post your results on your blog, write it in a journal, either online or on paper. However you set it up, make it a habit to post to your journal or log right away, as soon as you’re done with your log. It will motivate you to see your progress over time, and it’s a good way to see what you’re doing right and what you’re doing wrong.
13. Make it fun! Exercise doesn’t have to be a chore. I love doing a morning run, with the sun coming up, the world so quiet, my mind left to its own devices. Enjoy yourself and you will actually look forward to your workouts.
14. Fuel up. If your workout is more than 30 minutes, you really should have some energy in you. You shouldn’t work out on an empty stomach – but you also shouldn’t eat right before you work out. Eat a banana or some peanut butter toast or a ClifBar an hour or two before your workout, and you’re good to go.
15. Hydrate. Also an hour or two before you workout. Water is best. Use a sports drink during your workout (and after) only if you’re going to go an hour or more. If you’re going to do a tough workout, stay hydrated throughout the day. In fact, go ahead and do this whether you work out or not.
16. Get a workout buddy. Find someone at your level, and commit to working out a certain number of times a week together, at a certain time. This will make you more likely to keep that workout appointment, and workouts can be a lot of fun if you spend them chatting with your buddy. Just be sure to actually work out, and not just chat, Chatty McChatterson!
17. Get good clothes. Actually, you don’t need anything fancy to get started. But once you do start working out, it’s nice to get yourself some nice workout clothes, with breathable and comfortable fabrics, ones that look good on you. It’s motivating, and pleasurable. Make it so.
18. Put a cover model on your fridge. Not literally, of course, as that may be illegal, but find a good magazine photo of a model with the body you want, and post it up somewhere visible. You may never look like that model (heck, that model probably never really looks like that), but it’s motivating. Don’t pick a model that’s too good looking, or you may question your sexuality.
19. Change it up. Sure, walking or running every day can be a lot of fun. But getting some swimming or biking or strength workouts or aerobics or kickboxing into the mix can be a lot of fun, and can also help you get into better shape. They work out different muscles, and step up the metabolism. Variety is the spice of life and all that.
20. Do it early in the morning. My favorite time to work out is between 5:30 and 6:00 a.m. Plus, I know that if I work out at this time, nothing will get in the way of the workout later in the day. It’s a beautiful time of day, not too hot, and there’s nothing like showering and going to work knowing that I’ve put in a great exercise (and it allows me to feel superior and look down my nose at those lazy bums I work with).
21. Squeeze it in during lunch. OK, you’re not a morning person. You’re busy. You don’t have time to work out. Well, suck it up, buster, and sacrifice your lunch hour to the gods of fitness. Bring your workout clothes, do a quickie nooner, and be back at work ready to tackle the afternoon.
22. First thing after work. None of those options work for you? Not a problem, my friend. Make it a daily appointment to work out as soon as you get off work. This will also motivate you to finish your work on time so you can get out on time for your workout. It’s great to stop somewhere to do your workout before you even get home, because once you get home you’ll probably want to relax on the couch, fall asleep at the kitchen table, or rush to the computer to read the latest Zen Habits post.
23. A little and often. You don’t need to work out long, and you certainly don’t need to be a weekend warrior. Just 20-30 minutes every day. Who doesn’t have 20 minutes on their schedule. You? Well, scratch Walker Texas Ranger rerun off the schedule and make room for this instead.
24. Just lace up. Yeah, you’re dreading the upcoming workout. But don’t even think about it. Just lace up and head out the door. That’s all. After that, let nature take its course. Just relax and do what comes naturally. Which is exercise.
25. Join a race. Signing up for a 5K or a triathlon are my favorite motivators. It really gets me to do my workouts because if I don’t, I will look like a dork by collapsing 5 minutes after the starting gun goes off. But don’t worry about how you look – just go and have fun at these races – everyone else is worrying about themselves too much to notice you.
26. Get good gear. As a reward, get yourself some nice little gadgets – a sports mp3 player, a Polar heart rate monitor, a pedometer, a scale, a bike computer, whatever. Something cool that will make you look forward to your workouts.
27. Forget about the gear. Having said that, you don’t need any of that to actually work out. Just put on some cheap clothes and get out the door. Don’t let your lack of gear stop you, and for criminy’s sake, don’t go and buy all the gear before you actually start working out.
28. The 10 percent rule. Don’t increase your workout time or distance by more than 10 percent a week. This is a very conservative rule, and it can be broken by the best of the best, who know what they’re doing, but for the rest of us, stick with this to prevent burnout or injury.
29. Rest. It’s important. This is a commonly overlooked factor. If you don’t give your body some rest, you will burn out and get injured. Rest is just as important as the workouts in improving performance and fitness. As long as you’re doing the workouts too and not just the rest!
30. Hard, then easy. If you do a hard workout today, rest or go easy tomorrow. Don’t do two hard workouts in a row. The hard-easy approach can also work within a workout itself – run hard, then run slow, then run hard – you get the idea. This allows you to burn more fat than if you just run medium the whole time.
31. Listen to your body. This is extremely important – if you feel like you’re overdoing it, you probably are. Rest and allow your body to recover. And though you can run through some slight soreness or aches, you should stop as soon as you feel sharp pain or pain in the joints. You’ll just make it worse.
32. Strength is good. If you’re a walker or runner or cyclist or swimmer or something like that, you should also fit some strength training into your schedule. Nothing too intense, but just some core-strengthening exercises that will help your main sport as well as make you healthier and yes, more attractive.
33. Set goals. What are you trying to get out of your exercise? It’s good to know if you’re trying to build muscle or burn fat – because these are two competing goals. There are other goals, of course, but you should be clear what they are. Also, set goals for each week – what do you want to accomplish this week? Write it down, post it up, and see if you can meet them!
34. Take photos of yourself. Before and after photos. The best way to see your progress over time. But do it once a month, not every hour, you narcissist!
35. Workout first, diet later. If you’re just starting a workout plan, it’s best not to start a diet at the same time. Well, I don’t like diets in the first place, but still – one thing at a time. I’d prefer the workout first, and then worry about the diet after about a month of working out. You didn’t get fat overnight and you’re not getting skinny overnight either!
36. Star chart. Yeah, you know what these are. But they’re very motivating. Do a workout, put up a star. Fun!
37. Get a coach. You certainly don’t need one, but there’s nothing more motivating than a coach. Almost like a workout buddy, in that you are very likely to make the appointment, but less chatty and more knowledgeable. And if you’re going to learn swimming, a coach is a must. Yes, you can get a coach – there are master’s swimming classes at your local pool. Just sign up – they’re usually not that expensive.
38. Join the club. In my area, there is a great running club and a great cycling federation and triathlon federation. All of them sponsor races and Sunday rides and things like that where you can workout with a group and talk to more knowledgeable people. Well worth the small membership fee!
39. No pain – that’s good. Forget the old rule of “no pain, no gain”. You don’t need pain to get in shape. Just take it easy, progress gradually, and enjoy yourself.
40. Warm up. If you’re going to do any kind of exercise, don’t do it with your muscles cold. Gradually get your heart pumping and blood flowing. You’re less likely to injure yourself, and your workout will be more enjoyable.
41. On stretching. Sure, flexibility is important. But stretching out cold is a good way to get injured. If you’re going to stretch out before a workout, be sure to do so only after your warmup. Also, do not bounce. That’s another good way to tear your muscles. Do slow stretches and hold them without bouncing. Best of all: stretch after a workout, when your muscles are nice and loose.
42. Go for the long haul. Most of all, don’t think that you will become fit and healthy and sexy in one month. Think of exercise as a life-long habit, and your goals will come to you eventually. You’ll get there, my friend!

It is important to remember, when working through a resource list like this, that some things may work for you and others may not – a treatment for depression should start with professional help. Irrespective of this, it’s important to be involved in learning about your illness, including the treatments available. It seems that those who actively participate in their treatments have the most success in maintaining good health. Good luck!

THE BIG PICTURE

Large Website Resources
National Institute of Mental Health
National Alliance on Mental Illness
Medline Plus
MayoClinic.com
Blackdog Institute

Comprehensive PDF publications
National Institute of Mental Health
Mental Health Foundation – Dealing with Depression
HereToHelp – Depression Toolkit
Understanding Major Depression and Recovery

PDF Fact Sheets
Mind (National Association for Mental Health)
National Institute of Mental Health
SANE Australia
Black Dog Institute
Beyond Blue

Staying Well Plans
National Mental Health Information Center – Self-Help Guide
SANE Australia – Mental Illness and Keeping Well
Black Dog Institute – Ways of Staying Well
Sarah Russell – “Staying well with bipolar disorder”
(5th article from the top. Very applicable to depression.)

EVERYDAY LIFE

Exercise
MayoClinic.com – Depression and Exercise
Better Health – Depression and Exercise
MIND – The Mind Guide to Physical Activity
Mental Health Foundation UK – Up and Running!

Food
Mental Health Foundation – Healthy Eating and Depression
MIND – The Mind Guide to Food and Mood
MyPyramid.gov – Healthy Diet Plan

Stress Management and Relaxation
MIND – The Mind Guide to Managing Stress
MIND – The Mind Guide to Relaxation
Families for Depression Awareness – Coping With Stress

Sleep
HelpGuide – Tips for a Good Night Sleep
National Sleep Foundation – All About Sleep

TRUSTED BOOKS (links to Amazon)

Dealing with Depression: A Commonsense Guide to Mood Disorders

Living Well with Depression and Bipolar Disorder: What Your Doctor Doesn’t Tell You…That You Need to Know (Living Well)

The Relaxation & Stress Reduction Workbook

A Lifelong Journey: Staying Well With Manic Depression/bipolar Disorder

Loving Someone With Bipolar Disorder

PHYSICAL TREATMENTS

Medicines
National Alliance on Mental Illness – Information on Specific Medicines
Drug Digest – Information on Specific Medicines
National Institute of Mental Health – Detailed Information on Types of Medicines
Beyond Blue – Brief Introduction to Types of Medicines
MayoClinic – Brief but Helpful video on Understanding Antidepressants

Electroconvulsive therapy
MayoClinic.com Overview
MayoClinic.com Video
infrapsych

Vagus Nerve Stimulation
MayoClinic.com – VNS: A New Depression Treatment Option

Transcranial magnetic stimulation
National Alliance on Mental Illness – TMS
MayoClinic.com – TMS: An experimental depression treatment

PSYCHOLOGICAL TREATMENTS

Overview
APA – How Psychotherapy Helps People Recover From Depression
APA – How to Find Help Through Psychotherapy
Mental Health Foundation – We Need to Talk PDF

Cognitive Behavior Therapy (CBT)
National Alliance on Mental Illness – About CBT Treatments
National Association of Cognitive-Behavioral Therapists
MoodGym program – free online CBT course
Living Life to the Full – free online CBT course
liveandworkwell.com – Steps to Change: free online CBT course

ALTERNATIVE, COMPLEMENTARY AND SELF-HELP TREATMENTS

Overview
Healthy Place
National Mental Health Information Center
New Hope – Natural Remedies for Depression
Introduction to Dietary Supplements

Bibliotherapy
Holistic Online – Bibliotherapy

Omega-3
Medline Plus
Black Dog Institute – The Role of Omega-3 Fatty Acids as a Treatment for Bipolar Disorder
(Online presentation also applicable to unipolar depression)

Vitamin B6
National Institute of Health – Dietary Supplement Fact Sheet
Medline Plus

Vitamin B12
National Institute of Health – Dietary Supplement Fact Sheet
Medline Plus

SAMe
Drug Digest – Article on SAM-e

DHEA
Medline Plus – DHEA Overview
MedPage Today – DHEA Effective for Midlife-Onset Depression

Ginkgo Biloba
Medline Plus – Ginkgo Overview
NCCAM – Herbs at a Glance: Ginkgo

St John’s Wort
National Center for Complementary and Alternative Medicine – St John’s Wort
Drug Digest – St John’s Wort

Light therapy
MayoClinic – Seasonal Affective Disorder
PsychEducation.org – Light Therapies for Depression

Yoga
Better Health Channel – General Article on Yoga
The MIND Guide to Yoga

Aromatherapy
Holistic Online – Depression Remedies
Wavelengths Natural Therapy – How to use Aromatherapy for Depression
depression-guide.com – Depression and Aromatherapy

Massage therapy
National Center for Complementary and Alternative Medicine
Medline Massage Therapy Interactive Tutorials

Spirituality
Mental Health Foundation – The Impact of Spirituality on Mental Health

Creative Therapies
American Art Therapy Association
American Music Therapy Association
American Dance Therapy Association

Acupuncture
National Center for Complementary and Alternative Medicine
Acupuncture.com – Depression and the Five Elements

Meditation and Relaxation
National Center for Complementary and Alternative Medicine
MayoClinic online meditation video
MayoClinic Relaxation Techniques

Progressive Relaxation, Guided Imagery and Autogenic Relaxation
Calming.org
McMaster University – Relaxation: Physical and Mental

Ecotherapy
Mind (National Association for Mental Health)

Keep this list expanding! If you have another resource that you’d like to share please add it in the comments.

Research shows that one of the most popular treatments for depression – according to clinicians, researchers and patients – is exercise. The problem with exercise is that it’s very hard to start, or once started, very hard to continue to form a habit. If you’re like me you have a treadmill, a bike, or some kind of gym apparatus collecting dust in a corner of your house.

Here are some ideas to help.

1. Start slowly and set small goals. Aim for things that you can achieve, like walking for 10 minutes each day. If you go for a complete training program straight away then you are more likely to fail. I make this mistake all the time. I plan an elite-style exercise regime, then quietly concede a few weeks later that it never got off the ground.

2. Make exercise a habit. If you start slowly you are more likely to continue. Once you’re over the “exercise hump” – say the first couple of weeks – you will be well on the way to a healthy habit.

3. Do something you enjoy. This will help to associate exercise with positive feelings. Shoot baskets, go for a swim, or walk laps of the local mall. (But remember that ecotherapy is better than shopping center exercise). A symptom of depression and other mood disorders is a loss of pleasure in things that you once enjoyed. If you start and persist with an exercise that you used to enjoy, the pleasure is likely to return.

4. Exercise with other people. Exercise is very hard to start and then continue on your own. Especially if you have a strong gravitational force that prevents you from getting up. You are much more likely to succeed if there is a commitment involved, like a set of expensive aerobics classes, walking with a friend once a week, or hiring a personal trainer to cheer you on.

5. Rethink your attitude to exercise. Exercise is essential for keeping your body and mind healthy. It provides huge benefits to you, that can make a vast difference to your mental well-being. Exercise can also be enjoyable and bring a great sense of achievement or satisfaction. If you develop a positive attitude towards exercise you will find it easier to commit time to it.

6. Is anything else stopping you? Many of us have other barriers to activity, like self-consciousness. There are many different ways to exercise, so find one that you’re comfortable with. Don’t use it as an excuse that just prevents better health.

7. Build your exercise into a task. On the weekend I surprised myself by pulling down a fence (intentionally). Actually I only pulled down most of it – if I finished it in one day my wife would have been suspicious. Anyway, it was a lot of effort to pull it down. A lot of exercise. It is also exercise to walk the dog, or mow the lawn, or wash the car. If you combine your exercise with a task then you will have twice the satisfaction when it’s over.

8. Be reasonable. Exercise and depression don’t seem to go together, just as swimming against the tide doesn’t really work. Don’t be hard on yourself when things don’t go to plan. Give yourself full credit for your successes and keep persevering to form a strong habit.

“I have to exercise in the morning before my brain figures out what I’m doing.”
Marsha Doble

“I gotta work out. I keep saying it all the time. I keep saying I gotta start working out. It’s been about two months since I’ve worked out. And I just don’t have the time. Which uh..is odd. Because I have the time to go out to dinner. And uh..and watch tv. And get a bone density test. And uh.. try to figure out what my phone number spells in words.”
Ellen DeGeneres

“The trouble with jogging is that the ice falls out of your glass”
Martin Mull

About 5 years ago, during a long spell of health, I rode my bike everyday for up to two or three hours. My swan song was riding about 90 miles in a day, from one city to the next. I felt good, I looked healthy and my depression was under control.

Is there a link between exercise and mental health?

We all know that exercise benefits us physically, but there is also solid evidence that it benefits the mind. It is an effective treatment for depression. Most research is focused on the benefits for people who have mild or moderate depression, however there is also strong evidence that it is a very effective way to head-off a relapse of severe depression. A recent survey by the Black Dog Institute found that patients considered exercise to be the most helpful non-medical treatment option (see the previous post on “What Works for Depression“).

An inactive lifestyle increases the risk of depression, and depression increases the likelihood of an inactive life. The problem is getting up and going when you’re depressed. I know how hard it is. I’ve hardly touched my bike in 5 years!

So what are the specific benefits of exercise?

Exercise increases the serotonin levels in the brain, releases endorphins (“feel good” hormones), improves cardiovascular fitness, reduces cholesterol, reduces blood pressure, helps maintain a healthy weight and improves muscle tone.

Some other good reasons to exercise are:

• it gives you more of a sense of owning your own treatment
• it gets you out and about and meeting people e.g. walking with friends or playing a team sport
• it uses up adrenalin which reduces your stress levels
• it provides distraction from the negatives in your life and unhelpful patterns of thinking
• it tends to be less expensive than most other treatments
• there are no side-effects, except perhaps injury, compared with the many that can be experienced with medication.

There really is no excuse to not exercise. The trick is…how to start? Stay tuned!

There are many alternatives for depression that work well in addition to or in place of anti-depressants. For me it takes a combination of treatments to stay well; medication plus a healthy lifestyle ( good food, exercise, less coffee, more sunlight, avoiding stress).

Before I continue, let me make a clarifying point. A small proportion of people with depression have what is termed melancholic or biological depression. This includes people with bipolar disorder. For such people medicine is almost always needed to reach or remain in good health, while non-medical treatments are considered to be supplementary. For the more usual non-melancholic depression, treatments that use strategies other than medication are common.

Anyway, back to the merits of different treatments. If you want to look up one of the following terms the Medicine Net medical dictionary should have a definition.

The Centre for Mental Health Research (link below) did a survey of the scientific literature available, and ranked treatments according to the depth and quality of evidence supporting them.

Medical treatments

Antidepressants and electro-convulsive therapy are both ranked highly with strong scientific evidence for their effectiveness.

Psychological treatments

Cognitive behavioral therapy ranks highest with strong evidence for being very effective. Interpersonal psychotherapy, psychodynamic psychotherapy and bibliotherapy are all on the next tier. They are supported by scientific evidence as being effective, but the evidence is not as strong.

Lifestyle & Alternative Therapies

Exercise, light therapy and St John’s Wort are ranked on the second tier as useful treatments, with good evidence but not as strong as for, say, antidepressants. On the third tier there is a large group of other promising treatments with less evidence in support. It includes acupuncture, alcohol avoidance, massage therapy, relaxation therapy, vitamins and yoga.

The Black Dog Institute took a different approach, surveying what patients rated as the most helpful treatments. The leader of the study Professor Gordon Parker said that patients “do not necessarily share the views of professionals about effective therapies for depression”. Yes, we can be fairly incisive about what is or isn’t working!

2,692 individuals took part in the survey. Leaving aside medicines and “talk” therapies, people with depression rated exercise as being the most helpful. They considered yoga, meditation, relaxation and massage to be the next most beneficial. Acupuncture and homeopathy followed with moderate ranking scores, while the various herbal and Omega 3 preparations returned the lowest rankings.

So there you have it. My experience is that it takes more than drugs to get well. The more aggressively you pursue all of the the things that work for you, the more likely you are to maintain good health. Putting it into practice is the hard part!

Centre for Mental Health Research
Black Dog Institute (see the news release dated 18/2/07)
Previous post on green exercise

Yes, probably, although it might not be a strong link.

A study led by Brian Meier, a psychologist at North Dakota State University, concluded that posture does affect mood. In the study pessimists performed cognitive tasks better while looking down and optimists performed the tasks better when looking up. The study found that emotions have a highly physical basis, so sad thoughts could lead to a slumped posture with the eyes directed down, and happy thoughts to a more upright posture and the eyes looking up. They found the reverse to be true as well. Simply looking up could give a physical boost, that in turn leads to better posture and a better mood.

Why is good posture good for health?

Your body’s weight should be carried by your spine. Poor posture distorts the alignment of your bones so instead the weight is carried by your muscles. This causes tension in the muscles and undue pressures on joints. This has physical and emotional impacts on the body, from back pain and headaches, reduced blood and oxygen to the brain, increased fatigue and even depression.

When you are properly aligned your bones support your weight. This reduces the stress on your body, leaving you healthier and more energetic.

How to correct bad posture?

The first thing to do is change your environment to reduce situations that promote bad posture. Make sure that your computer is at the right height for typing. Make sure your car seat is correctly adjusted. Your back should be straight and your arms only slightly bent. Wear a backpack rather than use a heavy shoulder bag. Use the correct lifting technique for heavy items.

Secondly improve your posture by exercising, stretching and being aware of your center of gravity. Visualize a woman carrying a heavy pot of water on her head – a common sight in many cultures. She is able to do this for long distances because the pots are placed over her center of gravity, allowing her skeleton to bear the weight rather than her muscles.

“We are all in the gutter, but some of us are looking at the stars.”
Oscar Wilde, Lady Windermere’s Fan, 1892, Act III

According to research published last month by Mind, ecotherapy should become a recognized treatment option for people with mental health problems. Their report, “Ecotherapy: the green agenda for mental health”, is the first study commissioned to look at the benefits of “green exercise” on depression. (Mind is the National Association for Mental Health, the leading charity in England and Wales devoted to mental health.)

Its results are very interesting, although not completely surprising. Researchers from the University of Essex compared the effects of a 30 minute walk in a country park with the same amount of time in an indoor shopping centre.

• 71 per cent reported decreased feelings of depression after the walk in the park. 22 per cent reported an increase after walking in the shopping centre and only 45 per cent experienced a decrease.
• 71 per cent felt less tense after walking in the park, while 50 per cent felt more tense after walking in the shopping centre.
• 90 per cent claimed increased self esteem after the walk in the park; 44 per cent experienced lower self esteem after the shopping centre walk.
• 88 per cent reported an improved mood after the walk in the park. This compares with 44.5 per cent for the shopping centre, while another 44.5% per cent experienced lower mood.

Clearly walking in a park has health benefits, while there is a good chance that going shopping will worsen your state of mind.

There goes my article on retail therapy!

A second study conducted by the University surveyed 108 people with mental illnesses about their experience of ecotherapy. 94% said green activities had helped with their depression, and 90% said the combination of nature and exercise had the greatest effect. That’s an enormous positive response!

According to the report there are four main reasons why green exercise is beneficial:

• Natural and social connections: watching wildlife, evoking good memories, spiritual feelings
• Sensory stimulation: colors and sounds, fresh air, enjoyment, escape from pollution, contrasts with urban life, being exposed to the weather
• Activity: using manual skills, physically challenging activities such as digging or cycling
• Escape from modern life: time to think and reflect, clear the head, get away from pressures and stress.

Mind’s Chief Executive Paul Farmer said:

“Mind sees ecotherapy as an important part of the future for mental health. It’s a credible, clinically-valid treatment option and needs to be prescribed by GPs, especially when for many people access to treatments other than antidepressants is extremely limited. We’re not saying that ecotherapy can replace drugs but that the debate needs to be broadened.”

What do you think?