Depression Flashcards
What is Depression?
Depression is used to describe a dysphoric (sad mood) mood state, comprised of a cluster of symptoms or a clinical disorder.
How is depression linked too chronic disease and what causes it?
People who are diagnosed with a chronic illness often experience an initial sense of shock and disbelief. These reactions are common in young people who do not expect to get ill. A sense of loss of control however these tend to decrease with time.
- Number of pains (as number of pains experienced increased, so does risk of depression)
- Risk of disability
- Physical changes (changes in allostatic load)
What is negative implication of depression on disease?
1) Slower recovery and problems of return to social functioning.
2) Less likely to return to work within 6 months post-MI.
3) Poorer quality of life.
4) Increased risk of re-infarction / cardiac events (rhythm disturbance & / or abnormal clotting).
5) Poor prognosis.
6) Women are more at risk than men.
7) Reduces adherence to care recommendations: Less likely to make lifestyle changes, compromised medication compliance. coping mechanisms compromised= Poor disease outcomes
What are the effects of exercise on depression and mortality post MI?
1) 50% reduction in risk for subsequent death among regular exercise group vs non-exercisers.
2) Fewer non-fatal AMIs among exercisers.
3) Favorable physiological adaptations.
4) Reduction in cardiac risk factors
5) Improved endothelial function
6) Increased fibrinolysis (prevents blood clots)
7) Increased HR variability
8) Reduction in depressive symptoms
What is the importance of exercise for Depression sufferers?
Depression sufferers are generally less physically active and more deconditioned (Martinson, 1990) , however there is a positive correlation between physical activity levels and improved mental health.
What are the psychological benefits of exercise on depression?
Improved mood
Improved self-concept
Improved work behavior
Decreased depression and anxiety
What are the psychological mechanisms of action?
1) Distraction Hypothesis- Suggests diversion away from unpleasant stimuli leads to improved affect following exercise sessions. (Bahrke & Morgan,
1978) .
2) Self-efficacy- States the confidence in one’s ability to exercise it strongly related to perform the behavior (Bandura, 1977)
3) Mastery Hypothesis- Explains that a challenging pursuit such as exercise induces a sense of independence, control and success (Mellion, 1985).
4) Social interaction hypothesis- States that social relationships and mutual support which exercisers provide each other account for substantial portion of the effects of exercise on mental health (Ransford, 1982)
What are the physiological mechanisms of action?
1) Mononamine Hypothesis- Proposes that exercise enhances brain aminergic synaptic transmission and these include adrenaline, dopamine and serotonin.
2) Endorphin hypothesis: Extended exercise significantly activates endorphin secretion
3) Thermogenic model: Body temperature elevation is responsible for enhanced mood state
4) Visceral-afferent-feedback Hypothesis: The increase in afferent impulses arising from muscular & autonomic activity during exercise helps to improve mood.
What are the exercise testing implication?
1) Dizziness may be one side effect experienced if a patient is taking anti-depressant medication. If this is a reported side effect, then a cycle test may offer a safer & less intimidating mode of exercise test, particularly if they suffer with walking gait disturbance
2) If motivation is an issue as symptoms/ disability are likely to vary from day-to-day & therefore motivation & ability to perform efforts in tests will likely be compromised. It is therefore suggested that low-moderate intensity (conservative approach) protocol be adopted.
What is the physical activity prescription for depression sufferers?
1) Incorporate both aerobic and non-aerobic
2) Continuous moderate intensity more effective at improving mood symptoms
3) Frequency should be most days of the week may produce greater adherence and success
What is green exercise, what are the benefits and what are the barriers?
Evidence from physiological, psychological, biomechanical and social levels suggests exercise is useful role in primary and secondary prevention for disease and can play a vital role in rehabilitation programme.
Benefits:
1) Nature provides an environment that does not require direct attention, giving nature restorative properties therefore allowing recovery from mental fatigue
2) Lower perceived rate of exertion
3) Increases motivation (Extrinsic= What others think, Intrinsic= due to enjoyment or excitement of challenge)
4) Green environment improves self-esteem and negative mood scales.
Barriers:
1) Ease of access
2) Transportation
3) Personal safety
4) Safety Concer
