{"id":4657,"date":"2018-12-16T10:58:02","date_gmt":"2018-12-16T15:58:02","guid":{"rendered":"https:\/\/www.amyork.ca\/academic\/zz\/?p=4657"},"modified":"2019-05-25T22:42:25","modified_gmt":"2019-05-26T02:42:25","slug":"mental-health-mental-illness-and-mental-disorders","status":"publish","type":"post","link":"https:\/\/www.amyork.ca\/academic\/zz\/exercise\/mental-health-mental-illness-and-mental-disorders\/","title":{"rendered":"Mental Health, Mental Illness, and Mental Disorders"},"content":{"rendered":"<ul>\n<li><strong>Mental Health \u00a0<\/strong>o \u201cState the successful performance of mental function, resulting in productive \u00a0activities, fulfilling relationships with other people, and the ability to adapt to \u00a0change and to cope with adversity\u201d\u00a0 USHDDS, 1994, page 4 <strong>\u00a0<\/strong><\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<ul>\n<li><strong>Mental Illness \u00a0<\/strong>o Refers collectively to all diagnosable mental disorders <strong>\u00a0<\/strong><\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<ul>\n<li><strong>Mental Disorder \u00a0<\/strong>o \u201cHealth conditions that are characterized by altering thinking, mood, or \u00a0behaviour\u2026 associated with distress and-or impaired functioning\u201d\u00a0 USHDDS,<\/li>\n<\/ul>\n<p>1994, page 4 <strong>\u00a0\u00a0<\/strong>o Ex: Anxiety, depression<\/p>\n<p>&nbsp;<\/p>\n<h2>Mental Health Problem<\/h2>\n<ul>\n<li>\u00a0\u00a0 Signs and symptoms of <strong>insufficient intensity or duration<\/strong> to meet criteria for \u00a0mental disorders<\/li>\n<li>\u00a0\u00a0 Symptoms are sufficient enough to potentially warrant active efforts in health \u00a0promotion, prevention, and treatment<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Continuum of Mental Illness, Mental Health Problems, and Mental Health<\/h2>\n<h1>Mental Illness &#8212;&#8211; Mental Health Problems &#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211; Mental Health !<\/h1>\n<p>&nbsp;<\/p>\n<h2>Depression Defined<\/h2>\n<p>&nbsp;<\/p>\n<ul>\n<li>\u00a0\u00a0 <strong>Mood disturbances<\/strong>: Influences mood regulation beyond the usual variations<\/li>\n<li>\u00a0\u00a0\u00a0 Persistent low mood and inability to find enjoyment in activities<\/li>\n<li>\u00a0\u00a0\u00a0 Lack of motivation to begin or continue activities<\/li>\n<li>\u00a0\u00a0 Feelings of worthlessness<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Major Depressive Disorders\u00a0 <\/strong><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>\u00a0\u00a0 Depressive disorder\u00a0 unipolar major depression<\/li>\n<li>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bipolar disorder \u00a0&#8211; \u00a0 Dysthymia<\/li>\n<li>\u00a0\u00a0 Cyclothymia<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><u>Major Depressive Disorder<\/u><\/p>\n<ul>\n<li>Depressed mood, loss of interest or pleasure are primary symptoms \u00a0o Not driven by physiological causes\u00a0 Ex: Drugs\u00a0 or medical condition\u00a0 Ex: \u00a0Hypothyroidism<\/li>\n<li>\u00a0\u00a0 Other symptoms can vary widely<\/li>\n<li>Episodes last approximately nine months if untreated \u00a0o 80-90\u00a0 remit within two years of first episode<\/li>\n<li>50 will recur<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0 Symptoms cause significant impairment in social, work, or other important areas<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><u>Bipolar Disorder<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 One or more episodes of mania or mixed episodes of mania and depression<\/li>\n<li>Mania can range from pure euphoria-elation to irritability o Thoughts are grandiose or delusional \u00a0o Decreased need for sleep \u00a0o Easily distracted, with racing thoughts<\/li>\n<li>Excessive involvement in pleasurable activities that are likely to have painful consequences\u00a0 Ex: Unrestrained shopping spree, sexual indiscretions\u00a0 \u00a0&#8211; Higher familial prevalence\u00a0 e. Stronger genetic component<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><u>Dysthymia<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 Chronic form of depression<\/li>\n<li>\u00a0\u00a0\u00a0 Fewer than five persistent symptoms<\/li>\n<li>\u00a0 \u00a0Duration of approximately two years for adults, approximately one year for children \u00a0&#8211; \u00a0 Increased susceptibility to major depression<\/li>\n<li>\u00a0 \u00a0Seldom remits spontaneously<\/li>\n<li>\u00a0\u00a0\u00a0 Women are twice as likely be diagnosed as men<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><u>Cyclothymia<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 Marked by manic and depressive states, but of insufficient intensity-duration to \u00a0diagnose as bipolar or major depressive<\/li>\n<li>\u00a0\u00a0\u00a0 Increased risk of developing bipolar disorder<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Depression Generally Characterized by the Following<\/h2>\n<ul>\n<li>\u00a0\u00a0\u00a0 Feelings of sadness-elation<\/li>\n<li>\u00a0\u00a0\u00a0 Feelings of guilt-worthlessness<\/li>\n<li>\u00a0\u00a0\u00a0 xisturbances of appetite<\/li>\n<li>\u00a0\u00a0 xisturbances in sleep patterns<\/li>\n<li>\u00a0\u00a0 Lack of energy<\/li>\n<li>\u00a0\u00a0\u00a0 xifficulty concentrating<\/li>\n<li>\u00a0\u00a0\u00a0 Loss of interest in all-most activities<\/li>\n<li>\u00a0\u00a0\u00a0 Problems with memory<\/li>\n<li>\u00a0\u00a0 Thoughts of suicide<\/li>\n<li>\u00a0\u00a0 Hallucinations<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Prevalence<\/h2>\n<ul>\n<li>\u00a0\u00a0\u00a0 xisability Adjusted Life Years\u00a0 xALYs<\/li>\n<li>Estimate of the years of healthy life lost to premature death and years lived with a severe disability\u00a0 e., disease and disability burden<\/li>\n<li>Of the mental illnesses, major depression was 2<sup>nd<\/sup> only to cardiovascular problems and ranked ahead of alcohol use and traffic accidents in disease and \u00a0disability burden<\/li>\n<\/ul>\n<ul>\n<li>\u00a0Mood disorders\u00a0 e.g., major depression, bipolar disease\u00a0 are in the top 10 list of \u00a0disabilities worldwide<\/li>\n<li>\u00a0In a given year, 21\u00a0 of the U.S. adult population will have a diagnosable mental \u00a0disorder, which includes a 7.1\u00a0 one-year prevalence rate for any mood disorder<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Costs<\/h2>\n<ul>\n<li>Overall costs of depression: $83 billion per year in 2000<\/li>\n<li>Breakdown of costs: \u00a0o 31\u00a0 on direct treatment and rehabilitation, 7\u00a0 on mortality, and 62\u00a0 for \u00a0absenteeism and reduced work productivity<\/li>\n<li>Other costs: \u00a0o Increased risk for other diseases<\/li>\n<\/ul>\n<p>o xecreased quality of life for the individual and families<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2>Causes<\/h2>\n<ul>\n<li>\u00a0\u00a0 Not well understood<\/li>\n<li>\u00a0 \u00a0Physiological and psychosocial factors <strong>interact<\/strong> in response to some stressful events<\/li>\n<li>\u00a0\u00a0 Some research has focused on biological factors\u00a0 e.g., neurotransmitter deficiencies\u00a0 \u00a0but this is an insufficient explanation<\/li>\n<li>\u00a0\u00a0 Individual variation in manifestation<\/li>\n<\/ul>\n<p>o Heredity, coping skills, experience, gender, environment, and social support<\/p>\n<p>&nbsp;<\/p>\n<h2>Treatment<\/h2>\n<ul>\n<li>\u00a0\u00a0\u00a0 Depression is often <strong>untreated<\/strong> &#8211; due to stigma of mental illness<\/li>\n<li>\u00a0\u00a0 When depression is treated:<\/li>\n<li>Pharmacotherapy and psychotherapy o Noncompliance is frequent<\/li>\n<li>Can be expensive and have unwanted side-effects<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0 Physical activity could help both prevent and treat depression<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Measurement<\/h2>\n<ul>\n<li><strong>Standard Classification Criteria \u00a0<\/strong>o <em>Diagnostic#and#Statistical#Manual#of#Mental#Disorders<\/em>\u00a0 4<sup>th<\/sup> edition, revised,<\/li>\n<\/ul>\n<p>DSM-IV-TR<\/p>\n<ul>\n<li>Other classification criteria included:\n<ul>\n<li>Research Diagnostic Criteria RDC<\/li>\n<li>International Classification of Diseases ICD-10<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0 <strong>SelfCReport Measures <\/strong><\/li>\n<\/ul>\n<ul>\n<li>Questionnaires<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Self-Report Measures<\/u><\/p>\n<ul>\n<li>The two most common and well-validated questionnaires are:<\/li>\n<li>Beck Depression Inventory o Zung Self-Rating Depression Scale<\/li>\n<li>Center for Epidemiological Studies &#8211; Depression Scale CES-D<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Research on Preventive Effects of Exercise<\/h2>\n<ul>\n<li>\u00a0\u00a0 Research shows a connection between prevalence of <strong>decreased physical activity \u00a0and increased mental health problems <\/strong><\/li>\n<li>\u00a0\u00a0 Least active individuals have the greatest incidence of mental health problems, \u00a0including symptoms of depression<\/li>\n<li>\u00a0\u00a0 Regular physical activity can help prevent mental health disorders or reduce their \u00a0risk of occurrence<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><strong>\u00a0<\/strong><\/p>\n<h2>Research on Treatment of Nonclinical Depression<\/h2>\n<ul>\n<li>\u00a0\u00a0\u00a0 Various meta-analyses have shown:<\/li>\n<\/ul>\n<ol>\n<li>Exercise resulted in <strong>decreased<\/strong> depression<\/li>\n<li>Some factors <strong>moderated <\/strong>exercise treatments effects while others did not<\/li>\n<li>Exercise was <strong>as effective as, and sometimes more effective than<\/strong>, traditional therapies<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<h2>Exercise Variables as Moderating Factors<\/h2>\n<ul>\n<li>\u00a0\u00a0\u00a0 <strong>Mode of exercise\u00a0 <\/strong><\/li>\n<li>No difference for different types of exercise<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0 <strong>Length of exercise program <\/strong><\/li>\n<\/ul>\n<ul>\n<li>Length of exercise program is not as important as \u201cjust doing it\u201d<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0 <strong>Exercise intensity <\/strong><\/li>\n<\/ul>\n<ul>\n<li>More research needed<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0 <strong>Duration or frequency<\/strong><\/li>\n<\/ul>\n<ul>\n<li>More research needed<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0 <strong>Acute vs. chronic<\/strong><\/li>\n<\/ul>\n<ul>\n<li>Both single bouts and long-term exercise reduced depression<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0 <strong>Age<\/strong><\/li>\n<\/ul>\n<ul>\n<li>Exercise decreased depression for all ages<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0 <strong>Gender<\/strong><\/li>\n<\/ul>\n<ul>\n<li>Exercise decreased depression for both genders<\/li>\n<\/ul>\n<ul>\n<li><strong>Initial level<\/strong> \u00a0o Regardless of initial depression level, all participants showed decreases in \u00a0depression<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Effectiveness of Exercise vs. Traditional Treatments<\/h2>\n<ul>\n<li>\u00a0\u00a0 Exercise is better than no treatment<\/li>\n<li>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Exercise &#8211; traditional treatments\u00a0 i.e., relaxation, psychotherapy, some medication \u00a0&#8211; \u00a0 Exercise + psychotherapy is best<\/li>\n<li>\u00a0\u00a0 Exercise is cost effective<\/li>\n<li>\u00a0\u00a0 Exercise also increases physical health, as an added benefit<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Research on Treatment of Clinical Depression<\/h2>\n<ul>\n<li>\u00a0\u00a0 Hospitalized psychiatric patients rated exercise as the most important part of \u00a0comprehensive treatment plan<\/li>\n<li>\u00a0\u00a0 Both aerobic and nonaerobic exercise result in significant psychological \u00a0improvements<\/li>\n<li>\u00a0\u00a0 Interventions should last at least 10 weeks<\/li>\n<li>\u00a0\u00a0 Patients should exercise 3-5 times per week<\/li>\n<li>\u00a0\u00a0 For patients engaging in aerobic exercise, exercise intensity should be 50 to 85\u00a0 of \u00a0maximal heart rate<\/li>\n<li>\u00a0\u00a0\u00a0 For patients doing resistance training, intensity should be 80\u00a0 of 1-RM<\/li>\n<li>\u00a0\u00a0 Exercise sessions should be 45-60 minutes in duration<\/li>\n<li>Exercise treatment &#8211; pharmacotherapy\u00a0 drug\u00a0 treatment; also &#8211; combination \u00a0drug-exercise treatment \u00a0o Follow-up study at 6 months, exercise group was more likely to be fully or \u00a0partially recovered<\/li>\n<li>\u00a0\u00a0 Exercise might reduce the level of medication needed, length of time it is needed, \u00a0and perhaps even the need for medication at all<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Consensus Statements about Exercise and Depression<\/h2>\n<ul>\n<li>\u00a0\u00a0\u00a0 Exercise can be effective as a treatment for mild to moderate depression<\/li>\n<li>\u00a0\u00a0\u00a0 Exercise may be an effective component in the treatment of severe depression<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Mechanisms of Change<\/h2>\n<ul>\n<li>\u00a0\u00a0 Anthropological Hypothesis<\/li>\n<li>\u00a0\u00a0 Endorphin Hypothesis<\/li>\n<li>\u00a0\u00a0 Monoamine and Neurogenisis Hypothesis<\/li>\n<li>\u00a0\u00a0 Mastery Hypothesis<\/li>\n<li>\u00a0\u00a0\u00a0 Affect Regulation Hypothesis\u00a0 you feel better when you exercise<\/li>\n<li>\u00a0\u00a0 Social Interaction Hypothesis<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Anthropological Hypothesis<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 Evolutionary perspective<\/li>\n<li>\u00a0\u00a0\u00a0 We are genetically predisposed to be physically active<\/li>\n<li>\u00a0\u00a0 Technology has progressed so that we no longer have to engage in vigorous activity \u00a0for our survival<\/li>\n<li>\u00a0\u00a0\u00a0 Incidences of depression have increased dramatically<\/li>\n<li>\u00a0\u00a0 By violating our genetic predisposition by being sedentary, we risk having health \u00a0problems<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Endorphin Hypothesis<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 During stress\u00a0 e.g., exercise , the body produced endorphins &#8211; natural painkillers<\/li>\n<li>\u00a0\u00a0 Increase in endorphins may reduce depression<\/li>\n<li>\u00a0\u00a0 More research is needed before firm conclusions can be reached<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Monoamine and Neurogenesis Hypothesis<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0\u00a0 Effects of exercise on depression are due to altered brain neurotransmitters<\/li>\n<li>Serotonin o Norepinephrine\u00a0 \u00a0o Epinephrine<\/li>\n<li>Dopamine<\/li>\n<\/ul>\n<ul>\n<li>\u00a0\u00a0\u00a0 Neurotransmitters involved in the regulation of emotion<\/li>\n<li>\u00a0\u00a0\u00a0 Exercise increases the rate of neurotransmitter production<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Neurogensis: \u00a0o The synthesis of new neurons in the brain, particularly in brain areas shown \u00a0to be affected by depression<\/li>\n<\/ul>\n<ul>\n<li>Exercise promotes neurogenesis by increasing levels of brain-derived neurotrophic factor\u00a0 BDNF<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Mastery Hypothesis<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 Psychological effects of exercise are derived from accomplishment or mastery felt \u00a0upon completion of a task<\/li>\n<li>\u00a0\u00a0 Individual has a sense of greater self-worth and personal control over the \u00a0environment<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><u>Social Interaction Hypothesis<\/u><\/p>\n<ul>\n<li>\u00a0\u00a0 Exercise provides an individual an opportunity to interact with others<\/li>\n<li>\u00a0\u00a0 They hypothesis may account for part of depression reduction, but it cannot be the \u00a0sole explanation<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Practical Recommendations <\/strong><\/p>\n<ul>\n<li>\u00a0\u00a0 Regular exercise can be useful in <strong>treating<\/strong> depression as well as in <strong>protecting<\/strong> \u00a0against depression<\/li>\n<li>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Monitor the exercise dosage and modify as the individual\u2019s level of fitness changes \u00a0&#8211; \u00a0 Type of exercise doesn\u2019t seem to matter; just make it enjoyable<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Mental Health \u00a0o \u201cState the successful performance of mental function, resulting in productive \u00a0activities, fulfilling relationships with other people, and the ability to adapt to \u00a0change and to cope&hellip; <a class=\"continue\" href=\"https:\/\/www.amyork.ca\/academic\/zz\/exercise\/mental-health-mental-illness-and-mental-disorders\/\">Continue Reading<span> Mental Health, Mental Illness, and Mental Disorders<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[120],"tags":[],"_links":{"self":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4657"}],"collection":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/comments?post=4657"}],"version-history":[{"count":2,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4657\/revisions"}],"predecessor-version":[{"id":4791,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4657\/revisions\/4791"}],"wp:attachment":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/media?parent=4657"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/categories?post=4657"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/tags?post=4657"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}