Depression and Leisure time physical activity (LTPA)

About 27% of college students reported being diagnosed with depression, according to the spring 2023 American College Health Association National College Health Assessment survey (1).

A recent study looked at how depression could be impacted by leisure time physical activity as the semester progresses (2).

Who was studied? (2)

488 1st and 2nd year college students

What was the studied?

  • Depression was measured using the patient health questionnaire 9, a validated instrument to measure depression (3).
  • Leisure time physical activity was measured using the Godin-Shephard Leisure Time Physical Activity Questionnaire (4)
  • The key question asked was:  “During a typical 7-day period (a week), how many times on average do you do the following kinds of exercise for more than 15 min during your free time?” and then they respond to PA intensity related statements:
    • Vigorous-intensity LTPA (heart beats rapidly), such as running, soccer, vigorous swimming;
    • Moderate-intensity LTPA (not exhausting), such as tennis, easy swimming, folk dancing; and
    • Light-intensity LTPA (minimal effort), such as badminton, walking, yoga, bowling.

What were the results?

  • The study found that increasing light-intensity LTPA could decrease the elevation in depressive symptoms over time, regardless of initial level, when also accounting for covariances.
  • Surprisingly, vigorous and moderate intensity LTPA did not alter the depression slope as the semester progressed.

What are some caveats?

  • This is 1 small study.
  • Further research is needed.
  • Study population was College students at a university in China, which may not generalize to students in other countries.
  • Results relied on self report and may not match objective measures of activity.

Other resources:

https://ccs.osu.edu/outreach-and-education/outreach/campus-events/recess

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By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. American College Health Association. American College Health Association-National College Health Assessment III: Reference Group Executive Summary Spring 2023. Silver Spring, MD: American College Health Association; 2023.
  2. BoShen , Gaoyuan Cui & Jin Bo (2023) How does change in leisure-time physical activity influence the growth trajectory of depressive symptoms in college students?, Journal of American College Health, DOI: 1080/07448481.2023.2252503
  3. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613. doi:10.1046/j.1525-1497.2001.016009606.x.
  4. Godin G, Shephard RJ. Godin leisure-time exercise questionnaire. Med Sci Sports Exerc. 1997;29:36–38.

“Smart” drugs might NOT always help with focus

Stimulant medications like methylphenidate, dextroamphetamine, and related drugs are often prescribed for adhd (attention defecit hyperactivity disorder).

For individuals with adhd, these medications can be useful, particularly when combined with addressing other mental and physical health conditions that could be impacting focus, and reasonable nutrition, sleep, activity level, study/organizational skills, and healthy ways of using technology.

A recent set of studies looked at whether these  medications help if you do NOT have adhd.

What were the studies? (1)

  • Elizabeth Bowman and colleagues  four double-blinded, randomized  trials, each a week apart, the same 40 healthy participants took one of three popular ‘smart’ drugs (methylphenidate, modafinil, or dextroamphetamine) or a placebo (1).
  • They were assessed on how they performed in a test designed to model the complex decision-making and problem-solving present in everyday lives (1).
  • The exercise known as the Knapsack Optimisation Problem.  In this test, they were given a virtual knapsack with a set capacity, and a selection of items of different weights and values (1).
  • The participants had to figure out how to best allocate items to the bag, to maximize the overall value (1).

What were the results? (1)

  • Overall, participants without adhd and taking methylphenidate, dextroamphetamine, modafinil, and related medications:
  • Small DECREASE in accuracy and efficiency (1).
  • Large INCREASE in time and effort, relative to their results when not taking the medications (1).
  • When given methylphenidate non adhd participants took around 50% longer on average to complete the knapsack problem as when they were given a placebo (1).
  • Participants without adhd became less productive when given methylphenidate (1).
  • The study authors found that, while motivation increased, it led to more erratic thinking (1).

Additional thoughts:

  • Further research is needed on the cognitive effects and performance impact of adhd medications on people without adhd.
  • Whether or not one has adhd, adequate sleep, nutrition, activity level, and organizational skills can help improve  cognitive/academic performance.
  • In my experience, addressing co-existing physical and mental health conditions can also help improve focus and if you also have adhd, potentially reduce how much medication you need while maximizing benefit.

The following post discusses strategies to improve attention:

https://u.osu.edu/emotionalfitness/2021/03/30/strategies-to-improve-attention/

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

 

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

Reference:

  1. Elizabeth Bowman et al. ,Not so smart? “Smart” drugs increase the level but decrease the quality of cognitive effort.Sci. Adv.9,eadd4165(2023).DOI:10.1126/sciadv.add4165

 

Sedentary Behavior Activity/exercise and Anxiety

Anxiety is associated with sedentary behavior, according to a review of 31 studies (1).

They defined sedentary behavior as low levels of energy expenditure (1.0 to 1.5 of metabolic equivalent of task [MET]), usually occurring while sitting, during work or leisure activities, including screen behaviors (e.g., TV watching), hobbies (e.g., reading books), lying down, in transit, or during driving a car (1,2,3).

What was the study? (1)

The study authors (1) did a systematic review and found k = 31 original studies (total N = 99,192 ) and k= 17 (total N = 27,443) in a meta-analysis.

What were the results? (1)

The authors (1) concluded that higher levels of SB are associated with higher levels of anxiety symptoms.

A separate systematic review found exercise as helpful for anxiety (7).

What is a reasonable amount of activity or how much should I exercise?

The recommended exercise or activity duration according to The Department of Health and Human Services’ “Physical activity guidelines for Americans” (5, 6):

  • For moderate intensity activity, 20 to 42 minutes a day (150minutes to 300 minutes per week).
  • For vigorous intensity activity, 10 to 21 minutes a day (75 to 150 minutes a week).

What are some examples of moderate and vigorous intensity activities (exercise) ? (6)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What are some precautions?

  • It may be best to check with your healthcare provider to make sure it’s safe for you’re to start an exercise program.
  • Individuals with a history of disordered eating or disordered exercise should check with their health professional before exercising.
  • It may be wise to stop exercise and seek professional help if you notice:
    • Increased depression, disordered eating, and other mental health concerns due to exercise.
    • Injury, pain, or decreased motivation
    • Obsessive behaviors
    • Other symptoms.
  • Exercise may not help without proper nutrition, so it may be wise to learn about proper nutrition and proper exercise technique, and exercise/nutrition plans, before starting to exercise.
  • It may be helpful to gradually start exercising to give yourself time to adjust to an active lifestyle.
  • It might take weeks months or longer for some people to get used to and enjoy the minimum activity guidelines.
  • Occasional weeks without exercise or light activity may be important to prevent injury.
  • Figuring out what works best for you may give you lasting benefits.

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Stanczykiewicz, B., Banik, A., Knoll, N. et al. Sedentary behaviors and anxiety among children, adolescents and adults: a systematic review and meta-analysis. BMC Public Health 19, 459 (2019). https://doi.org/10.1186/s12889-019-6715-3
  2. Tremblay MS, Colley RC, Saunders TJ, Healy GN, Owen N. Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab. 2010;35(6):725–40. https://doi.org/10.1139/h10-079.
  3. Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev. 2010;38(3):105–13. https://doi.org/10.1097/jes.0b013e3181e373a2.
  4. Pate RR, O’Neill JR, Lobelo F. The evolving definition of “sedentary”. Exerc Sport Sci Rev. 2008;36(4):173–8. https://doi.org/10.1097/jes.0b013e3181e373a2.
  5. https://www.cdc.gov/physicalactivity/basics/adults/index.htm
  6. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
  7. Stonerock, Gregory L. et al. “Exercise as Treatment for Anxiety: Systematic Review and Analysis.” Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 49.4 (2015): 542–556. PMC. Web. 9 May 2018.