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INTRODUCTION
By physical activity we mean any movement of skeletal muscles
that requires energy. Also, it is a movement of the body that is
made possible by the musculoskeletal system and results in energy
consumption that is greater than what the body consumes while it is
at rest. Physical activity can be doing housework, recreational
activities such as cycling or running, or going to the gym and
lifting weights [1]. Physical activity was a condition for survival,
the survival of the individual and the whole community. (Stevo
Popović). The earliest records of targeted and organized exercise
come from ancient China (2500 BC). Back then, people were encouraged
to do exercises modeled after the movements of animals (tiger) and
today our association of Kung Fu with violent fighting is wrong.
This skill actually started as medical gymnastics, and some believe
it was adapted from yoga, which was still popular in India at the
time [2].
Today, man has less and less time for these activities because
modernization has led to such conditions that everything is easier
for man. Shopping and payment are over the Internet, work is done
from home, mostly in a sitting position, and walking and physical
activity have become a luxury [3].
The Centers for Disease Control and Prevention, as well as many
other institutions, recommend that the general population, and even
people with certain medical conditions, engage in regular physical
activity. This is the best way to improve public health and prevent
disease. 30 minutes of physical activity of moderate intensity, a
couple of days a week, and ideally every day, has a positive effect
on the prevention and control of hypertension, diabetes mellitus
(insulin dependent), osteoporosis and similar conditions. But what
about mental health, ie depression? It is considered that physical
activity can be very effective for the prevention and control of
psychiatric diseases [4]. Of course, apart from physical activity,
it is important what kind of air we breathe, what kind of food we
eat and what kind of water we drink, as well as in what quantity. It
seems that these last aspects are given special importance, and we
rarely hear that physical activity is equally important [5].
Depression is defined as a mood disorder characterized by persistent
feelings of sadness and loss of interest [6]. When a person is
suffering from depression it often seems like the last thing they
want to do is any kind of physical activity, however this can be
extremely helpful. This is precisely what our work deals with.
The goal of the work
The goal of our work is to explain what depression is, how it
manifests itself and how to recognize it. We will also explain how
depression is diagnosed and how it is most often treated. The main
goal of our work is to explain what physical activity is and how it
has a positive effect on mental health, specifically on depression,
and who should engage in physical activity and to what extent. Also,
we will mention the negative sides of persistent training.
Depression
Depression is by definition a mood disorder that makes a person sad
and prone to losing interest and more often affects women. Most
people will not seek medical help, 60% because of false perceptions,
and the rest because of stigma and prejudice from the environment.
Depressive disorders are classified into five categories and each of
them is characterized by sadness, emptiness, irritable mood that can
be accompanied by somatic or cognitive changes. The categories of
depression are as follows:
- Mood regulation disorder,
- major depressive disorder,
- Persistent depressive disorder (dysthymia),
- Premenstrual dysphoric disorder,
- Depressive disorder due to another medical condition [6].
The World Health Organization estimates that the proportion of
the population (globally) that has depression is 4.4%. These are
data from 2015, which would mean that there were 322 million people
with depression at that time. Today, those numbers are much higher,
even the number from 2015 increased by 18.4% compared to 2005 [7].
In 2022, the share of depression increased by a whopping 25%, and
the main reason was the COVID-19 pandemic [8]. As we can conclude,
depression is not at all a naive problem and it is extremely
important to understand why it occurs and how it manifests itself,
in order to be able to control it properly. In our work, we will
specifically deal with major depressive disorder.
Etiology and symptoms
The etiology of major depressive disorder is multifactorial, that
is, its appearance is influenced by both genetic and environmental
factors. Depression can also occur in people who do not have a
positive family history, but the chances are three times higher in
those whose parents suffer from depression. Diseases such as
Alzheimer's or Parkinson's, stroke, cancer, chronic pain or similar
conditions increase the chances of developing depression. Most
people react badly to the loss of a close person or some unfavorable
situation in life, so this can also be a reason for depression [6].
Symptoms of depression can be:
Common symptoms of depression include:
- Constantly sad, anxious or "empty" mood,
- Feelings of hopelessness or pessimism,
- Feeling irritable, frustrated or restless,
- Feelings of guilt, worthlessness or helplessness,
- Loss of interest or pleasure in hobbies or activities,
- Decreased energy (fatigue),
- Difficulty concentrating, remembering or making decisions,
- Difficulty sleeping, early morning awakening or
oversleeping,
- Changes in appetite or unplanned weight changes,
- Pain, headaches, cramps, or digestive problems with no clear
physical cause and that are not relieved even by treatment
- Suicide attempts or thoughts of death or suicide.
For a person to be diagnosed with depression, they must have five
symptoms every day, almost all day, for at least 2 weeks. One of the
symptoms that must occur is a depressed mood or loss of interest in
all activities. It is important to distinguish between irritability
and depression [9].
Physical activity and depression
Depression is usually treated with medication, psychotherapy, or a
combination of both. What kind of therapy will be depends solely on
the severity of the symptoms and the depression itself [9]. However,
sometimes the drugs do not have the desired effect, but have a
counter-effect and the patient falls into even greater mental
problems. Few people know the impact of regular physical activity on
mental health, and even fewer know how physical activity can affect
depression.
The positive impact of physical activity on the prevention and
control of physical diseases is clear, and today there is increasing
interest in the impact on mental health and depression [5]. Even a
large number of studies have proven the positive effects of exercise
on mental health, and one even showed that regular physical activity
significantly reduces the risk of depression. Even a single exercise
session has also been proven to improve mood and reduce symptoms of
depression [1].
Physical activity is a cheap and effective solution for all people
who suffer from depression or simply want to preserve their mental
health, and at the same time do not want to take medication. One
study showed that people who exercise continuously for a couple of
years have a 22% lower risk of mental illness. It is very important
to understand that you should not engage in physical activity only
if you are at risk of developing depression, or if you already have
a diagnosis. Even if you're in a bad mood, exercise can help you
feel better and alleviate feelings of sadness or loneliness, while
also helping you sleep better [5].
Mechanism of action and recommended dose of exercise
The mechanism of the beneficial effect of regular physical activity
on depression is described as follows:
- distraction,
- Social contact and
- Self-efficacy.
The effect of distraction is explained by the fact that a person
diverts attention from unfavorable stimuli during and after exercise
and directly improves mood. The effect of self-efficacy is reflected
in the fact that the physical activity itself is a challenge for the
individual and the ability to successfully perform it leads to an
improvement in mood and an increase in the sense of self-confidence.
Social interaction is perhaps the most obvious, given that we
previously stated that people with depression are often isolated and
have no desire for interactions or any activities. Interacting with
others helps them have someone to talk to and gives them support.
Apart from these three mechanisms, the effect of physical activity
on depression is also reflected in the release of hormones. During
exercise, the neurotransmitter monoamine is secreted, and its
synaptic transmission increases and is said to function as an
antidepressant. The hormone endorphin (enogenic opioid), which is
secreted during exercise, causes a feeling of calmness and improves
mood [4].
Different studies have shown different results and most have come to
the conclusion that you should train five times a week. The
recommended time and duration of exercise varied, some suggested 150
minutes a week, some more than 240 and so on [10]. However, the
duration of physical activity is less important in our opinion. What
is important is that the person focuses as much as possible on that
physical activity and applies it regularly. The positive physical
and mental effects will be apparent after a while, but it is also
equally important that a person eats healthy and drinks enough
water.
Excessive exercise and the impact on mental health
For some people, physical activity turns into an obsession, that is,
they become preoccupied with training, which can affect the psyche
and personal and professional relationships. As a consequence of
this obsession, a person can develop eating disorders, muscle
dysmorphia (dissatisfaction with appearance), use of anabolic
steroids, obsession with intense training, mood disorders, cycle
disorders in women and simply too much training [4]. It is important
to listen to your body and do only what pleases the person and makes
him feel better.
Conclusion
From all of the above, we can conclude that regular and proper
physical activity can help prevent many diseases, as well as
depression. However, it can be harmful at the same time if a person
overdoes it and does not implement it properly. You should choose
physical activities that you genuinely enjoy, that suit your
lifestyle, and it is always advised that they be outside in nature.
Depression is not a naive condition and it is important to have
enough real information to be able to recognize it in time. For all
people who suffer from depression or have some other psychological
problem, it is advised that in addition to physical activity, they
have the following:
- enough sleep,
- Regular and healthy meals,
- Avoiding alcohol, nicotine, drugs, even medicines not
prescribed by a doctor.
Regular physical activity can improve mood and is especially
beneficial for mild to moderate depression.
Every type of activity is useful, but only when it is done
continuously and if it is not overdone. It may sound like a
difficult process, but it is necessary to find the motivation and
start yourself.
LITERATURE:
- Lazarević U, et al. “Influence of Physical Activity on
Degree of Depression, Anxiety and Stress in Students of
University of Belgrade - Faculty of Medicine.” Sport - Nauka i
Praksa, 2021;11(2): 57–66. doi:10.5937/snp2102057l.
- MacAuley D. “A History of Physical Activity, Health and
Medicine.” Journal of the Royal Society of Medicine,
1994;87(1):32–35. doi:10.1177/014107689408700114.
- Krivokapic D, Popovic S.. Uticaj rekreativnih aktivnosti na
psihičko zdravlje.2011. Dostupno na:
https://www.researchgate.net/publication/318723266_Uticaj_rekreativnih_aktivnosti_na_psihicko_zdravlje
- Aurélio M., et al. “Physical Activity and Mental Health: The
Association between Exercise and Mood. Scielo. Br,
2005;60(1):61-70. Dostupno na:
https://www.scielo.br/j/clin/a/nJtsYg7cXYppsF7VZ7hhHXw/?format=pdf&lang=en.
- Ostojic S. Stojanovic M. Veljović D, Medjedovic B.at al.
FIZIČKA AKTIVNOST I ZDRAVLJE: Definicija problema, savremena
zapažanja i preporuke. 2009;3:1-13.
- Chand S.P., Hasan A. Depression. StatPearls Publishing,
2022.
- Depression and Other Common Mental Disorders. (WHO) Dostupno
na:
https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf
- “COVID-19 Pandemic Triggers 25% Increase in Prevalence of
Anxiety and Depression Worldwide.” Who.int, Dostupno na:
https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide.
Accessed 19 Feb. 2023.
- National Institute of Mental Health. Depression. Dostupno na:
https://infocenter.nimh.nih.gov/sites/default/files/2022-01/depression.pdf
- Mammen G. Faulkner G.. Physical Activity and the Prevention
of Depression A Systematic Review of Prospective Studies.
American journal of preventive medicine. 2013;45(5):649-57. DOI:
10.1016/j.amepre.2013.08.001.
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