Even recently, much of western medical care has treated ailments of
the mind and the body as separate fields of study, in a sort of
Cartesian dualism. As Timothy Smith points out, "...minds are [too
often] left to psychologists and psychiatrists, whereas bodies are the
business of other medical specialties and related health disciplines
(Smith, 2006)." Recent research in the fields of health psychology,
psychosomatic medicine, neuropsychology and behavioural medicine,
however, supports the usefulness of the biopsychosocial health model.
The simple fact that mentally ill people experience increased rates of co-morbid medical conditions — and die at higher rates from them, as well — is enough to challenge the validity and usefulness of the health system’s separate silos. For instance, the mind–body connection is exemplified well by the grim reality that cardiovascular disease is the major contributor to excess mortality in people with schizophrenia (Casey & Hansen, 2003). Similarly, people with depression and anxiety are at increased risk for developing cardiovascular disease (Suls & Bunde, 2005) and vice versa: People with this physical illness are at increased risk for clinically relevant emotional disorders. Moreover, the realization that people with cardiovascular disease have a worse prognosis if they also have depression (Smith & Ruiz, 2002) strengthens our understanding of the mind–body interconnection. Evidence increasingly suggests that similar relationships exist between mood disorders and various medical ailments (Evans et al., 2005), such as with HIV/AIDS (Stringer, 2005).
Although a notable number of longitudinal and cross-sectional research studies converge on the usefulness of physical activity as a preventative strategy and adjunct treatment for mental illness, the issue still seems unsettled in the eyes of many practitioners and patrons. One reason for this may be the rather cautious and ambiguous clinical recommendations of certain studies that actually found significant positive results. For instance, in their review of 14 randomized, controlled trials concerning the effectiveness of physical activity in the management of depression, Lawlor and Hopker (2001, p. 767) found that the effect of exercise was similar to that of cognitive therapy. Yet, their conclusion was that "the effectiveness of reducing symptoms of depression cannot be determined because of a lack of good-quality research on clinical populations with adequate follow-up." Guy Faulkner is one to challenge such conclusions while at the same time addressing relevant issues about some studies' methodological weaknesses. As he wittily remarked in one of his lectures, "...the placebo effect is a boon to therapy but the bane of research" (Faulkner, 2006). Along the same line of thought, Llewelyn and Hardy (2001) reminded us that "We know psychotherapy is effective, but we also know that different and apparently contradictory theoretical approaches are approximately equally effective in outcome, but very different in content."
Understandably, it pays a researcher to be cautious; the body of research on the impacts of physical activity upon mental health has its gaps. However, as Sir Austin Bradford Hill insightfully pointed out in 1965, “… all scientific work is incomplete — whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us as a freedom to ignore the knowledge we already have, or to postpone the action that it appears to demand at a given time” (Hill, 1965, p. 299).
The basis for the Minding Our Bodies: Physical Activity for Mental Health project is that the research evidence for physical activity’s beneficial effects upon people’s physical and mental health is convincing. Physical activity has been reported to help with a wide spectrum of issues ranging from self-esteem and sense of social inclusion to clinical disorders such as schizophrenia, depression, and anxiety. Overall, there seem to be four avenues for these effects: prevention of poor mental health; improvement in mental health; treatment of mental disorders; and improvement in the quality of life of persons with mental illnesses.
The simple fact that mentally ill people experience increased rates of co-morbid medical conditions — and die at higher rates from them, as well — is enough to challenge the validity and usefulness of the health system’s separate silos. For instance, the mind–body connection is exemplified well by the grim reality that cardiovascular disease is the major contributor to excess mortality in people with schizophrenia (Casey & Hansen, 2003). Similarly, people with depression and anxiety are at increased risk for developing cardiovascular disease (Suls & Bunde, 2005) and vice versa: People with this physical illness are at increased risk for clinically relevant emotional disorders. Moreover, the realization that people with cardiovascular disease have a worse prognosis if they also have depression (Smith & Ruiz, 2002) strengthens our understanding of the mind–body interconnection. Evidence increasingly suggests that similar relationships exist between mood disorders and various medical ailments (Evans et al., 2005), such as with HIV/AIDS (Stringer, 2005).
Although a notable number of longitudinal and cross-sectional research studies converge on the usefulness of physical activity as a preventative strategy and adjunct treatment for mental illness, the issue still seems unsettled in the eyes of many practitioners and patrons. One reason for this may be the rather cautious and ambiguous clinical recommendations of certain studies that actually found significant positive results. For instance, in their review of 14 randomized, controlled trials concerning the effectiveness of physical activity in the management of depression, Lawlor and Hopker (2001, p. 767) found that the effect of exercise was similar to that of cognitive therapy. Yet, their conclusion was that "the effectiveness of reducing symptoms of depression cannot be determined because of a lack of good-quality research on clinical populations with adequate follow-up." Guy Faulkner is one to challenge such conclusions while at the same time addressing relevant issues about some studies' methodological weaknesses. As he wittily remarked in one of his lectures, "...the placebo effect is a boon to therapy but the bane of research" (Faulkner, 2006). Along the same line of thought, Llewelyn and Hardy (2001) reminded us that "We know psychotherapy is effective, but we also know that different and apparently contradictory theoretical approaches are approximately equally effective in outcome, but very different in content."
Understandably, it pays a researcher to be cautious; the body of research on the impacts of physical activity upon mental health has its gaps. However, as Sir Austin Bradford Hill insightfully pointed out in 1965, “… all scientific work is incomplete — whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us as a freedom to ignore the knowledge we already have, or to postpone the action that it appears to demand at a given time” (Hill, 1965, p. 299).
The basis for the Minding Our Bodies: Physical Activity for Mental Health project is that the research evidence for physical activity’s beneficial effects upon people’s physical and mental health is convincing. Physical activity has been reported to help with a wide spectrum of issues ranging from self-esteem and sense of social inclusion to clinical disorders such as schizophrenia, depression, and anxiety. Overall, there seem to be four avenues for these effects: prevention of poor mental health; improvement in mental health; treatment of mental disorders; and improvement in the quality of life of persons with mental illnesses.
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