Influence Of Psychotherapy And Gender On Depression

1.0. INTRODUCTION 

This study will be centered on influenced of psychotherapy and gender on depression. But the type of psychotherapy that was used in this study was positive self-talk and exercise. Self-talk can be defined as what people say to themselves with particular emphasis on the words used to express thoughts and beliefs about oneself and the world to oneself. Positive self-talk are those words people say to themselves for encouragement.

Exercise can be defined as an activity or a task that trains the body or the mind. We have two types of exercise namely Isotomic and Isometric exercise. Isotomic exercise involves moving a muscles through long distance against low resistance as in running. While Isometric exercise involves moving a muscles through a short

distance against a high resistance as in body budding, wrestling, boxing and press up etc.

 We also have Aerobic exercise. Aerobic exercise are those exercise that help to increase cardiovascular fitness by improving the body’s use of oxygen and allowing the heart to work less strenuously.  Aerobic exercise include running, cycling, swimming and dancing.  Depression is a mood disorder that is characterized by emotional, physiological/behavioural and cognitive symptoms.

Emotional Symptoms

1. Sadness 

2. Depressed mood

3. Anhedonia (lost of interest or pleasure in usual activity)

4. Irritability (particularly in children and adolescents)

Physiological and behavioural symptoms 

1. Sleep disturbances (hypersomnia or insomnia)

2. Appetite disturbances 

3. psychomotor retardation or agitation) 

4. Catatonia (unsual behaviours ranging from complete lack of

movement to excited agitation)

5. fatigue and loss of energy

Cognitive Symptoms 

1. Poor concentration and attention 

2. Indecisiveness 

3. Sense of worthlessness or guilt 

4. Poor self-esteem 

5. Hopelessness 

6. Suicidal thoughts  

7. Delusion and hallucinations with depressing themes.

For some time now, it has been common knowledge that exercise is good for one’s physical health. It has only been in recent years, however, that it has become commonplace to read in magazines and health newsletters that exercise can also be of value in promoting sound mental health. Although this optimistic appraisal has attracted a great deal of attention, the scientific community has been much more cautious in offering such a blanket endorsement. Consider the tentative conclusions from the Surgeon General’s report on Physical Activity and Health (PCPEFS Research Digest, 1996) that “physical activity appears to relieve symptoms of depression and anxiety and improve mood” and that “regular physical activity may reduce the risk of developing depression, although further research is needed on this topic”.

 The use of carefully chosen words, such as “appears to” and “may” illustrate the caution that people in the scientific community have when it comes to claiming mental health benefits derived from exercise. Part of the problem in interpreting the scientific literature is that there are over 100 scientific studies dealing with exercise and depression or exercise and anxiety and not all of these studies show statistically significant benefits with exercise training. The paucity of clinical trial studies and the fact that a “mixed bag” of significant and non-significant findings exists makes it difficult for Scientifics to give a strong endorsement for the positive influence of exercise on mental health. There is no doubt that the mental health area variables associated with sound mental health. However, until

these clinical trial studies materialize, there is still much that can be done to strengthen statements made about exercise and mental health.

 What evidence would prompt some Scientifics to “stick their neck out” in favour of more definitive statements? One reason for  greater optimism is the recent appearance of quantitative reviews (i.e. meta-analyses) of the literature on a number of summaries of results across studies. By including all published and unpublished studies and combining their results, statistical power is increased.

Another advantage of using this type of review process is that a clearly defined sequence of steps is followed and included in the final report so that anyone can replicate the studies. Two additional advantages that meta-analysis has over other types of reviews include: 

(a) The use of a quantification technique that gives an objective estimate of the magnitude of the exercise treatment effect; and 

(b) Its ability to examine potential moderating variables to determine if they influence exercise – mental health relationships.

 Given these advantages, this paper will focus primarily on results derived from large-scale meta-analysis reviews. 

ANXIETY REDUCTION FOLLOWING EXERCISE

It is estimated that in the United States approximately 7.3% of the adult population has an anxiety disorder that necessitates some form of treatment (Regier 1988). In addition, stress-related emotions, such as anxiety, are common among healthy individuals (Cohen, Tyrell, & Smith, 1991). The current interest in prevention has heightened interest in exercise as an alternative or adjunct to traditional interventions such as psychotherapy or drug therapies.

Anxiety is associated with the emergence of a negative form of cognitive appraisal typified by worry, self-doubt, and apprehension. According to Lazarus and Cohen (1977), it usually arises in the face of demands that tax or exceed the resources of the system of … demands to which there are no readily available or automatic

adaptive responses” (p. 109). Anxiety is a cognitive phenomenon and is usually measured by questionnaire instruments. These questionnaires are sometimes accompanied by physiological measures that are associated with heightened arousal/anxiety (e.g. heart rate, blood pressure, skin conductance, muscle tension).

A common distinction in this literature is between state and trait questionnaire measures of anxiety. Trait anxiety is the general predisposition to respond across many situations with high levels of anxiety. State anxiety, on the other hand, is much more specific and refers to the person’s anxiety at a particular moment.

Although “trait” and “state” aspects of anxiety are conceptually distinct, the available operational measures show a considerable amount of overlap among these subcomponents of anxiety (Smith, 1989).   For meta-analytic reviews of this topic, the inclusion has been criterion which has been included in the review. Studies with

experiment-imposed psychosocial stressors during the post exercise period have not been included since this would confound the effects of exercise with the effects of stressor (e.g., Stoop color-word test, active physical performance). The meta-analysis by Schlicht (1994), however, included some stress-reactivity studies and therefore was not interpretable.

Landers and Petruzzello (1994) examined the results of 27 narrative reviews that had been conducted between 1960 and 1991 and found that in 81% of them the authors had concluded that physical activity/fitness was related to anxiety reduction and depression following exercise and there was little or no conflicting data presented in these reviews. For the other 19%, the authors had concluded that most of the findings were supportive of exercise being related to a reduction in anxiety, but there were some divergent results. None of these narrative reviews concluded that there was no relationship.

There have been six meta-analyses examining the relationship between exercise and anxiety reduction (Calfas & Taylor, 1994; Kugler, Seelback, & Kruskemper, 1994; Landers & Petruzzello, 1994; Long & van Stavel, 1995; McDonald & Hodgdon, 1991; Petruzzellor, Landers, Hatfield, Kubitz, & Salazar, 1991). These meta-analyses ranged from 159 studies (Landers & Petruzzello, 1994; Petruzzello et al., 1991) to five studies (Calfas & Taylor, 1994) reviewed. All six of these effects ranged from “small” to “moderate” in size and were consistent for trait, state, and psychophysiological measures of anxiety. The vast majority of the narrative reviews and all of the meta-analytic reviews support the conclusion that across studies published between 1960 and 1995 there is a small to moderate relationship showing that both acute and chronic employed (i.e., state, trait or psychophysiological), the intensity or the duration of the exercise, the type of exercise paradigm (i.e. acute or chronic), and the scientific quality of the studies.

Another meta analysis (Kelley & Tran, 1995) of 35 clinical trial studies involving 1,076 subjects has confirmed the psychophysiological findings in showing small (-4/03), but statistically significant, post exercise reductions for both systolic and diastolic blood pressure among normal normotensive adults.