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Trepidation: Should we be using more than just medicine to help treat depression?

Trepidation: Should we be using more than just medicine to help treat depression?

I attended an insightful evening at SAHMRI on depression. I don’t want to sound all melancholic at the start of this blog. However, quantitatively speaking, Australia is the unhappiest country in the world (per capita). We also have the highest prescription rate/use of antidepressants in the world (per capita).

Now I am really sounding melancholic.

Why do we have high rates of depression?

I was really saddened that Australia, a wonderful, optimistic, culturally diverse nation is so depressed. Are we trying to put a band-aid on by taking an antidepressant with the notion that quote un-quote “she’ll be right mate”? Are we ill-informed by our health & medical team? Or does one think or feel that a pill is the only way to remission? Or are we literally still stuck in time?

Maybe my past tense reference was justified…

Here’s the problem…

Depression is so much more complex than the first hypothesis from the 50s, which brought us the discovery of the first antidepressant, Fluoxetine (Prozac). The problem is that all that has changed in the last forty years is that we now have ten or more antidepressants rather than just one. The reason I am so passionate about the right co-care and management is because of the side effects of these medicines. For example, the growth factors in antidepressants can contribute to obesity, another morbidity that inundates our health care system.

So what can we do to help treat depression?

Recent advances have shown that our genes can be switched off by our environment, sedentary lifestyles and psychologically stressful events.  This includes our BDNF (brain derived neurotrophic factor) genes, which are the fertilisers for our brain. They help protect and grow our neurons.  However, positively, we can also switch this gene on by exercising and meditating. Therefore our actions and choices can potentially lead to melancholy or greater health.

I guess this is more of a personal release than an education problem solving blog. Please pardon the lack of clarity/direction. But it many ways I feel this is the current position we are in.

It all starts with the little things:

  • Move more…
  • Find space, breathe, form boundaries and find silence/solitude…
  • Hug more…
  • Connect more (interpersonally)…
  • Connect with nature…
  • Nourish your body… (remember where amino acids are derived from… FOOD. And what do amino acids make? Neurotransmitters!)
Bus stop action: Finding time to exercise

Bus stop action: Finding time to exercise

The other day while driving  through the hills, I saw something that surprised me… A young guy

doing chin ups on the bus shelter, while waiting for the bus! It made me stop and think (well not

literally as I was driving!) but continue to ponder for some time; why should this have made me look

twice? Shouldn’t we live in a society where this behaviour is normal? Here is a young guy utilising

his time while waiting for public transport, instead of sitting down on his phone. I had to commend

him!

Finding time to exercise

All too often I hear people discussing the barriers to exercise, with the most common theme in each

being TIME. I get it, life gets busy! There’s family, work, friends, pets and not to mention the

unexpected events. But what would happen if we took every opportunity we had to exercise a little

more?

Take the guy at the bus stop as the perfect example, he has utilised his time and surroundings to

create an opportunity to move. Now, I know we can’t all do chin ups and we don’t all take public

transport but can you think of any time throughout your day in which you’re waiting around or could

be combining the two? Perhaps walking around the oval while your child is at footy training;

completing push ups on the kitchen sink while waiting for the kettle to boil; walking around while

talking on your mobile; taking the stairs instead of the escalator/lift; or completing sit to stands from

your office chair.

Challenge accepted

So, my challenge to you is to recognise times where you can be proactive with movement and fill

these waiting moments with ‘chin ups’ or the like! I hope to see more action at bus stops in future!

The big ‘O’ word: Osteoporosis and Exercise

The big ‘O’ word: Osteoporosis and Exercise

Osteoporosis is a global disease in which the remodelling process (replacement of new bone for the old) results in an excessive loss in bone mass. This issue here is that it leads to an increase in our fracture rate (and severity), musculoskeletal impairment and mortality.

 

Why should we care about Osteoporosis?

By 2022, it is estimated there will be 6.2 million Australians over the age of 50 with osteoporosis or osteopenia. That is a 31% increase from our 2012 figures! Improving our lifestyle factors such as eating a well balanced diet, not smoking, minimising alcohol consumption and engaging in regular exercise are the easiest and most cost effective treatments in reducing our risk. Although osteoporosis is determined primarily by genetic factors, our environmental and lifestyle choices can modify around 30% of  ourbone mass, 

Women have higher risk of osteoporosis than men. Why the gender gap?

 

Did you know that women start with a lower bone density than their male counterparts. This becomes especially evident in postmenopausal women due to the decreased levels of estrogen production. This is because estrogen helps regulate a woman’s reproductive cycle as well as plays a role in maintaining bone density.

 

So what is actually happening in our body?

Human bones are constantly changing, our old bone cells are being replaced with new cells. The removal of old bone is controlled by cells called osteoclasts, while the formation of our new bone is controlled by cells called osteoblasts. Like a simple mathematical equation, bone growth is achieved when there is higher activity of osteoblasts. This is present in children up to early adulthood, where it peaks by 20 years of age. From our 30’s  this process starts to reverse, which is why it’s so important to maintain bone strength through proper diet and physical activity.

The role of exercise in osteoporosis is well known, especially in promoting calcium intake, maintaining bone mass and strengthening the functionality your bone. Regular exercise is believed to be the most important factor to increase or maintain bone mineral density (BMD). Basically the mechanical forces placed in the skeletal system when you exercise stimulate bone size, shape and strength. 

 

So what about Osteopeania then?

Osteopenia refers to a decreased BMD, but not low enough to be classified as osteoporosis. Having osteopenia means that there is a greater risk that you may eventually develop osteoporosis.

 

Good news

Well the good news is that osteopenia is reversible. A balanced diet and regular resistance based physical activity will help slow the loss of bone density and delay or better prevent osteoporosis. So lift some weights, get some sun and eat healthy to give yourself the best chance of maintaining a healthy BMD and decreasing the risk of fracture.

Can AFLW, WBBL and W-League influence women’s health?

Can AFLW, WBBL and W-League influence women’s health?

I sat glued to my television tonight watching the first ever women’s AFL game. I am in awe! Awe of the strong, fast, resilient women who have worked exceptionally hard behind the scenes to put this spectacle on. Awe in the spectators who have come out in their thousands to watch the game and even awe in the AFL (who I have ragged on, on many an occasion) for getting the league up and running. I will add that this is also the feeling when I watch the WBBL and the netball leagues.
Now I love sport and everything it brings but I also realize sport can be perceived as just a competition where people either chase the ball or each other to win (usually just for sheep stations). For some people, sport is not very interesting (crazy, i know). But I view this momentous moment as more thatn just another game of sport. Why?
Well let’s skip forward a little bit…
Currently as it stands only 9 per cent of girls aged 12-14 year old reached the minimum daily physical activity guidelines (which is less than half of the 20 per cent of boys reaching the standard.) This decreases to 6 per cent of 15-17 year old girls. NOT GOOD!
 But I digress…
Even though women started playing competitively in the 1920’s, this game has always been regarded as a ‘man’s game’. Up until 2004, girls could play in boy’s team until 12 years of age but then that was it. They either transitioned to open women’s games or they didn’t play. Now with AFL being the biggest sport in Australia participation wise and easily the most visible in the media, saying to girls you can’t play anymore is a pretty big negative.
Now if we have the most influential sport discouraging women to stop moving, it is not surprising that research shows that girls lag behind boys in their movement skills, balance and physical activity and that the gender gap only widens as girls get older. Then those women have children and those young kids see their mum’s being inactive and the vicious cycle continues. We previously discussed this in our previous blog Do your kids see you sweat.
So yes! AFL, SOCCER, cricket, netball, softball, hockey can all help us lead the way in teaching our girls that as females sweat and strength is great. It is something to be proud of rather than embarrassed about. As parents, we need to encourage it. Whatever movement our kids want to do, aid them in anyway you can. This can help build behaviours of physical and mental health.
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Relieving the pressure: How does exercise affect your blood pressure

Relieving the pressure: How does exercise affect your blood pressure

Before we begin, I just wanted to pop these stats in front of you….
·         34% of Australians (over 18) are have high blood pressure (BP) – that’s about 6 million people
·         4.1 million Australians have uncontrolled or untreated hypertension
So, let’s answer a few commonly heard questions around iNform:

1)
 How does a bout of exercise affect my BP?
A single episode of exercise is able to reduce BP post exercise. The magnitude (−2 to −12) and duration (4 to 16 hours) vary considerably between individuals as the environment, exercise prescribed, duration of exercise and genetic components can all affect change.
Let’s get scientific for a second:
Systolic BP (the first number) refers to how much pressure goes through the arteries as the heart is contracting. We would love it to be around 120.
Diastolic BP (the second and typically smaller number) refers to the arterial pressure during the relaxation phase of the heartbeat. The recommended value is approximately 80.
When we begin exercising our systolic BP increases because we need to pump more blood around the body to deliver oxygen and get rid of waste products. Our heart rate increases and the overall amount of blood moving through the arteries increases.  Therefore the pressure the blood creates on the arteries also increases. However BP does not usually fly off the charts because our arteries dilate to allow the extra blood through and as such the resistance (and the pressure) decreases. Think of it like opening doors wider to allow more people to shop during the post-Christmas sales.  So we would tend to expect a gradual increase in systolic BP until we hit a plateau at our exercise peak. Interestingly our diastolic does not often change much except in static exercises like wall sits.
How does it work?
This happens through a variety of ways including increased hormonal activity, decrease in heart rate and nerve activity (sympathetic  – due to decrease in circulating catecholamines).
However, given the many factors in our body that help regulate our BP, it is still proving difficult to identify a single mechanism for this drop. What is important though is the beneficial effects on the body!
2) Can regular exercise help me control my high BP
The big new is yes! Regular physical exercise has been recommended for the prevention and treatment of hypertension. We have had a range of clients who begin to exercise regularly, decrease their BP and thus the decrease or even cease the medication they are on (based on GP’s clinical decision).
3) What exercise is best for individuals with high BP?
Decrements in BP have been widely found in a majority of aerobic exercise including walking, running, cycling. Resistance training is a little more controversial is it tends to exhibit greater BPs during the exercise, however it does exhibit post exercise BP decrements. Each training mode produces different effects on the body so it highly encouraged to completing both modes.
4) How long should I exercise for?
The acute decrease in BP has been observed after as little as 10 minutes and as long as 170 min of exercise, although the majority of studies have used exercise lasting between 20 and 60 min. So if time is a factor, you still gain benefits from a short bout of exercise.
To make long term changes, research shows that there seems to be a positive association to 3-5 days of exercise for approximately 30-60mins at greater than 65% intensity levels. However, just remember any type and duration will have a positive response when compared with no exercise.
5) What is the best way to work out my BP repose to exercise?
Here at iNform, if we feel it is required we measure BP pre and post (sometimes during). This happens over a course of sessions and allows us to monitor the responses to the exercise prescription. It also allows us to change intensity, duration and mode to see how these effect individuals. We find different individuals respond better to different modes so we take an individual approach to determining it.
6) What risks are there of exercising with high BP?
Both aerobic or resistance training can increase systolic BP, so ensuring that this rise does not exceed approximately is important. If systolic BP rises greater than 250 mmHg and/or diastolic BP >115 mmHg during exercise, the training session should be terminated.
Ways to decrease risk:
a) Ensuring steady breathing during exercise is important to decrease build-up of pressure in arteries. This is especially evident in resistance training
b) Completing dynamic movements rather than static exercises (such as wall sits) are important to decrease risk of excessive BP
c) Upper body exercises tend to lead to an increase BP when compared to lower body exercise, however this is not saying no upper body exercise (just be mindful).
d) Ensuring a progressive build-up of intensity during warm up and slow down when cooling down to reduce risk of sudden drops or increases.
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