The Complete Guide to Physical Activity and Mental Health

Debbie Lawrence, Sarah Bolitho

• Publisher: Bloomsbury Sport
• Year: 2015
• Print ISBN: 9781408140215
• eBook ISBN: 9781408196465
• Edition: 1
• Topic: Biological Sciences
• Subtopic: Sport & Exercise Science
• Index: Biological Sciences

The Complete Guide to Physical Activity and Mental Health is a practical guide for fitness instructors working with clients with mental health issues. The book looks at the signs and symptoms, treatment plans and how to approach developing an exercise programme for a range of mental health conditions. From depression, stress, anxiety and eating disorders this book offers background information on the prevalence and various available treatment of each condition discussed. Clearly illustrated throughout with a section examining the specific symptoms and causes of a range of mental health conditions, it will provide fitness professionals all they need when planning an exercise programme to suit their clients. Written in an accessible style by a well-established consultant in the fitness industry, it will appeal to exercise instructors, and fitness professionals working towards the New Level 4 qualification. Including real-life case studies, advice on communication and development strategies when working with clients, this book puts theory into practice.

MENTAL HEALTH AND PHYSICAL ACTIVITY

Mental health is an aspect of our total health that is often taken for granted. We share our happy days and good moods and we celebrate our successes and joys. However it is a different story when we are feeling sad, grumpy or in emotional pain. Somehow these equally valid and important emotions are considered wrong, unpleasant and shameful. People are keen to share their happiness but all too often the less ‘happy’ emotions become internalised and locked away, unwanted and untreated.

This part aims to explore the concept of mental health and mental ill-health and to examine some of the theories surrounding mental health conditions. Also discussed are the more frequently encountered conditions, possible causes and available treatments, including activity.

The benefits of activity for mental health and the recommendations for participation are discussed and also examined are the barriers that exist, both internally and externally, that hinder the adoption of and adherence to physical activity.

It is hoped that this section will inspire you to consider your own mental health and to investigate your feelings about mental illness. As fitness professionals we have a role to play not only in promoting activity among individuals with mental health problems but also in developing awareness and understanding in others.

‘During depression the world disappears. Language itself. One has nothing to say. Nothing. No small talk, no anecdotes. Nothing can be risked on the board of talk. Because the inner voice is so urgent in its own discourse: How shall I live? How shall I manage the future? Why should I go on?’

– Kate Millett (1991) The Loony Bin Trip, Virago Press Ltd, UK

‘Mental illness is nothing to be ashamed of, but stigma and bias shame us all.’

– Bill Clinton

This chapter introduces the concepts of mental health and mental illness. It outlines some definitions of mental health from varied and respected sources and introduces some of the factors that will affect our perception of what is considered normal and what is considered abnormal. With regard to mental health, this would include the beliefs, thoughts, attitudes, feelings/emotions, sensations and behaviours that are deemed as normal within our environment. These attitudes and beliefs will affect how we treat others with mental health conditions, also the regard in which we hold, and the value we place on, our own mental health.

This chapter also introduces some of the psychological models used to diagnose and treat mental health conditions. It outlines the criteria used by the medical classification system (DSM) and identifies some criticisms of this approach, setting the scene for a more integrative approach to working with clients with mental health conditions.

Ultimately, chapter 1 serves as an introduction to some of the themes and issues that will be revisited throughout the rest of the book.

OBJECTIVES

By the end of this chapter, you should be able to:

• recognise some of the factors that contribute to the perception of what is normal/abnormal (thoughts, beliefs, attitudes, emotions, behaviours etc.) mental health;

• recognise the psychological models and medical classification system used to define, diagnose and treat mental health conditions; and

• recognise the integrative model as a holistic method.

DEFINING MENTAL HEALTH AND MENTAL ILLNESS

The terms ‘mental health’ and ‘mental illness’ probably conjure up a variety of images and hold different meanings for different people. If asked to answer the questions ‘what is mental health?’ and ‘what is mental illness?’ we may struggle to find clear definitions. Although our minds may be drawn to media and movie images depicting acts of behaviour that we may define as normal or abnormal in our world, Webster’s New World Dictionary (4th edn., 1998) offers the following definitions:

• Mental: ‘Pertaining to the mind. Effected by or due to the mind’

• Health: ‘Soundness of any living organism. General condition of the body or mind, as to vigour and soundness’

• Illness: ‘The state of being out of health. An ailment, sickness. Badness; evil’

These definitions provide a starting point, but in no way capture the wholeness of mental health, which is the more modern concept. Arguably, they may capture the essence of some of the generalised beliefs that exist with regard to mental illness – that it is abnormal, bad, evil, a taboo of society. Indeed, mental illness is a concept that has been recognised for centuries and throughout all civilisations and has been attributed to numerous causes, including witchcraft and possession by demonic spirits.

A number of organisations have offered definitions of mental health. The Health Education Authority (1997:5) describes being mentally healthy as having: ‘... the emotional and spiritual resilience which enables us to enjoy life and survive pain, disappointment and sadness. It is a positive sense of well-being and an underlying belief in our own and others’ dignity and worth’

The Mental Health Foundation defines mental health as: ‘A state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.’ (See www.mentalhealth.org.uk for more information.)

In keeping with these definitions, Jackson and Hill, eds (2006:5) emphasise good mental health as the ability to:

Good mental health (Jackson and Hill, eds, 2006:5)

• Start, keep and if necessary, end relationships

• Work or attend college/school

• Look after oneself and others

• Sleep

• Laugh and cry

• Eat

• Avoid problems with substances

• Deal with what others think about you

• Accept failure and deal with success

• Function sexually, if wished

• Learn

• Deal with loss

• Express good feelings

• Manage negative feelings

Figure 1.1 Single continuum model of mental health

NORMAL OR ABNORMAL MENTAL WELL-BEING

The continuum model indicates that mental health and mental ill-health are single dimensional entities. Using this model, classification of an individual’s mental well-being would probably teeter somewhere between the polar extremes of what psychiatric experts might refer to as being functional (healthy) and dysfunctional (not healthy). This relates to thinking, perception, responding, behaviour, personality, intellect and emotion; those aspects of functioning that are not specific to a bodily or physiological system, such as gastrointestinal and respiratory functioning (Daines et al., 1997) (see Figure 1.1).

However, there is no clear, single boundary that creates a defining point between what is considered positive mental health and what is considered mental ill-health or mental illness.

A psychiatrist generally uses the term ‘mental illness’ when there are a clear range of signs and symptoms (referred to as a ‘syndrome’) present and where there is a distinct deterioration in the person’s functioning (Daines et al., 1997). Some of the factors that contribute to the controversy of defining where the ‘cut-off point’ is are introduced later in this chapter (see here), along with references to the classification systems currently used to assess mental health.

An alternative model to the single continuum model is the dual continuum model. This model reflects a shift in awareness in that health is not merely the absence of disease or illness; it is more than that. This model accepts that a ‘mentally healthy person can become depressed under certain circumstances; just as a physically healthy person can acquire an injury or infection’ (Jackson and Hill, 2006:3). It also indicates that a person with a diagnosis of a mental health condition can function quite normally, provided they...

Table of contents

• Cover
• Title page
• Table of Contents
• Foreword
• Introduction
• Part 1 Mental health and physical activity
• 1 What is mental health?
• 2 Mental health conditions
• 3 The benefits of exercise
• Part 2 Motivation, behaviour change and communication
• 4 Motivation
• 5 Behaviour change
• 6 Communication
• Part 3 Working with clients
• 7 Roles, responsibilities and boundaries
• 8 Assessing client needs
• 9 Design, delivery and adaptation
• Appendices
• Glossary of terms
• References
• Acknowledgements
• eCopyright