Social isolation is one of the hallmarks of the world’s response to COVID-19, and it’s not likely to go away any time soon. With constant reports on the news about the physical health of those affected by the virus, it may be easy to overlook the impact on mental health of living during this time of social distancing, stay-at-home orders or even strict quarantine.
Even for those people who do not typically struggle with mental health concerns, these are trying times marked by loneliness, boredom, a lack of routine and, for many, economic insecurity. If you look below at the definitions of depression and anxiety, you may recognize some of these symptoms as things you’ve been going through in recent days. Most people I talk to seem to be struggling with disordered sleep, changes in appetite and a reduced interest in activities they used to enjoy while at home.
Of course, many people are affected by mental illness even during the best of times. According to the National Institute of Mental Health, about one in five adults in the United States is affected by mental illness each year, with depression and anxiety being the two most common disorders.
Depression is characterized by the following symptoms (American Psychiatric Association, 2013):
- Persistent negative mood
- Loss of pleasure and reduced interest in daily activities
- Lack of concentration
- Changes in sleep (insomnia or sleeping more than usual)
- Change in appetite (loss of appetite or eating too much)
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
Anxiety is characterized by nervousness, tension, fear and/or worry. It can be an acute state, meaning that it lasts for a short period of time typically in reaction to a circumstance (e.g., a job interview) and then resolves naturally, or a chronic state, meaning that a persistent pattern exists and does not resolve when a trigger goes away.
Technically speaking, the arrival of COVID-19 is an acute event, though it’s becoming clearer each day that the situation we’re all living in is a chronic stressor.
So, what can your clients do to combat feelings of anxiety and depression?
Here’s the good news…
The Role of Physical Activity and Healthy Eating in Improving Mood
While more research is needed to firmly establish the effectiveness of physical activity as a treatment for mental illness—and this blog should in no way be interpreted as a means to diagnose or treat depression or anxiety—there is a proven relationship between health behavior and mood.
If you have clients who struggle with depression or anxiety, it’s essential that you monitor the impact of behavior changes on their mood. Not everyone reacts to physical activity, healthy eating or other lifestyle changes in the same way, so it’s important that you not inadvertently exacerbate a negative response or negatively impact long-term adherence.
When it comes to exercise, a client’s mood immediately after a workout directly affects the likelihood of the client continuing with that behavior. Stated simply, no one wants to do something on a regular basis that puts them in a bad mood, so it’s essential that you help the client have an uplifting and enjoyable experience.
Another important factor to consider is exercise intensity, which has been shown to impact both mood during exercise and long-term adherence. Higher-intensity exercise tends to be more likely to worsen a client’s mood, as many people simply find very tough workouts to be unpleasant. If a client wants to perform high-intensity exercise but has told you about struggles with mental health, it’s best that they perform higher-intensity exercises early in a workout and end the session with lower-intensity movement (Zenko, Ekkekakis & Ariely, 2016).
Remind clients to monitor how pleasant or unpleasant an exercise feels, as this should guide changes in intensity (Ekkekakis, Parfitt & Petruzello, 2011). That is, if clients feel a workout is becoming unpleasant, they should lower the intensity until they begin enjoying themselves. Empowering your clients in this way, particularly if they have depression, may increase their motivation to exercise.
When it comes to healthy eating, help your clients find dietary practices or habits they feel they can stick with during these troubling times while remaining mindful of your scope of practice. Generally speaking, if people adhere to a healthy eating plan and lose weight, they are likely to experience an improvement in mood. While losing weight may not be a primary goal for many people right now, healthy eating and weight maintenance may be more meaningful and realistic goals at the moment.
It is more important than ever that health coaches and exercise professionals deliver positive and engaging experiences to their clients, so be especially vigilant about asking clients how they’ve been feeling after workouts or sessions with you and how they’ve been coping with the restrictions of their current lifestyle. Remember, delivering a positive, meaningful experience during every client interaction is a top priority.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5): Washington, D.C.: American Psychiatric Publishing.
Ekkekakis, P., Parfitt, G., & Petruzzello S.J. (2011). The pleasure and displeasure people feel when they exercise at different intensities: Decennial update and progress towards a tripartite rationale for exercise intensity prescription. Sports Medicine, 41, 641–671.
Zenko, Z., Ekkekakis, P., & Ariely, D. (2016). Can you have your vigorous exercise and enjoy it too? Ramping intensity down increases postexercise, remembered, and forecasted pleasure. Journal of Sport and Exercise Psychology, 38, 149–159.