Physical therapy is an obvious choice when you’ve injured your shoulder, sprained an ankle or are battling low back pain. But did you know that PTs are also trained to recognize the signs and symptoms of anxiety, depression and other mental health conditions?
According to current guidelines, depression includes experiencing five or more of the following symptoms:
- Sleep disturbance
- Interest/pleasure reduction
- Guilt feelings or thoughts of worthlessness
- Energy changes/fatigue
- Concentration/attention impairment
- Appetite/weight changes
- Psychomotor disturbances
- Suicidal thoughts
- Depressed mood
Some of these symptoms may be surprising, and it’s not uncommon for people to live with depression without a diagnosis or therefore a plan for treatment.
As a student in the final semester of my eight-year physical therapy education, I experienced this firsthand. I had never been one who felt extreme anxiety or depression before, but suddenly I was.
It started with diet changes while moving around for internships. Then, I developed a bad cough. Sleep became scarce. I was coughing nearly all night, and exhausted all day. Soon, my instructor told me that she did not feel I was performing at the level required. I was shocked and afraid. If I failed the internship, I failed the whole program. I worried that I would be saddled with my student loan debt with nothing to show for it, and no way to support my young family.
Though I didn’t recognize it for what it was at the time, the symptoms I was experiencing, and those that were to come, pointed to depression.
A recent study concluded that the rate of depression across the globe has risen about 70 percent since 2017. As more people experience symptoms associated with depression, physical therapists are playing a key role in impacting patients’ mental health.
Depression is an underlying condition often associated with chronic illnesses and orthopedic injuries that limit mobility and interfere with a person’s ability to enjoy life. While counseling and medication continuously improve options for treating depression, a broad collection of studies shows that across all ages, exercise consistently decreases overall tension levels, elevates and stabilizes mood, self-confidence, energy, memory, and improves sleep, all with virtually no negative side effects.
Working with a physical therapist who understands the importance of quality exercise is an opportunity to have a custom treatment and exercise plan designed for you, based on a thorough assessment of what your body needs to keep you feeling and being your best physically and mentally. PTs understand how health history, past injuries, individual background, and personal preference play into overall wellbeing and are dedicated to ensuring their programs empower patients to achieve optimal physical function which in turn can have an influence on depression.
Though exercise’s immediate effects on mental state are often temporary — which is why working with a PT to establish a regular, daily exercise routine is the optimal choice — new research is exploring how brain plasticity works with exercise to chemically restructure the way the brain functions. Findings indicate that exercise decreases the psychological and physiological response to stress for up to 24 hours and enhances things like attention, memory, problem solving and decision making for up to two hours after an exercise session. And the best part is, the positive effects apply for high- or low-intensity exercise.
For patients suffering from anxiety or depression, however, it can be stressful and overwhelming to think about adding exercise into their lives either for the first time or after a long hiatus. Symptoms often include fatigue and loss of interest in activities, making it especially difficult for patients to take that first step, literally and figuratively.
For me, as I focused all my dwindling energy in a desperate, last-ditch effort to find a pathway to success, I lost sight of everything outside of the nightmare I was living, the nightmare that felt like a horrible, out-of-body experience.
One day I could not seem to remember anything. By that afternoon, I could not remember what work had been done that morning. I struggled to answer simple questions. Robotically, I would get out of bed each morning and make myself show up an hour early to plan the day. It was the start of a cycle that continued for weeks, but the harder I pushed myself, the more clouded my mind became.
I failed the internship. My hopes and feeling of self-worth were shattered. My health was in shambles. The last of our finances were dwindling. Then, my school mentor offered me one last chance. So, I bought a one-way ticket to fly halfway across the country, without my family, and committed to one final internship.
It was the middle of winter in Iowa and ice covered everything. I missed my wife and children, and my new internship was progressing even slower than anticipated as patients could not make it to their appointments due to the ice and record-cold temperatures. Things looked bleak.
“Paul, I want you to take a walk every day.” The words of my school mentor seemed useless. I was at the end of my rope, and somehow taking a walk was supposed to help me feel better?
The walks were short at first. Step by step I plodded along the frozen wasteland, while bundled head to toe in thick, old winter gear. Then, weeks into my ordeal, something amazing began to happen. I began to look around me on these walks. The ice formations were exquisite. The nippy air became invigorating. The ice beneath my feet became a rink for my sliding pleasure. My walks became longer, and I found myself smiling and giggling as I played in this winter wonderland. Something had changed.
Those daily walks elevated me, allowed me to be present, and gave me eyes to see ahead. At last, the nightmare was over. I was on a return flight home, with a degree as a physical therapist and a brighter future ahead. In the end, it was the change in my approach to the situation, and not the situation, which defined my outcome. It was the loving encouragement of teachers, counselors, family, and friends which bolstered me. And it was movement that carried me out of the darkness.
Today, as a licensed Doctor of Physical Therapy, I am passionate about helping others through movement and exercise. PTs are trained to identify injuries or illnesses that require a special approach, and we excel at motivating patients to get moving, to perform exercises safely and effectively, even if it starts with a short walk every day.
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