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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 8 to 32 of 32. Go back in thread:
Posted by dancingstar on January 24, 2005, at 15:47:02
In reply to Re: Excercise Backfire., posted by denise1904 on January 24, 2005, at 14:17:42
Now because I have been feeling so badly in the last few months, usually two days after I exercise (for me vigorously) I do crash, sometimes badly, and I, too, just want to sleep. Still, I know that the rewards are greater than the pain because I have experienced them. Being very still is painful, and moving always brings me joy.
Even ten minutes of walking outside, not enough to do any harm, will start to build your strength. Ten minutes of yoga or stretching. Ten minutes of anything.
In a month or so move it up to 20 minutes. When I say start slow, I mean really slow. Give your body a chance to enjoy the air, to relax, to breathe, to feel good.
From everything I have read, if you go any faster than you can cope with, you will not experience the positive effects of exercise, and want to give it up. If ten minutes is too many, start with five. No one is watching. Do this for yourself, in your very own way.
You will see that you can make progress if you give yourself permission to take your own sweet time about it without any pressure.
Where you start to have to push through will be when you begin to sweat and catch your breath, start to need to recover from whatever it is you choose to do. At that point, you will probably need to let your body heal longer between exercise intervals until you adjust. But you will see that you will adjust if you are patient with yourself. Our bodies are designed to move unless we are physically disabled. More than likely, unless we are injured physically, being still causes us more pain than moving. Sometime down the line, maybe in three months, you can start to test yourself, but not now. Now you just want to start to prove that you can do this. So what I am thinking is that even a brief walk around the block to clear your head is all the exercise you need to do for an entire month. See how that goes, and take it from there.
I hope I've made a bit of sense to you because so much of it is in the doing it and seeing how you feel, and you need to prove the results to yourself.
Posted by emme on January 24, 2005, at 16:50:01
In reply to Excercise Backfire., posted by Bob on January 24, 2005, at 12:13:41
I know you aren't the first to complain of this. Are you eating well?
Posted by SLS on January 24, 2005, at 17:17:48
In reply to Excercise Backfire., posted by Bob on January 24, 2005, at 12:13:41
> Why is it that everyone says exercise is good for depression and anxiety, but whenever I try to do something physical, the next day I have a 'reaction' and feel worse than ever. Yesterday I forced myself to take a walk - a rare occurrence indeed - and today I feel angry and unhappy. I also didn't sleep well last night, which seem paradoxical. I almost never have any physical energy or motivation to do exercise, but even the slightest bit, and there's hell to pay.
A clinical investigator once told me that intense exercise can deplete the brain of catecholamine neurotransmitters. I think he was referring to weight training and other anaerobic exercise. While walking isn't usually thought of as being intense, perhaps it is for your system at this time. You might be severely deconditioned from lack of physical activity. You can try walking very, very short distances to see how it affects you. You are not alone in your negative reaction to exercise. I do not consider exercise to be a panacea for depression. However, it is certainly in your best interests to regain as much physical conditioning as your illness will allow. Some exercise is better than none. However, no exercise is certainly understandable with these illnesses. I haven't exercised in many years. Walking it the best start, though. In many cases, it is sufficient.
- Scott
Posted by eeyorena on January 24, 2005, at 17:18:05
In reply to Excercise Backfire., posted by Bob on January 24, 2005, at 12:13:41
Bob--
This has definitely happened to me after a period of inactivity (usually a depressive period) when I restarted an exercise routine.
Ditto what everyone else says. Crank it down a couple of notches and keep going.
I've found that if you exercise 3 times a week after 3-4 weeks, that rebound reaction disappears. It is a really strange phenomenon. Since it's happened for me a handful of times, I keep thinking of that moment when the rebound goes away and that keeps me motivated.
Posted by jeopardy on January 24, 2005, at 20:07:11
In reply to Re: Excercise Backfire. » jeopardy, posted by Bob on January 24, 2005, at 13:04:47
The reason you get tired and don't feel well the next day is your body is going through changes. Give it time. On the other hand though...what works for one person doesn't always fall true for the next. If you got that tired from just a short walk...it means you're not even close to being healthy...assuming, phyisically, you're okay of course. Talk to your Doctor, get a check-up and if everything is okay, set some small goals. I swear in a couple months you'll look back and will be amazed at your progress. Good luck Bob, keep the board posted on your progress.
Posted by Impermanence on January 24, 2005, at 22:26:48
In reply to Excercise Backfire., posted by Bob on January 24, 2005, at 12:13:41
If you can afford it you should join a gim and you will be assinged a personal trainer, they will gradually build you up and teach you how to eat properly. At first it's very hard, but as your body gets fitter it gets easier and actually enjoyable. In time you'll be a bag of energy and you'll look and feel great. Good personal trainers give you a great boost of confidence in the early stages when you feel like just giving up. Also if you take up a sport or an active hobby you basically exercise without even noticing you're doing it, it makes it alot easier. Whatever you choose, try to work up to at least an hours walk a day.
Exercise can be a miraculous cure for depression and anxiety, researchers have found that walking for 30 minutes each day quickly improved patients symptoms faster, than antidepressants typically do.
Copied:
Biochemical mechanisms - People suffering from depression have been found to have lower levels of endorphins in the brain. Exercise has been shown to increase the levels of these naturally occurring "hormonal mood adjusters" in the brain 11. It is also widely believed that exercise may indirectly result in the release of enkephalin, which in turn results in the feelings of euphoria occasionally experienced by athletes known as the "runner's high".Physiological mechanisms - Exercise has been shown to improve the body's adaption to emotional stress by increasing the efficiency of the adrenal glands and the autonomic nervous system. 12. Physical activity is also believed to inhibit some nervous activity at the brain causing an altered state of consciousness. The effect the exercise causes is thought to bring on the alpha state of consciousness that is associated with the relaxation state just before you go to sleep.
Psychological mechanisms - The single distraction of exercising can take your focus away from the problems of everyday life. Also, both during and after exercise, depressive symptoms, particularly anxiety, have been shown to be considerably reduced 13. Similarly, the feelings of mastery associated with heightened self-confidence that can occur during an exercise programme can alleviate depression. Regular exercise also enhances sleep quality which can, in turn, contribute to a reduction in the symptoms of depression.
Similarly, the social interaction resulting from playing a team sport or by regularly attending a fitness centre can bring enhanced feelings of meaning and value.
Posted by Jen2 on January 24, 2005, at 23:16:07
In reply to Excercise Backfire., posted by Bob on January 24, 2005, at 12:13:41
When I was in the pit of despair this past fall, my partner (who was initially skeptical that there was anything wrong with me at all) insisted that the best cure for what ailed me was good strong exercise. Needing something to do to try to prevent myself from going insane, I started accompanying him to the gym and tried a couple of fitness classes -- knowing in my rational brain that the flood of endorphins that results from good sweaty exercise can be a powerful mood enhancer (as per Impermanence's post). Understandably, the depression, anxiety and paranoia were more than just "feeling sad/bad" and thus going to the gym a couple of times didn't resolve the problem. In fact, sometimes it made me feel worse. However, I stuck with it. Eventually it did make me feel stronger and helped me to feel like I could begin to cope -- the rationale was, if I can make it through this excruciatingly painful workout, I can maybe make it through another few hours of another day.
I also got medicated and started therapy shortly thereafter. The combination is so far working well for me. Going to the gym now feels really helpful and enhances my mood considerably. I went tonight and felt very powerful.
My point is this - despite the fact that it often feels like crap and makes you feel like crap the next day, exercise is very important. I don't believe that it's able to resolve whatever's going on in one's head all on its own (at least it didn't work that way for me - maybe it does for others), but I think that it's a really important part of getting better.
Stick it out, keep it up. It will help eventually.
Jen
Posted by dancingstar on January 25, 2005, at 2:22:06
In reply to Re: Excercise Backfire. » Bob, posted by Impermanence on January 24, 2005, at 22:26:48
oh, heck, i can't resist adding 14. ...and it does wonders for your sex life :-)
Posted by denise1904 on January 25, 2005, at 3:46:30
In reply to Re: Excercise Backfire. » denise1904, posted by Bob on January 24, 2005, at 14:24:54
No,
If I take Seroxat, which I am doing, I don't feel so bad after excersising but if I'm not on anything then I do feel worse the day after, that has always been the case.
Denise
Posted by Optimist on January 25, 2005, at 12:01:08
In reply to Re: To Bob, posted by denise1904 on January 25, 2005, at 3:46:30
I've noticed that when I push it too hard with my workouts that I experience depression for the next day or so.
I agree with what someone else said earlier about catecholamine depletion. Vigorous exercise can cause short term CNS(Central Nervous System) exhaustion. It's basically where your CNS energy is depleted.
I've learned to curb my enthusiasm a notch when working out now, and make sure to have some left in the tank by the end of my workout. It seems to work. Another way of identifying the proper intensity of exercise is to make sure you go at a pace where you can enjoy it. If you're pushing yourself too hard, feeling pain, and having difficulty breathing you are most likely going to hard which will have a greater chance of causing exhaustion.
Another good way to prevent/diminish post-exercise fatigue is to limit your stimulant use(caffeine,Ritalin,amphetamines) since they tend to exhaust catecholamines.
Taking tyrosine and Vitamin C also helps as they support the adrenals, and allow for more raw material of the catecholamines that are associated with exercise exhaustion.
Brian
Posted by ed_uk on January 25, 2005, at 12:08:37
In reply to Re: Exercise Backfire., posted by Optimist on January 25, 2005, at 12:01:08
Even walking makes me breathless........ any exercise suggestions for a severely deconditioned me?
Ed.
Posted by dancingstar on January 25, 2005, at 12:18:24
In reply to Re: Exercise Backfire., posted by ed_uk on January 25, 2005, at 12:08:37
Yes, darlin', same thing...if you are physically capable of doing it, get yourself to walking.
That's the way you start to build up some stamina, just doing it. But I know you know that. :-)
Posted by Shortelise on January 25, 2005, at 12:46:35
In reply to Excercise Backfire., posted by Bob on January 24, 2005, at 12:13:41
exercise early in the day and don't overdo it. A short walk, maybe a mile, the first day, skip a day and walk just a bit farther.
Best not to exercise at night as it may interfere with sleep.
ShortE
Posted by Optimist on January 25, 2005, at 13:22:06
In reply to Re: Exercise Backfire., posted by ed_uk on January 25, 2005, at 12:08:37
> Even walking makes me breathless........ any exercise suggestions for a severely deconditioned me?
>
> Ed.How's your nutrition Ed? Improving one's eating habits can improve stamina and energy as well, leading to more enjoyable exercise.
Personally I follow a Zone diet 30/30/40 protein/ fat/carbs by calorie percentage. It has made a significant improvement in my energy, mood, and exercise performance. It's based on moderation and what your body thrives on. Nothing extreme that is painful, and starvation induced.
It allows me to be flexible as well which is important which my food choices. I eat pizza, icecream, chips etc... but always include a protein shake, some eggs, steak, chicken, etc... every meal to balance out the carbs and protein. So instead of eating 5 pieces of pizza I'll eat 2 instead and follow it with a protein shake.
It's done well for me. I'm 6'3, 230lbs, with about 8% body fat. I'm not a chronic exerciser either. I'm active with weight training and low intensity cardio/aerobic exercise only 2 times a week, for an hour and 15 minutes each time. Very doable for the average person.
Not everyone has the discipline and priorities to follow a nutritional plan but I think this eating regimand is based more on moderation which everyone can follow.
The book is called "The Zone" by Dr. Barry Sears.
Here's a link to Amazon:
http://www.amazon.com/exec/obidos/tg/detail/-/0060391502/103-0993337-9361446?v=glance
Brian
Posted by Ktemene on January 25, 2005, at 20:14:41
In reply to Excercise Backfire., posted by Bob on January 24, 2005, at 12:13:41
> Why is it that everyone says exercise is good for depression and anxiety, but whenever I try to do something physical, the next day I have a 'reaction' and feel worse than ever. Yesterday I forced myself to take a walk - a rare occurrence indeed - and today I feel angry and unhappy. I also didn't sleep well last night, which seem paradoxical. I almost never have any physical energy or motivation to do exercise, but even the slightest bit, and there's hell to pay.
>
>
I have had the same experience. About five years ago I had a terrible depressive slump that went on for two years. I didn't think I would live through it; I have never felt so intensely miserably for that long before. One of the strange things about that episode is that in the first few months I lost a lot of muscle mass. This was not just the effect of not exercising; muscle mass just melted off me. So I was left *very weak* and *very depressed*. I knew it was supposed to be good to exercise, so I tried to exercise a few minutes at moderate intensity, but the next day I felt as if a truck had hit me. I ached all over and my depression seemed to double in severity. Then I decided that I needed to start at a much lower level of exercise and keep track of the minutes I spent exercising and of the intensity level. So I got a heart monitor and exercised on my rowing machine at very low intensity for ONE minute. I am not kidding; I used a stop watch and did exactly one minute's worth of rowing. I waited 48 hours. And then I exercised TWO minutes. I waited another 48 hours. And then exercised THREE minutes. I got very impatient. And I didn't tell anyone because it felt so humiliating to be exercising for just a couple of minutes and then having to quit. But, it worked. After I had built up to exercising ten minutes at a time, I started added two minutes to each exercise session instead of one minute. After a couple of months, I was able to exercise 30 minutes at moderate intensity. And a couple of months later I was regularly exercising 50 minutes at fairly high intensity. But I always had to be careful to increase either the length or the intensity of the exercise session by no more than a tiny increment, or I ended up in complete misery the next day. I found it was necessary to keep a chart of which days I exercises at what length and intensity. Otherwise I forgot and hurt myself. Of course, YMMV, as always. But what worked for me was to be very unambitious. My exercise moto is: No Pain, Not Any, Ever. It worked for aerobic exercise, and when I started weight lifting the same method worked just as well. I started with the lightest weights in the gym, and I got a set of fishing weights, and added 1/8 of a pound at each exercise session. Eventually, I was stepping past the big hulky men who were using the thirty pound dumbbells, so that I could grab the thirty-five pound dumbbells. (I must admit, doing shoulder presses with heavier dumbells than most of the men used was the best part of going to the gym for me.) So my two cents worth of advice is that the secret to success in exercise is lack of ambition and keeping track. And, by the way, exercise did help my mood, just as everyone had always told me it would.
Posted by dancingstar on January 25, 2005, at 20:46:28
In reply to Re: Excercise Backfire. » Bob, posted by Ktemene on January 25, 2005, at 20:14:41
great post.
Posted by Bob on January 26, 2005, at 1:58:43
In reply to Re: Excercise Backfire. » Ktemene, posted by dancingstar on January 25, 2005, at 20:46:28
I have to say that there is a lot of great posts in this thread, and I now have much to think about. I've been med free for the longest period (greater than 2 months) in over twelve years. I don't know if I'll be able to stay away forever, so the exercise thing may be just a fantasty, but the concensus here seems to be to take it slower than even the most conservative estimates. I honestly don't know if my body can get strong again, but time will tell. I also must say that it is, ironically, relieving to see that others have trouble with exercise. There's so much advice given out about how everyone has to exercise that I was feeling somewhat guilty about not being able to do it sometimes. I don't know anyone else, personally, who doesn't have anything wrong with them' (at least nothing that turns up in a physical) yet has trouble with physical activity. So, to hear about other experiences here gives me a changed perspective.
Posted by Ktemene on January 26, 2005, at 10:10:56
In reply to Re: Excercise Backfire. » Ktemene, posted by dancingstar on January 25, 2005, at 20:46:28
Posted by ed_uk on January 26, 2005, at 14:29:22
In reply to Re: Exercise Backfire. » ed_uk, posted by Optimist on January 25, 2005, at 13:22:06
Hello Brian,
>How's your nutrition Ed?
To be honest, it's really quite poor. I can't cook so I buy a lot of takeaways!
>Not everyone has the discipline and priorities to follow a nutritional plan but I think this eating regimand is based more on moderation which everyone can follow.
Do you need to be a good cook to follow this plan? Is it time consuming to prepare the food?
Thanks for your help,
Ed.
Posted by Dr. Bob on January 28, 2005, at 0:45:10
In reply to Re: Exercise Backfire. » Optimist, posted by ed_uk on January 26, 2005, at 14:29:22
> >How's your nutrition Ed?
>
> To be honest, it's really quite poor...Sorry to interrupt, but I’d like to redirect follow-ups regarding nutrition to Psycho-Babble Health. Here’s a link:
http://www.dr-bob.org/babble/health/20050105/msgs/449001.html
Thanks,
Bob
Posted by Minnie-Haha on February 1, 2005, at 20:12:01
In reply to Excercise Backfire., posted by Bob on January 24, 2005, at 12:13:41
> Why is it that everyone says exercise is good for depression and anxiety, but whenever I try to do something physical, the next day I have a 'reaction' and feel worse than ever. Yesterday I forced myself to take a walk - a rare occurrence indeed - and today I feel angry and unhappy. I also didn't sleep well last night, which seem paradoxical. I almost never have any physical energy or motivation to do exercise, but even the slightest bit, and there's hell to pay.
I was just doing some research for my sister-in-law and came across this and it made me think about you! Scroll down and check out the SYMPTOMS of CFS (Chronic Fatigue Syndrome -- including "post-exertional malaise")!!
Posted by Minnie-Haha on February 1, 2005, at 20:16:20
In reply to Excercise Backfire., posted by Bob on January 24, 2005, at 12:13:41
Actually, "post-exertional malaise" is listed as a symptom of fibromyalgia, too!
Posted by Bob on February 1, 2005, at 21:25:37
In reply to Re: Excercise Backfire., posted by Minnie-Haha on February 1, 2005, at 20:16:20
> Actually, "post-exertional malaise" is listed as a symptom of fibromyalgia, too!
>
> http://www.fmnetnews.com/pages/criteria.html
>Yeah, that's the problem with these type disorders. When there's no actual diagnostic test for a condition, it becomes what my doctor once called, "a catch-all diagnosis". He didn't seem too interested in giving anyone any of those diagnoses.
Posted by CareBear04 on February 3, 2005, at 13:26:59
In reply to Re: Excercise Backfire., posted by Minnie-Haha on February 1, 2005, at 20:16:20
hi there! i don't know much about fibromyalgia, but do you know if there's a stimga attached to it? my sister is a 4th year med student, and she was telling me that each specialty has a dreaded problem case. in internal medicine, it's apparently fibromyalgia. i think i've read that there are specific physical criteria required for the diagnosis, so i don't understand why it's not taken more seriously or why it's attached somehow to psychiatric conditions and somatization. i think some physical symptoms originate or are made worse by the head and obsessions, but there are real physical implications and suffering. i don't see any point in obsessing on pain of psychological or medication-induced origin versus "pure' physical illness. suffering is suffering no matter what the cause.
anyway, the times i've made myself exericse, i've had the usual response of feeling tired but better-- physically refreshed and mentally feeling better about myself for having summoned the motivation to get out. if you're feeling worse and worse from exercise, it sounds like that's something serious that should be taken seriously by your doctor. have you seen anyone and had tests run and stuff? maybe thyroid tests and a CBC to check for anemia, exercise tolerance, etc. also, exercise is always hard to start at first. when i first started running again a few years ago, i was so tired and miserable and sore for the first week. soon after, though, when i made myself run every other day or a few times a week, i started to catch a second wind, and it became less miserable and tiring to exercise. i know it's hard to motivate yourself when exercise makes you feel worse, but maybe if you can find some incentive or a friend who will keep you accountable, you will soon get used to exercise and find it more enjoyable and less exhausting? just a thought.
wishing you the best!
Posted by Bob on February 3, 2005, at 15:55:54
In reply to Re: Excercise Backfire. » Minnie-Haha, posted by CareBear04 on February 3, 2005, at 13:26:59
> hi there! i don't know much about fibromyalgia, but do you know if there's a stimga attached to it? my sister is a 4th year med student, and she was telling me that each specialty has a dreaded problem case. in internal medicine, it's apparently fibromyalgia. i think i've read that there are specific physical criteria required for the diagnosis, so i don't understand why it's not taken more seriously or why it's attached somehow to psychiatric conditions and somatization. i think some physical symptoms originate or are made worse by the head and obsessions, but there are real physical implications and suffering. i don't see any point in obsessing on pain of psychological or medication-induced origin versus "pure' physical illness. suffering is suffering no matter what the cause.
> anyway, the times i've made myself exericse, i've had the usual response of feeling tired but better-- physically refreshed and mentally feeling better about myself for having summoned the motivation to get out. if you're feeling worse and worse from exercise, it sounds like that's something serious that should be taken seriously by your doctor. have you seen anyone and had tests run and stuff? maybe thyroid tests and a CBC to check for anemia, exercise tolerance, etc. also, exercise is always hard to start at first. when i first started running again a few years ago, i was so tired and miserable and sore for the first week. soon after, though, when i made myself run every other day or a few times a week, i started to catch a second wind, and it became less miserable and tiring to exercise. i know it's hard to motivate yourself when exercise makes you feel worse, but maybe if you can find some incentive or a friend who will keep you accountable, you will soon get used to exercise and find it more enjoyable and less exhausting? just a thought.
> wishing you the best!+++++++++++++++++++++++++++++++++++++++++++++++++
I think that med professionals are made to feel somewhat helpless by disorders that are not cut and dry. Ideally, there would be some sort of "litmus" test, e.g. a blood test, so that people can confidently say, "yup, you got it". Otherwise, the chance of a misdiagnosis goes way up, with all the collateral implications that brings with it. I've heard more than one doc proclaim that they liked surgery because it produces very concrete results, and there is visual proof you are helping someone.
I have to play it by ear with the exercise. It's somewhat hard to know whether todays physical exertion will end up being too much tomorrow, but once tomorrow comes, if it gets bad enough, the exercise doesn't continue.
This is the end of the thread.
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