The following is a guest contribution from Helen Jones. If you’re interested in submitting a guest article, please refer to our contribution guidelines.
Depression is one of the most common mental illnesses in the Western world, with one out of four women and one out of six men suffering clinical depression at some point in their lives. For this reason, it’s important that personal trainers know how to recognize the symptoms and meet the needs of clients with this mental illness.
Depression can come about from a stressful or traumatic experience in someone’s life, such as work troubles, relationship problems, death of a loved one, or bullying.
Depression affects people in a multitude of ways and can present very differently in each individual. Generally, a person with depression may lack energy and motivation. They may feel worthless and have a low self-esteem, feel anxious, overwhelmed, or numb.
If you’re a trainer and have a client who you believe might be depressed then watch for the following signs:
- A sudden change in a client’s personality.
- They may become withdrawn, short-tempered or easily frustrated.
- Overly self critical.
- Difficulty sleeping or eating.
- Difficulty concentrating or loss of interest in exercise.
A temporary shift in mood doesn’t automatically point towards a depression diagnosis. However, if the negative feelings last longer than a couple of weeks and begin to interfere with the person’s everyday life there is cause for concern.
Depression can be very difficult to recognize so if in doubt, refer a client on so that they can be properly diagnosed by a health care professional.
How exercise helps
As the Australian Institute of Fitness’ NSW Coach Kevin Troeger explained, exercise helps depression in both a physical and mental sense. Physical activity releases the feel-good hormones serotonin and endorphins while completing physical tasks gives clients a mental boost and a sense of accomplishment.
As far back as 1999, the Centers for Disease Control and Prevention examined the literature that explored the link between exercise and mental health. It concluded that physical activity did indeed seem to relieve the symptoms of depression and boost mood. As a result, it demanded that more research be done into the connection between exercise and the relief of depression.
In 2007, James Blumenthal, PhD, who teaches psychology and neuroscience at Duke University, conducted a study (1) on the antidepressant effects of exercise. He assigned 202 participants whom had been diagnosed with major depressive disorder, with one of four treatments – individual home exercise, group exercise, antidepressant medication or a placebo.
After 16 weeks of their prescribed treatment, the study showed that the placebo was the least effective, yet the home based exercise and group exercise had similar remission rates to the antidepressant medication.
What’s also important to recognize are the effects that depression medications might be having on your clients physical appearance. Fat loss efforts, for example, can be stalled as a result of the medication. For a list of the top 10 prescription drugs that trainers must know about, click this link.
What can Personal Trainers do?
Recognize the warning signs, stay informed and don’t be afraid to address the topic with your client and simply ask them if they’re okay. It may be difficult, but chances are that your client will appreciate the effort. Remember, empathy is a key trait of a good personal trainer.
Once you’ve established that a client is experiencing depression, you’ll need to alter your training sessions to suit them. You’ll likely have to start with low-impact exercises before working up to more intense sessions.
Troeger found that one client was highly motivated before depression and could easily do a one-hour session with a mix of cardio, circuit training, ab work, and stretching. However, after being diagnosed with depression, the client struggled with the motivation to do any exercise, which then made her feel incompetent and lowered her mood even further.
Troeger subsequently started with a shorter routine that incorporated reduced weights, single sets of exercises, and much lower overall intensity. He observed that his client was struggling, even with the reduced load, and fatigued much quicker than usual.
Personal trainers may also need to adjust their expectations and motivation methods. Aggressive and authoritarian training methods will rarely help a depressed client, but patience and learning how to best deal with mood swings certainly should.
If your client has been diagnosed with any sort of depression, it’s a good idea to speak to his or her primary care physician as well.
What Activities are Best?
To maximize the benefits from a workout, a trainer should aim for the activities to be fun and involve rhythmical breathing, as this can have a meditative effect. Both cardio and weight training have been found to have positive effects for clients suffering depression. Other activities that can help include yoga and laughter yoga, in which the physical and psychological benefits of laughter are explored.
A study (2) in the Journal of Psychiatric Practice went over the available data on exercise and depression and suggested that aerobic exercise is best for people suffering from a major depressive disorder. They recommended three to five aerobic sessions a week that last between 45 and 60 minutes each, at between 50% and 85% of the maximum heart rate. They suggested that the benefits of exercise will become noticeable within a month, but an exercise plan of 10 to 12 weeks is best.
Incorporating exercise into a client’s daily routine can be an effective way to help them when you’re not there, so encourage them to walk or cycle to work and be active on the weekends with activities like bushwalking, swimming, or types of sport. Try to get clients to view exercise as a lifestyle choice that can be integrated into their routine instead of a chore that needs to be scheduled.
What to watch for
Personal trainers need to be aware that it’s not just the depression itself needs to be accounted for, but depression medication can also have significant side effects. For example, clients may experience a suppressed appetite or lower blood pressure than normal while they’re on medication. Clients experiencing low blood pressure will need extra time to adjust when sitting down or standing up from different exercises to avoid feeling faint. Ground exercises may need to be avoided entirely.
Other things that may need to be avoided include intensely competitive exercises or heavy weights that are difficult to shift. The aim is to get the client moving without adding to the stress they’re already experiencing.
Personal trainers aren’t psychologists, though the nature of their job may at times put them in a similar position as they deal with clients on such a personal level. Without the qualifications on how to handle mental health, it’s important that a personal trainer encourages a depressed client to seek adequate professional help.
However, personal trainers have a role that can be crucial in the recovery of depression as they can tailor exercise routines to get those feel-good hormones working and allow depressed clients to feel a sense of accomplishment in their sessions.
(1) Blumenthal, J. A., Babyak, M. A., Moore, K. A., Craighead, W. E., Herman, S., Khatri, P., et al. (1999). Effects of exercise training on older patients with major depression. Archives of Internal Medicine, 159(19), 2349-2356.
(2) Rethorst, C. D., Trivedi, Madhukar, H. Evidence-Based Recommendations for the Prescription of Exercise for Major Depressive Disorder. Journal of Psychiatric Practice, 19(3), 204-212.
About the Author
Helen Jones is the National Communications Manager for the Australian Institute of Fitness. She has over eight years of experience in editorial and communications work in the fitness industry. Helen connects the Australian Institute of Fitness to its audience through fitness articles, blogs, social media and PR.