Tuesday, February 28, 2012

The Four-Hour Cure

The good news is that a four-hour treatment will shield you from depression and burnout.

The bad news is that it’s four hours a week, not just four hours.

If you were thinking that it would only take four hours you really need this treatment.

Ironically, four hours a week used to be the standard for real psychoanalysis. In the old days you needed to lie on the couch for at least four hours a week. Otherwise you weren’t doing a real psychoanalysis.

At least, the analysts got the four-hour part right. They were wrong in prescribing four hours of mind-numbing and slothful inactivity.

Substitute four hours on the treadmill for four hours on the couch, a good habit for a bad one, and you will do yourself a world of good.

The research coming out of the University of Tel Aviv, thoroughly consistent with other studies, says that four hours of strenuous physical exercise will effectively keep depression and burnout at bay.

Strenuous means breaking a sweat.

The American Friends of Tel Aviv University  website reports on the findings:

Depression and burnout rates were clearly the highest among the group that did not participate in physical activity. The more physical activity that participants engaged in, the less likely they were to experience elevated depression and burnout levels during the next three years. The optimal amount of physical activity was a minimum of 150 minutes per week, where its benefits really started to take effect.

In those who engaged in 240 minutes of physical activity or more, the impact of burnout and depression was almost nonexistent. But even 150 minutes a week will have a highly positive impact, says Dr. Toker, helping people to deal with their workday, improving self-efficacy and self-esteem, and staving off the spiral of loss.

But, what happens when it feels like everything is coming apart, like our world is unraveling, that we are overwhelmed.  

Sometimes it takes more than exercise to deal with a major life crisis.

Happily, today’s Wall Street Journal shows how a Florida woman, Hannah Shapiro, facing a major life crisis, got her life back under control.

After ending an unhappy marriage and getting laid off twice, Hannah Shapiro last year found herself alone with two small children to support in Miami, far from her family in England. "I was so scared, I was paralyzed," she says. "My heart was racing. I would take the kids to school and get back into bed."

After a week like that, Ms. Shapiro, age 33, says she had a "light bulb" moment. "I thought, 'What the heck am I doing in bed? I can turn this around.' And I did." She put her writing skills to work and set up a communications consulting business. She still gets anxious at times but no longer feels she's on the edge of breaking down. "I just made myself snap out of it," she says.

Hannah Shapiro had a suck-it-up moment. She did what she had to do. It’s fair to say that she did not have another option. She was the sole support for two small children. Spending all day in bed was not an option.

Flirting with a major depressive episode, Shapiro roused herself from her bed because she had no other choice.

Obviously, she was not cured by a flash of insight, a therapeutic epiphany. Her problems were real, not psychogenetic.

Now, think about how much depression could be controlled, if you cured, by four hours of exercise a week and by resilience. If so, why do we have a major industry devoting itself to treating and curing depression? Why does it happen that when someone gets depressed or burned out, the first thing everyone says is: get a prescription or get some counseling?

Doesn’t it feel like we’re shifting responsibility? And doesn’t it feel like we, as a culture, are feeding depression by telling people that there is nothing that they themselves, as moral agents, can do to ameliorate their condition?

Why do we have armies of therapists insisting that an injection of empathy is the cure?

If you don’t do your four hours of exercise empathy might console you, but it will not compensate for your sloth.

Empathy did not cure Hannah Siegel. Her moral sense did. She acted as a responsible adult should act. Not to put too fine a point on it, she could not afford to be depressed.

Granted, not all depressions are the same. Some do require medication. Still, you have to wonder which side the therapy profession is really on.


Tilda Tally-ho said...

As my trainer's T-shirt says: "If it's physical, it's therapy."

Daran said...

But to what extend is this a self selecting group? If you have the willpower to maintain a solid exercise regime that same willpower may help with the depression. (Similar case can be made for exercise and diet.)

Stuart Schneiderman said...

You make a good point... to some extent it is self-selecting. But the researchers also suggest that companies can create a culture of exercise by have an exercise room, trainers, and classes available on the workplace. Peer pressure is often very helpful in motivating people. And so is money... Safeway Stores instituted a program where they not only set up the facilities to encourage people to work out but offered reductions in health insurance premiums for those who improved their overall fitness.

It is also true that if people are convinced by the culture at large that the only solution for depression is medication, they will be less likely to maintain their exercise regimen.

To my knowledge, most therapists today are very clear about the importance of an execise regimen.