Understanding Schizophrenia and the Role of Exercise Physiology

Schizophrenia is a complex, chronic mental health disorder that affects how a person thinks, feels, and behaves. It can be a highly debilitating condition, but with the right treatment and support, individuals living with schizophrenia can lead fulfilling lives. One of the lesser-known yet highly effective treatments for managing schizophrenia symptoms is Exercise Physiology. This blog post will explore what schizophrenia is, how it affects individuals, and how tailored Exercise Physiology programs can make a big difference in the lives of those living with this condition.

What is Schizophrenia?

Schizophrenia is a severe mental disorder characterised by distortions in thinking, perception, emotions, language, sense of self, and behaviour. Common symptoms include:

Positive Symptoms

This refers to symptoms that are added to the usual everyday experience. These are psychotic behaviours not generally seen in healthy individuals. They can include:

• Hallucinations — a false perception of something that isn’t really there, involving your senses (sight, sound, smell, touch, and taste).
• Delusions — a clearly false, unshakeable belief that is not based in reality.
• Thought disorders — disturbances in thinking which affect language and communication.
• Movement disorders — such as agitated body movements

Negative Symptoms

This refers to symptoms that take away from the usual everyday experience. These are disruptions to normal emotions and behaviours. They can include:

• A flat affect (i.e. reduced expression of emotions via facial expression or voice tone)
• Reduced feelings of pleasure in everyday life
• Difficulty beginning and sustaining activities
• Reduced speaking
• Social withdrawal

Cognitive Symptoms

This refer to symptoms affecting cognitive functions, which can be subtle or severe and can include:

• Problems with attention, memory, and executive functioning (i.e. the ability to understand information and use it to make decisions).

The Impact of Schizophrenia

Schizophrenia typically emerges in late adolescence or early adulthood and can have a profound impact on an individual’s life. The disorder affects approximately 1% of the population and can lead to severe disability if not treated properly. There are a wide range of effects, influencing an individual’s personal, social, and occupational functioning.

Currently, there is no cure for schizophrenia and instead treatment involves taking medication to manage some of the symptoms. The medications available are quite effective in managing the positive symptoms; however, the negative and cognitive symptoms are much harder to treat.

Challenges Faced by Individuals with Schizophrenia

Those with schizophrenia face a range of challenges, including but not limited to:

• Social Isolation: Difficulty in forming and maintaining relationships.
• Occupational Impairment: Challenges in holding a job due to cognitive and emotional difficulties.
• Health Issues: Higher risk of physical health problems, including cardiovascular diseases and obesity, often worsened by antipsychotic medications.
• Stigma and Discrimination: Misunderstanding and prejudice surrounding the condition can lead to further social isolation and reduced opportunities.

The Role of Exercise Physiology in Managing Schizophrenia

Exercise Physiology is the study of the body’s responses to physical activity and the adaptations that occur over time. An Exercise Physiologist designs and implements exercise programs that are tailored to an individual’s health status, needs, and goals. There is increasing evidence showing that physical activity plays a vital role in managing all 3 types of schizophrenia symptoms. Furthermore, evidence also shows that exercise helps to reduce the gap in health and life expectancy experienced by people with schizophrenia.

People with schizophrenia are at a significantly higher risk for developing other health conditions, including cardiovascular diseases, obesity, metabolic disease, and diabetes. This is due to a range of factors, including:

• Significant weight gain being a main side effect of antipsychotic medications.
• Reduced motivation (a negative symptom of schizophrenia) making it difficult for those with schizophrenia to be motivated to engage in activities that improve their well-being.
• The cognitive symptoms associated with schizophrenia making it difficult to sustain the planning and organisation needed to engage in activities that improve health and well-being.

Because of the above factors, people with schizophrenia have a life expectancy of 10-20 years below the general population. The lower life expectancy is also mostly related to preventable conditions, such as cardiovascular disease and diabetes.

For people with schizophrenia, Exercise Physiology can offer numerous benefits, as outlined below. It is also important to note that research shows that the greatest benefit is seen in people who engage in 90 minutes or more of moderate to vigorous physical activity per week.

Physical Health Benefits

• Cardiovascular Health: Regular exercise helps improve heart health and reduces the risk of cardiovascular diseases.
• Weight Management: Exercise helps in managing weight, countering the weight gain often a result of antipsychotic medications.
• Strength and Flexibility: Tailored exercise programs enhance muscle strength and flexibility, promoting overall physical well-being.

Mental Health Benefits

• Mood Enhancement: Physical activity stimulates the release of endorphins, which help improve mood and reduce feelings of anxiety and depression.
• Stress Reduction: Regular exercise helps lower stress levels, which benefits individuals experiencing the high stress often associated with schizophrenia.
• Cognitive Function: Exercise has been shown to improve cognitive functions such as memory, attention, and executive functioning, which are usually impaired in schizophrenia.

Social and Behavioural Benefits

• Social Interaction: Group exercise programs provide opportunities for social interaction, reducing feelings of isolation and loneliness.
• Routine and Structure: Engaging in regular exercise adds structure to daily life, promoting a sense of routine and purpose.
• Improved Self-Esteem: Achieving exercise goals can boost self-esteem and confidence, improving overall mental health.

Designing Exercise Programs for Individuals with Schizophrenia

When designing an exercise program for individuals with schizophrenia, it is important to consider their unique needs and challenges. Here are some key factors to take into account:

Individual Assessment

• Health Status: Conduct a thorough assessment to understand the individual’s physical and mental health status.
• Medication Effects: Consider the side effects of antipsychotic medications, such as weight gain and fatigue, which may impact exercise tolerance.
• Personal Preferences: Take into account the individual’s interests and preferences to ensure the exercise program is engaging and enjoyable.

Setting Realistic Goals

• Short-Term Goals: Set achievable short-term goals to help the individual experience early success and stay motivated.
• Long-Term Goals: Establish long-term goals that align with the individual’s overall health and wellness objectives.

Creating a Supportive Environment

• Safe and Inclusive Space: Ensure the exercise environment is safe, inclusive, and free from stigma.
• Support Network: Encourage the involvement of family members, caregivers, friends, or peers to provide support and encouragement.

Monitoring and Adjusting the Program

• Regular Monitoring: Keep track of the individual’s progress and adjust the exercise program as needed.
• Flexibility: Be flexible and willing to modify the program based on the individual’s response and any changes in their condition.

Case Study: Success Story of an NDIS Participant

Background

An NDIS participant with schizophrenia faced significant challenges, including high falls risk due to age, social isolation, and decreased mental health. Antipsychotic medications contributed to weight gain and reduced motivation.

Intervention

After including Exercise Physiology in their NDIS plan, a tailored exercise program was developed focusing on strength training, balance exercises, and cardiovascular activities. Regular weekly sessions were held with an Exercise Physiologist, and the following outcomes were achieved over 2 years of consistent intervention.

Outcomes

• Increased body strength: The participant experienced a notable increase in body strength, enhancing the ability to perform daily activities independently.
• Improved walking capacity: The participant’s walking capacity increased significantly, allowing for regular walks with a support worker, contributing to better cardiovascular health and social interaction.
• Enhanced confidence with movement: Confidence in movement improved, reducing anxiety related to physical activities.
• Decreased frequency of falls: There was a marked decrease in the frequency of falls, thanks to improved strength and balance.
• Improved mental health: The participant’s mental health improved considerably, leading to a reduced need for psychiatric consultations and medications.
• Weight loss: The participant lost over 20 kg, combatting the weight gain caused by their antipsychotic medications.

The Future of Exercise Physiology in Mental Health Care

The integration of Exercise Physiology into mental health care represents a promising advancement in the treatment of schizophrenia and other mental health conditions. As awareness grows about the benefits of physical activity for mental health, more healthcare providers are incorporating Exercise Physiology into their treatment plans.

Conclusion: Empowering Lives Through Exercise

Schizophrenia is a challenging condition, but with the right support and treatment, individuals living with it can lead fulfilling lives. Exercise Physiology offers a powerful tool for managing the physical, mental, and social challenges associated with schizophrenia. By designing and implementing tailored exercise programs, Exercise Physiologists can help individuals with schizophrenia improve their overall health, confidence, and quality of life.

If you’re interested in learning more about how EP can help you, contact us. Let us know how we can help you start your journey to #ChronicGains!