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ACTIVE RECOVERY FOR

MANAGING YOUR MOOD!

WORKSHOP 3

Aim: Enhancing motivation and confidence to become more active

PART OF THE

IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES (IAPT) PROGRAMME

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"The information provided is based on the best evidence available and IAPT makes every attempt to ensure it is accurate and reliable. However, the information cannot always reflect all the most recent research and some of it is provided by third parties (including websites). IAPT takes no responsibility for errors or omissions".

Contents

Introduction 4

Definitions of physical activity & exercise 5

Are you fit for your life now and the life you want? 6

What are the benefits for you? 7

What is stopping you? 8

How much activity is enough? 9

How much energy do you have at the moment? 13

National recommendations for health 15

Home Activity record 18

Activity timetable 19

Session 1 Recap 20

Time for Action! 21

What’s the next Step? 22

Your Health. Your Choice 23

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Introduction This Active Recovery session is aimed at empowering people to become more confident and motivated to be more physically active and to consider the factors that can prevent us from becoming physically active.

• What types of activities are there?

o Aerobic - if ‘steady’, can do this for longer e.g_____________________________________________

o Anaerobic - can’t do for very long <2-3mins e.g_____________________________________________

o Strength/resistance - works specific muscles e.g_____________________________________________

o Stretching - improves flexibility & injury e.g_____________________________________________

o Co-ordination - improves our ability to do ‘tricky’ tasks

e.g_____________________________________________

SSoo wwhhaatt iiss PPhhyyssiiccaall

AAccttiivviittyy??

Any bodily movement

produced by skeletal

muscles that results in

energy expenditure above

resting level.

WWhhaatt iiss PPhhyyssiiccaall ffiittnneessss??

A set of attributes that people

have or achieve that relates to

the ability to perform physical

activity

WWhhaatt iiss EExxeerrcciissee??

Planned, structured and

repeated bodily

movement done to

improve or maintain one

or more components of

physical fitness

WWhhaatt iiss hheeaalltthh--eennhhaanncciinngg

pphhyyssiiccaall aaccttiivviittyy??

Any physical activity that benefits

either health &/or what we are

able to do, without undue harm

or risk.

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So why is being physically active important for me?

Extensive research (and lots of word of mouth!) has shown that:

PA helps to significantly improve physical and mental wellbeing.

• PA Improves o symptoms of

depression o mood o self-perception/worth o confidence o self esteem o quality of sleep o relaxation o focus/purpose o energy o healthy appetite o fun and achievement

PA reduces

o stress o anxiety o anger o mental fatigue o dwelling on unhelpful

thoughts/ worries o social isolation

How? PA is shown to increase levels of Serotonin and Endorphins which makes us happier. These may also be involved in sleep, appetite and sex drive.

It’s so good, in fact: PA is 1 of 4 recommended psychological therapies for people with mild to moderate depression and chronic physical health problems across England and Scotland. Others recommended are CBT courses, 121 CBT & cCBT.

In addition, PA promotion + Cognitive Behavioural Therapy (CBT) = longer lasting effects!

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Those people that do none/little PA

have most significant health benefits

to gain!

How much activity do we need to do to get these benefits?

This graph identifies potential health benefits that can be gained from PA:

▪ The bars demonstrate variations between the levels of activity and the health benefits that are gained from each level.

i.e. none/low levels of activity on an irregular basis i.e. moderate levels of activity on a regular basis i.e. vigorous levels of activity on a very frequent basis

DOSE RESPONSE

CURVE

BASELINE

ACTIVITY STATUS

LOW

MEDIUM HIGH

HEALTH

BENEFITS

Low

W

High

HIGH

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How do I know if I am doing enough/too much?

Doing vigorous activity has increased risks. Although extra health benefits can be gained from exercising harder, it is not a good idea to start exercising vigorously from doing nothing/irregular activity. It is important to build activity gradually to a level that is comfortable for you.

Would you pass the ‘Talk Test’? At a moderate level of activity we should still be able to talk, although we should notice a change in our breathing - no singing allowed though!!

Slightly raised heart rate (pulse rate)

Feel warmer

Slight shortness of breath

(For most this may equal a brisk walk)

To gain maximum benefit with the least

risks, physical activity should be ‘moderate’.

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Fitness is specific to what you are used to – you may be used to walking, but climbing stairs can work different parts of the body and make you more tired.

How much activity should I aim to do? National recommendations for health are to build up to: A Minimum of 30 minutes moderate activity on at least 5 days a week. (60 minutes for children or young adults.)

Or A minimum of 20 minutes of vigorous activity on at least 3 days a week.

And

approx. 10 strength exercises, 10 repetitions of each, 2 days a week

But

This can be broken up into bite size chunks of 10 minutes or more.

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How long you are active for will be related to:

o how hard you are working o what type of activity you are doing o how fit you are / how familiar you are with doing the activity

I.e. It will probably be harder to dig for 15mins than to walk for 15mins

Mental health benefits can be gained from short periods of physical activity

So…..Even a 10 minute walk can help you to feel more refreshed!!

Variety is the

Spice of life!!

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Cycle of Inactivity

The Cycle of Inactivity helps us to identify the ‘vicious circle’ inactivity can create. It helps us to see what an unhelpful impact being inactive can have on us. It can also help us to identify what factors keep us being inactive. Only when we have identified the impact of inactivity on us individually, can we look at breaking out of the vicious circle to a more helpful upward spiral. * Pain/unpleasant experience/Catastrophising:

- Current physical pain, or previous unpleasant experiences from doing activity can make us fearful of wanting to be active

- Low mood, anxiety, or unhelpful thinking can make us feel that being active is too much to deal with

* Fear of activity or stressful situations:

- From the experiences above, comes a fear/ anxiety/ stress of doing an activity, or thinking about doing an activity

* Avoidance

- This fear can ‘snowball’ in to avoiding the activity altogether

* Disability, disuse, depression - Avoiding doing an activity altogether can affect us physically

and mentally, and so potentially increase the vicious circle further

* No fear:

- Finding a way to increase our confidence in certain activities, will reduce our fears of doing an activity – what is ‘right’ for you?

* Confrontation & recovery - If we have less fear or stress, we are much more likely to try

certain activities & to tackle our apprehensions - one step at a time.

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-

Think about your own ‘cycle of inactivity’ – when you are considering becoming more active, what things do you do, think or feel? The first line is showing a few examples for you. See if you can fill in some more from your own experiences

What I say to myself

What I feel physically

What I feel emotionally

What I do

I’ll never be able to do it

Always tired / no energy

Feel hopeless Eat to make me

feel better

I know I’ll feel better when I

get there

Heart racing Nervous, but

excited

Arrange to meet a friend to walk

with

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So what about the things that get in the way?

Barrier Nothing Something Possible actions

I’m unfit

Start at own pace and build up Something is better than none!

Fear of failure Childcare/carer?

As above Community crèche/respite care?

Social anxiety

Single sex gym/ be active with a friend

Transport Money

Car share / walk / cycle? Activity on prescription/ Natural Choices / Living well

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Thoughts, physical feelings, emotions and behaviours

Think about your own situation – when you are considering becoming more active, what things do you do, think or feel? Use one row for each example and try and link the columns together. The first line is showing a few examples for you. Fill in some more from your own experiences

What I say to myself

What I feel physically

What I feel emotionally

What I do

I’ll never be able to do it

Always tired / no energy

Feel useless Eat to make me feel better

I know I’ll feel better when I get there

Heart beating faster

Nervous, but looking forward to it

Arrange to meet a friend to walk with

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Be active: make it happen! Before we can look to change something about ourselves, or our lives, we need to understand where we are at the moment in terms of making that change happen. Then we can look at what steps we need to take to make it happen The picture overleaf looks at the ‘Cycle of Change’ and can help us to see;

• where we are now

• where we have come from

• what steps we need to take to help us make that change

Use the space below to write down what each of the steps involve.

Pre-contemplation

Contemplation

Preparation

Action

Maintenance

Relapse

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Decisional Balance

This tool helps us to work out pros and cons of becoming more active and pros and cons of staying as we are. Use the diagram below to write down the pros and cons of becoming more active or not for you. Benefits / pros Costs / cons

Increase activity Staying same

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Top tips to be active!

Add your own ideas below:

Social • Be active with a friend – its

more fun together

• Be a good role model for your family (children learn from what their parents do!)

• Vary what you do to keep you motivated– variety is the spice of life!!

• A ‘good’ activity is only one that you can keep going with

• Be active in a green environment – helps lift your mood and can relax you more

• Distract yourself – listen to your favourite music whist doing the housework!

• Take the dog for a walk

Change for the better • Start slow at first

• Making small, but frequent changes are easier than big ones. I.e:

o Take stairs instead of lift o Walk to the next bus stop &

get off one stop early o Wash the car by hand o Walk for short distances o Throw away the remote

control!

• Write down how good you felt last time you were active and keep it on hand to remind you when your motivation is low

• Use reminders to prompt you to be active.

• Have a pair of comfy shoes in places where you could be active i.e. at a friends house

• Be patient, it won’t happen overnight – Rome wasn’t built in a day!!

Goals • Set yourself goals and be nice to yourself!!

• Remember to review your goals, don’t worry if you have to change the goal posts slightly, you are doing this for you!

• Use a pedometer to see how far you have come – literally!!

• If you miss an opportunity to be active, try to get back into it again ASAP, the longer you leave it the harder it becomes!

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Building up your activity levels

If you are unsure whether your health condition will affect your ability to exercise, it is important to ensure that you have checked with your GP before you to start increasing your activity levels. However, if your condition is ‘stable’ and you are looking to start/ increase moderate activity, there should be no reason why you cannot start slowly and build gradually. So, start with what you are able to do at the moment………

How should I increase my activity over time? Slowly! ………Look at the length of time you are active before making the activity harder. OR ………Look at increasing how often you are active, before making the activity longer or harder. I.e. “I am going to Increase my activity levels from 1 x per week to 2 x per week.” Research recommends that we should increase our activities by a maximum of 10% after a minimum of 3 times at the old level. For example: If you walk for 10 minutes per day, you can increase it by 1 min = 11 minutes new total If you walk for 30 minutes, you can increase it by 3 minutes = 33 minutes new total

(or slightly increase the speed or incline that you walk)

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Setting goals to become more active

Many factors affect whether or not we achieve our goal

Results

+/-

ActionsQuality

Quantity

Consistency

Attitude

+/-

ExpectationsSuccess

Failure

BeliefsLimiting

Empowering

GOAL

Self Image

+/-

The

Success

Cycle

Unforseen circumstances

=Things that just get in the way!!

Unforseen circumstances can crop up when we least expect them. You may have little or no control over them, so allow time to deal with them and give

yourself a break!

I.e. Instead of planning to go for a walk every day, start by aiming for a walk 3 days a week – just in case it rains or great Aunt Bessie calls and talks for

hours and you are not able to get away!

• How have you dealt with unforeseen circumstances before?

• How could you deal with unforeseen circumstances?

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Top tips for sticking to your activity programme (adapted from Living Well www.calgaryhealthregion.ca/cdm

Don’t Forget Plan

• Keep an activity record

• Allow for flexibility/unforeseen events

• Be prepared for relapse, forgive, forget & learn from it!

• Enjoyment Factor!

• The ‘best’ activity is one you enjoy

• Find support

• Know why you are exercising

• Variety is the spice of life!

• The environment in which you are active plays a big part!!

• Being active in the natural environment can help distract you whilst you are active, meaning you don’t notice tiredness as much

• Being active in a ‘green’ place is scientifically proven to be better for your emotional health –whatever the activity!!

Be safe

• If you have any pain which may you feel be cardiac, stop what you are doing and rest. If the pain persists, you should seek medical advice. If you have a GTN spray, don’t worry about using it!

• If you get short of breath, slow down what you are doing. Use the BORG scale to monitor it.

• Avoid straining / sudden jerks with movement to minimise the risk of injury

• If you are feeling unwell, or are injured, CHANGE what you do. Try not to stop altogether e.g. instead of swimming, go for a gentle walk

Food and Drink Try not to exercise too soon after eating. Allow:

o 1.5- 2 hours after a heavy meal

o 1 hour after a small meal o 30 mins after a snack

Try to ensure that you drink plenty of fluids, esp. if you sweat a lot

Comfort

• Try not to exercise in extremes of temperature i.e exercising in a freezing cold wind or in the midday summer sun

• Remember it’s NOT a competition; be active at your own pace!

• Be comfortable in what you wear & where you are

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Review your activity

Did I do what I planned?

What stopped me from doing my planned task?

No Yes

What went well?

What have I learned?

Is there something I could improve next

time?

What was I thinking at the time?

How did I feel?

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Session Recap!

• ‘Physical activity’ & ‘exercise’ differences / similarities

• The benefits of becoming more active are huge and span physical , mental and social aspects

• Those who do little or no activity have the most to gain!

• Start with what you do right now – build up gradually – it’s the small changes that count!

• At every opportunity to be active you can make a decision – make it an active choice!!

• Identifying thoughts, physical feelings and behaviours towards

physical activity helps us see the impact of being inactive on you!

• The Decisional Balance can be a useful tool to weigh up the

positive and negative factors of becoming more physically active

• Reviewing your activity is an important part of maintaining the

activity. Remember your top tips for getting and staying active!!!

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Time for Action?!

• Do I want to get active to aid my recovery? Yes / No

• What would I really like to do, in relation to physical activity?

• By when?........................................................................................

• How? To help reach this goal, I will (specific behaviours to reach goal, include frequency)…

• When I manage to do the above, I will (reward)

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What’s the next Step?...

What one thing could I do this week to become more physically active? Top Tip: Remember it has to be realistic and achievable for YOU! What can you do to take the next step?

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What can you do differently from today?

Activity level

Activity Low Moderate Vigorous A brisk walk on the flat

Walking up a flight of stairs

Hanging the washing out

Using a lift/escalator

Digging up a tree stump

Washing up

Cleaning the windows

Vacuuming/sweeping the floor

Walking uphill in the wind

Swimming

Pulling weeds out of the ground

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Need more help?

Locally

- Live Well Dorset; support with physical activity, slimming on prescription, stopping smoking and drinking less www.livewelldorset.co.uk or 0800 8401628 / 01305 233105 or email queries@livewelldorset.co.uk

- Natural Choices encouraging activity in the outdoors

https://www.dorsetforyou.com/natural-choices

- Leisure centres have gyms, badminton, squash, table tennis, fitness classes for all levels and swimming pools, together with private clubs using them i.e martial arts.

- Private run classes in church halls / community centres

Nationally

- Mental Health Foundation www.mentalhealth.org.uk

- NHS Choices www.nhs.uk

- National Trust www.nationaltrust.org.uk and search ‘allotments’

- BBC website www.bbc.co.uk/headroom/wellbeing

- BBC website www.bbc.co.uk/health/conditions/mental_health/index.shtml