Exercise as the fifth vital sign

You may be familiar with the four vital signs that clinicians monitor: body temperature, pulse, respiratory rate, and blood pressure. When you visit your health care provider for your annual physical exam, for example, they will measure each of these, as they are key indicators of health.

However, these are far from the only indicators of health. What about mental health? Body temperature, pulse, respiratory rate, and blood pressure can give us clues about your physical health and medical issues that may be affecting your body. But what are the vital signs of mental health?

It turns out that there are several ways to monitor the mental health of patients. Sleep patterns, eating habits, substance abuse problems, and exercise habits, among others, give you and your clinician clues about your mental health. Here I want to zoom in on exercise, in particular, and why I like to call it the fifth vital sign.

Our bodies and minds are intertwined

First of all, it’s important to remember that our minds and bodies are connected. What affects your mental state also affects your physical state. In fact, your mood can affect all four physical vital signs:

Body temperature: People with depression have a less active thermoregulatory system, which gives them a complicated relationship with body temperature. They also tend to have a higher core body temperature and are less able to sweat.

Heartbeat: A recent study found that depression could be detected with a 90% accuracy rate by monitoring a patient’s pulse for 24 hours.

Respiration rate: In a study examining the link between asthma and anxiety and depression, researchers found that respiratory symptoms such as wheezing, shortness of breath, and nighttime breathing problems were more prominent in people with depression or anxiety.

Arterial pressure: When you are depressed, your heart rate and blood pressure increase. Blood flow is also reduced and your body makes more of the stress hormone cortisol.

Additionally, we know that psychological stress can manifest itself in the form of headaches, stomach aches, other bodily pain, and general malaise. Because our mind is hardwired to protect our bodies from stress and trauma, we perceive feelings of anxiety as threats. And we know how our body reacts to threats: fight, flee, or freeze.

Stress and anxiety can also affect your digestion, and trauma can affect hormone levels, putting patients at risk for serious psychiatric disorders, such as depression, premenstrual dysphoric disorder (PMDD), or certain types of disorders. obsessive-compulsive (OCD). And serious psychiatric problems have been linked to an increased risk of chronic diseases such as heart disease, diabetes and stroke.

Additionally, while mental health issues can lead to physical health issues, the causal arrow can go the other way as well. Injuries or chronic illnesses that cause pain or limit physical activity can lead to poor mental health. For example, a runner with an ankle injury that prevents them from running or participating in other activities they enjoy, may feel anxious, upset, or angry. These feelings can be persistent and start to interfere with daily life.

So while it is certainly possible for astute clinicians to spot mental health issues in a patient by watching for physical signs, asking gentle lifestyle questions is much more likely to provide useful information.

Why exercise is the fifth vital sign

Since the start of the pandemic, there is no doubt that many of us have experienced negative impacts on mental health. Lockdowns due to COVID-19 have led to social isolation as well as an increase in cases of anxiety and depression. And for the record, those who weathered the pandemic storm the best were those who followed a regular exercise routine.

But even if you wouldn’t describe yourself as having a mental disorder, and even if you aren’t aware of how circumstances, such as a global pandemic, are affecting your psychology, that doesn’t mean you are the image of the. Mental Health.

The World Health Organization defines mental health as “a state of well-being in which an individual becomes aware of their own abilities, can cope with the normal stresses of life, can work productively and are able to make a contribution to its communities. Mental health is fundamental to our collective and individual ability as human beings to think, move, interact with one another, earn a living and enjoy life.

What is interesting about this definition is that it is about lifestyle and I know from my own clinical experience that lifestyle modifications can be most beneficial for people with disease. serious mental. Exercise is an essential part of lifestyle modification. And that’s why I call it the fifth vital sign.

In addition to the physical benefits, exercise improves mental health by reducing anxiety, depression, and negative mood, and improving self-esteem and cognitive function. For patients with schizophrenia, exercise is even more critical as they are vulnerable to obesity and weight gain is a common side effect of taking antipsychotic drugs.

To see the physical and mental benefits of moving your body, experts say that just 30 minutes of moderate exercise, such as brisk walking, three days a week is enough. And those 30 minutes can be continuous or spread out throughout your day. In other words, three 10-minute walks are as beneficial as a 30-minute walk.

The proof speaks for itself. Clinicians who regularly check patients’ vital signs should also educate themselves about their level of exercise. Even a quick conversation can put a patient on the path to improving their mental and physical health.

Regular exercise has several health benefits that every clinician should emphasize and reinforce for their patients, including:

  1. Improved sleep
  2. Increased interest in sex
  3. Better endurance
  4. Stress relief
  5. Improved mood
  6. Increased energy and stamina
  7. Reduced fatigue which can increase mental alertness
  8. Weightloss
  9. Lowering cholesterol and improving cardiovascular fitness

Although more research should be done to determine the impact of combining physical activity interventions with traditional mental health treatment, including psychopharmacology and psychotherapy, clinicians can learn more than they can. appears by asking patients about their exercise levels.

In addition to chatting with your clinician about your body temperature, pulse, respiratory rate, and blood pressure, make exercise part of the discussion. Let’s elevate exercise and consider it the fifth vital sign.


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