Homeostasis, Exercise, and COVID-19 Isolation

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The Value of Exercise

A recent post explored human needs during COVID-19 isolation. The success of social isolation policies will depend on minimizing long-term depreciation of mental health. In this post, I explain the benefits of developing a system of daily exercise to bolster well-being.

Exercise is an under-utilised resource that is freely available to almost everyone, which can bring profound benefits if applied systematically. The impact of exercise is one of the most powerful examples of regulation created by homeostasis. Regular physical activity not only has obvious physical benefits but significant psychological benefits also. During COVID-19 isolation, exercise offers the capability to reset body and mind to a more optimum state of equilibrium.

Hawley et al. (2014) state: “Exercise represents a major challenge to whole-body homeostasis, and in an attempt to meet this challenge, myriad acute and adaptive responses take place at the cellular and systemic levels that function to minimize these widespread disruptions.”

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The Physiological Responses to Voluntary, Dynamic Exercise. Multiple organ systems are affected by exercise, initiating diverse homeostatic responses. Reproduced from ‘Integrative Biology of Exercise’ by Hawley et al. (2014).

Note of caution

Apart from its general ability to challenge homeostasis to reset the body’s biological equilibrium, exercise has a role in two domains of well-being:

(1) the immune system is strengthened through regular physical activity (Campbell and Turner, 2018; Simpson et al., 2020)

(2) psychological well-being is enhanced (Mandolesi et al., 2018).

However, exercise is no panacea.

Exercise must be applied with caution especially by people with chronic conditions. If a person has a heart condition, strenuous physical exercise may put them at risk (Keteyian et al., 2016).

In some chronic conditions such as ME/CFS, exercise tends to make many patients feel much worse (Geraghty et al., 2019).

However, if used safely and appropriately, the majority of people can quickly feel physical and mental benefits from regular exercise.

Physiological Mechanisms

Some significant effects of physical activity can be explained by physiological mechanisms (Lopresti et al., 2013). Exercise within the context of psychological health promotion has also been an active research area (Chekroud et al., 2018; Curioni and Lourenco, 2005; Mikkelsen et al., 2017; Tiggemann and Zaccardo, 2018). Some researchers have focused on neurophysiological mechanisms, which aim to identify the positive outcomes of the relationship between exercise and mental health (Eyre and Baune, 2012). Exercise is understood as a relationship between intensity and frequency, and positive outcomes are mostly based on which exercise protocol will determine a better neurophysiological response (Lopresti et al., 2013). Exercise is recognized as a mediator of primary monoamine neurotransmitters, namely, serotonin, noradrenaline and dopamine. These three neurotransmitters receive reciprocal regulation, while exercise intensity modulates the stimulation of monoamine system (Lin and Kuo, 2013). However, it is also important to recognize the affective responses of physical activities and psychological variables are likely to mediate the relationship between exercise and mental health (Rodrigues et al., 2019). There is a sound empirical basis for an integrated account of the emotional effects of exercise. A recent study with a representative US sample of 1.2 million individuals linked exercise to mental health and exercising was associated with reduced self-reported mental health burden. Furthermore, motivation and mindfulness-based techniques act as mediators for these relationships, which seem to account for the strongest effect of the exercise on fewer days of poor mental health (Chekroud et al., 2018).

Joy and Happiness

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In the context of social isolation, exercise can be an inherently rewarding activity that contributes joy, happiness and satisfaction (Ryan and Deci, 2017; Standage and Ryan, 2012). The positive outcomes also appear as a function of affective consequences of exercise or anticipation of its affective response – the hedonic principle of the law of effect (Marks, 2018). In general, the expected pleasure versus displeasure is a determining principle of the motivation to repeat behaviour (Kwasnicka et al., 2016; Williams, 2008).

Isolation and quarantine are a disagreeable experience, which may lead to sadness and even impose dramatic mental illness for those who undergo it (Brooks et al., 2020). In this context, a daily exercise routine can be crucial to modulating pleasurable situations at some point during the day. People can feel more deeply satisfied through the experience of choice and volition, reinforce their sense of autonomy and competence, and renew a sense of joy (Lubans et al., 2017; Ryan and Deci, 2017; Standage and Ryan, 2012).

The benefits of exercise depend on the degree of internalization of the behaviour. In our daily lives, exercises are normally performed in order to achieve goals, such as social aesthetic standards (Sperandei et al., 2016). These goals are separable from the purpose of the exercise (a person may not enjoy exercising, but will do it to obtain a result); and therefore, people are generally not ‘authentic’. The lack of authenticity represents a person doing an activity for contingent reward or punishment, feeling tense and pressured, lacking intentionality and being oriented to avoid guilt, angst and social judgement or to protect contingent self-worth. Contrarily, people are authentic when exercise choice is aligned with personal goals, interest and is assimilated with the individual’s characteristics, ability and identity (Deci and Flaste, 1995). Identity is associated with ongoing positive experiences attendant on the behaviour (Kwasnicka et al., 2016), such as exercising at home.

Notably, the COVID-19 pandemic causes fear and the lockdown imposes limits on people’s movement (Brooks et al., 2020; Xiang et al., 2020).

The rationale for the positive side of exercising at home is that exercise can be experienced without any strong social pressure, having a totally internal source of inspiration. The behaviour might be accompanied by higher self-esteem and lower psychological ill-being, since we are free to choose the:

  • types of exercise
  • schedule
  • frequency
  • intensity

The fulfilment of basic psychological needs appear within this context.

Authenticity and Self-Compassion

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Another helpful process is that of self-compassion – the ability to treat oneself with the same concern and support in distressing situations; it is related to self-kindness, common humanity and mindfulness. In fact, it is associated with self-regulation when performing health-promotion behaviours (Holden et al., 2020; Semenchuk et al., 2018). Exercising at home, in a crisis situation, can be performed without self-criticism, which could hinder the process by increasing pressure and self-judgement, which in turn may provide adaptive coping, problem-solving and psychological well-being.

Research has provided empirical evidence on the positive relationship between self-compassion and exercise in providing exercise maintenance and enhancing positive emotions (Holden et al., 2020; Semenchuk et al., 2018).

Mastery and Self-control

Exercising at home can increase the individual’s sense of control. Research suggests that self-mastery is a crucial criterion for promoting positive effects on psychological outcomes (Mikkelsen et al., 2017; Ryan and Deci, 2017). In the face of this pandemic, we have seen many examples across the world showing that exercise can create a social arena in which individuals learn social skills and build social networks by adhering to exercise challenges, exercising in condominiums and encouraging others. These virtual social connections enhance feelings of autonomy and being fully alive. When autonomous forms of regulation guide behaviour, positive affective responses are expected (Ryan and Deci, 2017; Standage and Ryan, 2012). One example is the QuaranTrain launched at HAN University of Applied Sciences in the Netherlands, an online fitness programme promoting evidence-based information on exercise and resources to stay active during COVID-19 pandemic through blogs and videos (HAN University of Applied Sciences, 2020). They provide daily online support, according to World Health Organization advice on physical activity. Users post their workouts routines in social media using the trending hashtags #quarantrain and #quarantraining, with more than 5000 posts worldwide.

Self-efficacy and Self-esteem

Being engaged in exercise may result in higher levels of self-efficacy (Bandura, 1997) which can have the knock-on effect of improving one’s ability to carry out other activities (Mikkelsen et al., 2017). The relationship between changes in the ability to perform activities successfully and increased self-efficacy is fundamental, considering the observed association between depression and low self-efficacy (White et al., 2009). In the context of social isolation, physical activity may be one key to enhancing people’s feeling of competence. In addition, achievement of internal goals and satisfaction has been related to greater psychological wellness (Ryan and Deci, 2017; Standage and Ryan, 2012). This hypothesis has been confirmed by an experimental protocol in which mindfulness self-efficacy appeared to mediate the indirect effects of exercise on mental health and perceived stress (Goldstein et al., 2018), reinforcing the positive account of emotion for a better quality of life (Joseph et al., 2014).

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Mikkelsen et al. (2017) observed that exercise influences self-esteem through self-efficacy or mastery, and mood, distracting individuals from negative and worrying thoughts and rumination, improving the retrieval of positive thoughts and allowing time away from negative or stressful aspects of everyday life, and especially, the COVID-19 pandemic itself. These moderating factors might also explain the protection effect of exercise on mental health (Mikkelsen et al., 2017).

Physical activity programmes to improve self-esteem to people of all ages can be effectively delivered at home by DVD (e.g. see Awick et al., 2017) or by You Tube (e.g. PE with Joe).

Peer Support

Moreover, people in social isolation should try to create peer support through social networking services by involving friends and relatives in their exercise routines or challenges.

Resources

 

The negative impacts of COVID-19 lockdown on mental health can be ameliorated by the use of exercise, which should be as vigorously promoted as social distancing itself.

In this context, keeping moving seems to be the key.

Reference:

Thiago Matia, Fabio H Dominski and David F Marks (2020)

“A classic in the field”

Warm thanks to the following seven endorsers of  Health Psychology (4th & 5th Editions) quoted below:

Fourth Edition:

“This book has become a classic in the field – sophisticated,  accessible and interesting.   It is of great use to students, teachers and practitioners of Health Psychology world wide.”

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Leslie Swartz, Distinguished Professor of Psychology, Stellenbosch University, South Africa.

“This is a remarkable book. It is exceptionally complete, thoughtful, and deep.  It avoids the superficial accounting of many texts and does not shy away from controversy. It is fully rooted in today’s science of health psychology.”

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Stevan E. Hobfoll, Ph.D. Professor of Behavioral Sciences, Medicine, and Preventive Medicine, Rush University Medical Center, Illinois, USA.

 

“A very nice introductory text that takes a biopsychosocial approach to health and illness, and recognizes the importance of culture, health literacy, and issues such as racism and health inequities/disparities that continue to impact disadvantaged communities.”

Cheryl Holt

Cheryl L. Holt, University of Maryland, USA.

 

“Like other textbooks, this book provides a comprehensive introduction to the field of health psychology. Unlike other books however, this one takes a holistic-systems approach to health, and uses the novel concept of the Health Onion to do so: The myriad determinants of health are presented as different layers – biological, familial, behavioral, neighborhood, social and cultural – that must be scientifically-examined and peeled away to understand health. Consequently, the book contains many valuable chapters that other textbooks lack, including chapters on macro-level influences (Chapter 2), social justice and social inequality (Chapter 3), and cultural factors (Chapter 4). Moreover, the examples provided to illustrate each layer of the influences on health are global ones, and include health and its psychology in Europe, the USA, Asia, Africa, and elsewhere. This unique approach helps students understand that the health of individuals is a part and product of the family, social-network, neighborhood, and society in which they are embedded. Hence, this revised edition provides an excellent overview of health and of the science of health psychology in their local and larger contexts.”

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Hope Landrine, Professor of Public Health and of Psychology, Brody School of Medicine, East Carolina University, USA.

 

Just as the Journal of Health Psychology is not like any other journal in the field, this new edition of David Marks’ “Health Psychology” textbook is different from all the other textbooks in the field. It will broaden your perspectives as it educates your mind.

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Kenneth A. Wallston, Professor of Psychology, Emeritus, School of Nursing, Vanderbilt Institute for Global Health, USA.

 

Fifth Edition:

An essential text for both graduate and undergraduate health psychology courses, the authors elegantly and comprehensively explore health psychology in the 21st century.  The fifth edition further advances a critical perspective on health while introducing readers to emerging issues such as long-term conditions and end-of-life care.

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Christopher Godfrey, Professor of Psychology, Pace University, USA. 2018-01-01

Marks and colleagues’ capacity to provide a global perspective, while including elements of social justice, with a consideration of the social and political determinants of health, makes this text an invaluable companion when introducing undergraduates to the field of health psychology.

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Nancy L. Worsham, Professor of Psychology, Gonzaga University, USA.  2018-01-01