“Try to walk around the block once a day. If that feels overwhelming, try to walk around the house at least.”
Many times I have said this sentence to patients experiencing depression, whose condition drains most of them of all energy and motivation so that they would prefer to close their eyes to the world and sleep through the day. But how would taking a walk cure someone from depression? Well, it doesn't cure, but it does provide some much needed relief.
The mind and the body are in constant interplay. It is not useful to separate the mental processes from the physical ones, because these two affect each other and they together form a system which is us.
During my years working in MSF, I’ve come to witness this frequently. Patients with amputations who struggle with intense physical and phantom pain get relief from psychological treatment. The experience of pain has a significant psychological component and patients can be taught relaxation techniques, and new ways to think about and cope with their pain. The same patients start to feel joy again when their body heals and regains its functioning. However, the healing would not take place unless the patient had gained the psychological resources to work towards healing.
Psychologically traumatised patients will present with a number of somatic complaints; headaches, stomach pains, back pains, dizziness, chest pain, high blood pressure. The pathway between psychological trauma and physical illness is complex. Contributing factors include the unhelpful changes in behaviour that can result from the trauma – like immobility caused by the fear to go out - and physiological changes from chronic stress. The patients’ bodies will likely continue to hurt until someone helps them process that terrible event they experienced and explain how the memories of it are linked to the symptoms they manifest.
Here in Zimbabwe I work with psychiatric patients. We can see how their anxieties are relieved by movement, deep breathing and physical relaxation. These exercises will not remove anxiety, but they can reduce its impact from 90% down to 70%. The patients can use these skills to decrease their stress and avoid their psychiatric symptoms from becoming overwhelming.
Twice a week the psychiatric unit is visited by a group of professional dancers, who dance with the patients and help them connect the body and the mind. Some patients who have difficulties verbalizing their situation and who seem very introvert otherwise come out of their shell during the dancing, they interact with others and they start smiling.
On a personal note, physical movement is part of my own psychological wellbeing. When being humorous I tell my friends that if it wasn’t for indoor cycling, I would need to take benzodiazepines. Working in the field for MSF can be emotionally very demanding, and I have found that physical exercise is among the best preventive measures and cures for that stress.
Currently I am fortunate to work in a city setting where I have access to a gym. In other field projects one must be more creative: running in circles inside a 10x20 meter compound, dancing in a tukul at night with colleagues, doing tai chi exercises in the privacy of one’s own room, doing bush walks with the feet buried in mud, running on a shaky and broken treadmill, or doing push-ups next to big spiders in a basement. You name it, I’ve done it. Once I did Zumba with two colleagues in our little house which was built on poles. Our colleague later said that to the outside it sounded like three elephants were running amok inside the house. But we were happy!