Physical fun as remedy

Before Dr. Scott Nichols was a psychiatrist at Enloe Behavioral Health, he was a radiation oncologist who regularly found himself counseling cancer patients as they struggled with the enormity of being diagnosed with a potentially terminal disease.

“Once you have this life-threatening illness, a lot of people struggle with what’s meaningful in life, what makes life worth living,” Nichols said during a recent interview at Enloe Behavioral Health. “If people are facing the end of their life and then they get cured of the cancer, that throws everything they were previously doing into a new light.”

As he often does now with psychiatric patients suffering from depression or anxiety, Nichols would recommend his cancer patients seek fulfillment through physical exercise. But not just any exercise—for the greatest mental-health benefits, the physical activity had to come in the form of something the patient found genuinely engaging and fun.

“My work is to help [patients] reconnect with what’s meaningful in their life and put their life together in a way that they can feel good about,” he said.

Nichols will discuss the relationship between physical activity and mental health at the Gateway Science Museum on April 10, at 7:30 p.m., during his presentation, Motion/Emotion: Improving Health by Having Fun. His lecture is the second installment in the Gateway’s month-long Museum Without Walls lecture series, held each semester for the past 10 years. Curiously, this spring marks the first time the lecture series will be held in the museum; previous series were hosted by the CARD Community Center.

This spring’s theme, Medicine in Motion: The Science in Sports, ties in with the Gateway’s two current traveling exhibits, Sportsology (which focuses on physical challenges and physiology through interactive exhibits) and Brain Teasers 2 (which highlights mental challenges and cognitive neuroscience with a collection of puzzles), said Renee Renner, the museum’s director of exhibits and education.

“There’s a lot of interest in neurological disorders or injuries related to sports in the news, athletes who have suffered from depression or debilitating injuries to their central nervous system,” Renner said. “We realized [the lecture series] would be a good way to bring those two exhibits together.”

Judy Sitton, a member of the Gateway advisory board, said museum administration tapped Nichols for the presentation following a recommendation from an Enloe physician. “He’s just a great individual and has taken this assignment for the lecture series very seriously,” Sitton said. “We’re really looking forward to seeing what he has to say.”

Nichols said that he prescribes exercise to between 50 percent and 75 percent of all his psychiatric patients, many of whom deal with physical pain along with psychiatric ailments like depression or anxiety. While pain-killing opiate medications are effective for some, he finds that such meds can increase depression symptoms for many. Nichols said research has shown regular exercise and medication are roughly equal in terms of relieving depression, while the right balance of both leads to the best results.

“That’s really where this connects to what I’ll be doing at the Gateway Museum—what we do with our bodies affects our level of happiness,” Nichols said. “I’ll talk about some of the research behind that and how that applies as far as people being stimulated by things they actually enjoy.”

As an avid cyclist, and basketball and volleyball player, Nichols shares a philosophy often expressed by physical-fitness trainers and outdoor enthusiasts that’s also backed by a significant amount of research: If you find a physical activity particularly enjoyable and worthwhile, the benefits of that activity will extend beyond physical fitness. Conversely, if you find a particular fitness routine tortuous, the likelihood of maintaining that routine diminishes.

“Getting on a treadmill is great if you enjoy a treadmill,” offered Nichols. “If you hate a treadmill, but you love canoeing, think about which would be better. The one you enjoy is not only easier to do, but it [also] does something to the brain to help you feel better.”

A host of studies have documented that in terms of dopamine reward, exercise provides a sense of stimulation similar to that of smoking cigarettes or doing cocaine. The difference with exercise, said Nichols, is that because the stimulation isn’t artificial, there won’t be the “crash” afterward.

“If people use cocaine, they feel great and then they feel terrible,” he said. “When people exercise, they tend to feel better and then keep feeling better.”

If an individual begins to develop a positive association with exercise through heightened mental well-being, they will feel more compelled to seek it out, Nichols said. He maintains that such an association is much more effective than telling people what not to do.

“The motivation that something is enjoyable is much more powerful to people than avoiding a bad thing,” observed Nichols. “That you should exercise because it’s good, you’ll live longer and you won’t get a heart attack isn’t very motivating for people; what can be motivating is, ‘If you do this, you’re going to enjoy it.’

“If you can turn [exercise] from a should into a want, you are much more likely to be successful with it.”