Last year, a new client of mine confessed that due to her chronic pain she would regularly sit in a chair and stare into nothingness for hours at a time. I instantly thought, Am I out of my league here? Should I be referring her to a psychologist? It became extremely clear to me that she was realizing that her physical pain was beginning to have a deeper, more serious effect on her mood, psyche and ability to lead a productive life. I knew that she was in pain (that is after all why she started doing Pilates), but I saw a fighter, a woman who committed to walk into the studio three times a week, and always had a brave face on and a surprisingly positive attitude. I admired her ability to dig deep and not get lost in her sadness, so I committed myself to her cause and together we began to explore Pilates’ ability to correct her muscle imbalances and improve her function. And through rolling, stretching, strengthening and bending, her pain began to heal and her depressive symptoms began to reverse.
There is an intimate relationship between pain and depression, and research shows that depression affects the body as much as it does the mind. Pain can be depressing and depression causes and exacerbates pain. In my client’s case, her chronic pain was causing her to slip into depressive behavior, and luckily she recognized it and refused to allow it to pull her down completely. My experience with her got me thinking about how, why and if Pilates could actually serve as a complementary—if not the sole—treatment for those suffering from mild depression.
I discovered that one in eight women develop depression at some point in their life, and women suffer from depression twice as much as men. I bring these statistics to light because Pilates is more popular and practiced among women, which means it could potentially serve as an excellent treatment option for women dealing with depression. Depression can lead to changes in appetite, insomnia, anxiety, an overwhelming loss of energy, a withdrawal from others and unexplained pain in the lower back, neck and joints.
Pain and depression feed on each other; when one persists the other becomes increasingly difficult to treat and the hopes of recovery may seem futile. The problem resides in the brain pathways and the pain that is reflected in the circuitry of the nervous system. The nervous pathways that are presided over by the neurotransmitters serotonin and norepinephrine travel up the brain where they regulate mood and thinking. Interestingly, these same neurotransmitters also have pathways that descend down the spinal cord where they deflect signals of discomfort and suppress pain. Depression, as well as chronic pain, can alter the function and communication of these pathways within the brain and the nervous system. And when these pathways fail to operate efficiently, both physical pain and feelings of depression are intensified.
So how can we use Pilates to help rectify the relationship between pain and depression? With Pilates, we can help to break the cycle of pain and depression through creating muscular balance, improving mobility and by generating a functional body that can move with efficiency, control and intention. Research has found that exercise of any kind (aerobic and non-aerobic) can play significant role in the management of depression through physiological changes that show improvements of endorphin and monoamine concentrations. Research also suggests that positive feedback from others, social contact, the mastery of a new skill, and the diversion from negative thoughts are important mechanisms in how exercise can help with depression. Although there are no specific studies on the effects of Pilates relate to depression, when an individual practices Pilates principles and exercises, he or she can potentially treat pain and depression.
In a society that relies too heavily on drugs for a cure-all, and with the negative side effects of these drugs, I believe that individuals are justified in exploring the effects that a regular Pilates practice may have on pain and depression. What do you think?