In today’s modern world, we often hear individuals who exercise make statements about how they feel better than they did before they started exercising. If you were to ask these people to clarify what “better” means, most people would focus on the physical benefits. There is no doubt that engaging in activity has many physical benefits including weight management, improved cardiovascular fitness and control over diabetes and osteoporosis. However, there are also many psychological benefits to exercise which include positive effects on memory & thinking and improvements in levels of depression and anxiety. Let us take a closer look at each one of these.

Memory & Thinking

Many researchers have examined the effects of aerobic and anaerobic exercise on memory and thinking. The results have been mixed but for the most part indicate that that moderate levels of exercise (regardless of type) improves performance on memory and thinking tasks including addition problems, recall of numbers and words, perception & discrimination of geometric figures, and organization. It is important to note that both high and low levels of exercise have been found to either have no effect or actually impair performance on the tasks. The reason for this is unclear and is currently being studied.

Depression

Clinical depression is one of the most common psychological problems in our country. According to data from the President’s Committee on Mental Health, one of every four Americans suffers from depression at any given time. Depression is characterized by withdrawal, inactivity, and feelings of hopelessness and loss of control. By acting on each of these symptoms, physical exercise can be a useful therapeutic intervention for depression. Indeed, people who are physically active, have lower rates of diagnosable depression. One study conducted over a twenty year period found that those individuals that were most physically active at the beginning of the study were less likely to develop depression at a later date.

Researchers have even examined exercise as a treatment for depression. Individuals who had been diagnosed as depressed were put into three groups: time limited psychotherapy (10 weeks), time unlimited psychotherapy, and a running treatment group. The runners met with a running therapist and would stretch, walk and run for thirty to forty-five minutes, and discuss issues while exercising with little emphasis on the depression itself. Results indicated that 6 of the 8 patients in the running treatment group were essentially well at the end of three weeks, another at the end of the 16th week, and one that neither improved nor deteriorated. This should not be taken to mean that depressed individuals should drop out of traditional forms of treatment, just that running is a useful adjunct to traditional treatment.

Anxiety

One generally accepted benefit of exercise is anxiety reduction. In other words, people who exercise just feel less stressed or nervous. In general, research has supported this notion. In one study, subjects were placed into one of three groups: jogging, stress inoculation training, and waiting list. Individual’s self-report statements indicated that both the jogging and stress inoculation groups had lower levels of anxiety than the waiting list group immediately following the intervention. Furthermore, this finding held true when the researchers followed up one month and 15 months later. It is important to note that the joggers only continued to experience lower levels of anxiety if they continued to exercise (which was about 40% of the original group).

The reasons for improvements discussed above are unclear. Some people feel that various exercise strategies serve to divert or distract subjects from anxiety and depression-producing stressors. In addition, if you are working out at a gym or park, social contact works to reduce the isolation typically associated with depression. Another reason for the improvements in psychological well-being is that exercise alters various neurotransmitters within the brain (norepinephrine and seretonin) which is precisely the function of medication that is prescribed by psychiatrists. This should not be confused with the unsubstantiated theory that the release of “morphine-like” chemicals within the pituitary gland and the brain serve to reduce the painful effects while also enhancing the euphoric effects.

Conclusions

From the above discussion, it is clear that there are many benefits on psychological functioning that result from exercise. However, it is important to note that the relationship between physical activity and mood should be thought of as correlational not causative. That is to say, they are related but exercise should not be thought of as being the sole cause for the improvements in mood.

Although some studies featuring highly anxious patients have shown that exercise reduces both anxiety and depression significantly more than a placebo treatment, others have found the reverse to be true. More specifically, one group was told that their regimen was specifically designed to facilitate psychological well-being and no such intervention was made with the control group. The results showed improvements in fitness for both groups; but, the experimental subjects improved significantly on a measure of self-esteem when compared to the no intervention control group. This means that just thinking that something is good for you, is enough for it to have a beneficial effect.

So how should exercise be used to improve mood? If you have been diagnosed with an anxiety or mood disorder, probably the best approach to take is to use it as an adjunct to the treatment you have discussed with a mental health professional. Always use and follow the guidelines that they set forth for the treatment of your particular disorder and be sure to voice your interest in using exercise as an adjunct to treatment.

Athletes experience both success and failure, but what differentiates the two? While many books have been written on the subject, no definitive answer can be given. So what can you do to improve as an athlete? I feel that one area which holds a great deal of promise is setting clear and attainable goals for yourself.

Athletes, by their nature, are generally competitive individuals. My friend John has told me that when he is out for his evening run, he can’t stand to have someone pass him. No matter how tired he is, he always digs down for that something extra which makes him go faster than anyone else around him. His goal is not to let anyone beat him that night.

Businesses have used goal setting effectively to motivate sales forces for years. It should come as no surprise that the same technique has been used successfully in sports as well. More specifically, goal setting has been found to have a significant effect in a variety of sports including weight lifting, archery, and basketball. This effects holds true regardless of whether it is an individual sport like tennis or a team sport like football. The benefits of goal setting are clear – they work.

Using Goal Setting: The Basics

In order to effectively set goals for yourself or your players, it is important to follow these steps:

• Make goals attainable and measurable (BE REALISTIC)
• Set a long-term goal for the next 6 months (BE SPECIFIC)
• Set short-term goals for the next month (BE VERY SPECIFIC)
• Check your progress and make changes if needed (BE HONEST)

First and foremost is to make goals attainable. One of the biggest reasons why people don’t accomplish their goals is that they set the bar too high. This often results in feelings of failure and loss of drive to achieve goals. For example, a person who runs a ten-minute mile is setting an unattainable goal if they think that they can cut their time in half over the course of the next six months. He would have to take off about a minute a month! That’s another thing: goals need to be measurable. Whether you use 100 meter times or percentage of free-throws made depends on your sport, but it is invaluable in realistically measuring your progress. You need to BE REALISTIC.

Next, set a long-term goal. You should think of it as something that you want to accomplish throughout the course of a season – about four to six months. A good long-term goal will guide you in establishing the short-term goals that you need to achieve. Typically these short-term goals are things that you want to do over the course of the next month. Maybe our runner would set a long-term goal of running an eight-minute mile by season’s end. This means that his short term-goal would be to take 30 seconds off his original ten-minute time every month. You can even make really short-term goals – our runner would take ten seconds off his time every ten days. It’s important to BE SPECIFIC when setting long-term goals and BE VERY SPECIFIC about your short-term goals.

If you have been realistic in setting long-term and short-term goals that are specific and measurable, your job will be a whole lot easier when you check your progress. One easy way of doing this is to keep track on a calendar that shows you the whole month. I write my long-term goal in ink (because it is permanent) and the short term-goal in pencil (so that I can change it if I need to). I also keep track of my daily times on the same page (in ink so that I’m not tempted to lie to myself later on). When it comes time to turn the month, I sit down and evaluate my progress. It is important to remember to BE HONEST. If our runner has gone two months in a row without improving his time by more then 15 seconds each month (when he meant to improve by 30) his short-term goals need to be revised.

Confused? Maybe an example will help out. Below is a case that may clear things up.

Case Example: Goal Setting in Exercise

While the benefits of working out are clear to all of us, a lot of people often drop out of a routine that they have established for themselves. This is the case for 28 year-old over-weight Mike H. Mike has good nutritional habits but his doctor has told him that he needs to burn more calories. He knows that he needs to work out regularly but he does not. Perhaps goal setting can be of assistance. Mike is aware of the recommendations of the Surgeon General about physical activity: adults should complete 30 or more minutes of moderate-intensity physical activity, preferably on most days of the week. He decides to start a regimen on May 1, 2003. Below are the steps that would be taken in order to achieve this goal with the target dates written in parenthesis.

Long-term goal for November 1, 2003:
Engage in moderate-intensity physical activity 6 days a week (11/1/03)

Short-term goals for May, 2003:
Walk/run for 20 minutes 2 days per week (06/01/03) Ride stationary bicycle 20 minutes 2 days per week (06/01/03)

Mike tracks his workouts on a wall calendar in his kitchen. At the end of the month he checks his progress and finds that he has met his short-term goals. While his long-term goal stays the same, he needs to revise the short-term goals. He comes up with the following:

Short-Term Goals for June, 2003:
Walk/run for 25 minutes 2 days per week (07/01/03)
Ride stationary bicycle 25 minutes 2 days per week (07/01/03)

This time when Mike checks his progress he finds that he came up short on the walk/run goal and only did it one time a week. However, he achieved the stationary bike goal. He revises his goals as follows:

Short-Term Goals for July, 2003:
Walk/run for 25 minutes 2 days per week (08/01/03)
Ride stationary bicycle 25 minutes 3 days per week (08/01/03)

Mike again checks his progress and finds that he has met his goals. He decides that he needs to challenge himself a little bit more and extends the times of what he is currently doing.

Short-Term Goals for August, 2003:
Walk/run for 30 minutes 2 days per week (09/01/03)
Ride stationary bicycle 30 minutes 3 days per week (09/01/03)

When September rolls around and Mike looks at the calendar, he finds that he did not achieve his goals. Upon closer inspection he notices that he did not work out at all during the third week of the month. “That was the week I had that ear infection.” He decides to keep his goals the same.

Short-Term Goals for September, 2003:
Walk/run for 30 minutes 2 days per week (10/01/03)
Ride stationary bicycle 30 minutes 3 days per week (10/01/03)

Only one month to go and Mike is feeling pretty good about himself. This is the longest period of time that he has consistently worked out in his life! The pounds are melting off and compliments are flowing like crazy. Mike looks at his long-term goal once again and finds that he is very close to achieving it. He revises the short-term ones as follows:

Short-Term Goals for October, 2003:
Walk/run for 30 minutes 3 days per week (11/01/03)
Ride stationary bicycle 30 minutes 3 days per week (11/01/03)

Congratulations Mike! You did it! He has achieved the long-term goal he set for himself six months ago.

There are many reasons why Mike was so successful (other then the fact that it was fictional). First of all, he was REALISTIC. He set up a long-term and short-term goals that he could achieve. He increased the number of days and times by small increments. When he was unable to achieve the goal for the month, he tried again. Second, he was SPECIFIC about his long-term goal and VERY SPECIFIC when writing the short-term ones. Finally, he was HONEST. Mike faithfully tracked the number of days that he worked out, for how long, and in what activity. When he was sick, he was honest with himself about it and decided to keep the same goals. All that Mike has left to do to keep working out is set a new long-term goal. Maybe this time, he will decide to work out six days a week for 45 minutes!

Conclusion

It is all too easy to lose track of what you are trying to achieve. Corporations realized this a long time ago and started making use of goal setting with their employees. Previous research has found that it can have a significant influence on performance within sports as well. If you follow the steps above and apply it to your sport, you might experience as much success as Mike did too.

One of my students once asked me why there was so much research in the field of sport psychology on anxiety but very little devoted to depression. She was right, a disproportionate amount of attention has been given to anxiety disorders and eating disorders in the sport psychology literature. After giving it some thought, I have come to the conclusion that this is because of the nature of the problems. While we often hear that athletes do not perform at their expected level because of performance anxiety, you rarely hear that the cause of the problem is depression.

Think about the Superbowl. It is not unusual to hear that players to have a bad case of “nerves” which interferes with their performance. Simply put, they are too up for the game. You never hear that he was too depressed to play like he usually does. Depression is a disorder that typically involves withdrawal, inactivity and feelings of hopelessness and loss of control. This is not at all descriptive of the emotional character of an athlete. As a matter of fact, it would seem that physical activity actually combats each of these symptoms.

While data from the President’s Committee on Mental Health indicates that the rate of depression in American society might be as high as 25%, the rate is substantially lower among individuals who are physically active and regularly participate in athletic activity. In fact, level of fitness has been found to be inversely related to depression. It would seem that participation in physical activity actually protects you from depression.

Athletic Activity As Treatment

Exercise can be as effective as traditional forms of psychotherapy. One study that compared clinically depressed patients seeing a therapist once a week with those involved in a running group five times a week (discussing issues while exercising with little emphasis on the depression itself), found no differences in the improvements experienced by either group.

In most cases I strongly urge that individuals seek the services of an experienced psychologist. However, the benefits of athletic activity in the treatment of depression are clear. Be sure to discuss participation in sports as an adjunct to treatment with your therapist.

So, athletic activity can protect you from developing depression, and it can even help you once you have been diagnosed as clinically depressed. The question remains, why? Two theories may help explain this – Seligman’s Learned Helplessness Model and Beck’s Cognitive Therapy of Depression.

Seligman’s Learned Helplessness Model

Marty Seligman is a psychologist who believed that individuals learn much of their behavior from their experiences in interacting with the world. He proposed the theory that depressed people feel helpless because of efforts that have not resulted in desired outcomes. After this process is repeated over and over, people get to the point that they learn no matter what they do it will result in failure. To use his terminology, they make internal, stable and global attributions. This simply means that the belief that they are at fault for failure and that this will always be the case no matter what the situation.

Sports provides people with a forum to combat this feeling of helplessness. Although they may not always win the game or the race, most athletes experience some degree of success – even if this is only during practice. This is especially true today where organized sports allows for improved competition based on age and achievement level. For example, in most races people are grouped according to age. Many golf competitions take into account an individual’s handicap in order to level the playing field. You can readily how this model accounts for why athletes are rarely depressed.

Beck’s Cognitive Theory Of Depression

Aaron Beck is one of the leading researchers in the field of clinical depression. His work is the basis for much of the treatment that is conducted by psychologists today. According to his theory, depression is caused by dysfunctional automatic thoughts about the self and the world which he calls schema. Schema are models of the self, others and the world that develop throughout the course of life and are used to navigate the environment. According to Beck, depressed individuals process information from the environment such that they only pay attention to that information that confirms their beliefs.

Beck believes that depressive ideation involves what he calls “the cognitive triad.” This triad focuses on negative thoughts about the self, the future and the world. Therefore, physically active people are protected from depression because they have a reference point – their athletic achievements – to develop more positive schema. How does this occur?

• Negative views about the self:Typically, depressed individuals have had repeated experiences which cause them to have low self-esteem or a negative view of themselves. In other words, they have formed a schema in which they feel worthless. Whether it was comments from their parents, teachers, or employers they have simply never had the opportunity for success. Athletes, on the other hand, have many experiences with success. Whether it is in little league baseball, a pick up game of basketball at the gym, or beating their best time in a 1 mile run, they have experienced some success. Even when they have experienced a catastrophic failure, such as Bill Buckner in game 6 of the 1986 World Series, they have developed positive schema which allow them to view their failure as a single isolated event.
• Negative views about the future: Understandably, once negative schema have been developed they have a significant impact on an individual’s ability to be optimistic in the future. Thoughts such as “I’m never going to amount to anything” or “I’ll never be successful” are all too common for the depressed person. Clearly this will have a significant impact on their future performance which just serves to confirms their beliefs. Athletic individuals have a more optimistic outlook. “I lost today but I’ll get him next time” or “So what if I blew that play, I’ve done it a thousand times before and I’ll do it again” are typical thoughts. You can easily see how the schema that are used by these people help to protect them from depression.
• Negative views about the world: Once a person has developed a negative view of themselves and the future, it is next to impossible to have a positive view of the world. Thoughts that the world is an unfair place and that success is something that is controlled by others are not uncommon. Given the nature of their automatic thoughts this is something that is very difficult to control. Athletes have had more positive experiences. Although the referee may be favoring the other team on a particular day, this is not a universally occurring phenomenon. In this situation, their schema would probably cause them to try even harder because of their belief in their control over their own destiny.

Conclusion

The nature of most forms of athletic activity is such that it is not characteristic of depression. While the depressed person is isolated, inactive, and has feelings of hopelessness and loss of control, the athletic environment actively serves to combat each of these. People are forced to get out into the world and participate in something where they are bound to experience success. If you or someone you love is feeling depressed, encourage them to participate in sports as away of combating these feelings. Why not do it anyway just to keep these feelings away altogether?

In today’s modern world, we often hear individuals who exercise make statements about how they feel better then they did before they started exercising. If you were to ask these people to clarify what “better” means, most people would focus on the physical benefits. There is no doubt that engaging in activity has many physical benefits including weight management, improved cardiovascular fitness and control over diabetes and osteoporosis. However, there are also many psychological benefits to exercise which include positive effects on memory & thinking and improvements in levels of depression and anxiety. Let us take a closer look at each one of these.

Memory and Thinking

Many researchers have examined the effects of aerobic and anaerobic exercise on memory and thinking. The results have been mixed but for the most part indicate that moderate levels of exercise (regardless of type) improves performance on memory and thinking tasks including addition problems, recall of numbers and words, perception & discrimination of geometric figures, and organization. It is important to note that both high and low levels of exercise have been found to either have no effect or actually impair performance on the tasks. The reason for this is unclear and is currently being studied.

Depression

Clinical depression is one of the most common psychological problems in our country. According to data from the President’s Committee on Mental Health, one of every four Americans suffers from depression at any given time. Depression is characterized by withdrawal, inactivity, and feelings of hopelessness and loss of control. By acting on each of these symptoms, physical exercise can be a useful therapeutic intervention for depression. Indeed, people who are physically active, have lower rates of diagnosable depression. One study conducted over a twenty year period found that those individuals that were most physically active at the beginning of the study were less likely to develop depression at a later date.

Researchers have even examined exercise as a treatment for depression. Individuals who had been diagnosed as depressed were put into three groups: time limited psychotherapy (10 weeks), time unlimited psychotherapy, and a running treatment group. The runners met with a running therapist and would stretch, walk and run for thirty to forty-five minutes, and discuss issues while exercising with little emphasis on the depression itself. Results indicated that 6 of the 8 patients in the running treatment group were essentially well at the end of three weeks, another at the end of the 16th week, and one that neither improved nor deteriorated. This should not be taken to mean that depressed individuals should drop out of traditional forms of treatment, just that running is a useful adjunct to traditional treatment.

Anxiety

One generally accepted benefit of exercise is anxiety reduction. In other words, people who exercise just feel less stressed or nervous. In general, research has supported this notion. In one study, subjects were placed into one of three groups: jogging, stress inoculation training, and waiting list. Individual’s self-report statements indicated that both the jogging and stress inoculation groups had lower levels of anxiety then the waiting list group immediately following the intervention. Furthermore, this finding held true when the researchers followed up one month and 15 months later. It is important to note that the joggers only continued to experience lower levels of anxiety if they continued to exercise (which was about 40% of the original group).

The reasons for improvements discussed above are unclear. Some people feel that various exercise strategies serve to divert or distract subjects from anxiety and depression-producing stressors. In addition, if you are working out at a gym or park, social contact works to reduce the isolation typically associated with depression. Another reason for the improvements in psychological well-being is that exercise alters various neurotransmitters within the brain (norepinephrine and seretonin) which is precisely the function of medication that is prescribed by psychiatrists. This should not be confused with the unsubstantiated theory that the release of “morphine-like” chemicals within the pituitary gland and the brain serve to reduce the painful effects while also enhancing the euphoric effects.

Conclusions

From the above discussion, it is clear that there are many benefits on psychological functioning that result from exercise. However, it is important to note that the relationship between physical activity and mood should be thought of as correlational not causative. That is to say, they are related but exercise should not be thought of as being the sole cause for the improvements in mood.

Although some studies featuring highly anxious patients have shown that exercise reduces both anxiety and depression significantly more than a placebo treatment, others have found the reverse to be true. More specifically, one group was told that their regimen was specifically designed to facilitate psychological well-being and no such intervention was made with the control group. The results showed improvements in fitness for both groups; but, the experimental subjects improved significantly on a measure of self-esteem when compared to the no intervention control group. This means that just thinking that something is good for you, is enough for it to have a beneficial effect.

So how should exercise be used to improve mood? If you have been diagnosed with an anxiety or mood disorder, probably the best approach to take is to use it as an adjunct to the treatment you have discussed with a mental health professional. Always use follow the guidelines that they set forth for the treatment of your particular disorder and be sure to voice your interest in using exercise as an adjunct to treatment.

“I don’t feel like working out!” We’ve all had that thought at one time or another. The American College of Sports Medicine recommends that every American adult should accumulate at least 30 minutes of moderate physical activity such as brisk walking or gardening over the course of most, and ideally all days of the week. Indeed, physical activity has been identified as a behavior with potential benefits for improved physical and psychological health in men and women of all ages. Despite the fact that we began an exercise regimen, many of us often stray away form it. Why is that? The truth is that different people don’t work out for different reasons.

Individuality is one of the traits that is most valued in our culture. However, according to researchers people fit into one of five categories when it comes to working out: precontemplation, contemplation, preparation, action, and maintenance.

• Precontemplators do not exercise and do not intend to start in the next 6 months.
• Contemplators do not currently exercise but intend to start in the next 6 months.
• Prepapers are exercising some but not regularly (3 or more times per week for 20 minutes or longer, or accumulating 30 or more minutes per day 5 or more days per week).
• Individuals in the action stage exercise regularly but have been doing so for less than 6 months.
• Individuals in maintenance exercise regularly and have done so for 6 months or longer.

In order to stick to your work outs, it is important that you identify which of the above five categories you fit into so that you can choose which intervention strategy is best for you. When there is a mismatch between your category and the intervention strategy, the likelihood that you will maintain you exercise regimen decreases dramatically.

Several points need to be made which apply to individuals in all of the categories. First and foremost is the importance of believing in yourself. This helps to increase the likelihood that you will continue to work out. Making positive self-statements such as “I can do it!” or “I am a warrior!” are useful statements for increasing this belief in yourself.

Secondly, it is important to plan your goals. You should set up short term and long term goals. While these will differ depending on which category you fit into, they are useful for everyone. Individuals who are just starting to work out might set up a short term goal of walking 3 times per week and adding 5 minutes onto their workouts every week. They might make a long term goal of walking 5 days a week. Individuals on the higher end of the scale might set up a short term goal of running 5 days per week and adding 5 minutes every week to their time. Regardless of your specific goal, it is important to have one.

Finally, never under estimate the value of journal keeping. You might write in your long and short term goals along with a log of the actual activity and the length of time that you participated in it for. This is a useful activity since it allows you to see how far you have come.

Precontemplators need some event in their life to get them thinking about exercise. All to often it is a warning from a health professional about the need to start exercising. Research has shown that exercise provides protection against coronary heart disease. It also helps prevent colon cancer in men, reproductive cancers in women, obesity, and other chronic diseases such as osteoporosis in postmenopausal women. Perhaps the need to be a role model for an obese child is sufficient to move individuals to the next stage. As always, consult with your physician before beginning any exercise regimen.

A contemplator must first ask “What’s in it for Me?” There are many physical benefits such as weight control and lowering the risk of heart disease, but there are also psychological benefits as well. These include the reduction of depression and stress. Just the social benefits of working out alone are enough to achieve these improvements. You may meet some new people in a class or improve your relationship with a significant other by going for a walk and spending more time together. Finally, individuals in this stage need to look for ways to increase activity levels in their everyday lives. For example, take the stairs instead of the elevator or park the car at the end of the parking lot.

An individual in the preparation phase should make use of the short term and long term goal setting strategies described above. It is particularly important to reward yourself for achieving your goals. You might want to buy yourself flowers or a new piece of clothing for increasing the amount of time or the frequency with which you exercise. You may also find that you need to use time management skills to fit your new exercise lifestyle into your schedule. Perhaps you could ride an exercise bicycle while watching television or take the dog for a brisk walk or light run in the evening rather then the leisurely stroll you take. Maybe going dancing with your significant other or kids instead of going to a movie is what tit will take for you. Whatever ever you choose to do, read up on it at your local library. There are plenty of good resource books for any activity that might interest you. Why try to reinvent the wheel?

Individuals in the action category need to figure out how to keep it going. You have probably already experienced the health benefits (i.e., weight management and increased energy) as well as the emotional benefits (improved mood). You should focus on trouble shooting problems that could lead to relapse. Perhaps the biggest problem to deal with is boredom. You should combat this by participating in a variety of sports such as switching from running to swimming to bicycling. You may also want to try and gain social support by finding people who you can be active with or are supportive of your lifestyle. There are many clubs that you can join, take advantage of them. Another common problem is to set goals that are unachievable, which inevitably leads to feelings of failure. Make sure that your short term and long term goals are reasonable. Finally, don’t forget to keep rewarding yourself with both internal rewards like praise or external rewards like flowers.

Individuals in the maintenance stage have undoubtedly experienced the benefits of working out. The key question for them is similar to that for those in the action stage, how to keep it going. Continued self-rewards and setting reasonable goals are important strategies to use. Typically these individuals relapse when they become injured. It is therefore important to guard against injury. Read up on how you can do this for your individual sport. If you do become injured, look at your rehabilitation time as being a work-out rather than rehab. You won’t believe the difference that this makes mentally. Finally, stay in tune with your sport during that time. Put things around the house that remind you of exercising. Remember to set reasonable goals for yourself when you are able to return to your sport of choice.

Regardless of the category in which you fit, we are all in danger of receding back. It is important to be aware of this and do what you can based on the stage in which you find yourself. Remember to use strategies that are tailored to your category. Otherwise, they will not achieve their full impact on you. You would think that the physical and emotional benefits of exercise would be sufficient to keep us all going, unfortunately they are only part of the solution.