Its Fun: A Practical Algorithm for Counseling on the Exercise Prescriptions: A Method to Mitigate the Symptoms of Depression, Anxiety, and Stress-related Illness Elizabeth Pegg Frates * , Yasamina McBride and Jonathan Bonnet Spaulding Rehabilitation Hospital, Stroke Institute for Research and Recovery Director of Wellness Programming, USA * Corresponding author: Frates EP, Assistant Professor, Spaulding Rehabilitation Hospital, Stroke Institute for Research and Recovery Director of Wellness Programming, USA, Tel: + (919) 681-3028; E-mail: EFRATES1@partners.org Received date: February 04, 2016; Accepted date: March 01, 2016; Published date: March 07, 2016 Copyright: © 2016 Frates EP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract A growing body of research indicates that exercise is an effective intervention for depression, anxiety, and stress. Exercise as medicine provides an additional treatment tool for mental health professionals. With the initiation of the exercise prescription process, clinicians serve as an important link between physical and mental health. By collaborating with a team of health professionals and the patient, clinicians can successfully encourage patients to increase their physical activity, which will lead to positive mental and physical health changes. Exercise and fun are not always used as synonyms. To start and sustain an exercise routine, the clinician and the patient need to work together to find connections between the two words. The "It's Fun!" algorithm provides the clinician with a guide to hold exercise counseling sessions that are empowering and fun for both clinician and patient. Taking into account all the essential steps in exercise prescription writing and counseling- the interest level of the patient, a patient's past exercise history and timeline, the signs, symptoms, and risk factors for disease, favorite activities, unusual ideas for motivation and exercise, and finally negotiating as well as narrowing down the ways forward - the patient will engage in and enjoy the benefits of regular physical activity. Keywords: Exercise; Depression; Exercise prescription; Counseling; Stress; Anxiety; It’s fun Introduction “IT’S FUN” usually isn’t the frst phrase that comes to a practitioner’s mind when facing the responsibility of making a determination of what exercise to recommend to a patient with a mental health related issue or illness. Yet, as an algorithm, the six letters represent a formula that can lead to a successful, healthy outcome. In 2013, a meta-analysis investigating the efcacy of exercise and drug interventions on the mortality rate of certain physical ailments (heart disease, chronic heart failure, stroke and diabetes) found that in many cases, exercise can be just as efective as medicine [1]. Similar fndings result from research studies on the efcacy of exercise on the outcomes of mental health ailments including depression, anxiety, and stress [2,3]. Tis paper will explore the use of exercise prescriptions as an important tool in the practitioner’s toolbox that alleviate not only individual sufering, but collectively lower worldwide health care costs. According to a 2011 report by the World Economic Forum and the Harvard School of Public Health, the global direct and indirect cost of mental illness in 2010 was $2.5T and is estimated to grow to $6T by 2030 [4]. Currently, depression accounts for nearly a third of this expenditure. In 2014, 6.6% of all US adults (15.7 million people) reported experiencing a major depressive episode within the past twelve months [5]. Individuals who sufer from depression are more susceptible to other medical problems that afect the physical body such as cardiovascular disease or substance abuse. Further, feelings of anxiety were reported by 18.1% of the US adult population. Anxiety disorders disproportionately afect certain populations like women and military workers and include debilitating conditions such as post- traumatic stress syndrome (PTSD). In addition, chronic stress, while not considered a mental illness, can lower the immune system, bring about sleeplessness, and cause headaches- all symptoms a patient may report without making the connection that these symptoms are frequently reactions to stress. In recent years, a strong evidence base has been mounting which advocates for the use of exercise as an efective treatment to lower both the economic and personal costs of these mental health issues. Exercise as Medicine Exercise works by using several biochemical methods including increasing the presence of endorphins, regulating serotonin and dopamine levels, and afecting prefrontal cortex activity in the brain. It is now common knowledge that exercising regularly can have efects on the physical body such as: reducing blood pressure, reducing resting heart rate, increasing ftness, preventing obesity, reducing blood cholesterol levels, reducing low-density lipoprotein (LDL), increasing high-density lipoprotein (HDL), reducing triglycerides, changing body composition, increasing muscle mass which increases metabolism, reducing pain such as back pain, increasing circulation, increasing the number of capillaries, increasing the number of mitochondria in cells, reducing fbrinogen and increasing fbrinolysis, improving sexual desire and function, releasing nitric oxide as vasodilator, and helping to prevent bone loss; for these reasons alone, there is value in writing an exercise prescription. As early as 1988, research began looking at the apparent link between exercise and depression [6]. Te study found Frates et al., Clin Exp Psychol 2016, 2:2 DOI: 10.4172/2471-2701.1000116 Research Article Open Access Clin Exp Psychol Physical Exercise and Its Impact on Psychology ISSN:2471-2701 CEP, an open access journal Clinical and Experimental Psychology C l i n i c a l a n d E x p e r i m e n t a l P s y c h o l o g y ISSN: 2471-2701