Source: dima_goroziya/Pixabay

What comes to mind when you think of the posture or movements of a depressed person? Perhaps a slumped posture? Slow gait? A smaller motion range (e.g., of the hips and shoulders)?

Yet, treatments for mental illness usually focus on emotions and thoughts, not gross motor functioning (i.e., movement involving large muscles of the body), such as posture and movement.

It is time we pay more attention to the embodied view of mental illness. After all, emotions are bound and influenced by the body's movements.

To shed more light on the connection between mental illness and motor movements and posture, I discuss a recent paper by Elkjaer and coauthors, published in the Journal of Affective Disorders.

Psychomotor Changes in Anxiety and Depression

According to DSM, various mental health issues–anxiety, depression, bipolar disorder, post-traumatic stress disorder (PTSD), schizophrenia, alcohol withdrawal, and opioid intoxication–may be associated with motor changes, specifically with psychomotor retardation or psychomotor agitation.

Note: Psychomotor retardation refers to the slowing of bodily activities and speech. Psychomotor agitation, in contrast, refers to excessive, repetitive, and nonproductive movements, such as pacing or hand-wringing.

The research by Elkjaer et al. had two aims: To determine if there are gross motor differences between healthy individuals and those with anxiety or depression and to ascertain how changing motor displays affects the emotions and behaviors of people with anxiety or depression.

A total of 87 investigations were included in the authors’ synthesis. Of these, 82 (N = 58, 923 participants) compared motor differences in anxiety/depression with healthy individuals, whereas five studies evaluated motor changes in clinical samples.

And of the 82 investigations, 60 assessed depression and 22 anxiety, so most of the findings discussed below are particularly relevant to depression.

Motor Differences Between Healthy and Anxious/Depressed Patients

The meta-analysis’ findings indicate the presence of “robust group differences of a medium magnitude between clinical and healthy groups (k = 71; g = .38; p = <.001, adjusted for publication bias: k = 87; g = .26).”

These results were not moderated by sample type, age, comorbidity, medication use, or psychological disorder.

In terms of data on specific motor outcomes, differences in gait parameters were noted, with “depressive individuals showing reduced step/stride length/width, steps to turning/stepping reaction time, and more overall abnormal movement (i.e., sway, posture) compared to healthy individuals.”

Meta-analyses on specific postural outcomes showed that anxious and depressed individuals tend to have “increased head flexion [head bent forward] and smaller joint range of motion of knees, hips, wrists, shoulders, and elbows.”

Of course, more research is necessary to determine whether these motor changes are risk factors for anxiety or depression, maintenance factors for patients who already have anxiety or depression, or only symptoms of these conditions.

The Effects of Changing Motor Displays in Anxiety and Depression

The synthesis’ second goal was to evaluate the effects of changing motor displays on patients’ emotions and behaviors.

And the results showed that movement manipulations could alter emotional states in individuals with depression. These findings have important therapeutic applications. As the researchers noted: "Changing posture and movement (e.g., from slumped into an upright posture; from slow/downward into swift/upward movement) could potentially be applied and integrated in treatment for depression," particularly when it is useful to "counteract lack of motivation and energy” or to “facilitate approach behavior.

Source: JerzyGorecki/Pixabay

Takeaway

People with anxiety and especially depression, when compared to healthy individuals, have less postural control.

Those with depression also have abnormal posture and sway, slower gait, decreased step or stride length or width, reduced number of steps to turn around, and reduced stepping reaction time.

Manipulating the motor system may have a positive influence on the emotional state of people with anxiety and depression, helping them feel more energized and motivated.

Some examples are encouraging upright posture instead of slumping; or encouraging swift and upward instead of slow and downward movements.

A 2017 study concluded that an upright posture could improve mood and reduce fatigue in people with depressive symptoms.

In terms of the application of the findings, here are some suggestions for those of you receiving treatment for anxiety or depression:

Pay attention to how you sit, stand, walk, or move your body while working.

How is your posture/movement associated with your mood?

Ask your therapist if certain postural and movement changes might improve your anxiety and depressive symptoms.

To find a therapist, visit the Psychology Today Therapy Directory.