Spartans Mind

Boxing and Neurological Disorders

Boxing has often received a lot of negative press due to the propensity for head injuries through repeat exposure to punches. The poor publicity is warranted. Competitive boxing comes with risks. While most boxers are amateurs and hobbyists who do not sustain brain injury, the numbers are much higher with professional boxers. Moreover, the type of neurological disorders such as Parkinson’s that affects boxers may be unique to boxing and not the same as normal Parkisons (Davie, Pirtosek, Barker, Kingsley., Miller, & Lees, (1995). Head injuries are common in many sports and boxing takes continual steps to make the sport safer for athletes (Jacko, 2002).

However, there exists a surprising exercise connection between non-contact boxing and the proactive treatment of neurological disorders. Boxing, through technique-based classes appears to have a positive impact on the treatment of neurological disorders, especially Parkinsons.

The link between Parkinson’s and non-contact boxing is well-documented (Combs, Diehl, Chrzastowski, Didrick, McCoin, Mox, Staples, & Wayman, 2013; Dawson, Sayadi, Kapust, Anderson, Lee, Latulippe, & Simon, 2020; Dibble, Hale, Marcus, Gerber, LaStayo, 2009). Programmes such as Rock steady boxing run out of New York (Horbinski, Zumpf, McCortney. et al., 2021) have long helped individuals delay the onset of Parkinson’s, a disease caused by a chronic deficiency in dopamine in the brain. The lack of dopamine triggers increased muscle stiffness, tremors, and decreased coordination and balance. Other symptoms include difficulties with speaking, fatigue, dizziness all of which precipitate mental decline and life satisfaction in people with Parkinson’s as they self-isolate from the community.

Given boxings negative link to neurological functioning it is a counter intuitive idea that boxing could have such positive effect on those suffering from Parkinson’s. However, a link is appearing through multiple studies. The positive impacts include reduced falls in those who participate in non-contact boxing, increased psychological well being through improved social life and less fatigue.

A direct positive impact of boxing for those with Parkinson’s is reduced falls. (Horbinski, Zumpf, & McCortney, K. et al, 2021). In addition, psychological benefits were also noted such as an improved social life and a drop in fatigue.

The causal mechanism for why boxing benefits those suffering from Parkinson’s appears to be  improved balance and coordination while maintaining a wide stance (Horbinski, Zumpf, McCortney, et al., 2021). The wide stance ensures balance and the weight transfer improves the performance of balancing while not being static. The coordination comes from the hitting of pads or bags, with set routines.

The positive impact of boxing as part of treatment plan for Parkinson’s should be cautionary. The quality of the studies demonstrating positive impacts is generally poor and most do not met the standards for exercise reporting (Morris, Ellis, Jazayeri, Heng, Thomson,, Balasundaram, & Slade,  2019). Moreover, the positive impact of boxing may not be maintained after cessation of the exercise programme (Sangarapillai, Norman, & Almeida,(2021).

Limitations noted, there is evidence that boxing may indeed play a pivotal role in the treatment of neurological disorders by increasing the life satisfaction of those suffering form the likes of Parkinsons. As such, non-contact boxing may be a beneficial adjunct to any treatment plan for those with Parkinson’s who aim to improve their quality of life. References

Combs SA, Diehl MD, Chrzastowski C, Didrick N, McCoin B, Mox N, Staples WH, Wayman J. (2013).

Community-based group exercise for persons with Parkinson disease: a randomized controlled trial. NeuroRehabilitation. 32(1):117-24.

Davie, C. A., Pirtosek, Z., Barker, G. J., Kingsley, D. P., Miller, P. H., & Lees, A. J. (1995). Magnetic

resonance spectroscopic study of parkinsonism related to boxing. Journal of Neurology, Neurosurgery & Psychiatry, 58(6), 688-691.

Dawson, R. A., Sayadi, J., Kapust, L., Anderson, L., Lee, S., Latulippe, A., & Simon, D. K. (2020). Boxing

exercises as therapy for Parkinson disease. Topics in Geriatric Rehabilitation, 36(3), 160-165.

Dibble LE, Hale TF, Marcus RL, Gerber JP, LaStayo PC. (2009) High intensity eccentric resistance

Training decreases bradykinesia and improves Quality Of Life in persons with Parkinson’s

disease: a preliminary study. Parkinsonism Relat Disord. (10):752-7. doi: 10.1016/j.parkreldis.2009.04.009. Epub 2009 Jun 3. PMID: 19497777.

Horbinski, C., Zumpf, K.B., McCortney, K. et al. (2021) Longitudinal observational study of boxing

therapy in Parkinson’s disease, including adverse impacts of the COVID-19 lockdown. BMC Neurol 21, 326 (2021). https://doi.org/10.1186/s12883-021-02359-6

Jako, P. (2002). Safety measures in amateur boxing. British Journal of Sports Medicine, 36(6), 394-

395.

Morris, M. E., Ellis, T. D., Jazayeri, D., Heng, H., Thomson, A., Balasundaram, A. P., & Slade, S. C.

(2019). Boxing for Parkinson’s disease: has implementation accelerated beyond current evidence?. Frontiers in neurology, 10, 1222.

Sangarapillai, K., Norman, B. M., & Almeida, Q. J. (2021). Boxing vs sensory exercise for Parkinson’s

disease: A double-blinded randomized controlled trial. Neurorehabilitation and Neural Repair, 35(9), 769-777.

At Spartans Boxing Club, we have long championed the benefits of boxing for mental health. In previous blogs, we discussed the benefits of boxing for trauma, depression, and mental resilience. We have also reviewed studies examining the impact of exercise on general well-being, noting that boxing is one of the few modalities shown to benefit those recovering from mental health issues.

Just out is a recent study (Bozdarov, Jones, Daskalakis, and Husain, 2022) covering a review of research on boxing as an intervention for mental health. The author identified sixteen studies suitable for review, and in the following article, we will review the paper noting key findings.

The paper starts with a commentary on the benefits of exercise as an alternate treatment, especially for those who did not respond well to either therapy or pharmaceuticals. The paper notes that exercises involving breathing or High Intensity Interval Training (HIIT) are especially beneficial. The hypothesis is that boxing involves mindfulness and HIIT-based training, so it should be well suited to recovery from mental health issues. The author notes that the relationship between mental health and exercise is supported by a cross-sectional study of 1.2 million Americans conducted between 2011-2015, showing that those involved in physical exercise reduced the health burden by 20.1% (Chekroud, Gueorguieva, Zheutlin, et al., 2018).

The author decided on a scoping review as the most appropriate methodology for the study as there were too few papers to conduct a meta-analysis. The studies were strictly boxing, with other martial arts, such as Thai Boxing, excluded. Google Scholar, Medline and Psychinfo were used to source relevant studies. However, most sources identified for the review were rated as low-quality evidence.

The studies reviewed included qualitative, quasi-experimental, randomised control studies, case studies with pre-and-post measures, and mixed-method designs. Participants were from across the globe, New Zealand, Canada, China, the United States, Ireland and England. While the author identified 155 studies, 16 meet the stringent requirements for the review. 81% of the studies were journals, with the remainder reports and dissertations. 69% were with adults, 19% with youths and the remainder elderly with Parkinson’s 13%.

The boxing intervention was non-contact. A few studies included cognitive training. Typical routines included shadow work, pads and heavy bags and most interventions were in group settings (88%).

The positive impacts of boxing were apparent in all studies. A summary of findings is below:

“ As it relates to mental health, the majority of articles collectively included results that boxing reduced stress, and improved mood, self-esteem and quality of life (94%). Studies showed significant improvement in overall mood, reduced substance use, improvement in self-esteem and confidence, perceived physical ability, performance in school, and overall well-being and mental health. With the use of measurement-based care, a few articles reported a statistically significant reduction in specific symptoms burden post boxing intervention. These included symptoms of depression as per PHQ9, BDI-II and CES-D; symptoms of anxiety as per STAI; negative symptoms of schizophrenia as per PANSS; and symptoms of PTSD as per PCL-5. In addition, there was a statistically significant decrease in mental health distress and psychological symptoms as per BSi-18 and improvement in quality of life as per PDQ-39, WHOQOL and HRQoL.” (pg. 9)^. Other benefits noted in the study include an outlet for aggression, escape from rumination and negative emotions. Adverse effects were minimal and unrelated to mental health issues (e.g. muscle skeletal). Most importantly, there was no violence transfer from the training to the community.

While a critical review of studies indicates low quality, the general findings are difficult to dispute. Moreover, the causal mechanism for why boxing appears to be so effective for treating mental health appears tied to the unique focus on technique (mindfulness) and HIIT. At the same time, punching a bag has cathartic effects, and boxing reduces body fat and positively impacts cardiovascular health, two areas known to be impacted by depression. Boxing organically increases community involvement and social support. Music increases the enjoyment factor of members. The positive impacts do not appear to be affected by gender. The article also concludes that an optimal dosage may be as little as two 45-minute classes over a week.

Over the past three months, we have covered an extensive review of the benefits of boxing and mental health. Indeed, further evidence of the same findings would seemingly add little to the conversation. The jury is no longer out, and the judgement is in-boxing is a well-documented and well-supported intervention for mental health and recovery from mental health issues.

References

1. Bozdarov J, Jones BDM, Daskalakis ZJ, Husain MI. Boxing as an Intervention in Mental Health: A Scoping Review. American Journal of Lifestyle Medicine. 2022;0(0). doi:10.1177/15598276221124095
2. Chekroud SR, Gueorguieva R, Zheutlin AB, et al. Association between physical exercise and mental health in 12 million individuals in the USA between 2011 and 2015: A cross-sectional study. Lancet Psychiatr. 2018;5(9):739-746. doi:10.1016/S2215-0366(18)30227-X

A recent study in Singapore has looked at how people recover from mental health setbacks (Kuek, Raeburn, Chow, & Wand, 2022). There is much research in the country on understanding mental health and information on the ability to diagnose mental health issues. However, the road back to recovery is far less understood. 

With this in mind, a review of the study is timely. Until recently, research investigating personal recovery is primarily from western countries (Leamy et al., 2011), with only a handful of studies published in the 2000s from Asian settings, primarily applying western conceptualisations of personal recovery.

I have uplifted directly from the recent study to provide a summary of key findings; plagiarism noted! The piece concludes by looking at how Spartans address many vital mental health needs for recovery.

Social Support for Mental Recovery

“ Nearly all participants identified the invaluable contribution and healing properties of social support from a variety of sources such as friends, family members, significant others and even colleagues at work in some cases. These important avenues provided a source of comfort, feelings of safety, encouragement, opportunities to talk through their challenges and other more pragmatic actions (e.g. helping them take a bath, etc.).

However, when social support was not present or considered unhelpful, there was a detrimental impact on the recovery of participants. Specifically, participants shared several negative experiences of family-related instances which contributed to the exacerbation of their mental health challenges”.

Affordability of Mental Recovery Interventions

“While formal mental health professional services were viewed to be important during the recovery process, participants also shared how it could be challenging to find the right type of support. Affordability of these services was one of the main concerns of participants”.

Locating Mental Recovery Interventions

“Another concern raised was the challenge of knowing where to find various mental health professionals where participants shared how difficult it was for them to navigate the mental health system”. 

Personalized Coping Strategies for Mental Recovery

“Participants shared a wide variety of different personalised coping strategies used to manage such as adopting techniques they learned in therapy, engaging in hobbies and finding new, enjoyable experiences”. 

Misperception of what mental health issues are in Singapore

“Some unique societal factors that influenced the recovery process that participants shared were the highly stressful Singaporean educational system, general acceptance and understanding of mental health issues and stigma and the comparison-oriented culture.

However, what was also apparent was the potential for negative impact should these relationships become soured. In some instances, family, a known protective factor of mental health conditions, perpetuated negative experiences. In Singapore, living with one’s family as an adult, even after marriage, is often less a function of choice and more a necessity given the high cost of living and other societal norms where there exists an expectation for a person to look after their parents as they age.

This need was due to the many societal influences that shaped recovery, such as the high paced and comparison-oriented culture in Singapore. Coupled with prevalent and stigmatising attitudes towards people with mental health conditions documented in other Singaporean studies (Tan et al., 2020; Yuan et al., 2016), mental health recovery became more challenging for participants. 

Consequently, the lack of knowledge about various available mental health services and their costs could make help-seeking challenging and prevent people from doing so, negatively impacting their recovery”.

Personalized Mental Recovery Strategies

“However, participants in our study also recognised that while help-seeking was necessary, the many personalised strategies they used to support themselves were central to their recovery. In some instances, it could be adopting what they learned in therapy, while in others, it could be reconciling with their innate personalities and learning how to move forward. These ideas echo the type of personal responsibility often espoused in personal recovery literature but should also be considered within the context of a broader societal view”. 

How Spartans aims to close the gap

At Spartans, a core value of our gyms is the concept of an inclusive community. We create an environment where people can come and are accepted. Spartans becomes the social support, an indirect lifeline for those going through difficult times. 

Rather than paying for individual sessions, members are encouraged to use the gym as much as possible. There are set times for classes and opportunities for self-paced training. As such, boxing at Spartans is a highly affordable psychotherapeutic intervention. 

Our coaches and GMs have basic instruction in mental first aid. The training includes understanding mental health conditions and what to look for if someone may be currently experiencing mental health issues when entering the gym. As a result, there is no stigma with mental health in gyms, quite the contrary. Coaches understand mental health issues and the road to recovery.

Spartans becomes part of a personalised strategy to cope with mental health issues. This blog series well-documented the benefits of physical fitness for mental health. Spartans becomes the hobby, the new interest, for the person working through mental health issues.

Finally, with gyms across Singapore, finding a gym close to the person’s place of residence is no issue. Access to exercise as part of a road to recovery is not hindered by location.

Spartans boxing club aims to address the factors influencing mental health recovery in Singapore directly. Our dedication to mental health is second-to-none in the fitness field. We have designed our repair programme directly to address the needs of those potentially suffering from mental health issues. Spartans is a suitable partner to any psychological intervention and one that may indeed make up for deficiencies in other treatment options.

References

Leamy, M., Bird, V., Le Boutillier, C., Williams, J. and Slade, M. (2011), “Conceptual framework for

personal recovery in mental health: systematic review and narrative synthesis”, British Journal of Psychiatry, Vol. 199 No. 6, pp. 445-452.

Kuek, J. H. L., Raeburn, T., Chow, M. Y. Z., & Wand, T. (2022). Lived experience perspectives of factors that 

influence mental health recovery in Singapore: a thematic analysis. Mental Health and Social Inclusion, (ahead-of-print).

Tan, G.T.H., Shahwan, S., Goh, C.M.J., Ong, W.J., Wei, K.C., Verma, S.K., Chong, S.A. and

Subramaniam, M. (2020), “Mental illness stigma’s reasons and determinants (MISReaD) among Singapore’s lay public – a qualitative inquiry”, BMC Psychiatry, Vol. 20 No. 1, p. 422.

Yuan, Q., Abdin, E., Picco, L., Vaingankar, J.A., Shahwan, S., Jeyagurunathan, A., Sagayadevan, V.,

Shafie, S., Tay, J., Chong, S.A. and Subramaniam, M. (2016), “Attitudes to mental illness and its demographic correlates among general population in Singapore”, PlosOne, Vol. 11No. 11, p. e0167297.

In a previous blog, we introduced the concept of optimal performance, the alignment between ones lived reality and a sense of well-being. In response to the blog, many people asked whether the model advocated an elitist view of life, the idea that one can only be optimal if one reaches their perfect existence. Optimal performance is not elitist, nor is it about perfection. It is about the journey toward the best version of you, recognising that road will be rocky. Underpinning this journey is one’s sense of self-esteem and mental health. 

People who are only happy when they have obtained their goals or live a life of misery due to envy lack self-esteem. Self-esteem is at the foundation of mental health and is one’s opinion of oneself, independent of external achievement or rewards. You have an appropriate level of self-esteem when you trust your mind and believe that you deserve happiness due to your inherent worth. For many people, however, self-esteem is dependent on the external, dependant on others’ judgement. However, the psychological model of self-esteem depends not on others’ judgement but one’s judgement of themselves. 

Psychology has many models of self-esteem. Often psychologists define self-esteem as one’s sense of global self-worth or how much value one believes they have. Self-esteem is more than self-belief; to be practical, we need to have models that describe self-esteem and prescribe how to cultivate self-esteem. One such model is the model developed by Nathaniel Branden, the famous Objectivist psychologist who practised psychotherapy up to his death in 2014. Below I review Branden’s model of self-esteem, known as the six pillars and discuss how to practise the pillars through Boxing, which results in developing a deep sense of self-esteem, the psychological foundation of the optimal self.

Pillar 1: Live With Awareness of Your Self-Esteem and Mental Health

Ironically, the starting point for self-esteem is not the self. Self-esteem starts with respect for reality. The definition of well-being discussed last week is a link between the internal state and respect for reality. Self-esteem is not a means of escaping reality. While pseudo-self-esteem involves escaping reality to keep a notion of the self in tack, genuine self-esteem reflects respect for reality. People who ignore reality are choosing ignorance rather than wisdom to protect what is a fragile sense of sense.

Individuals with high self-esteem will attempt to confirm reality or the truth when the truth is unknown; they will test themselves and their ideas about what is real. They will not distort reality because it is comforting to do so. Their sense of self is not affected by this reality, but the reality is essential for gathering information on what behaviours to continue and those behaviours to cease.

One of the greatest gifts from Boxing is learning respect for reality quickly. Many times, someone comes into a gym believing they know how to fight only to quickly be humbled and, from there, be able to appreciate the sweet science. The same is true for those that want to learn techniques and engage in Boxing without bruises. Often they will think that Boxing is a simple and brutal sport only to find that the coordination of feet and hands is far more sophisticated than they realised. 

In Boxing, there is no faking reality. Respect for reality is guaranteed. There are few moments in life where one can not cheat reality, where some intelligent talker can not distort the truth. Boxing does not allow this to happen and is such a great environment to fully appreciate the first pillar of genuine self-esteem.

The second pillar is to be able to accept yourself

Aligned with the first pillar are self-acceptance and the ability to accept one’s limitations while simultaneously being one’s best advocate. Self-esteem means being willing to experience all one’s emotions and behaviours, for by accepting one’s strengths and weaknesses, one will know areas one wishes to improve. Accepting oneself also means accepting that one is human and treating oneself with kindness by accepting poor behaviour and then empathetically questioning the gap between the desired and actual behaviour. 

Again Boxing is a great teacher in this regard. People can improve only when they move past their ego and into self-acceptance. They accept the need to make improvements. They accept that their error created the opportunity for the opponents to overhand the right to land. They accept that they don’t know how to bob and weave correctly. Acceptance is the catalyst for the third pillar of taking responsibility for one’s life.

The third pillar is to take responsibility for your life

Self-acceptance does not mean that one accepts their failings. We need to differentiate what can be changed from what is fixed and look to fix what can be changed. Having accepted oneself, one must then take responsibility for their life. You think independently. You analyse others’ opinions, only repeating them if you believe and understand them. You are responsible for reaching your goals. You understand that only you can develop and implement a plan to be your optimal self. People are not there to save you, but self-esteem means you take responsibility for developing and ultimately saving yourself.

Only you can take responsibility for learning to bob and weave correctly. Only you can take responsibility to keep your hands up when in the fight, and only you can learn to dig deep when the situation demands that the only way through is to find an inner self you did not know.

The fourth pillar is to assert yourself in order to improve your self-esteem and mental health

Self-esteem will invariably mean asserting one’s needs in a world of committing demands. Self-esteem does not mean taking a back seat or railroading through one’s point of view. Self-esteem means asserting oneself and recognising that others also have the right to assert their needs. The need for assertiveness as a measure of self-esteem can best be recognised by those who lack self-esteem and will often let others’ needs take priority or those who aggressively want their way without considering the needs of others.  

Self-assertiveness is again naturally practised in Boxing. In training, it is self-assertiveness, which means that questions are directed at coaches to improve your technique. In sparring, self-assertiveness means communicating how hard you wish to fight, not allowing your partner to push you into deep waters beyond your comfort level. In fighting, a core tenet is to assert your will on the opponent, not be a victim of their self-assertion. When it comes to self-assertiveness, Boxing is a great teacher.

The fifth pillar is to have intentionality in regards to your self-esteem and mental health

Intentionality concerning self-esteem means goal-setting. The ability to set goals is to create an intent. Those with self-esteem are clear on the goals that they set for themselves. They live their life in line with their goals, and they move toward the accomplishment of these goals.

No one improves in Boxing without clarity of goals. Short-term goals are stepping stones to longer-term goals. Many trainees engage in an 8 or 12-week challenge to achieve their goals; Boxing is a goal factory, which is why it is such a powerful exercise modality.

The sixth pillar is to live with integrity in order to support your self-esteem and mental health

The final pillar of Branden’s model of self-esteem is integrity. Concerning self-esteem, integrity means being integral or whole and consistent. Integrity means that one’s actions match one values and the words that one speaks.  

Integrity creates a virtuous cycle, Branden, as your self-esteem will drive and depend on your behaviour in a never-ending cycle: Your actions align with your expectations. Your behaviours inevitably affect your self-esteem—you can’t avoid feeling some way about how you choose to behave, and these feelings affect your opinion of yourself.

Integrity is a core part of the boxing lifestyle, especially at Spartans Boxing. Integrity means living the life of a boxer, respecting others in the gym independent of their sexuality, nationality or any other demographic variable you wish to choose. Integrity means recognising that everyone is on their journey of self-improvement. Integrity means committing to the FIGHT code of Spartans. Integrity means living your life in line with the person you wish to become.

How to Improve Your Self-Esteem Boxing

One of the strengths of Branden’s model is that it provides a template for how one would improve their self-esteem. Branden explains that by practising these pillars, you behave in ways that foster and improve your self-esteem. Since behaviours both cause and are effects of self-esteem, practising the pillars creates a virtuous cycle: The more you accept yourself, the more you’ll raise your self-worth—and thus your self-esteem. The higher your self-esteem, the more self-worth you have, and the more you’ll accept yourself. 

Boxing is the practice ground for the development of self-esteem. Boxing naturally results in developing a true sense of self, a deep appreciation of individuality, and an acceptance of your worth. Boxing is where everyone is on their journey of self-improvement and at the heart of the psychological journey is self-esteem. I know of no better exercise regiment than Boxing to build strong, healthy individuals with the self-esteem required to take on the world.

This article tackles boxing and depression, in order to understand this interaction, we need to know more about depression before explaining how it interelates with boxing. Depression is the world’s most prominent non-communicable disease. According to the World Health Organisation (WHO), depression is the leading cause of disability in the US and Canada, ahead of coronary heart disease, cancer and AIDS. Not surprisingly, mood disorders are a focal point for psychiatric work.

People often have difficulty distinguishing depression from simply feeling down. Many symptoms of depression are felt by those who are not clinically depressed but are experiencing an off day. Many of the symptoms can be opposites making diagnosis even more complicated. Those suffering from depression may show symptoms of sleeping too little or too much, eating very little or overeating, severe outbursts or becoming sullen. 

Clinically, the difference between depression and a bad mood is the number of presenting symptoms. According to the DSM 5 (the manual used by psychiatrists and clinical psychologists to diagnose), one needs a collection of symptoms to be considered depressed. In reality, most people know whether the mood they are feeling is more than a passing state and is pervasive enough to be more than just a bout of the blues. 

Pharmaceutical intervention for depression focuses on increasing three related neuromodulators in the brain known as monoamines; norepinephrine, dopamine and serotonin (see last week’s blog). In particular, the majority of drugs used to treat depression slow receptive uptake of neurotransmitters in the brain, the net effect being that you have more of the chemical circulating than would otherwise be the case. SSRIs (selective serotonin receptor inhibitors), such as Prozac and Lexapro, are effective in treating depression but also have a range of side effects, such as weight gain, sexual dysfunction, and withdrawal effects. Similar effects are found for the drugs that inhibit the reuptake of norepinephrine and dopamine (NDRIs). Moreover, anti-depressants don’t work for everyone. For some poor unlucky people, the SSRIs and NDRIs result in side effects for no gain. 

Depression can be considered a form of pain. Depression is a hibernation response to keep still and stay out of harm’s way during a painful psychological disturbance. The impact is primarily an inability of the brain to adapt. The impact is on areas like the hippocampus, becoming locked into negative memories. The brain can’t reach alternate conclusions about the cause of depression that it is trying to process. 

Boxing and depression, how exercise is benfecial in the treatment of depression

Given the prevalence of depression, its debilitating effects and the ineffectiveness of medication for some, we need alternative treatments. One such treatment is exercise. Exercise not only positively impacts the production of monoamines but also the brain’s natural painkillers, the endorphins. We have opiate receptors in the brain specifically for endorphins, and it is the link between exercise and a mental high, known as the runner high, which is, for many people, the introduction to the benefits of exercise for mental health. Endorphins are, however, not simply a natural high. Endorphins calm the brain and relieve muscle pain, lessening the mental anguish of depression.

Exercise, however, does more than increase the production of feel-good chemicals in the brain. Exercise protects the neurons by increasing what is known as brain-derived neurotrophic factors (BDNF). Amongst other things, BDNFs protect neurons from the adverse effects of cortisol covered in last week’s blog and increase neuromodulator uptake. BDNFs help neurons communicate, grow and aid neuroplasticity, which is central to the brain’s capacity to adapt and develop new thoughts. BDNFs are vital for executive functioning (think high reasoning); therefore, exercise is likely to play a facilitative role in psychotherapy (Ratey and Hagerman, 2008).

Given the positive effects of exercise on mental health, why is its role in mental health treatment not discussed more? The reality is that the scientific community has long known the positive effects of exercise on preventing or limiting the effects of depression. In a study dating back to 1974, people with no sign of depression which became inactive were 1.5 times as likely to develop depression (Housman, & Dorman, 2005). In this same study, those that were inactive and became active were no more likely to have depression than those with a history of poor mental health.

The findings of the 1974 study are not unique. A Dutch study of nearly 20,000 twins demonstrated that exercise reduced anxiety and depression (Willemsen., Vink., Abdellaoui, Den Braber., Van Beek., Draisma., … & Boomsma, (2013). Furthermore, Blumenthal and colleagues (2007), in their examination of exercise and medication, concluded that exercise was as effective as medicine in treating depression. More accurately, exercise was the most significant predictor of whether someone felt better, including psychotherapy. While exercise is not a replacement for medicine, there is a strong case that exercise be part of a treatment protocol. Exercise works as a prevention and cure and is effective for those for whom medication is unhelpful (Rethorst. & Trivedi, 2013).

Trivedi and his lab have developed protocols for the prescription of exercise for the treatment of depression. Protocols for exercise are very much in their infancy, but intensive workouts over an extended period (30-60 minutes) 3 times a week, burning up to 14,000 calories per week, seems adequate. Exercise is effective and intensive exercise over an extended period is very effective.

Boxing and depression: How does Boxing Help with Depression

High-intensity workouts are where boxing comes in. Boxing as an exercise modality positively impacts neurotransmitters, BDNFs, plasticity and executive functioning. A typical 45-60 minute class, run by Spartans, hits the prescribed exercise intensity without depletion. Workouts are designed to energy, focus, and recovery, leading to increased calmness. 

Recognising how difficult it is for people to start an exercise programme often when experiencing depression, Spartans have developed a dedicated programme for psychological repair. The 12-week programme starts with minimal intensity, using our InGymXperience@home, slowly but methodically progressing a person to in-gym training and finally to class interaction.

With our commitment to science, we monitor our clients’ progress through our Spartans Mind app. We hope to have publishable results that track the effectiveness of the various protocols we implement.  

Pound-for-pound, it is hard to find a better exercise than boxing to integrate with psychotherapy to treat depression. Spartans are incredibly excited to be leading the way in furthering exercise science to treat depression. 

References

Blumenthal, J. A., Babyak, M. A., Doraiswamy, P. M., Watkins, L., Hoffman, B. M., Barbour, K. A., … & 

Sherwood, A. (2007). Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic Medicine, 69(7), 587.

Housman, J., & Dorman, S. (2005). The Alameda County study: a systematic, chronological 

review. Journal of health education, 36(5), 302-308.

Ratey J., & Hagerman, E. (2008). Spark. Little Brown and Company.

Rethorst, C. D., & Trivedi, M. H. (2013). Evidence-based recommendations for the prescription of 

exercise for major depressive disorder. Journal of Psychiatric Practice, 19(3), 204-212.

Willemsen, G., Vink, J. M., Abdellaoui, A., Den Braber, A., Van Beek, J. H., Draisma, H. H., … & 

Boomsma, D. I. (2013). The Adult Netherlands Twin Register: twenty-five years of survey and biological data collection. Twin Research and Human Genetics, 16(1), 271-281.

Boxing is a sport that we typically associate with mental resilience, and did you know that a huge amount of research has been done on the impact of boxing on the mind. It’s been found that boxing can foster confidence, improve concentration, increase self-awareness, and help with stress relief.

Research has shown that even just 15 minutes of intense physical exercise a day can have a significant impact on the brain asit releases the feel-good hormones which can elevate mood. Boxing is a great way to expend extra frustration and energy you have which can help to de-stress as well as relieve any pent-up anger. It also serves as an active meditation, helping the brain enter a focused state of “flow” where you’re completely absorbed in the activity. Finally, it’s a great way to improve self-efficacy and control which has been negatively correlated with depression and low mood. 

It’s because of this that at Evexia Collective we are excited to partner with Spartan’s Boxing in Singapore, where we will be providing our Mental Fitness solution to Spartans clients so that they can Measure and improve their Mental Fitness alongside their physical fitness. 

To celebrate, we wanted to share a bit more about our methodology for mental fitness here at Evexia Collective. Mental Fitness consists of three core pillars, each corresponding to different parts of our brain and therefore to different behaviors. 

Energy: 

This relates to how much energy you have right now, it is a combination of how awake, positive, motivated, passionate, and driven you feel

• Behaviors: Motivation, drive, behavioural & emotional responses
• Limbic system

We all know that feeling of waking up feeling well rested, energetic and ready to start the day. Unfortunately this feeling can be tricky to come by if we aren’t sleeping well or if we are running on empty. Therefore a core part of mental fitness relates to how much quality sleep we are getting. But Energy isn’t just about sleep, it’s also about how passionate and excited we feel about life. This often comes down to a sense of purpose in life and can impact how motivated we feel in our personal and professional lives. 

Find out more in this video: https://youtu.be/x1ouHp-4ph4 

Calm: 

This relates to how calm you feel and includes how well you are managing stress and how easily you can relax.

• Behaviors: Wakeful rest, balance, self-referential processing, introspection, memories
• Default mode

We often associate our mental wellbeing with how stressed we are. Yet whilst chronic stress is bad for us mentally and physically, we also need a certain amount of stress to help motivate us and perform to our best. So that’s why we focus on our sense of calm, as you may have some healthy stress in your day, but if you are able to bring on a sense of calm and relaxation when you want to, then you are keeping yourself in “good” stress really well.

Find out more in this video: https://youtu.be/FriVmAPp690

Focus:

This relates to your decision-making ability and how well you can pay attention to one task at a time without being distracted.

• Behaviours: Wakeful rest, balance, self-referential processing, introspection, memories
• Paratial Frontal Executive System

Being able to focus on one task at a time without distraction is a common difficulty in the workplace, especially when other aspects of Mental Fitness are weaker (energy and calm). When we have a million things to get done, it can be difficult to pay attention to each one in turn. But that’s usually when we need to focus most! As well as paying attention, this part of Mental Fitness includes decision making ability and aspects of logical thinking, both of which are particularly important in the workplace and come under strain when our Mental Fitness isn’t doing it’s best. 

Find out more in this video: https://youtu.be/NxRXjnxufuo 

All three of these pillars are impacted by social connection which is how connected to others we feel. This doesn’t need to mean you have hundreds of friends, but rather the quality of the close connections you have. These relationships help us feel calmer, more energized and in turn can impact focus. So it’s an addition key aspect of Mental Fitness.

So as we launch our partnership with Spartans Mind, we are excited to explore these aspects of Mental Fitness alongside boxing and see how it helps to improve Mental Fitness.

References:

• https://journals.sagepub.com/doi/full/10.1177/15598276221124095]
• https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjgqp6Vtbv6AhUylOYKHS1LCeEQFnoECAcQAQ&url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7550717%2F&usg=AOvVaw0A-Hyrs3_ZFSxG9FFleMMa
• https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjgqp6Vtbv6AhUylOYKHS1LCeEQFnoECAcQAQ&url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7550717%2F&usg=AOvVaw0A-Hyrs3_ZFSxG9FFleMMa
• https://doi.org/10.22271/journalofsport.2020.v5.i2a.1977

Optimisation is a term that we use pretty extensively at Spartans. We aim to optimise the health and well-being of our members. We take optimisation very seriously, aiming to optimise physical and mental well-being. We have programmes that align with our goal of optimisation.

However, we have recently been asked: “what do we mean when we refer to optimisation? What is our definition of optimisation, and how does it avoid becoming an endless quest for perfection?”

At Spartans, we define optimisation as follows: When the external reality matches the individual’s internal subjective experience and goals“. I recognise that this definition can seem a bit of a mouthful, so let me unbundle the definition’s various components and make the Spartans definition of optimisation clear.

The starting point for understanding optimisation is to understand the individual. Each of our members has their own goals and areas they want to improve. Likewise, given the right tools, individuals can define for themselves when they are taking steps toward their optimal self and when they are making improvements to their internal and external well-being. So optimisation is individualised.

The second point is the link to external reality. Just as individuals will imagine their ideal future, optimisation aligns with that ideal future and external reality. In short, our goal is not that one imagines their optimal life but that their optimal life becomes a reality with the help of Spartans; when the external reality matches a person’s subjective goals, one can be said to be in a state of optimisation.

To better understand the model, we can graph the core parameters of optimisation. We can also look at how the break between subjective experience and reality can lead to sub-optimal alternative ways of being.

Optimisation matrix

The graph has two axes corresponding to the two optimisation parameters used at Spartans. Subjective well-being is how a person feels about themselves and their emotional, mental and physical well-being. The other graph is their external reality which, as discussed, is their alignment between their hoped-for and experienced life.

At the bottom of the graph, we have low levels of subjective well-being and poor external congruence. In psychology, people in this block are said to be experiencing depressive realism. The theory of depressive realism was initially brought forth by Alloy and Abramson (1979), who noted that depressed people might often see the world more accurately. The subjective experience matches the external reality.’

Next, we have those whose external reality remains negative, but their subjective well-being remains positive. Many people negotiate life by activating these positive illusions (Taylor & Brown, 1988). While maintaining positive illusions is certainly better than being in a negative emotional state, the ultimate goal is that a change in thinking patterns matches changes in external reality.

The next block in the graph is those with a favourable external reality but who remain in a negative subjective state. These are people significantly helped by boxing as the physical fitness component of boxing can help them to experience more internal positive states and ultimately have more gratitude for the life that they are experiencing.

Optimisation, the goal Spartans has for its members, is when a positive emotional state matches a positive external reality (Englert, 1997; Englert, 2016). Spartans’ goal is optimal performance through our various boxing programs and Spartans Mind. When the subjective experience and external reality are both positive, a person is on the road to optimisation.

We at Spartans recognise that people will move between the various categories in the optimisation matrix. Life throws curve balls, changing our external reality. We may experience changes in subjective well-being as we progress through life. We may experience optimisation only to set new goals and start the growth process again. 

Spartans is with our members for the journey with apps and programmes that help throughout the optimisation process. We believe that boxing is a lifestyle that aids physical and mental health, and we are privileged to partner with our members on their journey toward optimal mental health.

What is optimisation: References

Alloy, L.B.; Abramson, L.Y. (1979). “Judgment of contingency in depressed and nondepressed students: 

Sadder but wiser?”. Journal of Experimental Psychology: General. 108 (4): 441–485. doi:10.1037/0096-3445.108.4.441. PMID 528910. 

Englert, P. (1997). Eliminating the negative in positive illusions: A blueprint 

for the maintenance of mental health during unemployment and redundancy. In P. Howland (Ed.). Voices in Continuum (pg. 115-126). Victoria Postgraduate Association: New Zealand.

Taylor, S. E., & Brown, J. D. (1988). Illusion and well-being: a social psychological perspective on mental health. Psychological Bulletin, 103(2), 193.

Societal change, driven by generational youth movements, is very much part of human history. Rock and roll in the ’50s, the anti-war/peace movement of the ‘60s, and, more recently, the Arab Spring are all attributable to the youth of the time. Youth often usher in a new age that improves the human experience and addresses shortcomings in the current system. In recent years, millennials and Generation Z have influenced business ethics. No longer can businesses solely focus on profit. Organisations need to take their responsibility seriously to the community. A new term has been born, Corporate Social Responsibility (CSR). 

For many companies, however, CSR is nothing more than virtue signalling with a profit motive. Businesses adopt a CSR strategy because it is good for business. When oil companies start talking about the environment, banks start talking about their love for people in financial need, and alcohol companies start responsible drinking campaigns, a degree of cynicism is only natural. Not that virtue signalling is necessarily a negative. Indeed, if one focuses on outcomes, virtue signalling is a catalyst for powerful outcomes.

CSR is, however, often a one-off event marketed extensively on social media. The sleep-out once a year on the street, the quarterly volunteer day and beach clean-ups all make for good PR, without any substantive change or actual impact on lives, be it the business people or the recipients.

When it comes to CSR, boxing gyms are different. CSR has always been part of the very fabric of many boxing gyms. In the spit and sawdust gyms located in many working-class areas, the gyms have always been a natural community for troubled youth and those less fortunate. Gym owners and boxing coaches donate their time, resources and even homes to help the less privileged. Many world-class boxers got their start through such gyms, including; Mike Tyson, Canelo Alveraz, and Tyson Fury. Legendary trainers like Cus D’Amato are legends not only for developing champions but also for how they devoted their lives to helping others.

Spartans is a unique blend of original boxing ethos within a world-class modern fitness centre. Our roots remain with the fight gyms of the past, packaged for the modern environment. We cater to the fighter, weekend warrior and the general community simply looking for a means to get fit. Our roots are in boxing history but with a broader offering than many of our predecessors.

Spartans does not have a CSR division, nor do we talk of CSR. We are a boxing gym, and the community is implicit in the business model. Spartans integrate CSR in our business not as a sporadic event but as a pillar of Spartans Mind. CSR is not an add-on to our business; CSR is what we do.

Strengthen is the pillar within Spartans mind focussed on community outreach. Under strengthen, we work with two groups, each with its strategic partner. The first group that we work with is at-risk youth. In Singapore, we have connected with Impart, an organisation that provides holistic support for youth in Singapore. Our programme includes boxing for physical fitness and social services to ensure that no one falls through the cracks.  

The second group we partner with is Neugen, to work with ex-offenders and their families. Real change comes from working with a broader net than just the ex-offender, and reintegration starts with the family.

Futureselves underpins both of Spartans outreach programmes. Futureselves is an assessment and intervention hosted free by our technology partner, Podium. The Futureselves programme helps people set life goals across multiple domains and then put the strategies to achieve their goals in place.

For Spartans, CSR is how we do business. We don’t call it CSR. Community is a core value of our corporate office and each gym. Through ‘Strengthen’, we aim to build communities not with one-off donations or one day of voluntary work but through dedicated programmes with strategic partners. CSR is a good thing, a great thing driven by a need for societal change. For Spartans, we call it BAU.

I have been working with young people since I was 19 years old. One of my favourite questions to ask a young person is, “What’s your dream?” It was this exact question that led me to seek assistance for a youth to fulfil his dream to become a boxer.

Narish, the youth, has made significant strides in the Singaporean boxing scene. He faced many childhood adversities and did not have role models to guide him while he was growing up. Personally, I witnessed his growth as he picked up boxing. He managed to overcome his unfortunate circumstances to achieve greatness in the boxing realm, which translated to growth in his other spheres of life.

It got me wondering how effective it would be if I could enrol more youths in a boxing programme. This was when I chanced upon the Spartans Youth Outreach Boxing programme and decided to enrol a couple of my youths. The journey that awaited me was beyond my wildest imagination.

The story of “Zack”

Zack’s life wasn’t easy, filled with domestic violence and neglect. Led away from familial safety, he sought solace in gangs, substance abuse, and promiscuity.

His transformation came when he joined Spartans boxing youth outreach programme. There, he met many people and heard many stories. One of the most inspiring moments for Zack was with Amir Khan. Amir Khan was one of the guest speakers. He shared his life story on how martial arts impacted his life. Amir Khan pursued his dreams against the odds that he faced in his life. He didn’t let setbacks or limitations determine the path he was going to take. This showed Zack that a life of crime was not the only pathway forward.

The story of “Dan”

Dan’s life was full of unrelenting crisis, filled with abuse. He was removed by the child protective services to be placed in safe places. Often, he found himself suicidal in prolonged depressive states.

Dan’s high point in life came after joining Spartans boxing youth outreach programme. He managed to pick him up through sheer determination and the physical activity helped his condition. Over time, his moods stabilised and he was motivated to do boxing. He was even offered an admin job at one of the clubs which allowed him to sustain himself. The change motivated him to complete N levels and enrol with ITE. Now, he is in higher Nitec and trying his best to complete the programme. This gives him a fighting chance in life to achieve bigger things for himself.

Some of these boys were victims of complex trauma as a result of the numerous adversities they experienced in their childhood. Yet, they came out as victors after joining a boxing programme. For them, a more active approach such as boxing was beneficial for managing the physical impacts of trauma. I witnessed how boxing relieved their tension rather than them trying to calm their impulses through their former coping mechanisms. I discovered that the youths were able to experience significant release as they were working with the impulse and energy rather than against it.

I can personally testify of the transformation of every youth in the programme. Their growth began when they were willing to try something new like boxing. They had embraced their failures and worked through their discomfort. This process of redefining discomfort was a necessary part of adopting a growth mindset: It meant that they showed up even when they didn’t have the mood for it. It meant that they pressed on when they felt like giving up.

Pressing through these moments of discomfort fostered their growth. Over time, the boys learned to push past their comfort zone and understood what progress looked like. You have to dig deep and press on sometimes, and the programme helped facilitate the process, strengthening their individual sense of grit.

Project Grit, which will be done in partnership between Impart and Spartans Boxing Club, builds on these youths’ experiences to bring something better. Group therapy is interwoven with traditional boxing and fitness training to bring a programme that marries the best of mind and body care. 

The 12 week pilot will work with youths aged 13-18 years, with sessions split into two parts. The first half consists of group therapy led by a clinical psychologist / psychotherapist and the second half is traditional boxing and fitness training led by a professional boxer and boxing coach.

Through group therapy, youths are equipped with practical skills which empowers them in terms of interests, education and/ or employment.

Through boxing training,  youths will learn boxing fundamentals and self-defense techniques while promoting the development of physical fitness and healthier lifestyle habits.

Drawing on the power of community, this programme uses the Developmental Relationships Framework to engage and nurture the youths-facing- adversities. The youths will be brought on learning journeys to visit different companies for exposure to possible working environments. And there will be guest speakers from varied walks of life who will inspire the youths to aspire towards their future selves with their life stories. 

Put together, we will empower a community of peer supporters, volunteers, role models and professionals to support youths-facing-adversity in a safe, trauma-informed space to build resilience, and mental health skills, inculcating values, and imparting relevant life/vocational skills using a psychological toolkit called FutureSelves. 

I hope every little moment of interaction during Project Grit will help youths-facing-adversity to experience a span of new narratives about themselves, their prospects, and their communities. Consequently, youths will be better positioned for adulthood and the workplace.

With regards,

Narash Narasimman

Of all the precursors to poor mental health, perhaps none is as impactful as trauma. As a category, trauma captures a deeply distressing or disturbing experience. Hence, it is tautological that trauma negatively impacts a person’s sense of well-being. Indeed, the impact of trauma on mental health is pervasive. In this article, you will know more about the trauma and how boxing can help to recover from it.

Trauma is a significant cause of anxiety as the triggers reactivate brain circuitry related to the initial traumatic event. Trauma is debilitating and often results in depression and general inactivity for many people. Trauma can also result in psychosis-like symptoms such as dissociation as the brain attempts to process and make sense of the traumatic event.

A healing process will need to commence post the traumatic event. The bulk of this will naturally be psychotherapy and, where appropriate, psychopharmaceuticals to help the healing process. However, more experts are calling for exercise to be part of the treatment plan to help a person to get back on their feet (Ratey &  Hagerman, 2008).

As discussed in earlier blogs, boxing is a modality that aligns well to be an additive component of mental-health treatment. Boxing fits into a broader category of exercise known as HIIT (High-Intensity Interval Training). HIIT has a growing body of supporting evidence indicating its benefits for mental health (Martland, Mondelli, Gaughran, & Stubbs, 2020). The following are some key findings on HIIT and how these relate to addressing the impacts of trauma.

Trauma and Boxing: Focus

People who experience stress due to trauma are often on edge, their minds prepared for the fight or flight response. Humans are unique in that we don’t require danger to be clear and present to elicit the ‘danger response’- our minds can imagine the situation. 

However, just as the mind can work against us, we can utilise our understanding of the brain to work for us. Boxing has some unique benefits as an exercise modality for reducing trauma-related stress. 

As boxing has a skill component, the brain is activated away from thoughts of the imagined stressors and toward the new activity. Learning new movements results in a hormonal rush of norepinephrine arousing attention and dopamine focusing the attention toward goal behaviour. The drive toward goal-directed behaviour increases focus and improves one’s sense of well-being.

Trauma and Boxing: Energy

When we are stressed, cortisol signals increase glucose in the bloodstream. Increased cortisol is why stressed people often gain a spare tire around their mid-section as glucose unused will eventually become fat. Cortisol adds injury to insult as it increases protein breakdown for energy, resulting in muscle loss. Our bodies respond to the perceived stress as they would the stress of a famine. Once the event subsides, we store the extra glucose and protein breakdown as fat around our belly- protection against future famines.

The upshot is that you need an outlet for all the energy build up and boxing is a natural outlet as it is cardio-intensive and high impact. Boxing will increase calorie expenditure during exercise and decrease the chance of belly fat occurring after the event as the body utilises the additional cortisol in naturally responding to the fight or flight response.

Trauma and Boxing: Calm

Stress is a nasty bedfellow when it comes to memory. The brain wants the person to avoid the traumatic experience again; therefore, we have adapted to deeply recorded negative experiences. In addition, the increased cortisol can stop new memories from being encoded effectively – The neurons can’t be part of new circuitry. Ultimately it is hard to learn new material. Your brain has become obsessed with the trauma. 

Through mindful attention to the development of the new skill, new memories are formed in an environment where external and internal distractions are minimised. Boxing classes not only have the skill component, activating new memories, but the non-threatening class environment naturally reduces stress enabling new memories to be formed.

Energy, calm, and focus are three of the most critical psychological markers that people should measure daily to keep on top of their mental health. For this reason, the Spartans App allows all of our members to have a daily check on these areas, graphing responses over time. However, the benefits of boxing at Spartans go well beyond just energy, calmness and focus.

An insidious effect of trauma is social isolation. Loneliness is one of our greatest perceived threats to survival. A cruel outcome of trauma is that it often isolates people, leaving them locked at home and in their minds as they avoid any traumatic triggers. Social isolation deepens the effects of trauma, such as depression, creating a negative cycle for mental health.

Boxing classes allow a person to interact with others in a safe environment. There is accountability to attending booked classes and a no-pressure environment of participation. The person feels a sense of community, safety and belonging. Having access to programmes at home, the person can start at their own pace, with some helpful prodding from the gym and systematically transition into class. 

In summary, boxing is an effective additive to a trauma recovery programme. Boxing provides a healthy distraction in a supportive environment, rerouting brain circuitry, improving resilience, and providing the outlet to help a person get back on their feet and set them free from the trauma.

References

Martland, R., Mondelli, V., Gaughran, F., & Stubbs, B. (2020). Can high-intensity interval training 

improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan. Journal of sports sciences, 38(4), 430-469.

Ratey J., & Hagerman, E. (2008). Spark. Little Brown and Company.