Posture and Depression
The Research vs The Buzz
A recent study 1 concluded with the suggestion that “adopting an upright posture may increase positive affect, reduce fatigue, and decrease self-focus in people with mild-to-moderate depression”. This arena has been hard to study really well because bodies and habits differ, so there’s a lack of agreed upon normative benchmarks for “good posture”.
Which is why its astounding (and encouraging) how much positive media coverage an article that scheduled to appear in the March 2017 issue of Journal of Behavior Therapy and Experimental Psychiatry, has gotten!
Here’s some of the headlines:
- Psychology Today: “Good Posture May Ease Symptoms of Depression: When you’re down in the dumps, sitting up straighter may lift your spirits”.2
- Live Science: “How Good Posture May Help with Depression Symptoms”3
- The Evening Standard: “Standing up straight and improving posture could treat depression”4
- Daily Mail: “Standing up straight could treat DEPRESSION, study claims: How posture has a direct impact on your mood”5, with 3 subtitles:
- Previous studies have found slouching can crush self-esteem and energy
- But a new study in New Zealand has tested the theory on people with depression
- They found that sitting up straight boosted energy, enthusiasm, and attention
The study findings agrees with what we teach. HOWEVER, there’s one very significant perspective I believe is being missed.
WHAT THE RESEARCHERS DID:
43 females and 18 males diagnosed with mild-moderate depression were randomly assigned to two groups. The good posture group were shown a picture of good posture and given advice to focus that focused their attention on their head, torso and arm position, after which rigid kinesiology tape was applied. The control group had sham tape applied, without tension. During the next 25 minutes participants were asked to compose a short speech, solve some basic math problems, and given a social stress test.
WHERE I AGREE WITH THE BROADBENT STUDY:
The study concluded that “improving slumped posture may improve mood in people with depressive symptoms”, and lead author Elizabeth Broadbent states that “Sitting upright can make you feel more alert and enthusiastic, feel less fearful, and have higher self-esteem after a stressful task6”.
WHAT I BELIEVE THE STUDY IS MISSING:
Insight into the interaction between EXTERNAL postural effects (e.g. Rigid kinesiology tape) and INTERNAL effects (e.g. Patient perceptions of the instructions to “sit straight”). The study found the upright group that was taped “experienced significantly lower fatigue than the usual posture group”. Since the control group was not being posturally supported by the tape, effects from muscle stress to ease of breathing could be involved. And, since only the control group was advised to improve their posture, the 25 minute effect might be from that alone… and not sustainable.
The StrongPosture® Position: Unless the internal stabilizing muscles are trained towards the improved posture position, any effect of the tape will ultimately lead to weakening of the deep intrinsic muscles responsible for postural alignment.
Which opens the question of Actionablity – How to take sustainable action.
For the depressed patient, posture awareness can provide a somatic focus away from negative self-talk, and while tape may be a therapeutic enhancement to this refocus, to be sustainable it should be coupled with internal awareness to control that new position in motion. And, unless their posture environment helps to promote this change, old habits will likely take over.
Author Elizabeth Broadbent acknowledges that it’s a preliminary study, prompted by her noticing “that I was walking with my shoulders slumped and looking at the ground. I looked up and put my shoulders back, and immediately I felt much better.” Their study concluded by advising future investigations of “postural manipulations over a longer time period and in samples with clinically diagnosed depression”.
For future studies, I’d suggest bench-marking posture awareness to an objective reference, and then correlating that internal posture control and an intelligent posture environment.
1 Wilkes, Carissa, Rob Kydd, Mark Sagar, and Elizabeth Broadbent. “Upright Posture Improves Affect and Fatigue in People with Depressive Symptoms.” Journal of behavior therapy and experimental psychiatry 54 (2017): doi:10.1016/j.jbtep.2016.07.015.