A piece I wrote for the GP's magazine Pulse:
Have you ever recommended exercise to your patients to help their mental health? A study commissioned by the Mental Health Foundation in 2008 showed that 22% of GPs had suggested exercise for mild depression. But do we practice what we preach? We’re working at a time of huge stress for GPs, struggling to cope with the NHS reforms, patient demand, pensions and changes to services. How many of us recommend exercise to help stressed out patients, then jump in the car and sit in a traffic jam on the way to a home visit? There is a growing body of evidence that exercise can help in depression and anxiety. Perhaps as doctors, we should be tapping into that, setting a good example to our patients and helping to reduce our own stress levels.
Whilst long days at the surgery leave little time to get to the gym, there is a simple solution. How about cycling to work? Jonathon Tomlinson, a GP at the Lawson Practice in Hoxton, East London rides to work every day because it is the easiest and quickest way to get to work and visit patients. But that’s not the only reason. “Exercise shouldn't be a chore. If you work long hours, the only practical solution is to make it part of your day” he says. It’s a philosophy I can identify with and the reason I started commuting by bike myself. But it’s not just about keeping fit. Riding to work energises me for the day ahead, and riding home helps to de-stress me. It appears I’m not the only one. Dr Nick Cavill is an Independent Public Health Consultant: “Anecdotally many cyclists report benefits to mental health- linked to fresh air, being outdoors and a chance to switch off from other worries.”
After five years of cycling to work, I’m known to many of my patients as the cycling doctor and whilst that initially raised questions as to whether I had been banned from driving or couldn’t afford a car, it now gives me credibility when recommending that patients get more active. Research has shown that doctors’ health practices strongly influence patient behaviour. It isn’t for nothing that they write “Most Doctors Don’t Smoke” on cigarette packets. If I know that cycling helps my stress, I’m more likely to suggest it to my patients and they are more likely to give it a go - patients become more receptive to health promotion counselling from doctors who demonstrate healthy behaviours themselves. Riding a bike to home visits is a highly visible way of showing that I believe in what I say.
Not that it’s always easy – when the rain is pouring down, it’s sometimes tempting to leave the bike in the garage. Even that might represent a missed opportunity. When Patisserie Cyclisme blogger Louise Mullagh was recommended exercise to help with her depression, she took to her bike in all weathers. “It was really good to feel the cold, the rain and to fight against it, it made me be mindful and just exist in that moment. It helped me to lose some of the numbness brought on by the medication.” The message is clear – embrace the British weather, it’s good for you.
Perhaps you have more prosaic reasons for not taking to the saddle. Perhaps you’re worried that the sight of you in Lycra might actually mentally scar your patients rather than help them. What about punctures? Oily chains? Helmet hair? No more excuses! Numerous companies now produce cycling clothing that can be worn without shame in the surgery, puncture-proof tyres keep the flats at bay and bikes are now available with carbon fibre belts instead of the humble chain. Helmet hair might be more difficult, but is a small price to pay for sorting out the rest of your head.
Still not convinced? Whilst cycling improves your psychological well-being, driving actually makes it worse. Research from the University of Sussex showed that commuting by car significantly increased levels of stress, physical tension and blood pressure, especially in congested conditions. That traffic jam again – ever felt frustrated as you sit trapped in your car as a cyclist cruises past in the cycle lane? For the sake of your mental health, you should think about joining them.