The act of doing: feeling real

For some participants the act of PA allowed them to engage in what they perceived as being in the real world. It was like PA permitted the participants to break free from their illness. This was described when participants were in hospital and also when they were in the community. In either environment, their illness was like an oppression, they were being held against their will in an unfamiliar place which was not perceived as being real. PA was their escape from this oppression to a familiar real world.

It were quite a weird period…it were really funny actually because I was stiff as a board...and me nanna and me great auntie came down. I were just sat back you know in my bed like stiff and me nanna immediately shot down with a walking stick down to the nurses station, ‘do you realise how stiff my grandson is do you know that he’s poorly you’re not looking after him properly’ and they gave me some procyclidine and then David [name changed]

appeared on ward and the stiffness just went with the procyclidine ... and I felt like going, so I went for the walk, really enjoyed it, we had something to eat, and then I got back on the ward and the doctor were shocked that I’d actually been out and gone for a walk and I felt really good and unfortunately for me at that time things didn’t go well....but going for that walk that time and I felt that bit better, after feeling so low and being in bed and stiff it was just like it was like this is amazing, I had a snapshot of real life just for a day or two in a bad spell (Paul).

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The experience Paul shared demonstrated how the relief from the stiffness associated with the antipsychotic medication allowed him to feel able to go for a walk. Paul described a huge contrast of experiences between the walk and the rest of his life at the time. It was as though the walk encouraged some light to shine on Paul’s dark days, it provided him with a view of the outside world.

When describing a different experience Paul went on to state:

There’s that unreal feeling that you can have when you’re poorly, when you’re anxious and sport pops that anxiety bubble a little, certainly for that moment when you’re doing it and that while after and if you keep doing it, it does pop that anxiety bubble a little bit and things that have looked unreal and flat and maybe a bit darker, become more 3D and more colourful and stuff – that’s what I’ve found (Paul).

Paul claimed that PA helped him to feel more real, as though he was using his body to engage in the world that beforehand he was not able to do because his thoughts would not allow him. Paul described how his perception of objects altered in that they became more alive, more colourful and 3D, his outlook became brighter. It was like Paul had been existing through observing the world on a black and white 2D TV, the glass of the TV was a barrier preventing him from entering into the world. PA was like being given a pair of colour 3D glasses, where he broke down the barrier and entered the 3D world. A world that he could touch and feel, one which he felt was real life. Engaging in this world perhaps permitted Paul’s self to re-engage in this 3D world.

PA and the environment

All of the participants described different types of activity and the different space that they undertook PA. For some they liked to be part of a group environment, for others they preferred individual workouts. Some liked to undertake PA inside, others outside.

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A bit of cycling, cycling’s good for heavy depression as it works on your senses a bit...them bikes in the gym aren’t good for depression but I did notice like the proper mountain bike or on the road it was good for depression...I just think if you’re on a bike in the gym you’re not looking where you’re going and just putting brakes on and stuff and going round corners, flying round the corner, I think it’s lot better than being on the bike in the gym, I mean you have these reactions...in the brain and responses and stuff, it seems to get them when you’re cycling it’s a good form of exercise…(Mike).

It was like Mike was experiencing freedom. His depression was perceived as being oppressive, dulling his senses whereas cycling with the wind in his face, with decisions to take, with the environment to take in awakened his senses and provided him with a body world connection.

Tom also believed that being active in nature helped him to balance his thoughts. However unlike for Mike, Tom undertook walking in nature to slow and calm his mind down:

Part of my recovery was - I used to go for a five mile walk everyday of the week no matter what the weather was, wind, rain I find it very calming being out in nature I feel calming and it helps me face the day and put things in balance (Tom)

Too much PA

Although PA was usually described in positive terms, caution was stated with respect to the amount of PA which participants engaged in. It was felt that if participants undertook too much PA too quickly they could return to that unwanted pit:

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Paul: If you jump into it too soon…and you’re not up to it, it can knock you back,

Researcher: Right, in what way?

Paul: It can make you think you’re a failure, it can make you think …I’m not up to it anymore I can’t do it, people are better than me, or you might think, normally I’d run rings round that person but I can’t today because I’m very ill or whatever...if you do go and you can and do too much at once you can over flood your brain and you can become a bit foggy…it can make you want to not do anything really, make you a bit depressed actually, but if you take it steady you’re alright.

Paul described how doing too much can ‘flood the brain’, make him ‘foggy’ and make him feel ‘depressed’, these were all seen as a return to how things were before he was able to engage in the real world; before he was able to creep out of the pit. However, he also talked about how on some occasions, PA reduced his confidence which also knocked him back down the ladder.

This theme outlined how the act and routine of PA helped the participants in altering their perception of lived space. It also highlighted that the environment in which PA was undertaken impacted upon the individual PA experiences. For some being outdoors in nature helped to control the perceived symptoms, for others, undertaking PA outside only added to paranoid thoughts.