Reference: Wilkes, C., Kydd, R., Sagar, M., & Broadbent, E. (2017). Upright posture improves affect and fatigue in people with depressive symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 54, 143-149.
While you are reading this article, are you leaning forward, with your back curved in hunchback position while leaning toward the computer? We all have heard during our lives that adopting the right posture was healthier for our spine and our inner organs, but now we are learning that our mind can benefit from it too.
Research over the past two decades has shown how upright posture improves mood and self-confidence in general, but less was known about the effects that it could have for depressed individuals. Because depression diagnoses increase each year worldwide (1), recently, a group of scientists lead by Carissa Wilkes at the University of Auckland have further investigated this issue. Given that slumped posture with forward head position is a diagnostic feature of depression (2) they selected about sixty people who not only met the diagnostic criteria for mild-to-moderate depression – set by the Diagnostic Statistic Manual (DSM V; 3) – but they were also all affected by poor posture, showing a curved spine with neck and head pushed forward and out of line.
The participants were randomly split into two groups: the “upright posture group,” and the “usual posture group”. In the upright group, participants were provided with the correct application of postural taping (Kinesiology taping) to improve thoracic extension, neck-spine alignment, and lumbar positioning (4). This technique involves the use of large strips of special tape attached to the skin to support correct posture and movement by restricting the range of motion of the areas treated. When wearing the tape, the body is forced to use correct posture or else the strips will lightly pull the skin. The “usual posture group” participants were given only general information; their posture was not corrected because the tape was applied loosely so that it could not serve any therapeutic purpose.
Following the taping procedures, both groups underwent psychological testing to record mood and anxiety levels. All participants scored similarly in terms of low mood and self-perception. Then both groups were asked to prepare and complete a short speech and complete mental arithmetic – tasks meant to induce social stress. Finally, participants reported on their affect and level of fatigue. These tasks and measures took about 25 minutes to complete.
Posture effects on fatigue and language use
Overall, upright posture had a positive influence on participants’ mood. After the kinesiology tape was applied, the upright posture group reported greater positive affect (e.g., enthusiasm and excitement) than the usual posture group. The upright posture group also reported lower fatigue compared the usual posture group. And, upright shoulder angle was associated with lower anxiety, confirming once again the link between posture and personal emotional states (5, 6).
The authors also analysed language use during the speech task and found that posture had an influence. The usual posture group needed more pauses while speaking, exhibiting signs of psychomotor retardation compared to the upright posture group. Not only did the upright posture group speak more (i.e., use more words in their speeches), they also used less first-person singular pronouns (e.g., “I”, “me”) than the usual posture group. While this finding may seem trivial, it actually says a lot in terms of levels of self-absorption that individuals with anxiety and depression display due to a variety of reasons, including being unable to detach themselves from their own feelings or automatically feeling personally hurt by others’ pain (5, 6).
Promising findings, but questions remain
This is the first study that examines the effects of a curved spinal posture and its relation to depressive symptoms. Although the results are promising, the authors note a few limitations. First, the participants all reported mild-to-moderate depression, as those with severe depression were excluded given that they would require more intensive treatment. Future research should explore the influence of posture on severely depressed people as well as in other metal disorders such as schizophrenia and bipolar disorders, where previous research pointed in the same direction (7).
An additional limitation of the experiment is the absence of a physical exercise professional to work alongside the physiotherapist who placed the tape in the correct positions. The short experiment could not tackle a more practical issue: would people be able to sustain correct posture over a full day or week without guidance? Incorporating exercises to help maintain posture in everyday tasks could lead to long-term benefits. Would the benefits of upright posture last for longer periods of time? For example, could adopting upright posture help depressed individuals reduce their antidepressant intake over time?
Finally, the reasons why upright posture can have such a positive impact on thoughts and behaviour is still not fully understood. Physiologically, a correct spinal alignment is linked to thyroid functioning, subsequent hormone release, and brain activity (8, 9); while psychologically, an upright spinal positioning can improve our self-perception (10). When we curve, twist, and incorrectly bend the spine, we are also harming our internal organs, particularly the lungs and gastrointestinal tract (11). Henceforth, we may become more prone to see positive things around us over negative stimuli (12). Could these physiological symptoms explain why poor posture is so closely associated with negative thinking?
More research is needed to answer these important questions. The topic is certainly worth researching further, as back pain, back injury, and depression, are all rather costly in terms of absences from work and public expenditure worldwide (13, 14). While correcting our posture takes effort and help from a specialised trainer/instructor, it provides long-lasting results that can improve behavior and general mental wellbeing, along with saving money and despair later in life. But also, compared to other types of treatments, changing posture is a low-risk method where we can re-learn how to align our spine while executing simple daily tasks. Perhaps by facing our days ahead by holding our head up high we would be able to look and feel better. And, our spine would be the whole reason for that to happen.
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5. Brinol, P., Petty, R. E., & Wagner, B. (2009). Body posture effects on self-evaluation: A self-validation approach. European Journal of Social Psychology, 39, 1053e1064.
6. Canales, J. Z., Cordas, T. A., Fiquer, J. T., Cavalcante, A. F., & Moreno, R. A. (2010). Posture and body image in individuals with major depressive disorder: A controlled study. Revista Brasileira de Psiquiatria, 32, 375e380. http://dx.doi.org/10.1590/S1516-44462010000400010
7. Thomson Daniel, Turner Alyna, Lauder Sue, Gigler Margaret E., Berk Lesley, Singh Ajeet B., Pasco Julie A., Berk Michael, Sylvia Louisa. A brief review of exercise, bipolar disorder, and mechanistic pathways 2015 – Journal Frontiers in Psychology, Volume 6. https://www.frontiersin.org/article/10.3389/fpsyg.2015.00147
8. Khan, M. N., Sharfuzzaman, A., & Mostafa, M. G. (2014). Spinal cord compression as initial presentation of metastatic occult follicular thyroid carcinoma. Journal of neurosciences in rural practice, 5(2), 155–159. https://doi.org/10.4103/0976-3147.131661
9. Ogbodo, E., Kaliaperumal, C., Keohane, C., Bermingham, N., & Kaar, G. (2011). Sciatica as a presenting feature of thyroid follicular adenocarcinoma in a 79-year-old woman. BMJ case reports, 2011, bcr1020115014. https://doi.org/10.1136/bcr.10.2011.5014
10. Schouwstra, S. J., & Hoogstraten, J. (1995). Head position and spinal position as determinants of perceived emotional state. Perceptual Motor Skills, 81, 673e674.
11. Dainese, R., Serra, J., Azpiroz, F., & Malagelada, J. R. (2003). Influence of body posture on intestinal transit of gas. Gut, 52(7), 971–974.
12. Niedenthal, P. M. (2007). Embodying emotion. Science, 316(5827), 1002e1005.
13. World Health Organisation, Depression, 30th January 2020. Depression (who.int)
14. World Health Organisation, Musculoskeletal conditions. 8th February 2021 Musculoskeletal conditions (who.int)