DISCUSSION
anxiety, pain, depressive disorder, repair cell damage, psychiatric, depressed, depressive symptoms, depression
MUSCLE RELAXATION, DISORDERS
According to the study, no significant differences were observed between the control and intervention groups concerning demographic parameters, such as age, gender, marital status, place of residence, history of physical and mental illness, duration of illness, and history of medication, and thus the patients in the groups were homogeneous concerning the demographic features. The occurrence of major depressive disorder was twice as high in women compared to men almost all over the world and in all countries and cultures [The prevalence of depression was higher among women in this study. This disparity may be due to a higher prevalence of addiction among men in Rafsanjan, leading to their exclusion from the study based on the exclusion criteria. Consequently, the study population comprised a higher number of women. The highest frequency of depression was observed among patients under 40 years of age. The average age of onset of major depressive disorder is about forty years, and the age of onset in 50% of the patients in this study was 20 to 50 years [This study also indicated a significant difference (P<0.001) in the mean depression score before the intervention (37.26±7.70) and after the intervention (8.01±5.22) in the intervention group. This finding confirmed the positive effect of movement therapy and progressive muscle relaxation on reducing depression in patients admitted to the psychiatric ward. This finding was consistent with the results of Salmon Katherine (2019) in the United States [Exercise affects people's mental conditions by releasing endorphins and lowering the level of cortisol in the blood (that is secreted due to psychological distress). Endorphins relieve pain and thus create pleasant feelings when the individual is doing physical activity. The secretion of endorphins increases with exercise. Thus, more endorphins and serotonin are released in the body, changing people's moods and creating pleasant feelings [One of the most important psychological benefits of physical exercises and activities is the social dimension. When doing exercise, the individual has to interact with others who may have many things in common, so the individual feels that he/she belongs to a group of people who are doing a useful activity, and thus he/she does not feel isolated and lonely. This socialization improves the individual's quality of life. Other benefits of exercise include improving self-esteem and self-confidence. When doing exercise, the individual feels that he/she is capable like other people and will eventually develop a higher level of self-confidence. Moreover, physical activity and exercise are effective in reducing depressive symptoms by creating a better body image [Consistent with the present study, Ramasamy This study also indicated a statistically significant difference between the mean depression score before and after the intervention in the control subjects (P<0.001), showing routine treatment programs conducted for the patients in the control group also reduced their depression compared to the time before the intervention. However, this difference was much smaller than in the intervention group. Similarly, Gourgouvelis The mean depression scores for patients in the intervention group were 8.01±5.22, and 22.96±9.43 in the control group, after the intervention. The independent samples t-test indicated a statistically significant difference between the groups concerning their depression scores after the intervention (P=0.001), confirming a greater decrease in depression scores in the intervention group compared with the control group. Patients in this study were hospitalized and were all under medication. Drug therapy is the first line of treatment for psychiatric disorders. Therefore, after the intervention, there was a decrease in the average score of depression in the patients in the control group; however, this decrease was smaller compared to the subjects in the intervention group, as confirmed by Ghasemi The results of the study suggest that physical exercise impacts human social development and influences various psychological and social traits. Self-esteem is one of the most important psychological and social characteristics of human beings and is affected by social interactions and physical activities. It is a feeling of self-worth, approval, emphasis, acceptance, and value that a person has towards themself. Self-esteem manifests in all daily human activities and is one of the main personality traits determining human behavioral characteristics [Accordingly, movement therapy and progressive muscle relaxation can be used along with medication to accelerate the improvement of depressive symptoms. Based on our findings, therapists can use these interventions in addition to drug therapy to treat depressed patients and achieve better and more reliable results. Progressive muscle relaxation leads to the production of natural chemicals that repair cell damage and eliminate toxins. It also strengthens mental strength and self-confidence, thereby increasing the efficiency and awakening of inner talents, creativity, and intellectual power. Furthermore, it creates a balance between the anterior and posterior hypothalamus. It ultimately reduces stress and anxiety, increasing the patient's concentration and memory and leading to higher physical and mental well-being [