With each passing year, mental health is becoming an increasingly focal topic and with less stigma attached to it there is a worrying picture emerging of just how many people are affected by issues of mental health. The last three years have been filled with increased uncertainty and social isolation due to the pandemic and this appears to have exacerbated the number of people dealing with a mental health condition. The latest government statistics showed that nearly half of Australians aged 16-85 had experienced a mental disorder and close to a quarter had experienced one for longer than 12 months. Exercise has often been suggested as an add-on to other treatments, such as therapy and medication, but a recent study showed that exercise should be front and centre for managing mental health.

Exercise as an intervention

A research team at the University of South Australia recently completed a systematic review of research into physical activity and its effects on mental health. Eligible studies had to be randomised controlled trials, the gold standard, designed to increase physical activity and measure effects on depression, anxiety, and psychological distress. This narrowed the field to 97 meta reviews which included 1039 trials and 128119 participants. The results of the analysis showed that physical activity had a significant effect on depression, anxiety, and psychological distress when compared to usual care: physical activity produced a reduction in mental health issues by 42-60%, whereas medication and therapy as an intervention only elicited a 22-37% improvement.  The best outcomes were observed in people with depression, HIV and kidney disease, in pregnant and postpartum women, and in participants with no known disease or disorder.

The authors observed that 150 minutes of physical activity (for example: brisk walking, resistance training, and yoga) elicited significant improvements in mental health measures. There was also a greater benefit for those who exercised for 6-12 weeks as opposed to shorter interventions and a diminishing improvement for longer interventions. Long term habitual exercise is still an important factor for maintaining the mental health improvements observed in the first 6-12 weeks.

There was a positive correlation between higher intensities of exercise and greater improvements in mental health, so if you’re heading out for some exercise think of going for a purposeful, fast-paced walk as opposed to a stroll.

How does it work?

There are multiple pathways that may contribute to physical activity having a positive impact on mental health. Immediately after exercise there is a release of neurotransmitters in the brain. These chemicals have an immediate effect on mood and symptoms of stress and in the long term can help with inflammation, immune function, and cognition.

Another theory for the acute benefits of exercise, is that the increase in body temperature resulting from exercise may cause a reduction in muscular tension which leads to feelings of relaxation and diminished feelings of stress and anxiety.

Exercise can improve quality of sleep which is an important factor in the management of anxiety and depression. There is also a sense of accomplishment when someone completes regular exercise and this could psychologically play a part in improving energy and mood.

Traditional vs. “alternative” treatments

The most common prescription for managing mental health disorders, such as anxiety and depression, is the use of medication supplemented by therapy. Lifestyle changes, such as exercise, are discussed but they are used either as an add-on to medication and therapy or as an alternative if other treatments are not working. However, the most current evidence shows that exercise is not only a great supplement to “traditional” interventions but can actually elicit greater benefits.  The analysis of systematic reviews showed that exercise is 1.5 times more effective than medication and therapy in improving symptoms of depression, anxiety, and psychological distress. Exercise also has the added benefit of improving other health measures such as cardiovascular and musculoskeletal health, body weight, and cognition. Moving forwards health professionals should be framing the role of exercise in a similar way to how medication and therapy has been previously prescribed – as an effective and viable treatment in managing symptoms of mental health disorders.

Safety

Always check with your Doctor before commencing a new exercise regime and discuss the possible risks and benefits. This can be managed in coordination with an Exercise Physiologist or other health professional.