Can Exercise Improve Your Mental Health?

16 February 2021

Accredited Exercise Physiologist Matilda Sweeney explains the benefits of exercise for individuals experiencing mental health conditions.

What do we mean by mental health?

Mental health is a broad term that covers our emotional, psychological, and social wellbeing. The World Health Organisation (WHO) refers to mental health as “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community”¹.

When people are experiencing poor mental health, and mental illness it affects many domains of our life and can influence our thoughts, mood, behaviours, relationships, and our physical health.

In Australia, an estimated 45% of the population will experience a mental illness at some point in their life. Further, it is estimated that over the past 12 months, as many as 1-in-5 of the population have experienced a mental illness. The most prevalent of these are depression, anxiety, and substance abuse².

Did you know, our mental health affects our physical health too?

Individuals living with conditions such as bipolar disorder, schizophrenia, and major depressive disorder are significantly more likely to suffer from diabetes, hypertension, cardiovascular disease, respiratory illness, and cancer. Synonymous with this, compared to their mentally well counterparts, people with mental illness have a reduced life expectancy by up to 20 years^{2, 3, 4, 5, 6, 7}.

This increase in morbidity and mortality is largely due to factors such as side effects from medications, poor management of chronic disease, and lifestyle factors (smoking, diet, physical inactivity).

Individuals living with mental illness commonly have higher levels of sedentary behaviour, lower levels of physical activity, poor dietary habits, high rates of tobacco use, and high rates of substance abuse⁷. These all contribute to significant increase in the risk of disease. These are modifiable factors, meaning they are behaviours that can be changed, however, individuals with mental illness experience additional barriers to initiating and maintaining behaviour change, such as lack of access to resources and services, mental illness symptoms such as avolition and executive dysfunction, and sedative effects of medication⁷.

Why exercise?

Exercise has many benefits, both physical and mental.

Exercise is one of the single biggest protective factors against the development diseases such as diabetes, cardiovascular disease, some cancers, stroke, and osteoporosis^{8, 9}.

Exercise can help manage physiological risk factors for disease, including weight, blood pressure, bone density, blood glucose, and blood cholesterol. It can strengthen bones and muscles, improve circulation, improve balance and mobility, and help individuals maintain independence.

There is overwhelming evidence to support exercise as a healthy adjacent therapy for individuals with a wide range of chronic conditions. Exercise can help improve long-term outcomes in individuals living with chronic disease, decrease incidence of hospitalisations, reduce severity of disease symptoms, reduce treatment side effects, and reduce overall morbidity and mortality.

Exercise can also help manage fatigue and pain. It can have cognitive benefits, such as improving memory and attention, and can reduce age-related cognitive decline¹⁰.

Mentally, exercise has shown to decrease anxiety and depression, reduce stress, improve libido, improve sleep, improve mood, increase confidence and self-efficacy, and improve the overall quality of life^{10, 11}.

Specific benefits for specific populations

Thanks to a growing body of evidence, exercise interventions are widely being recognised as a valuable treatment modality for mental illness.

In psychosis (conditions such as schizophrenia and bipolar disorder), exercise is shown to help reduce both positive and negative symptoms. This is especially significant, as medications used to treat psychosis are only effective at treating positive symptoms, and often individuals are left to deal with the equally distressing negative symptoms. In psychosis, exercise is also hugely beneficial to improve the disease-induced cognitive impairment and manage the weight gain and metabolic dysfunction associated with taking anti-psychotic medication^{12, 13, 14, 15}.

There has been research that suggests that aerobic exercise as an adjunct therapy in PTSD can reduce the severity of symptoms such as hyperarousal, hyper-vigilance and avoidance¹⁶.

There is some evidence that supports that exercise when closely monitored and nutritionally supported, can be beneficial for individuals with eating disorders (such as anorexia nervosa, bulimia nervosa, and binge-eating disorder), as it may improve treatment outcomes. Exercise may reduce psychological symptoms such as depression, body dissatisfaction, excessive exercise attitudes and behaviours, and improve the overall quality of life. Exercise may also facilitate weight gain, improve body composition, increase strength, increase bone density, and treat disease-induced cardiac abnormalities ^{17, 18}. However, it is important to note that exercise inclusion in treatment needs to be considered on a case-by-case basis, as excessive exercise compulsion occurs in this population and is associated with increased disease severity.

Rehabilitation from substance abuse disorders and addiction (such as drug, alcohol, and gambling) may also benefit from the inclusion of exercise. Benefits may include improved outcomes in substance use, reduced cravings, and a decrease in risk factors for relapses such as increased self-efficacy, improved mood, and reduced depressive symptoms¹⁹.

Psychosocial benefits of exercise

Additional to the physiological benefits, there are a number of psychosocial mechanisms proposed for how exercise improves our quality of life.

Exercise often has a social element and provides an opportunity for individuals to have positive social interactions and form positive relationships. It can prevent isolation and social withdrawal^{11, 20, 21}.

Exercise can improve confidence and self-efficacy, by allowing individuals the opportunity to challenge themselves and achieve goals. This can also provide a sense of autonomy, as individuals can have a sense of control. Through exercise, individuals can improve their physical function and ability to complete activities of daily living, which again improves self-efficacy and quality of life^{11, 20, 21}.

As individuals can improve their physical function, strength, and body composition, exercise can improve feelings of self-worth, self-perception, and body image, which in-turn feeds into improved mood and quality of life^{11, 20, 21}.

Where to start?

To achieve the health benefits of exercise, the recommendations are a minimum of 150 minutes per week of moderate-intensity aerobic exercise. This can be broken down into 30 minutes of exercise for five days a week^{21, 22}. For individuals experiencing psychosis, some research even suggests that performing a minimum of 90 minutes per week can be enough to reap the mental and cognitive benefits¹³.

Moderate exercise can include activities such as jogging, hiking, swimming, cycling, dancing, surfing, tennis, boxing, and gym classes. It is important for individuals to choose activities they enjoy, as this can improve motivation and adherence.

Some research suggests that exercising outdoors in nature, also known as “green exercise”, can have a positive impact on mental wellbeing. Some evidence also suggests that it can increase motivation to participate in exercise^{21, 23}.

Get started!

An exercise physiologist is a university-qualified allied health professional that specialises in the design and delivery of exercise programs for individuals with chronic and complex medical conditions, including mental illness.

At Total Rehab Solutions, our exercise physiologists take pride in working together with clients to set goals and achieve the best possible outcome for their wellbeing.

You can book in to see an exercise physiologist by calling us on 1300 685 046, or sending an email to admin@totalrehabsolutions.com.au

References:

Written by Exercise Physiologist, Matilda Sweeney

Originally from the Far North Coast of NSW, Matilda relocated to Brisbane where she has recently graduated from her Bachelor of Clinical Exercise Physiology at Queensland University of Technology. Matilda is friendly and client-focused, with a creative approach to help every individual achieve their health goals. She aims to deliver highly individualised exercise interventions specific to her clients needs.

Matilda is a firm believer that exercise is medicine, and is incredibly passionate about working together with her clients to problem solve and ensure optimum outcomes.

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