How Exercise Can Benefit Our Mental Health

Exercise not only changes your body, it changes your mind, your attitude and your mood. —Unknown

The unknown author of the quote clearly knew what he/she was talking about. Last week, Newswire posted an article citing the results of a study conducted at the Royal College of Surgeons in Dublin and published in Psychosomatic Medicine.

Study of Patients With Heart Disease and Depression

The study investigated three treatment options for patients with heart disease who suffered from depression. The options included psychotherapy, antidepressants, exercise, and combined psychotherapy, and medication. The lead author, Dr. Frank Doyle, concluded, “exercise is likely to be the best treatment for depression following coronary artery disease. Our findings further highlight the clinical importance of exercise as a treatment as we see that it improves not only depression, but also other important aspects of heart disease, such as lowering blood pressure and cholesterol, in these patients."

As a psychiatrist who treats many patients with co-existing physical and mental health issues, I recommend regular exercise as part of a multi-faceted approach to treating depression and anxiety. Not only good for weight control, management of sleep issues, and a host of physical disorders, it is also good for your brain—the computer in your head where psychiatric symptoms arise. I not only recommend this, but I practice what I preach, and was one of many who purchased a Peloton at the onset of the pandemic. Unlike those who now use it as an expensive clothes hanger, I continue to use mine regularly.

According to the World Health Organization, the global prevalence of anxiety and depression increased by 25 percent during the first year of the COVID-19 pandemic. In the United States, 40 million adults suffer from anxiety disorders. Earlier this month, the U.S. Preventive Services Task Force recommended anxiety screening for adults under the age of 65. The draft recommendations are designed to help primary care clinicians identify early signs of anxiety during routine care.

How Exercise Treats Depression and Anxiety

How does exercise treat depression and anxiety? In my review of multiple clinical studies, exercise treats depression and anxiety in the following ways:

• Psychosocial and cognitive factors: Using data from individual physical therapy aerobic exercise regimens for up to 10 weeks, investigators discovered exercise can increase your sense of self-worth, self-confidence, sleep quality, and life satisfaction. Some studies documented that during exercise interventions, you may seek social support, which reduces loneliness. Based on psychological and social benefits, group exercise may be more effective than individual exercise.
• Anti-inflammatory factors: It is well known that inflammation is involved in the development of depression. Stress can cause your brain to release chemicals that lead to the experience of depression and/or anxiety. In a 12-week study of depressed elderly patients, aquatic exercise decreased depression and anxiety as well as inflammation.
• Brain growth: The anti-depressant effects of exercise are associated with neurogenesis—the process by which your brain increases the number of brain cells. In addition, exercise is positively associated with increased neuroplasticity—the ability of the brain to form new connections and pathways and change how its circuits are wired.
• Release of natural chemicals that make you feel good: Endorphins, natural cannabis-like brain chemicals, are increased during vigorous exercise. This likely explains the well-known, “runner's high.”
• Decrease in stress hormones: Cortisol is one of your body’s stress hormones, released as part of the fight-or-flight reflex. It shuts down less-critical functions like reproduction and immunity to focus on fighting a perceived threat. This would be very helpful if you were being held at knifepoint. However, it is less than ideal when living in our modern world where stress is everywhere. Too much cortisol for too long can have serious, negative effects. Increased cortisol leads to tissue breakdown, reduced protein production, and conversion of protein into glucose, which can decrease your muscle content and increase abdominal fat. It also suppresses levels of growth hormone and sex hormones, which can reduce your libido and fertility. It lessens your body’s use of glucose and increases blood levels, potentially predisposing you to diabetes. It can also lead to calcium reabsorption, increasing your risk of osteoporosis. Exercise is perceived by the body as a form of stress, and initially stimulates the release of cortisol. However, the more your fitness improves, the better your body becomes at dealing with physical stress. This means less cortisol will be released during exercise and, more importantly, in response to emotional or psychological stressors.
• Distraction: When you engage in strenuous exercise, it takes your mind off the things that are troubling you. You can take a break from a cycle of negative thoughts that feed depression and anxiety.

OK, so the thought of jumping on a spin bike or going for a run is not your idea of a good time, especially if you feel depressed. But exercise may include a wide range of activities that can increase your heart rate. Gardening, washing your car, or cleaning your house can all be counted as exercise. Any physical activity that gets you off the couch can improve your mood. Even better, all your exercise does not have to be done in one session. Most experts recommend 30 minutes of vigorous exercise five times per week for maximum benefit. You could split this into two 15-minute sessions or even three 10-minute sessions per day. When it is broken down that way, it doesn’t seem too overwhelming, does it?

According to a study published in the International Journal of Environmental Research and Public Health, 11.4 suicides occur for every 100,000 individuals worldwide accounting for 804,000 deaths. Available data indicate the number of suicides continues to rise rapidly in young people. The investigators wondered if physical activity could be a protective factor against suicidal thoughts in different populations. They conducted a systemic review that documented individuals with high levels of physical activity had lower suicidal ideation than those with low levels of activity.

A study published in the British Journal of Sports Medicine found that exercise was equivalent to antidepressants in effectively treating mild to moderate depression. Interestingly, adding an antidepressant to an exercise regimen did not increase the effectiveness of the medication. In the population studied, exercise used alone as treatment worked just as well as medication.

This in no way dismisses the need and usefulness of antidepressant medication, which for many can be lifesaving. However, for those who would prefer to avoid medication and are suffering mild to moderate symptoms, a regular exercise program can be part of an overall healthy approach to treating common psychiatric symptoms such as depression and anxiety. Along with diet, limited alcohol, quality sleep, and social interaction, exercise can positively change the health of your body and your mind.