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How does exercise impact mental health?

Evidence has proven the numerous health benefits of exercise – from your heart, to your bones and weight – but now, more and more studies are showing that exercise is good for your mind too. We spoke to researchers exploring the link between exercise and mental health to try and answer some key questions and dig deeper into this hot topic.

Could exercise reduce the risk of developing schizophrenia? 

A fascinating study published this year, showed evidence that low levels of exercise when you’re a child or adolescent predicted later development of psychosis and schizophrenia.

From the ages of nine up until 18, Finnish participants in the study answered questions about their physical activity, which were then compared to data concerning psychiatric diagnoses recorded in the Finnish Hospital Discharge Register. 

We spoke to the lead-researcher Elina Sormunen about her study: “The reasons behind low physical activity early in life, before the onset of psychosis, is probably dependent on many things, including abnormal movement development in childhood known to associate with schizophrenia. On the basis of our study, it is impossible to say – concerning low physical activity and schizophrenia – which is the cause and which is the effect. Nonetheless, a relationship between them exists.” 

How does exercise relate to wellbeing? 

study compared self-reported data on exercise habits from 3403 participants (men and women aged between 25 and 64) to the answers in a psychometric test which analyses the severity of depression, called the Beck Depression Inventory. 

The results indicated that individuals who exercised at least two to three times a week experienced significantly less depression, anger and stress than those exercising less frequently or not at all. People who exercised regularly were also found to have stronger feelings of social integration compared to those who didn’t engage in physical activity. This shows that exercising relates to people feeling better and experiencing less depression, what this study doesn't tell us is whether exercising more can produce these positive effects. More research is needed to be able to determine whether exercise could be an effective preventative measure.

Exercise as a treatment for depression

Patrick Callaghan, Professor of Mental Health Nursing, has looked at the data exploring whether exercise can alleviate symptoms of depression: “I’d say there was moderate evidence pointing towards exercise having a positive effect on mental health and wellbeing – but there’s not been enough large-scale trials to create really strong evidence.”

Professor Adrian Taylor, who’s spent his career looking at the effects of behavioural interventions for mental health, including physical activity, agrees with Patrick and told us that exercise does appear to reduce depression over time.

He also told us that there appears to be short-term mood-enhancing benefits: “We’ve done lots of lab studies where you see that short-term physical exercise is a known mood enhancer – most people feel uplifted, more positive and energised.” 

One of the largest randomised-controlled trails carried out was a study called TREAD, which looked at exercise as a treatment for depression, recruiting 361 patients aged between 18-69 years who had recently been diagnosed with the condition.   

Participants were split into two groups to receive either the physical activity intervention in addition to their usual treatment, or just their treatment on its own. They were followed up for 12 months to assess any change in their symptoms. The results suggested that adding a physical activity intervention to usual care did not reduce symptoms of depression more than usual care alone. 

This contradicts with a trial Patrick conducted looking at 38 women between 45-65 who had been diagnosed with depression and giving them a group exercise regime – it showed that exercise improved their wellbeing, but as this trial is relatively small, more research is needed to draw firm conclusions. 

Tailoring exercise to the indivdual 

Patrick’s previous studies interviewing women of that age bracket indicated that they had felt overwhelmed when the doctor ‘prescribed’ them a certain amount of exercise recommended by guidelines. He was interested to see whether giving the participants an option of the amount of exercise they did had an effect. “We were hypothesising that it might not be necessary to do the level of exercise prescribed to generate positive and social outcomes for people facing depression – and that’s what that trial showed, exercise that’s tailored to someone’s preferred exertion levels is likely to improve a depressed woman’s overall health and wellbeing.”

Adrian talks about the barriers holding people with mental health problems back from exercising: “One of the challenges we face is that people in a state of poor mental health don’t feel energised to feel active. They tend to cut things out that might be routine and pleasurable.” 

Adrian’s been working on ways to address this issue: “I think for many people the idea of exercising when they’re depressed might seem too hard, but if you can get people to be less sedentary, they can feel better, feel a sense of achievement and feel more in control. There are subtle ways of building up physical activity – one way is to get people to identify how much time they spend sitting and lying down and then get them to set goals for increasing activity in small steps. We can do this using wearables, like FitBits. Those short bits of activity might include going to the shops, or walking to the post box. We got people to set goals based on their own ability and performance – rather than national guidelines.”

These studies open up questions around the importance of setting achievable goals for people facing depression and understanding more about whether this is specific to exercise could be important for informing treatments options.

Talking to the researchers, it’s clear that there are still big gaps in our understanding of the potential benefit that exercise could have for mental health. The only way we can truly understand exercise’s impact on our mental wellbeing is by investing in more research. 

Last updated: 8 June 2017

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