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Exercise for Mental HealthThe effects of exercise on physical wellbeing, in particular coronary heart disease, are well understood by health practitioners and the general public alike. Although studied since the early 80s’, the positive effects that exercise has on mental wellbeing, such as anxiety and depression, is only now coming to the attention of mental health practitioners. When researching this article I came across a case of a depressed man who had heart diseases, and I thought it an appropriate example to start this paper off. Kenneth Cooper (aerobics expert) reported on one example he encountered, " He was so despondent that he wanted to die. Because his heart was weak, he thought the best way to commit suicide without embarrassing his family was to run around the block as fast as he could until he killed himself. After several futile attempts at causing a fatal heart attack in this manner, he discovered to his surprise that he began to feel better and eventually chose to live instead of die "(1). A consistent finding of early research examining the effects of resistance as well as aerobic training was that regular exercisers exhibited less depression, anger, and confusion, and were less tense than non-exercisers (2,3,4). Most recently, Hassmen et al (6) examined exercise habits, and mental wellbeing, of 3,403 Finnish adults. Many of the Finnish population suffer from a depressive disorder known as SAD or Seasonal Affect Disorder brought about by the low number of sunlight hours over winter months. Hassmen found that individuals who exercised 2-3 times per week reported significantly less depression, stress, anger and cynical distrust than non-exercisers. What are the mechanisms by which exercise has this positive effect on mental well being? Three main mechanisms have been put forward by researchers (5).
Probably the most well known example of a biochemical contribution
comes in the form of a feeling of euphoria following intense prolonged
exercise. Known as "runners high" increases in plasma
b -endorphin are believed to underlie this mental state, though it
is still unclear if it promotes mental well being long-term. More
promising research points to norepinephrine, and serotonin (5-HT) as
mechanisms for improved mood, both are elevated following acute exercise.
Given that many anti-depressant medications also work by increasing the
levels of these neurotransmitters in the brain, it seems reasonable to
assume that this may be the means by which exercise operates.
Many of the feelings of stress, anxiety, and depression we experience
come from appraisals of the way our body feels at any given point. For
example if we perceive muscle tension in our neck as stress, then it is
stress, and we may react in a manner consistent with stress responses.
Elevations in pulse and breathing rate may be perceived as anxiety, which
in turn really makes us anxious. Given that exercise results in lower
blood pressure, slower pulse, and easier breathing, we might assume that
this is effecting our perceptions of depression and anxiety. I’m afraid
not, studies find only a weak relationship between physical fitness and
reduction of depression and anxiety. However, this doesn’t rule out the
increase in cerebral blood flow and improved muscle relaxation that
accompanies physical fitness.
A number of hypotheses are offered within this area, and is probably the most easily understood. The idea that regular exercise and physical fitness can improve perceptions of our self-worth and self-esteem is not new, and is probably a drive to participate in exercise for most of us whether depressed or not. In today’s materialistic society "Body Image" appears to be one of the biggest obsessions. It affects us to the point that our every move is guided by it. Eating patterns, dressing habits, exercise habits, and even the way we walk or hold ourselves is in some way related to our drive to have a good body image. It’s not unexpected to find that body image and self-esteem are more closely associated with each other than any other dimension of self (5). Many of the effects of exercise such as loosing fat and improving muscle shape and definition, offer a means to improvement of body image and therefore self-esteem. It should be noted that positive self-esteem is related to good mental well being. Changing our body appearance through exercise may also contribute to positive self-esteem through the sense of control we gain when we bring about change in our bodies. Another factor that may contribute is social interaction that accompanies activities that involve exercise. However, this would also suggest that playing chess could be just as effective if it was a simple act of social interaction. The underlying cause of elevated mood is unlikely to be a function of any individual factor, but instead a complex intermingling of factors that feed on each other to produce the positive results. Perhaps it isn’t necessary, or even possible to single out the specific underlying factors that contribute to the mental well being for a given individual. "Different strokes for different folks", as they say. What should be addressed is the general reluctance of mental health practitioners to prescribe exercise in their treatment programs. Given that physical exercise is as effective as psychotherapeutic interventions in treating depression and anxiety (5), it seems illogical not to include it in treatment, given its wide ranging positive effects, such as neurotransmitter release, improved body image etc. Why isn’t exercise used as a treatment by psychologists/psychiatrists? Several reasons are offered: The first is due to a genuine lack of knowledge of exercise research, and a bias towards classical treatments. The second revolves around the belief that exercise cannot be incorporated with traditional treatment methods. The final reason is probably due simply to the belief that exercise couldn’t possibly be as effective as the other techniques that we have spent years learning about. This final reason flies in the face of current research, and can only be justified by claiming complete ignorance to that research. So spread the word, because research is proving the saying, "healthy body, healthy mind". References
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