So many of our clients come to see us with fitness goals, but forget about the positive effects that fitness can have on mental health. They start their journey – reach their goal, then find that they ‘need’ that fitness fix in order to keep everything in balance! So, what role exactly does fitness have on mental health and how exactly does it work?
Mental disorders are of major public health significance. It has been claimed that vigorous physical activity has positive effects on mental health.
The strongest evidence suggests that physical activity and exercise probably alleviate some symptoms associated with mild to moderate depression. The evidence also suggests that physical activity and exercise might provide benefit for a number of other problems including alcoholism and substance abuse, improving self-image and social skills, reduce the symptoms of anxiety. So why on earth is this not used in a treatment plan when we go to see the doctor?
Suicide rates in New Zealand are significantly higher for men than for women. Depression is a problem that 4 in 5 people experience at some stage in their life… which is an incredibly high statistic. 75% of the population. People who are experiencing depression woulld usually primarily visit their GP first, and would receive medication as a primry form of treatment. So how can exercise help with this instead and perhaps prevent the pharmalogical response?
It is suggested in research that the people who seek GP assistance for depression perhaps have not been educated in alternative forms of therapy that do not involve drugs.
Research has also shown that depressed patients are less fit and have diminished physical work capacity on the order of 80% to 90% of age-predicted norms, which in turn may contribute to other physical health problems. Therefore, primary care providers are uniquely positioned to promote behavioral approaches, such as exercise, that complement pharmacologic treatment and may ultimately provide relief from this chronic and often treatment-resistant disorder as well as enhance overall physical well-being.
Many studies have examined the efficacy of exercise to reduce symptoms of depression, and the overwhelming majority of these studies have described a positive benefit associated with exercise involvement. very small but regular quantities of aerobic or strength and resistance exercise have proven to have significant positive effects on patients with depression. Research shows little difference on the effect of the exercise based on type, so no, you don’t need to do heaps of aerobic exercise to have the same positive mental health effects.
A direct comparison of running and psychotherapy shows that they are both equally effective in the treatment of depression. Are you surprised?
The thermogenic hypothesis suggests that a rise in core body temperature following exercise is responsible for the reduction in symptoms of depression. Increases in temperature of specific brain regions, such as the brain stem, can lead to an overall feeling of relaxation and reduction in muscular tension.
The endorphin hypothesis predicts that exercise has a positive effect on depression due to an increased release of β-endorphins following exercise. Endorphins are related to a positive mood and an overall enhanced sense of well-being.
The monoamine hypothesis appears to be the most promising of the proposed physiologic mechanisms. This hypothesis states that exercise leads to an increase in the availability of brain neurotransmitters (e.g., serotonin, dopamine, and norepinephrine) that are diminished with depression. These neurotransmitters increase in plasma and urine following exercise.
The distraction hypothesis suggests that physical activity serves as a distraction from worries and depressing thoughts. In general, the use of distracting activities as a means of coping with depression has been shown to have a more positive influence on the management of depression and to result in a greater reduction in depression than the use of more self-focused or introspective activities such as journal keeping or identifying positive and negative adjectives that describe one’s current mood.
The enhancement of self-efficacy through exercise involvement may be another way in which exercise exerts its antidepressant effects. Self-efficacy refers to the belief that one possesses the necessary skills to complete a task as well as the confidence that the task can actually be completed with the desired outcome obtained.
There is clearly some strong evidence to support the connection with exercise and depression, however this type of person might also be lacking in self motivation and therefore we encourage primary care providers to support their patients into a healthy lifestyle to treat depression by starting slowly, with something they enjoy doing.
In New Zealand there is also the green prescription program that can be prescribed by GP’s tp help support their patients into a healthier lifestyle that supports positive mental health.