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Exercise and Mental health



In recent times, the role of exercise in prevention and treatment of illness has become a growing area of interest, with many health conditions becoming associated with a lack of activity as research into their causes improves. Whilst it is becoming apparently very clear that regular exercise could potentially represent a first level treatment option for doctors, a recent statement on the subject by MacAuley, Bauman, & Frémont (2015) in the British Medical Journal highlights that the medical community has been slow to action this information.


A report by The Academy of Medical Royal Colleges (2015) emphasised the powerful effects exercise can have in the prevention of illness and disease, claiming this approach is preferable to drugs in many cases. The report also outlines some worrying statistics, such as the fact that 80% of obese patients have never discussed their weight with their GP, meaning many people may be missing a key intervention opportunity before further complications develop as a result of physical inactivity. In fact, the report goes on to identify physical inactivity as one of the ‘big four’ factors (Smoking, poor nutrition, physical inactivity and alcohol consumption) responsible for premature death and long-term illness in the UK, which costs the NHS and other public health bodies in excess of £15bn.


Many physical conditions have been shown to respond favourably or be less likely to occur when regular exercise is undertaken, including but not limited; type 2 diabetes, heart disease, sarcopenia and some cancers. what is less often discussed however, is the potentially huge benefits of exercise for mental health.



Mental health in the UK

Mental health issues are an ongoing and growing problem in the UK, with an estimated 1 in 6 people experiencing a common mental health problem in the past week, and 1 in 4 experiencing a mental health problem in any given year (mentalhealth.org.uk). Mental health problems represent the largest burden of disease in the UK and unfortunately, with the NHS more stretched than ever, many people face delays in receiving treatment, if they seek help at all. Sadly, another growing occurrence linked to this rise in mental health conditions is a rise in suicides, with 6,122 reported suicides in 2014, with males aged 45-49 most at risk (Samaritans.org).



Mental health and exercise

Taking part in regular physical activity has been shown to improve many mental health conditions such as depression and anxiety as well as reducing the likelihood of developing dementia and other long term mental illnesses (Brymer & Davids, 2016). These benefits can occur acutely too, with just one moderate exercise session being shown to immediately improve mood, reduce stress and reduce mental fatigue, however long term adaptation of physical activity is crucial to maintaining the positive benefits (Backhouse, Ekkekakis, Biddle, Foskett, & Williams, 2007). Specific reviews into the benefits of exercise for certain mental health conditions have been extremely promising, with improvements being shown in schizophrenia patients (Stanton & Happell, 2014), improved cognitive functioning and ability to perform daily tasks in dementia patients (Forbes, Forbes, Blake, Thiessen, & Forbes, 2015) and reduced risk of developing anxiety, depression or mood disorders in general populations (Ten Have, de Graaf, & Monshouwer, 2011).




Environmental factors

Whilst improvements in mental health have been consistently shown with basic physical activity such as walking, gardening or attending a gym, taking part in a sport has been shown to produce great improvements. Team based sports appear to be most beneficially, however non-team based sports (e.g. golf or tennis) still appear to provide greater benefits over simply increasing physical activity, which is good news for those who find they are less keen to attend team based sports due to confidence issues (Sciamanna et al., 2016). This is likely due to the additional social engagement seen with these types of sports versus completely solo pursuits.

Where activity takes place also appears to influence the magnitude to which exercise can improve mental state. According to Rogerson et al., (2016), taking part in physical activity outdoors can vastly enhance an individual’s mood state and augment the benefits of exercise on mental health. Termed ‘green exercise’, training in natural outdoor spaces such as parks, woodland, close to rivers and other natural features appears to bring out reductions in stress, anxiety and mental stress. As such, taking part in exercise in these environments may offer a great benefit to people suffering with mental health conditions.




Conclusions

Thanks to emerging evidence and growing academic support, it is now clear that exercise is the top modifiable factor for chronic disease (Lim et al., 2017) and represents an effective preventative treatment for many illnesses. Crucially, taking part in regular exercise has been shown to improve mental health, reduce stress & anxiety, improve mood, improve productivity and help those with mental health conditions get closer to recovery. Key factors which improve the effectiveness of this include; training outdoors, taking part in sports or training as part of a group.

The key to all of this is action. If we want to make a difference, we need to help and encourage those in need to take part in regular physical activity and recognise that this initial step may be very difficult for those affected. Ultimately the easier it is for us to talk about these issues and promote the benefits of exercise for mental health, the more chance we have of changing things for the better.


By Andy Kay





References

Backhouse, S. H., Ekkekakis, P., Biddle, S. J. H., Foskett, A., & Williams, C. (2007). Exercise makes people feel better but people are inactive: Paradox or artifact? Journal of Sport and Exercise Psychology, 29(4), 498–517.

Brymer, E., & Davids, K. (2016). Designing Environments to Enhance Physical and Psychological Benefits of Physical Activity: A Multidisciplinary Perspective. Sports Medicine, 46(7), 925–926.

Forbes, D., Forbes, S. C., Blake, C. M., Thiessen, E. J., & Forbes, S. (2015). Exercise programs for people with dementia. The Cochrane Database of Systematic Reviews, 4, CD006489.

Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., … Ezzati, M. (2017). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990 to 2013;2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2224–2260.

MacAuley, D., Bauman, A., & Frémont, P. (2015). Exercise: not a miracle cure, just good medicine. BMJ (Clinical Research Ed.), 350(4), h1416.

Rogerson, M., Brown, D. K., Sandercock, G., Wooller, J.-J., & Barton, J. (2016). A comparison of four typical green exercise environments and prediction of psychological health outcomes. Perspectives in Public Health, 136(3), 171–180.

Sciamanna, C. N., Smyth, J. M., Doerksen, S. E., Richard, B. R., Kraschnewski, J. L., Mowen, A. J., … Yang, C. (2016). Physical Activity Mode and Mental Distress in Adulthood. American Journal of Preventive Medicine, 52(1), 85–93.

Stanton, R., & Happell, B. (2014). A systematic review of the aerobic exercise program variables for people with schizophrenia. Current Sports Medicine Reports, 13(4), 260–266.

Ten Have, M., de Graaf, R., & Monshouwer, K. (2011). Physical exercise in adults and mental health status findings from the Netherlands mental health survey and incidence study (NEMESIS). Journal of Psychosomatic Research, 71(5), 342–348.

The Academy of Medical Royal Colleges. (2015). Exercise: The miracle cure and the role of the doctor in promoting it. Report from the Academy of Medical Royal Colleges, (February). Retrieved from http://www.aomrc.org.uk/




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