Mental Health Week 2022

Five Ways to Wellbeing: #2 Be Active

Regular physical activity benefits not only physical health, but also mental health. 

For people experiencing mental health problems, exercise is often widely recommended as part of treatment. Research has found that 45 minutes of aerobic exercise, three times per week, has an antidepressant effect on individuals with major depressive disorder. [1] For people experiencing mild symptoms of depression or anxiety, physical activity is found to have a medium effect on reducing depressive symptoms, and a mild effect on reducing anxiety symptoms. [2] Randomized controlled trials with adolescents (aged 12-18 years) with depression have found moderate-intensity aerobic exercise for 30 minutes, 4 times/week for 6 weeks had optimum results for reducing symptoms of depression. [3] Other studies have found that exercise is as effective as antidepressant medication in reducing symptoms of depression in adults with non-severe depression. [4]

Research has found that:

• HIIT is effective in reducing stress and improving wellbeing, [5]
• Pilates can reduce symptoms of depression, anxiety, and fatigue, and increase energy, [6] and
• Yoga is effective in reducing symptoms of depression, anxiety, and stress. [7]

Exercise is also an effective treatment for managing poor sleep – which is often a part of living with mental illness. [8] Physical exercise is also a component of treatment for more serious mental illnesses such as schizophrenia, where it is found to improve symptoms, as well as quality of life and overall functioning. [9] Physical activity interventions (specifically, yoga, sports, and health coaching) have also been found to facilitate posttraumatic growth after exposure to traumatic events [10]. 

Exercise for Preventing Mental Health Problems

Exercise can not only have an antidepressant effect on people experiencing mental health problems, it can also prevent the onset of depression in healthy people.

Research has found that engaging in physical activity equivalent to 2.5 hours of brisk walking per week is associated with a 25% lower risk of depression. [11]

Assuming causality, this means 1 in 9 cases of depression might have been prevented if everybody in the population was active at the level of current health recommendations. This is incredibly important considering depression is the leading cause of disability worldwide, and Australia is the second highest consumer of antidepressants amongst OECD countries. This research also found that people who completed only half of the recommended volume of physical activity (75 minutes per week) still have an 18% lower risk of depression compared to completing no activity. [11] This means that even small increases in activity may benefit the mental health of sedentary or elderly people.

There is also some evidence that physical activity can protect against cognitive decline (e.g., memory problems), including Alzheimer’s disease, in later life. [12]

How Does Exercise Improve Mental Health?

It is likely that physical activity benefits mental health via multiple pathways. These include:

• Biological responses to exercise, including hypothalamic-pituitary adrenal axis regulation, and anti-inflammatory effects. The concentrated use of the breathing pattern during Pilates and yoga, for example, is proposed to activate the parasympathetic nervous system, and thereby reduce stress.
• Enhancing brain neuroplasticity
• Increased serotonin levels
• Increases in perceived self-efficacy (that is, an person's belief that they can achieve their goals)
• Improved physical self-perceptions and body image
• A sense of mastery by helping to set goals or challenges and achieve them
• Perceived ability to cope
• Distracting from unhelpful thoughts
• Improved sleep quality and duration
• Socialising opportunities  

How to Be More Active

Working in our industry, a lot of people are already very active. But, if you, or someone you know, wants to be more active to improve their wellbeing, then consider the following:

1. Start small. Increase your activity levels gradually. Begin with simple activities, such as walking, gardening, or doing small household tasks. Take the stairs and not the lift. Get off the tram one stop earlier and walk the final part. Walk to someone’s desk instead of emailing. Take a short 10-minute walk around the block when you wake up in the morning, or at lunchtime, or when you get home.
2. Do what is enjoyable. Do activities you enjoy with family and friends. Over time, these activities will become easier, more interesting, relaxing, and satisfying. Exercising with other people also helps to gain the benefits of connection for mental health. 
3. Make a plan and commit to it. Try setting SMART goals: specific, measurable, achievable, relevant, and time-bound goals. SMART goals increase your chances of achieving what you want in life. You are also more likely to commit to that goal if you share it with someone else. You might want to consider a goal of doing a fun run or walk for charity. 

Please Note. The contents of this article are general in nature. Mental health problems are complex, and develop as a result of a range of intersecting biological, psychological and social factors. Please always consult with a general practitioner or mental health professional for treatment of a mental health problem. 

Read Article #1: Five Ways to Wellbeing: #1 Connect

Read Article #3: Five Ways to Wellbeing: #3 Take Notice

References

1. Morres, I. D., Hatzigeorgiadis, A., Stathi, A., Comoutos, N., Arpin‐Cribbie, C., Krommidas, C., & Theodorakis, Y. (2019). Aerobic exercise for adult patients with major depressive disorder in mental health services: A systematic review and meta‐analysis. Depression and Anxiety, 36(1), 39–53. https://doi.org/10.1002/da.22842
2. Rebar, A. L., Stanton, R., Geard, D., Short, C., Duncan, M. J., & Vandelanotte, C. (2015). A meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychology Review, 9(3), 366–378. https://doi.org/10.1080/17437199.2015.1022901
3. Wang, X., Cai, Zd., Jiang, Wt, Fang, Yy., Sun, Ww., & Wang, X.  (2022). Systematic review and meta-analysis of the effects of exercise on depression in adolescents. Child and Adolescent Psychiatry and Mental Health, 16. https://doi.org/10.1186/s13034-022-00453-2

4. Dauwan, M., Begemann, M. J. H., Heringa, S. M., & Sommer, I. E. (2016). Exercise improves clinical symptoms, quality of life, global functioning, and depression in schizophrenia: A systematic review and meta-analysis. Schizophrenia Bulletin, 42(3), 588–599. https://doi.org/10.1093/schbul/sbv164

5. Recchia, F., Leung, C. K., Chin, E. C., Fong, D. Y., Montero, D., Cheng, C. P., Yau, S. Y., & Siu, P. M. (2022). Comparative effectiveness of exercise, antidepressants and their combination in treating non-severe depression: A systematic review and network meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 56, 1375-1380. http://dx.doi.org/10.1136/bjsports-2022-105964

6. Martland, R., Korman, N., Firth, J., Vancampfort, D., Thompson, T., & Stubbs, B. (2021). Can high-intensity interval training improve mental health outcomes in the general population and those with physical illnesses? A systematic review and meta-analysis. British Journal of Sports Medicine, 56(5), 279–291. https://doi.org/10.1136/bjsports-2021-103984
7. Fleming, K. M., & Herring, M. P. (2018). The effects of Pilates on mental health outcomes: A meta-analysis of controlled trials. Complementary Therapies in Medicine, 37, 80–95. https://doi.org/10.1016/j.ctim.2018.02.003
8. Breedvelt, J. J. F., Amanvermez, Y., Harrer, M., Karyotaki, E., Gilbody, S., Bockting, C. L. H., Cuijpers, P. & Ebert, D. D. (2019) The effects of meditation, yoga, and mindfulness on depression, anxiety, and stress in tertiary education students: A meta-analysis. Frontiers in Psychiatry, 10, 193. https://doi.org/10.3389/fpsyt.2019.00193
9. Kelley, G. A., & Kelley, K.S. (2017). Exercise and sleep: A systematic review of previous meta-analyses. Journal of Evidence Based Medicine, 10(1), 26–36. https://doi:10.1111/jebm
10. Zhang, N., Xiang, X., Zhou, S., Liu, H., He, Y., & Chen, J. (2022). Physical activity intervention and posttraumatic growth: A systematic review and meta-analysis,
    Journal of Psychosomatic Research, 152. https://doi.org/10.1016/j.jpsychores.2021.110675.
11. Pearce, M., Garcia, L., Abbas, A., Strain, T., Schuch, F. B., Golubic, R., Kelly, P., Khan, S., Utukuri, M., Laird, Y., Mok, A., Smith, A., Tainio, M., Brage, S., & Woodcock, J. (2022). Association between physical activity and risk of depression: A systematic review and meta-analysis. JAMA Psychiatry, 79(6), 550–559. https://doi.org/10.1001/jamapsychiatry.2022.0609
12. Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L.N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., Orgeta, V., Ritchie, K., Rockwood, K., Sampson, E. L., Samus, Q., Schneider, L. S., Selbæk, G., Teri, L., & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet, 396(10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6