Exercise has been recognised as an incredibly potent therapy for physical health and longevity - but only recently has a similar amount of attention been paid to the vast range of benefits exercise and movement can have on mental and emotional health.

“Our understanding of the relationship between exercise and mental health has evolved considerably in recent years. Once viewed as ‘just’ a distraction from negative thoughts, exercise is now recognised as an evidence-based, fundamental component of treatment for a range of mental illnesses,” - Dr Simon Rosenbaum (School of Psychiatry, UNSW Sydney & Black Dog Institute)

Common Mental Health conditions:

In Australia, 1 in 5 individuals will experience a mental health issue in their lifetime. Australians are most commonly affected by anxiety disorders (14%), depressive disorders (6%) and substance use disorders (5%) - which are often present in complex combinations.

Other common mental health conditions include schizophrenia, bipolar affective disorder and personality disorders.

While every person experiences each condition differently, in both acute and chronic mental illness there is a lot of high quality evidence to show that exercise can be an effective treatment method for many of the symptoms experienced by suffering from mental health concerns.

Exercise & Brain Chemistry:

What actually happens to the body and brain when you start exercising ?

An acute bout of exercise results in the immediate release and modulation of neurotransmitters involved in brain circuits that help us to feel good (ie, Dopamine, Serotonin, Norepinephrine, Acetylcholine, Gamma-Aminobutyric Acid (GABA), and Glutamate).

Endorphins, also referred to as Endogenous Opioids, are another key player that are involved heavily in the processing of pain modulation, response to rewards or stress, and autonomic control.

More recently there has been a focus on the effect of exercise on Endo-cannabinoids, which are involved in a variety of processes including pain, mood, memory, and appetite. Together, these systems and their response to exercise are thought to be responsible for the euphoria and mood elevation experienced with the so-called “Runner’s High”.

Over time, regular exercise can also result in better overall:

mood and stress regulation,
fatigue resistance and mental altertness,
energy and stamina,
sleep quality and quantity,
sexual/reproductive health,
as well as self-perception, self-efficacy and self-esteem

The physiologic mechanisms behind these changes appear to involve several regions of the brain, primarily:

the Limbic system (which controls motivation and mood)

the Amygdala (which modulates fear in response to stress)

and the Hippocampus (which plays an important role in memory formation as well as in mood and motivation).

On top of this, there are many side effects of medications commonly prescribed to manage different mental health conditions - which research has shown can often be limited or prevented with appropriate exercise. While side effect lists can often be quite long - exercise has been proven effective in combating various issues, from weight gain in response to certain anti-psychotics as well as improving general fatigue/energy levels or even sexual health that may be compromised with long-term use of some anti-depressants and anxiolytic medications.

Exercise Dosage:

While 30 minutes daily is a great goal to strive for - research has shown as little as 10 minutes of exercise per week or 1 day of doing physical activity each week might result in increased levels of happiness.

Another recent study took a closer look at the way different doses of exercise affect brain function actually found that high and low intensity exercise influence different areas of the brain. Researchers discovered that low-intensity exercise preferentially activates the parts of the brain involved in cognition control and attention processing. Alternatively, high-intensity exercise appears to primarily activate neuronal circuits involved in emotional processing.

Some research has also suggested that there is a direct relationship between exercise intensity and circulating Serotonin levels, showing that a single bout of high intensity exercise has a significantly greater increase in blood Serotonin than low intensity exercise. It should also be noted that even in response to low intensity exercise there is still an improvement seen.

Most other changes to neurotransmitters like Norepinephrine, Acetylcholine and Glutamate also appear to be dependant on intensity, with greater increases seen in response to higher intensity exercise.

While this is very promising and useful information - it’s also important to consider that high intensity exercise is not for everyone and that it can take some time to build up to. Some forms of high intensity exercise like circuits and interval based training can be more interesting for some - but can be difficult to stick to in the early stages of beginning an exercise routine. Most exercise studies have shown a significant reduction in depressive symptoms after eight weeks or more so it’s most important that whatever exercise you are prescribed/ plan to do is something sustainable, that can be participated in regularly.

Importance of Goal Setting:

Long term exercise and physical activity can be daunting, especially if it’s not a normal habit.

Goal setting is foundational to achieving success and can be of particular use when trying to stick to a plan to improve specific health, fitness and lifestyle outcomes. A useful approach is the S M A R T framework, which suggests that goals should be:

Specific, Measurable, Attainable, Relevant and Timely

This is a great framework for those who struggle to set or achieve goals they have set. Although it may seem complex at a glance, even the simplest of all goals can have much better chances of achievement when there are some guidelines or a plan to help you work towards it.

Many people with mental health issues struggle more than others with being able to set goals and can benefit from having structure to achieving an outcome. The great thing about exercise is that, by nature, humans will adapt and progress as they continue with any form of physical activity. The key thing is that we can keep track of progress in whatever way it happens and no matter how small the progression is.

One of the most simple ways of doing this is by setting goals.

This could involve a goal of walking a set distance in a certain time by a specific date in the year - or it may be a broader goal of successfully completing an exercise on at least 1 day each week for a month. It may even be useful to have smaller more manageable goals throughout each day to assist in achieving larger scale goal over weeks to months.

To get started, the act of writing or coming up with a goal that hits the SMART criteria is an achievement in itself that paves the way for a plan to continued success.

How an Exercise Physiologist Can Help:

Exercise Physiologists have an in depth understanding of the way the body works, as well as the clinical science behind how exercise can be used as medicine in many different health conditions. With physical and mental conditions alike - this involves knowing the physiology behind how a disease develops, how it responds to different treatment as well as a specialised knowledge of how specific types of exercise have an effect on disease.

Exercise Physiologists also receive expert training in effective goal setting and delivering health/lifestyle/behaviour-change interventions to achieve these goals. For those who struggle with goal setting, it can be useful to have an Exercise Physiologist work with them towards setting goals that are meaningful and will have a positive effect on their health.

By combing these skills, an Exercise Physiology intervention aims to develop a plan for lifestyle modification and health behaviour change with a focus on physical activities, exercise and movement. By taking into account the individuals’ medical history, symptoms in addition to their personal preferences and goals, an Exercise Physiologist is able to support those suffering from mental health concerns through a personalised exercise and physical activity program to suit their specific needs.

This could involve regular supervised 1-on-1 exercise based consultations, less frequent reviews of a largely self-managed home/gym exercise program, support and guidance through a group based exercise program that still tailors to the individual needs of each person attending, or any combination/variation of these types of treatment.

For some - this might be through regular and frequent consultations to get things started with lots of guidance, or for others it may involve a largely self-managed plan that has intermittent reviews with an Exercise Physiologist every few weeks/months to review progress and re-evaluate goals as they are achieved.

As mentioned above - everyone experiences mental health differently, but the common factor is that exercise and movement can have beneficial effects when prescribed appropriately.

If you’d like more information on any of the information above or would like a better understanding of how movement can be medicine for you, keep an eye out for more content like this or get in touch for a personalised plan of action today.

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