Stepping Into Hope: The Impact of Exercise on Mental Health
Written by Clarie Miles, an accredited CBT therapist with over 16 years of experience working in the NHS and also part of the team here at Kintsugi Hope.
Ever heard of the vicious circle of mental health? That’s the one where I feel sad and low, which makes me tired and unmotivated. So I don’t do any exercise, and eat loads of junk food (insert your own unhealthy behaviours here). Then I feel bad about myself, and guilty, which makes me feel sad, and low. Repeat. Sound familiar?
Figure 1 — My Vicious Cycle
And just as familiar to that is the cry of ‘exercise is good for you.’
The Evidence
The evidence is in — people who are more physically active, are less likely to develop depression and anxiety disorders — and this happens even when you take into consideration other factors such as age, sex, smoking, weight and other physical conditions. And on top of that, exercise is as effective as anti-depressants in decreasing symptoms in people who are already depressed and anxious. And that unlike the meds, there are no side-effects to exercise (Schuh & Vancampfort, 2021).
To me it sounds crazy — that exercise can work as well as the drugs, but studies looking at the brain changes and functioning help us understand this (Smith & Merwin, 2021). In order to take on new information — to see the world in a different way, which is what we can do when we are well, and is so hard when we are depressed — we need neuroplasticity. Our brains need to be able to grow and change — to grow new brain cells (neurogenesis) and to create new connections. And it turns out, that just as the SSRI and other psych medications increase neuroplasticity in our brains, so does exercise. Moving our bodies changes our brains.
Self-Regulation
Taking up physical activity also changes our relationship to our body, and to our behaviour. We learn to set goals, and to get rewards like feeling proud of ourselves, or feeling fitter, from meeting those goals. Researchers call this ‘self-regulation’ — and as our brains grow and change with exercise, and as we do more and more physical activity, so does our ability to self-regulate, to choose behaviours that are good for us.
Exercise grows our ability to tolerate short term discomfort for long term goals. We listen to feedback from our body. We learn strategies to override the ‘I don’t want to’ with ‘I can’. All of these are key skills that people who have undergone psychotherapy may recognise in different forms. Fundamentally, the skills learnt from increasing our physical activity, combined with the changes in our brain, mean we now have a greater ability to manage both our thoughts, and our emotions.
The Virtuous Cycle
And this is the bit which links back round and completes our new, ‘virtuous’ circle.
Figure 2 The Virtuous Circle adapted from Smith & Merwin, 2021
By doing physical activity we’ve grown our ability to choose to face the challenges, to override our mood, to put on the trainers and get out there . And next time? Next time it is just that little bit easier to do.
The first step is up to you — it might be joining a class at the local gym, or digging out your trainers to go for a walk, or even pushing the hoover around the lounge. NHS guidelines suggest 150 mins per week of moderate activity (that’s anything which gets your heart rate up a little bit) but you don’t have to start there. The evidence suggests that physical activity — anything at all that moves your muscles and uses up energy — is good. The more you do, the greater the impact. But you can choose to start from where you are.
The Next Steps…
So how much are you moving, at the moment? And what would be, for you, the next step to moving a bit more? How can you step on to the virtuous circle of improving your mental health, just by moving your body?
References:
Schuh, F. B., & Vancampfort, D. (2021). Physical activity, exercise, and mental disorders: it is time to move on. Trends in Psychiatry and Psychotherapy, 43(3). Retrieved from https://doi.org/10.47626/2237-6089-2021-0237
Smith, P. J., & Merwin, R. M. (2021). The Role of Exercise in Management of Mental Health Disorders: An Integrative Review. Annual Review of Medicine, 72, 45–62. Retrieved from https://doi.org/10.1146/annurev-med-060619-022943
