Exercise is generally considered an activity that primarily benefits our physical health. From improving muscle strength, balance, and oxygen flow, there are dozens of fitness-related reasons to stay active throughout your lifetime.
However, even many psychologists are not fully aware of the impact of exercise on mental health, including mood disorders like anxiety and depression.
Since an estimated one-third of people in the US are experiencing symptoms of anxiety and depression (close to double the original estimates for 2020), health coaches must consider how exercise and physical activity guidelines apply to those experiencing these conditions.
In this article, we review the evidence and science behind how exercise impacts anxiety and depression.
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The Science Behind Exercise’s Impact on Mental Health
Overview
Exercise and physical activity require increased breathing and heart rates and the activation of parts of the brain that control balance, muscle activation, and coordination. When we exercise, our metabolic rate (the processes by which our bodies convert food and drinks into energy) increases so our cells can gain access to energy as their activity increases.
The brain is involved in every single one of these processes. While we tend to separate mental health from bodily health, remember that the brain is responsible for controlling both conscious actions and unconscious actions. Conscious actions, which originate in the cerebellum, including picking up a weight, moving from warrior II to triangle pose, or deciding to pick up the pace on your morning walk. Unconscious actions originate in the brain stem, and these include increasing your breathing and heart rate and controlling your blood pressure.
When we refer to mental health, however, we are referring to thoughts, feelings, emotions, and cognition. These, of course, also originate in the brain, more specifically in the limbic system, which includes the amygdala, the hypothalamus, and the hippocampus.
The Impact of Exercise on Mental Health
In general, health professionals are less aware of the mental health outcomes of exercise than the physical health outcomes. This is, in part, due to the fact that there is less research on the exercise-mental health connection, and limited sources have theorized and tested the biological mechanisms of action.
To date, most of the research that examines the benefits of exercise and physical activity focuses on mental illness rather than on mental health. There is plenty of evidence as to how physical activity benefits people with anxiety and depression, which we discuss below. Still, few researchers have examined how exercise benefits mental health regardless of mental illness, in part due to the challenges involved in identifying and reporting positive measures of mental health.
Research recently published in the International Journal of Behavioral Nutrition and Physical Activity took on the challenge. The researchers examined how participation in physical activity impacted basic psychological needs. They enrolled 937 children aged 10-11 and took regular measurements of physical activity levels and mental health.
Researchers found that physical activity promotes mental health by mediating three basic psychological needs:
- Autonomy: a feeling of the ability to self-govern behavior, choices, and decisions
- Competence: a sense of mastery through effective interaction with the social environment and opportunities to express one’s capabilities
- Relatedness: feeling a secure sense of belongingness and connectedness to others in one’s social environment
Additionally, the more years participants participated in physical activity, the better perception they had of their general mental health.
Finally, researchers found that the longer participants regularly engaged in physical activity in general, the more likely they were to engage in moderate to vigorous physical activity. Moderate to vigorous physical activity has added physical health benefits for most people.
Some of the theories and explanations as to how exercise and physical activity may benefit mental health include:
- Increased blood flow to the brain stimulates the release of endorphins, which are natural mood-enhancing chemicals.
- Exercise increases the levels of brain-derived neurotrophic factor (BDNF), which is associated with enhancing mood and helping brain cells survive longer.
- Exercise increases levels of the brain stimulant phenylethylamine, which is likely linked to the release of dopamine and endorphins—two natural antidepressants.
- Exercise can influence brain plasticity by facilitating increased adaptation, cell renewal, and cell-protective processes.
- Regular exercise modified the stress response.
The Impacts of Exercise on Anxiety and Depression: What the Research Says
A growing body of research demonstrates the therapeutic effects of exercise on mood disorders, including anxiety and depression. Below, we summarize the main findings of this research:
Exercise protects against depression.
A systematic review of studies examined whether exercise effectively prevented depression. The researcher found that there is substantial evidence from longitudinal studies that physical activity and exercise offer protection from depression in adolescents, adults, and older adults.
Exercise is an effective adjunctive intervention for the treatment of mild to moderate depression.
The same systematic review mentioned above also examined whether studies were consistent in their findings that exercise had therapeutic effects on people with mild to moderate depression. The researcher found that there is, in fact, support for the use of exercise on symptoms of depression. The impact may be significant, but a lack of consistent study designs doesn’t allow for the quantification of the potential impact.
Exercise is linked to better health outcomes in people living with mood disorders.
In people with mood disorders, anxiety and depression increased the body’s stress response, thus increasing generalized inflammation. Inflammation is linked to an increased risk of numerous negative health outcomes, including chronic diseases and suppressed immune systems. Exercise helps to counterbalance inflammation, not only mitigating the risk of chronic diseases but also potentially improving the outcomes of mood disorders.
There is limited research on the effect of exercise on anxiety, but the results are positive.
Research published in the International Journal of Mental Health and Nursing carried out a systematic review of the inpatient studies (studies that involved patients who were admitted to the hospital for mental health episodes) where exercise was recommended or prescribed as an adjunct therapy.
While the researchers confirmed that there is substantial evidence to confirm the positive effect of exercise on people living with depression, there is a severe lack of evidence examining the effect of exercise on anxiety disorders. Those studies that were identified found that there was a positive effect, however.
Both resistance and aerobic exercise may benefit less active people with generalized anxiety disorder.
A six-week randomized control trial was carried out with sedentary women who had a generalized anxiety disorder. The researchers found that there were reductions in anxiety-tension and irritability in those who carried out resistance exercise twice a week, and there was a moderate reduction in symptoms of worry in groups that combined aerobic and resistance exercise.
Tips for Integrating This Knowledge into Your Coaching Practice
As a health or fitness coach, you likely already integrate strategies to support your clients in getting regular physical activity. However, a person’s transition from a desire to exercise, to beginning to exercise, and then maintaining exercise as part of the health behavior change continuum is not a natural process for many.
This is where your coaching skills can make a difference in supporting clients along their physical activity journey.
Here are some tips for supporting your client who may be having mental health issues in making exercise part of their regular routine:
- Support them in identifying types of exercise they enjoy and don’t enjoy.
- Create a safe space for them to discuss their experience with exercise in the past, including elements that may not have made the experience enjoyable.
- Help them navigate resources that will allow them to seek professional mental health support.
- Avoid pressuring clients into exercising or shaming them for not following through with a fitness plan. If a client isn’t following the fitness plan, work with the client to reevaluate the plan and make changes if necessary.
- After gaining their permission, offer information as to how exercise may benefit their mental health.
Main Takeaways
Human bodies evolved to move. Researchers have demonstrated the benefits of physical activity for supporting multiple dimensions of wellness, including mental and emotional health.
Some of the mechanisms of action that describe how exercise can positively impact mental health include increasing blood flow, modulating hormone release and uptake, and reducing inflammation.
Clinical studies with people living with and at risk of depression and anxiety have demonstrated that regular physical activity and exercise can help prevent and treat symptoms of mood disorders.
As health coaches who may have clients with anxiety and depression, it is important to implement best coaching practices that are sensitive to how anxiety and depression can impact your client’s interactions with you and create a safe space for them to build confidence to want to exercise.
References
- https://www.apa.org/monitor/2011/12/exercise
- https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm
- https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/brain_tumor/about-brain-tumors/how-the-brain-works.html#:~:text=The%20cerebrum%2C%20the%20large%2C%20outer,vision%2C%20hearing%20and%20other%20senses.
- https://opentextbc.ca/introductiontopsychology/chapter/3-2-our-brains-control-our-thoughts-feelings-and-behavior/#:~:text=The%20limbic%20system%20is%20a,the%20hypothalamus%2C%20and%20the%20hippocampus.
- https://onlinelibrary.wiley.com/doi/abs/10.1111/inm.12045
- https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-020-0911-5
- https://pubmed.ncbi.nlm.nih.gov/7562360/
- http://www.elaborer.org/cours/A16/lectures/Ryan2004.pdf
- https://pubmed.ncbi.nlm.nih.gov/7562360/
- https://www.tandfonline.com/doi/abs/10.1080/14038190701395838
- https://www.sciencedirect.com/science/article/abs/pii/S0378512217308563
