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Exercise Rehabilitation for Mental Health

Mental health and wellbeing is paramount to the overall health of New Zealanders. 1 in 5 adults aged 15 years and over are diagnosed with a mood and/or anxiety disorder (1).

The World Health Organisation estimates that over 300 million people suffer from depression and over 250 million suffer from anxiety disorders worldwide, with prevalence for both increasing over the past decade. Physical inactivity is the cause of approximately 9% of premature death worldwide, and people experiencing mental illness engage in significantly lower levels of moderate-vigorous physical activity and spend significantly more time engaging in sedentary behaviour (2).

Overview

Depression

Regular exercise can be an effective way to relieve some forms of depression and is often a neglected strategy for treatment of depression. Numerous studies have shown that people who exercise regularly experience fewer symptoms of depression and anxiety than those who do not exercise regularly (3, 4)

Anxiety

Like depression, those who suffer from anxiety also tend to do little physical activity.

Stress

Stress is an inevitable part of life. Most people experience it on a daily basis, and this can have a significant impact on our lives. It is fairly impossible to eliminate stress, but you can learn to manage it.

Benefits

Depression

  • Exercise is now being considered a treatment for established depression, either as a stand-alone intervention for mild-to-moderate depression (5)
  • Even one workout a week is known to have important, protective benefits for those living with depression (6)
  • Aerobic exercise has been proven to be as effective as psychotherapy or pharmacotherapy for alleviating depressive symptoms by: (5, 7).
    • Increasing energy levels
    • Improving sleep
    • Distracting from worries
    • Providing social support
    • Increasing a sense of control and self-esteem, by allowing people to take on an active role in their own wellbeing

Anxiety

  • People with anxiety who reported a high-level physical activity were better protected against developing anxiety symptoms than those who reported low physical activity (8). Even five minutes of aerobic exercise can begin to stimulate anti-anxiety effects.
  • Exercising causes positive changes in your brain chemistry, like increasing the availability of important anti-anxiety neurochemicals including serotonin, GABA, BDNF and endocannabinoids (9).
  • Moving your body decreases muscle tension, lowering the body’s contribution to feeling anxious
  • Engaging in exercise diverts you from the very thing you are anxious about
  • Exercise activates frontal regions of the brain responsible for executive function, which helps control the amygdala, our reacting system to real or imagined threats to our survival (10)

Stress

Exercise may improve mental health by helping the brain cope better with stress – virtually any form of exercise can act as a stress reliever, and it is particularly great for:

  • Increased endorphins
  • Improved sleep and less fatigue
  • Improved mood, alertness and concentration, as well as enhanced overall cognitive function

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Sources

1. Ministry of Health. 2019. Annual Data Explorer 2018/19: New Zealand Health Survey [Data File]. URL: https://minhealthnz.shinyapps.io/nz-health-survey-2018-19-annual-data-explorer/ 2. Stubbs B, Williams J, Gaughran F, Craig T. How sedentary are people with psychosis? A systematic review and meta-analysis. Schizophr Res. 2016;171(1):103–9. 3. Schuch FB, Vancampfort D, Firth J, et al. Physical activity and incident depression: a meta-analysis of prospective cohort studies. Am J Psychiatry 2018; 175: 631–48 4. Chekroud SR, Gueorguieva R, Zheutlin AB, Paulus M, Krumholz HM, Krystal JH, Chekroud AM. Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: a cross-sectional study. Lancet Psychiatry. 2018 Sep;5(9):739-746. doi: 10.1016/S2215-0366(18)30227-X. Epub 2018 Aug 8. PMID: 30099000. 5. Cooney  GM, Dwan  K, Greig  CA, Lawlor  DA, Rimer  J, Waugh  FR, McMurdo  M, Mead  GE. Exercise for depression. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD004366. DOI: 10.1002/14651858.CD004366.pub6. Accessed 30 June 2021. 6. Harvey S, Øverland S, Hatch SL, Wessely S, Mykletun A, and Hotopf M. (2018) American Journal of Psychiatry: Exercise and the Prevention of Depression: Results of the HUNT Cohort Study. 175:1, 28-36 7. Rethorst CD, Trivedi MH. Evidence-based recommendations for the prescription of exercise for major depressive disorder. J Psychiatr Pract. 2013 May;19(3):204-12. doi: 10.1097/01.pra.0000430504.16952.3e. PMID: 23653077. 8. Schuch, FB, Stubbs, B, Meyer, J, et al. Physical activity protects from incident anxiety: A meta-analysis of prospective cohort studies. Depress Anxiety. 2019; 36: 846– 858. https://doi.org/10.1002/da.22915 9. Brellenthin AG, Crombie KM, Hillard CJ, Koltyn KF. Endocannabinoid and Mood Responses to Exercise in Adults with Varying Activity Levels. Med Sci Sports Exerc. 2017 Aug;49(8):1688-1696. doi: 10.1249/MSS.0000000000001276. PMID: 28319590. 10. Schoenfeld TJ, Rada P, Pieruzzini PR, Hsueh B, Gould E. (2013). The Journal of Neuroscience. Physical Exercise Prevents Stress-Induced Activation of Granule Neurons and Enhances Local Inhibitory Mechanisms in the Dentate Gyrus. 7770-7777; 33(18)