Exploring and Utilizing the Relationship between
Exercise and Mental Health
1. Explore the relationship between physical activity and mental health
2. Identify the benefits of exercise on the reduction of anxiety.
3. Recognize the effects of exercise on depression.
4. Explore the effect of exercise with PTSD.
5. Explore the role of self-esteem and self-efficacy in mental well being.
6. Identify the models explaining why exercise has a positive effect on mental health.
7. Explore the mental health field for examples of using exercise as a treatment approach.
8. Prepare the professional to incorporate exercise into their counseling of clients.
We offer talk therapy, drug therapy, shock therapy, music therapy, art therapy, light therapy and animal assisted therapy just to name a few however, despite the growing body of evidence supporting the relationship between exercise and mental health, professionals in the field of mental health have been unhurried to utilize physical activity as a viable adjunctive intervention strategy for improving the mental health of patients.
Much work has to be done to convince those who deliver mental health services to focus on the links between mind and body and to look more positively on the role of exercise as a treatment in mental health issues.
Historically, traditional Western medicine has approached healing in just the body or just the mind. More recently we have begun to look at a more holistic approach using the mind to heal the body and the body to heal the mind. There are two approaches, alternative, working in place of traditional approaches or complementary, working along with traditinal therapies. This course focuses on the latter, exploring the potential value of exercise therapy as an supplementary treatment in alleviating mental health issues.
Physical Activity & Emotional Well-Being
The physical health benefits of exercise are well known. People who engage in regular aerobic exercise, such as walking, running, cycling or swimming, increase their capacity to function in daily life through improved cardiovascular and respiratory function.
Many people with mental health problems already use physical exercise to make them feel better, a survey by the charity Mind has found. They found that 83% of people with mental health problems looked to exercise to help lift their mood or to reduce stress. Two-thirds said exercise helped to relieve the symptoms of depression and more than half said it helped to reduce stress and anxiety. Some people even thought it had a beneficial effect on manic depression and schizophrenia. Six out of ten said that physical exercise helped to improve their motivation, 50% said it boosted their self-esteem and 24% said it improved their social skills.
Twenty-six men with chronic heart disease participated in a six-month study assessing both physiological and psychosocial outcomes of exercise (Koukouvou et al., 2004). Functional capacity was increased in the exercising group, and the exercising group also experienced a significant reduction of anxiety and depression, compared to non-exercising controls. Interestingly, the participants who were most depressed at the onset of the study achieved the greatest physiological results. Clearly, exercise had positive effects both psychosocially and physiologically for these participants.
Specifically, as noted and further explored below, physical activity has been shown to have a positive effect on anxiety, depression, and PTSD, as well as a myriad of other mental health factors such as self esteem, self-efficacy, restful sleep, body image and confidence.
Exercise and Anxiety
When stress effects the brain, with its many nerve connections, the rest of the body feels the impact, as well. Or, if your body feels better, so does your mind. Exercise and other physical activity produces endorphins – chemicals in the brain that act as natural painkillers-and also improve the ability to sleep, which in turn reduces stress.
Psychologists studying how exercise relieves anxiety and depression suggest that a 10-minute walk may be just as good as a 45-minute workout. Some studies show that exercise can work quickly to elevate depressed mood in many people. Although the effects may be temporary, they demonstrate that a brisk walk or other simple activity can deliver several hours of relief, similar to taking an aspirin for a headache.
Science has also provided some evidence that physically active people have lower rates of anxiety and depression than sedentary people. Exercise may improve mental health by helping the brain cope better with stress. In one study, researchers found that those who got regular vigorous exercise were 25 percent less likely to develop depression or an anxiety disorder over the next five years.
According to some studies, regular exercise works as well as medication for some people to reduce symptoms of anxiety and depression, and the effects can be long lasting. One vigorous exercise session can help alleviate symptoms for hours, and a regular schedule may significantly reduce them over time.
Although exercise has a positive effect for most people, some recent studies show that for some, exercise may not have a positive effect on anxiety or depression or may not make a strong impact on long-term mental health.
Like all forms of therapy, the effect can vary: Some people may respond positively, others may find it doesn’t improve their mood much, and some may experience only a modest short-term benefit. Nonetheless, researchers say that the beneficial effects of exercise on physical health are not in dispute, and people should be encouraged to stay physically active.
The manner in which exercise and anxiety reduction are related is not simple or necessarily obvious.
The UC Psychological Service Center offers the following:
1. Single bouts of aerobic exercise have been shown to reduce anxiety for several hours afterwards. This appears true whether the intensity of the workout is low or high, although it seems that with high intensity workouts there may be a “lag time” immediately following exercise (some research would indicate around 20 minutes) before the reduction of anxiety is felt.
2. Bouts of resistance exercise (weight lifting) have not been shown to reduce anxiety in the short term. While it cannot be conclusively said that no such benefit exists, present research has failed to show such benefits.
3. Chronic aerobic exercise has been shown to decrease the amount of anxiety a person typically experiences in his/her daily life. It appears that low to moderate intensity exercise is best for such a benefit, while an exercise intensity level that is too high may not be of as much (if any) benefit. Such an impact on anxiety has not been demonstrated for resistance exercise.
4. The impact of chronic aerobic exercise on the amount of anxiety a person typically experiences in his/her daily life is even greater for those who have diagnoses of anxiety disorders. This appears to be true regardless of whether or not a person experiences any increases in physical fitness. It also appears that this benefit is noted when the intensity of exercise is low to moderate.
Exercise and Depression
As with anxiety, the same goes for depression. Since the early 1900s, there have been over 100 studies examining the relationship between exercise and depression. Results consistently show that both acute and chronic exercise are related to a significant reduction in depression. Findings have indicated that the antidepressant effect of exercise begins as early as the first session of exercise and persists beyond the end of the exercise program. These effects are also consistent across age, gender, exercise group size, and type of depression inventory.
The following conclusions of the International Society of Sport Psychology (Singer, 1992) are based on examining the research literature regarding depressed patients:
- Exercise can help decrease the level of mild to moderate depression.
- Exercise may be an adjunct to the professional treatment of severe depression.
- Exercise can help reduce various kinds of stress.
- Exercise can have beneficial emotional effects across all ages for both sexes.
While research does show benefits related to exercise, it is important to realize that not all types of exercise are equal in terms of providing benefit.
The following information is offered by The UC Psychological Service Center:
1. Aerobic and anaerobic exercise have both been found to lead to improvements in mood. This seems to be true in the short term, although immediate reductions of depressive symptoms following a single bout of exercise do not seem to be as apparent as they are in the case of anxiety reduction. It does not appear that an increase in physical fitness level is necessary to achieve a reduction in depressive symptoms. These results have been found across different types of people who differ in physical fitness level.
2. Chronic exercise does seem to be somewhat effective in reducing the likelihood of a relapse into a depressive episode when a person with a diagnosis of a depressive disorder is not experiencing symptoms.
3. Research regarding the effectiveness of exercise amount or intensity has been less clear. However, research does seem to indicate that mild to moderate intensity exercise may be more effective in reducing depressive symptoms than more intense exercise.
4. Exercise has been shown to have antidepressant effects for those diagnosed with mild to moderate levels of depression. However, those with no such diagnoses do not seem to experience the same effects for occasional depressed mood that everyone experiences in their lifetime.
Exercise and Post Traumatic Stress Disorder
The effects of exercise on PTSD symptoms have been the subject of many recent as well as long range studies. Various traumatic events such as auto accidents, sexual abuse, kidnapping, and sudden loss of a loved one leave clients feeling a lack of control over their circumstances. Any of these unchosen circumstances expose survivors to anxiety, depression, phobia and self-blame.
In the PTSD literature, voices are calling for experimentation with and use of exercise and sport programs for therapeutic purposes. Stuhlmiller (1994) calls action-based programs “one of the most powerful, yet generally overlooked approaches to PTSD” (p. 386). One program, Ending Violence Effectively (EVE), was specifically designed for females who had been victims of rape, incest, physical and verbal assault, sexual harassment and other forms of trauma. In wilderness settings, traditional counseling was offered in addition to an action-based component which included “movement and meditation, massage, relaxation training and hypnosis”.
In order to provide a possible explanation for the effectiveness of exercise and sport programs, Stuhlmiller (1994) pointed out that over time, exposure to trauma has been shown to result in reduced production of serotonin, catecholamines, norepinephrine and endogenous opiods. These biochemical deficiencies are associated with the avoidance, emotional constriction and depressive symptoms characteristic of PTSD. The role of regular exercise in increasing these chemical levels, thereby contributing to a heightened sense of well-being, has been substantiated.
Using Physical Activity as a Tool to Help Clients Move Beyond Their Current Situation
A client’s belief system plays an important role in how they feel. If they focus on their depression and how it feels like they are stuck in this feeling forever with no hope for relief there likely won’t be any relief.
Reframing is simply the conscious act of thinking about a situation or set of circumstances differently. Taking this approach with clients it is possible to help them to acknowledge that the circumstances of their life are what they are, but to recognize that they have choices about how they view those circumstances and that they have the power to respond to the circumstances in either a positive, proactive manner or to to be a non participative bystander stuck in their current perception.
Using physical activity as a tool provides a proactive approach to help a client take control in dealing with life issues; move forward both physically and mentally rather than perceiving that outside circumstances have complete control over them.
According to Richard Nongard, MA, “exercise of any kind is a very tangible, corporeal experience. An individual makes a conscious choice to engage in it or not, and it is done purposefully and deliberately. Those characteristics of exercise inherently provide the client with an element of control.”
Exercise and Self-Esteem
Low self-esteem has been related with many mental health issues. It is believed that individuals with high self-esteem who may be predisposed to psychological disorders are better equipped to cope with those disorders, and thus, reduce the negative consequences that may result. It stands to reason then if self-esteem can be enhanced, potential negative consequences of psychological stressors can be reduced. It has been found that exercise has a positive effect on self-esteem.
A study of the effects of an eight-week walking program on self-esteem in women at Northeast Louisiana University showed improvement in self-esteem following the implementation of a fitness program.
A study at University of Illinois tested the extent to which self-esteem changed over time with exercise participation and within the hierarchical structure of self-esteem as postulated by Sonstroem and Morgan (1989). The authors conclude that the findings are consistent with the Sonstroem and Morgan model indicating that self-efficacy predicts physical competence which then impacts self-esteem.
Reviews of the literature illustrate clearly that exercise contributes to improvements in self-esteem.
Self Efficacy and Self Esteem
Individuals high in self-efficacy, the belief that they can be successful at an activity, and in self-esteem, a perception of positive self-regard, are more likely to engage and adhere to an exercise program (Fontane, 1996; Gauvin & Spence, 1996; McAuley, et.al., 1997). Albert Bandura’s theory of determinism indicates that behavior, personality, and environment interact together to determine personality and behavior. Thus, the personality trait of positive self-regard leads to the adaptation of exercise behavior. Engaging in the behavior of exercise, in turn, leads to greater positive self-regard; thus, they impact on one another is a reciprocal fashion.
Bandura (1986), a prominent researcher in the area of self-efficacy, further purports there are four primary mechanisms responsible for the development of self-efficacy: personal successes, witnessing others experiencing success, verbal encouragement from others and physiological and affective states.
Self-efficacy is a complex construct comprised of such factors as past experience with task performance, secondhand observation or verbal encouragement (Clark, 1999). In theoretical terms, efficacy expectations are formed through four different forms of influence. Primary experiences (e.g., experiences with physical activity) are the most persuasive. Seeing others engage in physical activity (secondary experience) is another influence on efficacy expectations. Verbal persuasion from individuals supporting the behavior change is the third influence on efficacy expectations. A final impetus for development of efficacy expectations is physiological state, which may include physical discomfort related to activity or positive feelings associated with exercise. Each of these influences can serve either as a catalyst or barrier to adoption of behavior change regarding exercise.
Exercise sessions be recognized as successive opportunities for mastery in the development of self-efficacy and that consistent participation in exercise programs contributes to a well-developed sense of self-efficacy. Many have reported that numerous psychological benefits, including improved self-efficacy are related to participation in physical activity. Subjective feelings of well-being accompanying an exercise program are associated with self-efficacy.
A study by Rejeski, Ettinger, Martin, and Morgan (1998) revealed that knee osteoarthritis patients who participated in a year and-a-half-long exercise program scored higher in stair-climbing self-efficacy than a control group, regardless of whether they were in a resistance training or aerobic training group. McAuley, Blissmer, Katula, Duncan and Mihalko (2000) found physical self-efficacy to be related to self-esteem in respect to subjective assessments of physical attractiveness, strength and health status. Participation in physical activity is related to improved self-efficacy and enhanced subjective assessments, regardless of objective physical changes.
There is a cyclical relationship between physical activity and self-efficacy. In addition to an increase in self-efficacy as a result of participation in physical activity, self-efficacy yields an increased likelihood of taking part in exercise.
The enhancement of self-esteem and self-efficacy can be an important contributing factor to both the prevention of psychological and physical illness and the maintenance of health.
Models Explaining The Benefits Of Exercise On Mental Health
So far we have heard that physical activity has a positive result, but how and why?
Several biological, psychosocial and psychological models and theories have been suggested that may help us to understand the proposed relationship between exercise and mental health.
- Psychological Theories
According to jeannie Paton, MS, CSCS there are three psychological theories as to how exercise may have a complementary effect with other forms of mental health counseling. First, it may serve as a distraction from stressful input. Second, exercise is a form of mastery or control, which allows a person to regain control over her/his body and life and the third theory suggests the antidepressant effects are due to the psychological benefits derived from social interaction that accompanies group activity.
In addition to this thee are several hypotheses that have been offered to explain how exercise functions to reduce symptoms of mental health dysfunction:
- Biological Models
Numerous biological and chemical hypotheses have been proposed to explain the effects of exercise on positive psychological health. One theory implies that exercise increases levels of brain norepinephrine and serotonin levels and that the release of endogenous opioids from the pituitary gland act as a mood enhancer and antidepressant.
Another hypothesis is the thermogenic, also referred to as hyperthermic theory which suggests that increases in body temperature have a tranquilizing effect. Core body temperature increases resulting from physical exertion may contribute to a decrease in muscle tension and possible changes in brain neurotransmitters. Although this possible physiological effect on mental health has not been thoroughly studied, more research is being conducted. This suggests that the primary stimulus for promoting affective change is the elevation in body temperature from exercise, and this alteration in physiological state is manifested in a number of responses that are orchestrated by the hypothalamus. The belief that elevating body temperature can be therapeutic is longstanding (e.g. saunas and steam room). Indeed, research has revealed that total body warming (e.g. warm showers) reduces muscle tension.
Support for the this explanation of how exercise effects mental health has been mixed. Let’s explore some of the other models that attempt to explain the relationship between physical activity and psychological well-being.
The endorphin hypothesis proposes that the effects of acute exercise on psychological well-being is caused by the release and subsequent binding of endogenous opiods, these being -endorphins to receptor sites in the brain (Steinberg & Sykes, 1985). The endorphin hypothesis originated from early research on rat brain tissue that revealed significant increases in opiate receptor occupancy after the rats had been forced to exercise (Pert & Bowie, 1979; Wardlaw & Frantz, 1980). Furthermore, DeMeirlier et al (1986) reported a positive relationship between endorphins and exercise, which they contended leads to more positive affective states. The endorphin hypothesis remains one of the most popular explanations of the psychological benefits of exercise.
Some experts believe that simply moving large muscle masses in regular rhythmical ways is inconsistent with depression. Some endorse a psychobiological theory to explain the antidepressant effect of exercise. They suggest that there are both biochemical and psychological changes resulting from exercise that influence depression.
- Psychosocial Models
Several psychosocial hypotheses have been presented concerning the connection between exercise and improved perceptions of well-being. Exercise and physical activity can furnish a sense of achievement, promote feelings of personal control, provide a channel for emotional release and reconnect one to the play of childhood. The positive feelings derived from exercise and physical activity may also be due to feelings of mastery, self-efficacy and accomplishment of a task. Involvement in physical activity has also been suggested to provide a sense of competence, an emotional catharsis and a form of biofeedback, which teaches participants how to regulate their emotions.
Other psychosocial models focus on the the possibility that physical activity provides a distraction from problems, and that exercise can offer a change of scenery and divert one’s mind from anxious thoughts. This concept of distraction suggests that exercise can serve as a ‘time-out’ from stressful stimuli and that this can lead to improved psychological wellness. In this respect, patients may find exercise a useful strategy to help them focus on events other than their particular life circumstances.
Group exercise also leads to social interactions with other individuals with similar likes, behaviors and situations. The relationship between a trainer and a client or a coach and an athlete can function in place of or in addition to parental relationships, as well as peer support.
Related to the concept of mastery is the idea that exercise can provide positive, quantitative feedback of improvements in someone’s overall functional abilities. These physical signs could be viewed as positive cues towards a sense of achievement in one’s physical self. This is important for clinical patients who often have negative feelings about themselves and their bodies.
Other Variable Associated With Mental Health
Another area associated with positive mental health is the relationship between exercise and restful sleep. Restful sleep provides the foundation for our mental and physical well-being. Exercise is particularly effective at helping to release tension, which promotes sound sleep. Regular aerobic exercise has been found to increase more restful sleep. Exercise doesn’t have to be vigorous to be beneficial. Walking three times per week for a minimum of twenty minutes has been shown to improve sleep.
Evidence From the Mental Health Field
It is important to note that this course is not touting exercise to improve physical appearance and therefore be happy, but rather exercise as a therapeutic approach in addressing mental health disorders. We have addressed the benefits to self-esteem and body image, but the subject matter is moreover specifically designed to explore the curative benefits of exercise as a mechanism to address disorders.
“It is important to realize that we are all doing the same thing–working to build self-esteem, strengthen mental health, prevent pregnancy and AIDS and prevent drug abuse. There is a real need to integrate exercise and sport into existing programs,” says Dr. Debra Klein-Walker, Assistant Commissioner, Bureau of Family and Community Health, Massachusetts Department of Public Health.
Although it is not fully utilized as a treatment modality, many programs, such as the Montanari Residential Treatment Center in Hialeah, Florida and the Columbus College Counseling Center, are incorporating physical exercise into psychological treatment. The most successful programs provide meaningful and consistent activities, are goal-oriented and are administered by a knowledgeable and supportive interdisciplinary team.
Dr. Lawrence Meisel, Columbus College Counseling Center, was involved in a program that integrated both aerobic and nonaerobic exercise training into a counseling treatment program for inpatient delinquent adolescents. According to Meisel, one of the major results of this cost-effective intervention was that after six months of training, the girls and boys showed considerable improvements in self-concept and confidence and always had significantly more internal locus of control. Meisel would run with the students and, at the point where they were struggling, he would whisper in their ears, “This is what it feels like to want to give up–but in about ten minutes you will know what it means to succeed!”
The Three Springs Treatment Center in Huntsville, Alabama, has a physical activity program that is supplemental to the main therapeutic program. It is a challenging outdoors program that includes such activities as a ropes course, caving, rappelling, rock climbing, backpacking, hiking and orienteering. They have reported having had success with adolescent girls in improving self-esteem and teaching goal-setting and problem-solving skills (Jim Chritzberg, Director).
Project Light was started in 1991 as a Boise State University research study. The research conducted confirmed that exercise reduces symptoms of depression and depression-related illnesses in many cases. It has now developed into an ongoing program in the community to promote exercise as one of the treatment modalities for persons suffering from depression. Mental health professionals are encouraged to include this exercise program as a treatment modality in addition to traditional psychotherapy treatments.
Exercise as a Preventative Measure
Although our primary focus is on using exercise in treatment, it is also important when discussing exercise and mental health to note that exercise may be useful both in therapeutic and preventive scenarios. An inverse relationship between exercise levels and occurrence of depression has been demonstrated in cross-sectional epidemiological studies, and sedentary lifestyle in non-depressed populations has been correlated with future depression (Brooks, Fahey, White & Baldwin, 2000). Exercise appears to have both shorthand and long-term effects on mental health (Brooks et al., 2000). “Exercise may help to prevent some forms of psychopathology by assisting people in managing some of the symptoms associated with psychopathology” (Plante, 1993).
Incorporating Exercise in Mental Health Treatment With Your Clients
It is advisable for anyone beginning an exercise program to consult with their physician. It is important to talk with your clients about their safety before you prescribe exercise. An interdisciplinary approach, including the mental health therapist, a physician and a certified sports specialist, is recommended.
Clients should start with moderate activity and pick something that they will stay with. Consistency is important because consistent exercise will help to keep emotions more even. A prescribed program can begin with something as simple as a 10 to 15 minute moderately paced walk. Walking helps to clear the head. Sometimes it is difficult to clear the mind of thoughts. The suggestion can be made to let the thought pass through the mind and then try to focus on the circularity of breathing. Learning to breath from a deeper space in the body can be calming.
Exercise, as a means to improve mental health, should ideally be pleasant. Additional recommendations for clients include:
- Start slowly and build up gradually. Give yourself plenty of time to warm up and cool down with easy walking or gentle stretching. Increase the amount of time you exercise by one to five minutes per session. Aim for at least 30 minutes of exercise most days of the week.
- Exercise in a location where you feel safe, secure and non-judged.
- After exercising, spend a few minutes of quiet meditation or meditation with soothing music or a warm bubble bath.
- Stay consistent. It has been found that general guidelines recommended for improving depression, anxiety, etc. is 30 to 40 minutes of aerobic activity 5 days per week.
- Goals should be focused on maintaining and/or increasing overall fitness, improving mood, self-concept and decreasing depression and anxiety, not oriented to improving a specific perceived body flaw.
- The Influence of Exercise on Mental Health conducted by the President’s Council on Physical Fitness and Sports Research state that exercise shows greater results when it lasts for more than 10-weeks. This study further states that exercise has more effect than casual recreation or relaxation training.
- Listen to your body. If you feel pain, shortness of breath, dizziness or nausea, take a break. You may be pushing yourself too hard.
As noted earlier, helping a client to begin physical activity as a means to treat mental health issues, should incorporate other professionals such as their physician and an exercise specialist, As a guidline, the first step the client needs to take is to assess ther fitness level. Next they need to design a program, including the recommendation made earlier, that will take into account their goals, a logical progression of activity designed to improve their range of motion, strength and/or endurance. Finally, tracking the program and incorporating the results into therapy sessions is an important set. The following is an example of a chart that can be used with clients:
Rate Overall Mood for the Day on a scale of
Note any Emotional Reaction During or After Activity
Flat before, a little more productive afterwards
A little sad, not sure why but anxious. Felt less anxious afterward
Proud of myself for making me a priority
Although is is a sample, and reflects a fast paced small example, ideally we would see the overall mood score improve over several weeks.
One of the biggest challenges to using exercise as a treatment approach with depression is that one of the most symptoms of depression is feeling tired and flat. Michael Craig Miller with Reuters Health noted in a Harvard Mental Health Letter (December 2005), “some depressed individuals may simply not have the desire to exercise.” Citing the popular NIKE slogan, Miller said, “Most people cannot ‘just do it,’ particularly if they are depressed.” He advises that people who fall in this category do as much as they can, even if it means exercising for a few minutes at a time. “The advantage of doing a little bit is that sometimes a little bit leads to a little bit more,” he said. “You don’t have to have a program that includes 45 minutes of sweating and grunting and moaning,” he added. “A 10-minute walk is as good a place to start as anything else.”
Another challenge is that some clients with low self-esteem are unable to take the risk of getting into a fitness program due to the fear of failure. Focusing on enjoyment level during physical activity as opposed to difficulty level can help with adherence, leading to improved self-image.
The physical benefits of exercise — improving physical condition and fighting disease — have long been established, and physicians always encourage staying physically active. Given the prevalence and considerable financial costs associated with poor mental health, exercise as a therapeutic possibility deserves attention.
The overall benefits of exercise on mental health include:
1. Reduce Stress
One of the most common mental benefits of exercise is stress relief. Exercise also increases concentrations of norepinephrine, a chemical that can moderate the brain’s response to stress.
2. Boost Happy Chemicals
Exercise releases endorphins, which create feelings of happiness and euphoria. Studies have shown that exercise can even alleviate symptoms among among the clinically depressed.
3. Improve Self-Confidence
On a very basic level, physical fitness can boost self-esteem and improve positive self-image.
4. Prevent Cognitive Decline
As aging and degenerative diseases like Alzheimer’s kill off brain cells, the head actually shrinks, losing many important brain functions in the process. While exercise and a healthy diet can’t “cure” Alzheimer’s, they can help shore up the brain against cognitive decline that begins after age 45.
5. Alleviate Anxiety
The chemicals that are released during and after exercise can help people with anxiety disorders calm down.
6. Help Control Addiction
The brain releases dopamine, the “reward chemical” in response to any form of pleasure, be that exercise, sex, drugs, alcohol or food. Short exercise sessions can effectively distract drug or alcohol addicts, making them de-prioritize cravings (at least in the short term).
This course has explained the relationship between physical activity and mental health. Although more research is needed into some of the psychobiological mechanisms at work in the connection, a clear connection has been documented—particularly in relationship to anxiety, depression, and PTSD. Clearly, physical activity can be a useful tool in mental health settings.
Of all the questions that remain to be answered, perhaps the most perplexing is this: If exercise makes us feel so good, why is it so hard to do it? According to the Centers for Disease Control and Prevention, in 2017 25 percent of the U.S. population reported zero leisure-time physical activity.
Starting out too hard in a new exercise program may be one of the reasons people disdain physical activity. When people exercise above their respiratory threshold — that is, above the point when it gets hard to talk — they postpone exercise’s immediate mood boost by about 30 minutes. For novices, that delay could turn them off of the treadmill for good.
The exercise mood boost, on the other hand, offers near-instant gratification. Therapists would do well to encourage their patients to tune into their mental state after exercise — especially when they’re feeling down.
“Many people skip the workout at the very time it has the greatest payoff. That prevents you from noticing just how much better you feel when you exercise,” he says. “Failing to exercise when you feel bad is like explicitly not taking an aspirin when your head hurts. That’s the time you get the payoff.”
It may take a longer course of exercise to alleviate mood disorders such as anxiety or depression, but the immediate effects are tangible — and psychologists are in a unique position to help people get moving.
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