Benefits of Exercise
The benefits of exercise have been explored for decades. The profit of a holistic approach to psychotherapy that incorporates a physical regime may improve outcomes in mental health treatment (Weir, 2011). Three exercise routines per week, lasting 20-30 minutes in conjunction with psychotherapy and a concurrent medication regime has been associated with enhanced mental health treatment. However, more often than not, mental health professionals don’t incorporate physical activity into treatment planning. Very few graduate programs teach students how to implement physical exercise into treatment. Would adding exercise to treatment planning provide the missing link to more positive outcomes in therapy? Would daily exercise assist a client with a serious mental disorder reach their mental health goals?
Exercise is often the primary step in lifestyle modifications for the prevention and management of chronic diseases (Anderson, Shivakumar, 2013). Primary care physicians often recommend exercise along with diet to assist in bettering physical health. Weight loss, muscle growth and improvements in cardiovascular health are among the number of physical enhancements related to exercise (Hillman, Erickson, & Kramer, 2008). Physical exercise has been associated with an increase in bone strength, diabetes management, and the prevention of some cancers (Anderson, Shivakumar, 2013). Physically fit people tend to have improved quality of life as they are able to engage in everyday activities without becoming easily fatigued and are more apt to fight off sickness and disease (Callaghan, 2004).
Depression and Anxiety Treated with Exercise
Depression and anxiety are among the most frequently treated mental health disorders across the nation. Anxiety affects over 40 million people and is the most common mental illness in the United States. Depression is the leading cause of disability in the United States for ages 15 to 44. The number of people receiving treatment for these disorders has grown over the last 10 years. Psychologists have made gains in effectively treating the disorders and outpatient clinics are more readily available than in times past. Treatment modalities are numerous and can include behavioral therapy and cognitive behavioral therapy. Exercise has also proved beneficial in reducing mental health symptoms (Matther et al 2002, Kramer, Erickson, & Colcombe, 2006, Alexandratos, Barnett and Thomas, 2012, Callaghan, 2004, Craft, Perna 2004). However, physical activity is often overlooked when treating mental health disorders (Callaghan, 2004, Alexandratos, Barnett and Thomas, 2012).
Exercise can be fun and invigorating. New cardiovascular machines, innovative classes such as Zumba, Kick boxing and Crossfit has made working out more exciting than ever. Many gyms now have state of the art theatres to encourage people to attend more frequently. Depending upon hours of operation and equipment, gym membership costs can be economical. But fun isn’t the only benefits of exercise. Socially, exercise provides an opportunity to meet new people and to gather with friends combating loneliness and isolation. Exercise groups help hold participants accountable and afford the possibility of establishing lasting relationships. While the gym frenzy is fluttering about there is more benefits to exercising than just physical improvements. There may be more bang for your buck after all.
History of Exercise and Mental Health Benefits
As early as the 1900’s, researchers began to connect mental well-being to physical health. Day (1923) reported that physical and mental activities affected systolic and diastolic blood pressures. Franz (1917) discussed diseases, exercise and mental disorders and Dearborn (1935) proposed exercise as a coping skill to aid in managing maladaptive and repetitious behaviors. Far earlier than the 1900’s Claudius Galen, born around 131 A.D. in Asia Minor, concluded that the impairments of the mind was attributed to faulty customs in eating, drinking and exercise (Callahan, 2004). Though, the connection between mental health and exercise was noticed, much of the research continued to focus on the somatic component of physical exercise; therefore, leaving a gap in knowledge on the measurable benefits of physical activity.
More recently, researchers have begun to study and observe the relationship between exercise and improved brain function and mental health (Alexandratos, Barnett and Thomas, 2012, Callaghan, 2004, Craft, Perna 2004). Population studies have shown clear correlations between mental health and physical activity in younger and older adults (Matther et al 2002). There is a growing body of evidence supporting the psychological and cognitive profits of exercise (Kramer, Erickson, & Colcombe, 2006). The research provides further support that mental health professionals could be more persistent in adding exercise to treatment.
Physical exercise has been found to improve mood, symptoms and quality of life in individual with serious mental health (i.e. schizophrenia) by providing an avenue for social interaction and goal directed activity (Alexandratos, Barnett and Thomas, 2012). Babyak et al 2000 found that individuals with serious mental health that participated in an exercise group were more likely to be partially or fully recovered after six month follow-up when compared to control group or combination group. Further, the exercise group had significantly lower rates of depression than other groups. Smith et al 2007 found that participants in exercise group demonstrated significant improvements in self-reported measures of self-esteem.
Physical activity has been found to enhance cognitive functioning in areas of the brain such as the hippocampus and suggests improvements in memory (Kramer, Eickson, Colcombe 2006). Studies have yielded evidence of positive effects of physical activity on neurocognitive functioning in older adults (Kramer, Erickson, Colcombe 2006). Individuals exercising less than three times per week were found to have higher incidences of Alzheimer’s disease (Kramer, Erickson, Colcombe, 2006). Individuals who exercise frequently demonstrate slower rate of age-related memory and cognitive decline in comparison to those who are more sedentary (Anderson, Shivakamur 2013). Halperin and Healey (2012) suggested that physical exercise combined with cognitive challenges may potentially serve as a vehicle for treatment for children with Attention Deficit Hyperactivity Disorder. Again, the literature further provides evidence for actively incorporating physical activity into mental health treatment planning,
Chemical imbalances have been related to mental health disorders. There are hormonal benefits associated with exercise. One theory proposes that exercise has a positive effect on depression due to an increase in endorphins following physical activity. The results are improved positive self-esteem and positive outlook (Craft, Perna 2004, Harvey et al 2010) and are components in improving depressive symptoms. The increase in endorphins also produces a euphoric affect also known as “runner’s high” and is described as energizing and invigorating. Endorphins can also produce a relaxing affect that can ease anxiety Another theory involves monoamine and purports that exercise increases the availability of brain neurotransmitters (i.e. dopamine, serotonin, and norepinephrine) that are depleted with depression. Abnormalities in monoamines function have also been associated with anxiety (Anderson, Shivakamur, 2013).
Exercise is a behavioral intervention that has shown promise in treating mental health disorders (Craft and Perna, 2004). Adults who engage in regular exercise experience fewer anxiety and depressive symptoms suggesting that physical activity provides a protective effect against the development of mental disorders (Anderson, Shivakamur, 2013, Harvey et al 2010). It’s unfortunate that many mental health professionals don’t include physical exercise into treatment planning. An area for further exploration may include examining the barriers to implementing exercise as tool in therapy. But for now, the literature corroborates that physical activity is key in overall well-being. Something simple such as including a stroll during therapy sessions can promote relaxation and may assist in building therapeutic rapport. Incorporating education on physical activity, local gym information, and measurable exercise goals as a part of sessions may improve mental health. It may just be that missing link in a patient’s progress.