Exercise has a proven track record of assisting in the management of mental health issues.  Since the 1980s, a great deal of research has been published that demonstrates that exercise can help relieve anxiety and depression.  While in many cases physical activity is part of a holistic treatment plan that also includes medication and counseling, in mild cases it can be a stand-alone treatment.  Always consult with your doctor before implementing something new, or adjusting an existing protocol. How does exercise do this?  We are actually not quite sure.  While copious studies show an effect, “an analysis of the findings from only the most methodologically robust studies showed a weaker effect that was not statistically significant.  So, more high-quality trials are required to clarify the effectiveness of exercise as a treatment for depression” (Edmunds, ).  However, growing evidence indicates that physical activity can be a valuable adjunctive therapy, particularly for people with severe symptoms.  Researchers from the University of Texas Southwestern and the Cooper Institute in Dallas, found that exercise can serve as a supplemental treatment for 50% of patients with depression who have not been cured by a single antidepressant medication (Trivedi et al. 2011).  The amount and type of exercise need to be customized to the individual, as many people who start on an antidepressant medication feel better after they begin treatment, but “still don’t feel completely well or as good as they did before they became depressed”.

Interestingly, data analysis showed that women with a family history of mental illness benefited more from a moderate exercise regimen, while intense exercise helped those with no family history of depression.  In men, regardless of family history, symptoms improved more with a high volume of exercise.  This may be why the effect of exercise on mental health is hard to capture with well-controlled studies, which do not individualize programs for each study participant in the quest to capture a statistically significant result. According the science, exercise improves may improve mental health in the following ways:

• By enhancing physiological health.  Physical activity benefits overall brain health by reducing peripheral risk factors for poor mental health, such as inflammation, diabetes, hypertension, and cardiovascular disease.  As well, it increases blood flow and associated delivery of nutrients and energy.
• By raising tolerance for emotional stress.  Since exercise is stressful, regular exercise increases a person’s resilience toward other forms of physical and emotional stress.
• By increasing familiarity with physical stress.  For some anxiety sufferers, an elevated heart rate, profuse sweating, chills, and other stress symptoms that can occur during an anxiety attack are, on their own, upsetting.  By exercising regularly, people can learn to control their experience of physiological stress, making these symptoms less frightening.
• By boosting self-efficacy.  People who master a new skill improve self-efficacy, which subsequently leads to higher self-esteem
• By fostering social contact.  Social interactions can improve mood, and lead to opportunities to spend time with others.  Encouragement from friends and family is also beneficial.
• By increasing exposure to the outdoors, sunlight and green environments.  Engaging in outdoor exercise (“green exercise”) helps to lift mood.  As well, exposure to sunlight, even on darker days, can raise neurotransmitters levels and elevate mood.
• By diverting negative thinking.  People with depression and anxiety usually get stuck in negative thought cycles.  Exercise, especially mindful exercise, may be diversion from self-rumination toward engagement with pleasurable experiences.
• By encouraging engagement instead of avoidance.  Focusing on pursuits involving physical activity provides value in itself.  A structured program encourages participation instead of withdrawal, and teaches persistence.  This lesson in engagement can help people with anxiety to overcome avoidance in other arenas of life.

If you suffer from anxiety or depression, try exercise.  Start with small amounts with no pressure.  You may be pleasantly surprised at the result. References: Archer, S (2014).  Train Yourself Happy.  IDEA Fitness Journal, June. Clow, A., & Edmunds, S. (Eds.). 2014. Relationship between physical activity and mental health in Introduction to Physical Activity and Mental Health. Champaign, IL: Human Kinetics. Otto, M., & Smits, J., 2011. Exercise for Mood and Anxiety, Proven Strategies for Overcoming Depression and Enhancing Well-Being. New York: Oxford University Press. Trivedi, M.H., et al. 2011. Exercise as an augmentation treatment for nonremitted major depressive disorder: A randomized, parallel dose comparison. Journal of Clinical Psychiatry, 72 (5), 677-84.