Exercise and Mental Health

Mental health and cognitive decline are on their way to become a global health crisis, affecting the lives of millions of people worldwide. The World Health Organization (WHO) is projecting mental health disorders to become the leading cause of disability by 2030. Unsurprisingly, the search for treatments is in full swing, with an increased interest in non-pharmacological options to supplement or even replace traditional approaches. 

Anyone that ever experienced a “runners high” - a rush of endorphins following intense exercise - knows that the benefits of exercise go beyond the purely physical. Today, we want to look into the findings of a recent scientific review that summarises the potential of exercise to tackle psychological and cognitive issues [1]. 

Why Exercise?

When speaking to regular gym-goers, many of them will tell you that their habit is essential for their mental health. Some might even nickname it their “therapy”. This connection is in fact something that’s well-documented by science - but often underappreciated and underutilised as a treatment option. Exercise can be a vital component of mental wellness. Regular physical activity has been shown to mitigate the symptoms of depression, anxiety and cognitive decline. It’s a powerful tool in our mental health arsenal for people in all stages of life.

Exercise and Brain Health in Ageing

In the context of cognitive health, research has connected the dots between exercise and our brain function as we age:

• In children and adolescents: Studies show that exercise enhances academic performance and cognitive skills like attention span and executive function [2].
• In adults: Regular physical activity is linked to enhanced memory, a quicker processing of information and better executive functioning [3].
• In the ageing population: For seniors, exercise has been shown to protect from cognitive decline and increase brain plasticity - meaning it helps to maintain cognitive functions for longer [4].

The Science Behind Exercise and Cognitive Function

Exercise promotes blood flow to the brain, and with that the delivery of oxygen and nutrients. This, in turn, supports neuron health and function - crucial for the maintenance of cognitive abilities. In addition, exercise stimulates the production of so-called “neurotrophic factors”: chemicals that are essential for the creation of new brain cells and synapses, both enhancing our ability to learn and remember things [5].

Exercise and Mood Regulation

Beyond physical brain health as in cognitive function, exercise is also a potent mood regulator:

• Endocannabinoid Activation: Exercise activates the so-called endocannabinoid system (located in the central nervous system), known for its role in mood and stress regulation [6].
• Endorphin Release: Endorphins are often referred to as our 'feel-good' hormones. They are produced during exercise, improve our mood, lower pain and promote feelings of wellbeing [7].
• Improved Self-Esteem and Body Image: Regular physical activity can significantly boost self-esteem and improve the way we feel about ourselves - even in the absence of any physical changes [8]!
• Social Interaction: Participating in group sports or guided exercise classes can foster community and support networks, all further boosting mental health [9].

Exercise in the Management Mental and Cognitive Health

It’s clear that exercise can help us think sharper and prevent us from getting caught up in bad feelings - but it isn’t only preventative. It can also be therapeutic in the context of mental health disorders:

• Depression and Anxiety: Regular exercise was shown to reduce symptoms of depression [10] and anxiety and improve overall mental health [11].
• Cognitive Impairments and Neurodegenerative Diseases: Physical activity offers potential benefits for those suffering from conditions like Alzheimer’s and Parkinson’s [4].
• Schizophrenia [12], Bipolar Disorder [13] and Eating Disorders [14]: There is emerging evidence suggesting that exercise can reduce the symptoms and enhance the quality of life for individuals with these conditions.

Exercise as a Standard in Mental Health Care

By now, the evidence about exercise and its profound impact on mental and cognitive health isn’t only anecdotal - it’s scientifically proven. Over time, we will hopefully see more healthcare professionals and policymakers promote it as a key component in treatment plans and prescribe more movement rather than more pills. 

Regular physical activity could be one of our most effective “medications” for mental and cognitive wellbeing. So next time someone goes for a run to clear their head or refers to lifting weights as therapy - you know what they mean. Consider joining them.

Sources

[1] Pujari V. Moving to Improve Mental Health - The Role of Exercise in Cognitive Function: A Narrative Review. J Pharm Bioallied Sci. 2024 Feb;16(Suppl 1):S26-S30. 

[2] Khan NA, Hillman CH. The relation of childhood physical activity and aerobic fitness to brain function and cognition: a review. Pediatr Exerc Sci. 2014 May;26(2):138-46. 

[3] Smith PJ, Blumenthal JA, Hoffman BM, Cooper H, Strauman TA, Welsh-Bohmer K, Browndyke JN, Sherwood A. Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosom Med. 2010 Apr;72(3):239-52.

[4] Groot C, Hooghiemstra AM, Raijmakers PG, van Berckel BN, Scheltens P, Scherder EJ, van der Flier WM, Ossenkoppele R. The effect of physical activity on cognitive function in patients with dementia: A meta-analysis of randomized control trials. Ageing Res Rev. 2016 Jan;25:13-23. 

[5] Cotman CW, Berchtold NC. Exercise: a behavioral intervention to enhance brain health and plasticity. Trends Neurosci. 2002 Jun;25(6):295-301.

[6] Fuss J, Steinle J, Bindila L, Auer MK, Kirchherr H, Lutz B, Gass P. A runner's high depends on cannabinoid receptors in mice. Proc Natl Acad Sci U S A. 2015 Oct 20;112(42):13105-8. 

[7] Boecker H, Sprenger T, Spilker ME, Henriksen G, Koppenhoefer M, Wagner KJ, Valet M, Berthele A, Tolle TR. The runner's high: opioidergic mechanisms in the human brain. Cereb Cortex. 2008 Nov;18(11):2523-31. 

[8] Sonstroem RJ. Exercise and self-esteem. Exerc Sport Sci Rev. 1984

[9] Cruwys T, Dingle GA, Haslam C, Haslam SA, Jetten J, Morton TA. Social group memberships protect against future depression, alleviate depression symptoms and prevent depression relapse. Soc Sci Med. 2013 Dec;98:179-86. 

[10] Schuch FB, Vancampfort D, Richards J, Rosenbaum S, Ward PB, Stubbs B. Exercise as a treatment for depression: A meta-analysis adjusting for publication bias. J Psychiatr Res. 2016 Jun;77:42-51. 

[11] Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clin Psychol Rev. 2001 Feb;21(1):33-61. 

[12] Pajonk FG, Wobrock T, Gruber O, Scherk H, Berner D, Kaizl I, Kierer A, Müller S, Oest M, Meyer T, Backens M, Schneider-Axmann T, Thornton AE, Honer WG, Falkai P. Hippocampal plasticity in response to exercise in schizophrenia. Arch Gen Psychiatry. 2010 Feb;67(2):133-43. 

[13] Sylvia LG, Salcedo S, Bernstein EE, Baek JH, Nierenberg AA, Deckersbach T. Nutrition, Exercise, and Wellness Treatment in bipolar disorder: proof of concept for a consolidated intervention. Int J Bipolar Disord. 2013 Oct 1;1(1):24.