Exercise could be the first line of attack in mental health treatment
Linking exercise with improved mental health outcomes is certainly not a new concept, with previous individual studies looking at the effects of physical activity on schizophrenia, anxiety and depression, as well as analysis of the duration and type of workouts.
But researchers have now undertaken the most comprehensive meta-analysis of its kind, looking at nearly 100 studies featuring all modes of physical activity on depression, anxiety and psychological distress across broad adult populations to conclude that it’s as effective, if not more so, than psychotherapy or pharmacotherapy as an initial treatment.
“Physical activity is known to help improve mental health," said Ben Singh of the University of South Australia, co-author of the study. “Yet despite the evidence, it has not been widely adopted as a first-choice treatment. Our review shows that physical activity interventions can significantly reduce the symptoms of depression and anxiety in all clinical populations, with some groups showing even greater signs of improvement.”
One in eight people across the globe live with some kind of mental disorder, according to the World Health Organization, and most sufferers don’t have access to adequate medical care for their conditions.
The data was analyzed from 97 reviews featuring 1,039 trials and 128,119 participants. The studies included 27 on cancer patients, 11 on adults with depression, five each on older adults and dementia, four each on postnatal or postpartum women, chronic obstructive pulmonary disease, and multiple sclerosis, three each on anxiety disorders, cardiovascular disease, adults with various chronic diseases, and healthy adults. The remaining 15 covered a range of mental and physical health concerns such as post-traumatic stress disorder, arthritis and rheumatic disease, neurological disorders, schizophrenia and HIV/AIDS.
The team found that different modes of exercise offered different physiological and psychosocial benefits, and it backed up previous thought that resistance training had the largest impact on people with depression, and mind-body-focused workouts such as yoga, and higher intensity exercise, were the best performers for those with anxiety.
The data also confirmed previous individual trials that showed moderate- and high-intensity activity to have the most effective on relieving both depression and anxiety symptoms. This is partly due to neuromolecular mechanisms at play, such as increased availability of serotonin and norepinephrine. As such, low-intensity physical activity may not provide the same benefits for stimulating neurological changes in those with depression and anxiety.
Interestingly, the data concluded that the largest benefits appear to come from shorter interventions, with small weekly durations of physical activity being more effective than longer. Researchers suggest it could be that shorter bouts are easier to comply with, especially when participants are already faced with mental and physical health challenges.
“Higher intensity exercise had greater improvements for depression and anxiety, while longer durations had smaller effects when compared to short and mid-duration bursts,” said Singh, adding that there was a benefit from all types of activity analyzed in the studies, but tailoring to the specific mental health challenge was key. “Importantly, the research shows that it doesn’t take much for exercise to make a positive change to your mental health.”
The studies accessed were limited to peer-reviewed work across the databases CINAHL, Cochrane, Embase, MEDLINE, Emcare, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, PsycINFO, Scopus, Sport Discus, EBSCOhost and Web of Science.
While the study does not pit physical activity as an alternative to therapies such as counseling and medical treatment, it highlights the need for physical activity – tailored to the capabilities of the patient – to be treated as an essential facet of the overall mental-health approach.
With access to mental health services a prohibitive factor in treatment worldwide, the researchers believe that further studies into physical activity as a frontline therapy has the potential to benefit many of the estimated 970 million people living with mental disorders.
The umbrella study was published in the British Journal of Sports Medicine.
Source: University of South Australia