Mental health disorders such as depression and anxiety aren't easy to treat. Medications help many but have a high failure rate and may bring nasty side effects. Talk therapy is time-consuming and expensive. And neither approach is suited to preventing the disorders from developing in the first place.
But many people overlook another option that, when it works, can be one of the most effective, least disruptive and cheapest ways of managing mental health disorders: Exercise.
It's hardly news that exercise is good for your physical health, and has long been extolled as beneficial for mental health, as well. But researchers are now making progress in understanding how exercise works its mental magic.
Exercise, they are learning, has profound effects on the brain's structure itself, and it also provides other, more subtle benefits such as focus, a sense of accomplishment and sometimes social stimulation - all of which are therapeutic in their own right. And while more is generally better, even modest levels of physical activity, such as a daily walk, can pay big dividends for mental health.
"It's a very potent intervention to be physically active," says Anders Hovland, a clinical psychologist at the University of Bergen in Norway.
But that knowledge has barely begun to percolate into practice, says Joseph Firth, a mental health researcher at the University of Manchester in the United Kingdom. Just ask a hundred people receiving mental health care how many are getting exercise prescriptions as part of that care. "You wouldn't find many," Firth says.
Some of the strongest evidence for the mental benefits of exercise centers on depression. In 2016, Hovland and his colleagues searched the published literature and identified 23 clinical trials that tested the effectiveness of exercise in treating depression. Exercise was clearly effective and, in a few studies, on par with antidepressant drugs, the researchers concluded.
And exercise offers several advantages. For one thing, antidepressant medications generally take several weeks to show their full effect. Exercise can improve mood almost immediately, making it a valuable supplement to front-line treatments such as drugs or therapy, says Brett Gordon, an exercise psychology researcher at the Penn State College of Medicine. Plus, he says, exercise can counteract some of the unpleasant side effects of antidepressants, such as weight gain.
In addition, exercise has few of the negative side effects common with drugs. "Many people who have mental health concerns are not enthusiastic about starting a medication for the rest of their lives, and are interested in pursuing other options. Exercise might be one of those options," says Jacob Meyer, an exercise psychologist at Iowa State University.
There's now emerging evidence that exercise also seems to help in treating or avoiding anxiety disorders, including post-traumatic stress disorder (PTSD), and possibly other serious psychotic conditions, as well. "The more we do these studies, the more we see that exercise can be valuable," Firth says.
But researchers are still figuring out how muscular exertion acts on the brain to improve mental health. For most biomedical questions like this, the first stop is animal experiments, but they aren't as useful in studies of mental health issues.
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