The Role of Exercise in Mental Health


As we celebrate ESSA’s 30 year anniversary, we will be looking at the different health areas of the exercise and sports science industry that have significantly grown over the last decade or two.

One of these is the role of exercise in improving poor mental health and managing and treating mental illnesses. Although the work is still continuing, there has been a collection of researchers and practitioners who work tirelessly to continue educating Australians and the world that exercise is medicine for mental health.

Looking back
Mental illness has always been surrounded by stigma. Prehistoric efforts to treat people with ‘aberrant behaviour’ or mental illness might be considered barbaric at best and included removing a section of the skull in a procedure known as ‘trephination’, presumably to allow the demons inhabiting the skull a method of escape.

The first randomised controlled trial on exercise and depression was conducted in 1979, showing benefits comparable to psychotherapy. Although initially dismissed as ineffective for methodological reasons, researchers continued to examine how exercise might benefit people with mental illness.

In a nutshell, exercise improves mental health by reducing anxiety, depression, and negative mood and by improving self-esteem and cognitive function. Exercise also improves the comorbidities of mental illnesses, such as obesity, heart disease and diabetes.

Over 15 years ago, the evidence suggested that, despite the benefits, exercise was often a neglected intervention in mental health care and the importance of exercise was not adequately understood or appreciated by patients and mental health professionals alike.

Our understanding of the relationship between exercise and mental health has evolved considerably in recent years. Once viewed as ‘just’ a distraction from negative thoughts, exercise is now recognised as an evidence-based, fundamental component of treatment for a range of mental illnesses.

The mental health benefits of exercise extend beyond reducing the symptoms of common conditions such as depression and anxiety. Increasingly, the mental and physical effects of exercise are being used as an integrated part of routine treatment for psychotic disorders including schizophrenia, substance abuse disorders, eating disorders, and cognitive impairment.

There is now irrefutable evidence that exercise, even in small doses, is a valuable contributor in its prevention and treatment. Even 10 minutes of moderate-intensity exercise performed once per week can reduce the risk of future depressive episodes.

Plus, 16 weeks of regular exercise has been found to be equally effective as antidepressant medication in the treatment of mild to moderate depression.

Evidence exists for both aerobic exercise (e.g., brisk walking, cycling or jogging) and resistance exercise (e.g., weight-lifting) in reducing the symptoms of mental illness. Not to mention the benefits on our mental health that playing sports has.

Moving forward
In the industry, we then began to see more research be published on the benefits of exercise on our mental health.

In 2015, a consensus statement on the role of Accredited Exercise Physiologists within the treatment of mental health disorders: A guide for mental health professionals was published by ESSA with a team of researchers to inform the broader mental health sector of the types of interventions, modes of delivery, and benefits associated with the role of an Accredited Exercise Physiologist in mental health care.

Then in 2016, Dr Robert Stanton (who was part of the consensus statement team) was awarded the prestigious ESSA Medal for 2015 for his thesis on 'Developing an understanding of exercise in the inpatient mental health setting'. Dr Stanton's achievement further highlighted the growth in the exercise and mental health field.

From a national perspective, the benefits of exercise was being acknowledged more regularly in the Australian mental health sector. In 2015, the Royal Australian and New Zealand College of Psychiatrists (RANZCP) released the Keeping Body and Mind Together report which outlined the need for more to be done to address the gap in physical health and life expectancy between those who live with a mental illness and the general population. Then in 2016, the Mental Health Commission of NSW released the Physical health and mental wellbeing: Evidence Guide which discussed the importance of looking after our physical health in order to improve our mental health.

Both resources indicate the need for mental health professionals to refer to and engage with an Accredited Exercise Physiologist.

In 2017, a joint position statement with ESSA, Dietitians Association of Australia, and the Australian Psychological Society: Addressing the Physical Health of People with Mental Illness endorsed increased access to dietary and exercise interventions in addition to evidence-based psychological and medical treatment for individuals experiencing mental illness, as well as referral to appropriately qualified allied health professionals to address lifestyle issues and physical health needs (where indicated).

Internationally, the World Health Organisation (WHO) released the Management of physical health conditions in adults with severe mental disorders guidelines in 2018 which added to the global conversation to increase the recognition of physical activity that ESSA and the exercise and sports science industry have been a key part of.

Also in 2018, ESSA, alongside the American College of Sports Medicine, British Association of Sport and Exercise Science, and Sport and Exercise Science New Zealand, officially released a joint international consensus station: The Role of Sport, Exercise, and Physical Activity in Closing the Life Expectancy Gap for People with Mental Illness.

This was the first joint international consensus statement which aimed to define the key factors that must be addressed by key decision makers to increase access to appropriate exercise programs for people with mental illness and subsequently contribute to closing the life expectancy gap.

The statement identifies that exercise practitioners, such as Accredited Exercise Physiologists play an important role in improving the lifestyles of those with mental illness, with the ability to address major modifiable risk factors.

“Although not a magic bullet, physical inactivity is a key, modifiable risk factor that we overwhelmingly know how to address. Helping people experiencing mental illness to live active lives is not a gap in knowledge, rather a lack of implementation,” explained Associate Professor Simon Rosenbaum, lead author and mental health researcher, at the time of the international consensus statement release.

Since its conception in 2014, there has been a wide range of mental health blogs shared on the Exercise Right website, written by ESSA accredited exercise professionals, helping to promote the use of exercise in the treatment of mental health. Check them out here.

Then in mid-2018, ESSA published its first ever Exercise Right eBook, Exercise & Mental Health, serving as a free resource for people to find out more on how exercise can be beneficial for mental health and a range of mental disorders.
Exercise and mental health during COVID
With exercise being deemed an essential activity by the government and the World Health Organisation at the beginning of the COVID-19 pandemic, it’s been encouraging to see more people do their best to maintain movement or start getting active during the current crisis.

With the extreme stress that is being placed on all Australians, especially our front-line workers, exercise may also offer some protection against anxiety, and can help to manage symptoms for people living with an existing mental health issue like anxiety or depression.

It has also helped to reduce stress and keep our minds clear and focused during the pandemic.

ESSA and Exercise Right created the campaign, Exercise Right at Home at the beginning of the pandemic, to ensure people could continue keeping active during the lockdowns and the restrictions to support their mental health.

Although this research field is ongoing, thanks must go to the wide variety of researchers, clinicians and academics who work tirelessly in the field of exercise and mental health to promote its important. This includes Robert Stanton, Simon Rosenbaum, Bonnie Furzer, Oscar Lederman, Kristine Grainger, Angela Douglas, Kirrily Gould, Amanda Semaan, Louise Pontin, and Phil Ward.

If you'd like to find an ESSA Accredited Exercise Physiologist in your area who can help improve your mental health or manage a mental health disorder, visit our online search function today.

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Supporting health through exercise for 30 years 

To celebrate 30 years of Exercise & Sports Science Australia (ESSA), we are reflecting on 30 stories which commemorate the profound impact the exercise and sports science industry and its professionals have had on our communities, and how they have benefited the health landscape in Australia.

Click here to read more like this one