By Caroline Heaney

Campaigns and initiatives such as World Mental Health Day have helped to raise awareness of mental health difficulties (e.g., Norwich City FC video below). Mental health difficulties can affect anyone – it is estimated that 1 in 4 people experience a mental health problem each year, which means that most of us will be affected by a mental health condition at some point in our lives, either directly or through someone close to us. It is vital that once someone has taken the difficult step to disclose mental health difficulties they can access the right treatment and support, however, the NHS is struggling to meet the demand for mental health services. It is estimated that only 1 in 3 people with common mental health difficulties are getting the treatment they need. There are various treatment options available including talking therapies and medication, but medication is reported to be the most commonly used treatment for mental health problems. In recent years there has been a significant rise in the number of people taking antidepressant medication, which comes with a huge financial cost to the NHS, and it has been suggested that non-pharmacological treatments should be prioritised for those with mild to moderate depression. If only there was a low-cost treatment with few side effects and many additional health benefits. Well there is – exercise!

Exercise has long been recognised as an effective intervention in both the prevention and treatment of mental health conditions. For example, in their meta-analysis of the literature exploring exercise in the treatment of depression Heissel et al. (2023) found exercise to be an effective treatment for those with depression. Similarly, exercise has also been found to be an effective tool in the prevention of depression (Hu et al., 2020). The simple logic behind the link between exercise and mental health is that exercise can make us feel better. This means that exercise can benefit your mental health whether or not you have a diagnosed mental health problem. As well as combating diagnosed mental health conditions such as depression, exercise can enhance mood and reduce stress levels, thus allowing us to tackle daily challenges in a more positive, optimistic and constructive way. Up and down the country there are many people who are advocates for the beneficial role of exercise in preventing and treating mental health conditions. A few years ago I was lucky enough to meet a group of inspiring people who were referred to a scheme which involved prescribing exercise as part of a programme to tackle mental health conditions such as depression and anxiety. A clear message from these participants was that exercise was a powerful tool in helping them to combat mental health challenges. They described exercise as a far more positive treatment than medication.

Image by Moondance from Pixabay

Potentially, exercise can be used to treat mental health problems in place of or in addition to medication and other therapies, but in order for patients to benefit, medical professionals need to be confident in its role as a treatment and have access to suitable programmes to which they can refer their patients. In the past exercise referral for mental health reasons has been relatively uncommon, but in recent years there has been a drive to increase such ‘social prescribing’. For example, in 2022 a £12.7million scheme was launched in 11 local authorities for GPs to prescribe physical activity for those experiencing a range of physical and mental health conditions.

There lots of evidence to show that exercise can have a positive impact on mental health, but why is this the case? What is it about engaging in physical activity that leads to enhanced mental health? There is no one theory or hypothesis that has been universally accepted to explain the link between exercise and mental health. Instead, several different hypotheses have been proposed. These can be split into two categories: physical or psychological explanations (see Table 1). It may be that a combination of factors is causes improvements in mental health, rather than one factor alone. Additionally, because people differ greatly, explanations for improvements in mental health may vary according to the individual concerned.

Table 1: Examples of physical and psychological explanations for the relationship between exercise and improved mental health (adapted from Weinberg and Gould, 2015)

Conclusion

It would appear that exercise can be a highly effective tool in the prevention and treatment of mental health conditions. Exercise is a comparatively low cost treatment that can be used on its own or as an adjunct therapy and has virtually no side effects. In addition, it can tackle many other health conditions such as hypertension and heart disease. Surely prescribing exercise to treat mental health is a no brainer!

To find out more on this topic try our free OpenLearn course Exercise and Mental Health.