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For an accurate diagnosis of a mental health disorder, you should seek an evaluation from a qualified mental health professional.
Exercise and Mental Health
The Australian Department of Health has reported that up to one in five Australians aged 16-85 experience a mental illness in any year (3.2 million Australians) and almost half of all Australians experience a mental disorder at some point in their lifetime. There is no doubt that 2020 has thrown some serious curve balls at the community and now more than ever it is important to be taking a proactive approach to our mental wellbeing. With the recent R U OK? Day, I thought this would be a great time to kickstart the discussion around exercise and mental health.
In addition to the above, here are a few quick statistics surrounding mental wellbeing in Australia according to a 2017 report released by the Australia Bureau of Statistics:
- Suicide is the leading cause of death in those aged 15-44 years
- Suicide is the second leading cause of death in those aged 45-54 years of age.
- Mental disorders also lead to a higher risk of cardiovascular disease, with relative risk of death approximately 2.2 times greater.
So, what is the link between Exercise and Mental Health?
There is a significant amount of research and evidence to support exercise as a way of reducing the risk of poor mental health, improving mental health and as an effective adjunctive treatment for those diagnosed with a mental health condition. Governing bodies who have officially endorsed exercise as part of the treatment for poor mental health include:
- The Royal Australia and New Zealand College of Psychiatrists
- The American Psychiatric Association
- The National Institute for Health and Care Excellence (UK)
- The Canadian Psychological Association
As further research into various methods of treating and preventing mental health disorders continues to emerge, there is mounting evidence to support the intervention of exercise, delivered by an Accredited Exercise Physiologist or experienced fitness coach.
A few more stats on exercise and mental health:
- 12% of cases of depression could have been prevented by just one hour of exercise per week (2018)
- A 2018 article in the American Journal of Psychiatry has identified that physical activity can help to avoid the development of depression irrespective of age or geographical location.
- Exercise shown to significantly decrease symptoms for those who have already been diagnosed with depression.
- Exercise has also been proven to improve physical and mental health in those already diagnosed with depression.
So exactly how should someone with a mental health condition exercise?
So we know how important exercise is for mental health, but in reality – how do we do it? In my experience, the following 3 points are key in an exercise program for anyone, healthy, or otherwise:
Your program should tick off the above three points in order to set yourself up for success. Make sure you start small and build as exercise becomes part of your normal routine.
Below are some guidelines as to how you should tailor your exercise program for specific mental health conditions.
Frequent exercise has been shown to be effective in reducing the symptoms of major depression. Exercise should include both aerobic (increased heart rate) and resistance training. A recommended intervention is as follows:
30-60 mins, 3 or more days per week.
Activities such as cycling, walking, swimming, jogging, etc.
30-60 mins, 3 or more days per week.
Suggested to start with 3 sets x 8 repetitions of each exercise.
Resistance training can also include other activities that require use of body strength such as gardening.
*It is important to note that exercise at all intensities have been proven to be effective in managing symptoms of depression. Therefore, exercise at all intensities should be considered beneficial and the intensity level should not be a barrier to participation.
Anxiety is prevalent in our society and can present in many ways and to varying degrees. It has been reported that in Australia as many as 33% of women and 20% of men will experience an Anxiety Disorder at some point in their life. The Black Dog Institute has advised that exercise can assist to alleviate symptoms of anxiety by:
- Increasing energy levels
- Improving sleep
- Distracting from worries and rumination
- Providing social support and reducing loneliness, if exercise is done with other people
- Increase a sense of control and self-esteem, having an active role in our own wellbeing
The Black Dog Institute have also advised that “Exercise does not need to be extremely vigorous to be helpful for anxiety, even a brisk walk each day can be beneficial.”
The recommended intervention for Anxiety disorders is to exercise for 30 minutes, three times per week. There is no specific intervention recommendation with regards to the type or intensity of exercise. It is also worth noting that just 10 minutes of exercise per day can lift your mood and decrease fatigue levels! With this in mind however, remember that a very high intensity workout can increase stress levels and may be counterproductive. Each individual will experience this differently and it is about personal preference.
Bipolar Affective Disorder (BPAD) is identified by a swing between a low/state of depression and a high/state of mania. Each individual will experience these differently and each stage can be short-term or last months at a time. The below table is an example of some of the behaviours displayed during each phase:
Depressive (Low) Phase
Manic (High) Phase
Low or flat mood
More easily excitable
More likely to engage in unhealthy activities such as gambling
NB: This is not an exhaustive list and will vary between clients.
Practical implications for exercise and mental health with BPAD
Exercise recommendations are similar to general population in that they recommended dosage is to accumulate 150-300 minutes of moderate activity or 75-150 minutes of high intensity exercise across a week. The aim is to be active on most days of the week. Exercise type and intensity however, should change depending on the BPAD status of the individual.
In a depressive or low phase, a person will likely experience low energy and motivation. In this phase, any and all participation in exercise is beneficial, however where possible it is best to implement exercise with the following characteristics:
- Higher intensity
- Fun and engaging (find a training buddy!)
When in a manic/high phase, they are likely in a state of over-stimulation and increased sympathetic nervous system activation. In this situation, exercise should be used to calm and focus on movement / mindfulness. Be careful not to overload the sympathetic nervous system by performing high intensity or duration stressful workouts. Exercise such as yoga, stretching and lower intensity activity are recommended here.
Remember, speaking to your GP is always recommended if you are experiencing and psychological or physical concerns.
If you are experiencing any symptoms, please remember the following resources are available and always willing to talk:
- Lifeline: 13 11 44
- NSW Health Mental Health Line: 1800 011 511
- Beyond Blue: 1300 22 4636
- Kids Helpline: 1800 55 1800
Sam Rooney, Accredited Exercise Physiologist
The Department of Health, Prevalence of mental disorders in the Australian population
Australian Bureau of Statistics, Causes of Death Australia 2017
Exercise & Sports Science Australia, Exercise and Cancer eBook
National Center for Biotechnology Information, The benefits of exercise for the clinically depressed
Black Dog Institute, Anxiety