1 Exercise and mental health
Activity 1 The psychological benefits of exercise
Timing: Allow about 30 minutes
View the Mental Health Foundations’s guide on ‘How to look after your mental health using exercise’. [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)]
Make a list of the key psychological benefits potentially associated with participating in physical activity and some of the research studies that support these beenfits.
Comment
The key benefits noted within the guide are:
- Exercise is associated with increased mental alertness.
- Exercise can lead to an increase in energy and positive mood.
- Exercise can lead to an increase in self-esteem.
- Exercise results in the reduction of stress and anxiety.
- Exercise can prevent the development of mental health problems.
- Exercise can improve the quality of life of those who are experiences mental health problems.
Activity 2 Evidence to support the link between physical activity and mental health
Timing: Allow about 30 minutes
In the previous activity you examined some of the evidence that links participation in physical activity with improved mental health. In this activity you will examine the importance of such research and the types of research evidence that exist.
Listen to Track 1, ‘Physical activity and mental health: what’s the evidence?’, and complete the tasks below. In this clip you will hear Dr Gaynor Parfitt and Professor Adrian Taylor discussing the evidence that exists to support the notion that there is a link between physical activity and mental health. Dr Parfitt and Professor Taylor are exercise psychologists at the University of Exeter, specialising in this field of research.
Download this audio clip.Audio player: Physical activity and mental health: what's the evidence?
Transcript: Physical activity and mental health: what's the evidence?
Prof. Adrian Taylor - Exercise Psychologist, Exeter University:
When I speak to students and people involved in exercise programmes, there's hardly anybody I ever meet that says that exercise doesn't make you feel better. So, obviously, people continue doing exercise, [and because] they feel better, they continue doing it. When it comes to looking at the scientific evidence for whether physical activity improves mental health, it becomes a very different challenge. Why is that question important? Because it might lead to extra resources within healthcare services being directed into exercise programmes for treating people with mental health problems. So accumulation of scientific evidence is paramount in an evidence-based health service. So what evidence is there for exercise improving mental health for different conditions? Let me first start by looking at exercise and the treatment for depression. Many studies have been conducted on the effects of physical activity and depression, not quite so many on people with defined clinical levels of depression, but in those studies that have, there is a general consensus that exercise does help reduce depression.
Dr Gaynor Parfitt - Exercise Psychologist, Exeter University:
One of, perhaps, the most robust [proofs] is [evidence] from some epidemiological research that's actually showing that, if certain criteria are met for a health problem that's being treated by a certain intervention, if there's consistency of data across gender, for example, if there's coherence across nations for the effect size – how big a change occurs. For all of those things, depression certainly has been shown to be improved [as a result of] physical exercise.
Prof. Adrian Taylor - Exercise Psychologist, Exeter University:
Not always, and if you look at the more rigorous trials, a more recent review that came out in 2009, by Mead, identified that the most rigorous trials actually don't support the very strong benefit of exercise compared with nothing. Exercise does help, compared with cognitive behavioural therapy; the benefits are similar. So overall, it becomes really difficult to say, does exercise work or not? The jury may still be out. If you conduct studies, for example, where the people who are assessing depression are not aware of whether the person is doing exercise or not, then those studies don't show as strong an effect.
Dr Gaynor Parfitt - Exercise Psychologist, Exeter University:
There's also been some dose response research that's shown that, if we measure people and their levels of psychological health that are exercisers, versus those that aren't, they've actually identified that exercising and accumulating a certain amount of physical activity over a week does have a protective effect against future depression.
Prof. Adrian Taylor - Exercise Psychologist, Exeter University:
So there are problems with some of the research that has been done over a period of 30 years. Maybe the standard – the level of scientific evidence – isn't quite as strong as it might be, say, for a drug trial with double randomised blind effects, and so on. So the jury may be out. Although if you ask most people, they would say that exercise makes you feel better.
Dr Gaynor Parfitt - Exercise Psychologist, Exeter University:
Depression has the strongest relationship [with exercise]; for anxiety and self-esteem, the effect sizes aren't as strong. And typically, we look at exercise as an adjunct treatment rather than, potentially, as just a stand-alone. So when we use it with psychotherapy, or with drug therapy, then it certainly has been shown to provide an additional benefit.
Prof. Adrian Taylor - Exercise Psychologist, Exeter University:
In terms of other mental health conditions, we might think about stress and anxiety. And, again, there is evidence that exercise reduces general levels of anxiety over time and, also, … – on a transient level from each exercise session – there may be reductions in anxiety and, perhaps, also reactivity to stress. So, for example, to put that last statement into practical terms, if you exercise just before an interview with your boss or a stressful moment, it may be that your blood pressure and your reactivity to that stress aren’t as great after a single bout of activity. So there is evidence that exercise does reduce our general levels of anxiety and arousal, including blood pressure and so on. In terms of other mental health conditions, the typical ones that we think about that have been most reported in the literature might be more severe mental illnesses, such as schizophrenia. The evidence there really is that it's not going to change your medical condition. It may improve some of the symptoms, some of the feelings of mood and worthlessness, but it's not going to change [you]. It's not going to be a total treatment for a psychotic illness, but it certainly would improve quality of life and, again, there is an evidence base that's improving there. For example, somebody with severe mental illness, often due to side-effects of medication, [may] put on large amounts of weight, so exercise could be used as part of that weight management programme, which, in turn, improves people's self-esteem, and so on.
Physical activity and mental health: what's the evidence?
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- Make a list of the types of research they discuss (e.g. epidemiological research). Search for definitions of these types of research using the internet.)
- Why is it important to provide research evidence of the link between exercise and mental health?
- What is said about the quality of some of the research that exists?
Comment
- Dr Parfitt and Professor Taylor discuss two main types of research:
- Dose–response research. As the name suggests, dose–response studies involve participants being given a dose of something, after which their response is measured. In this case, participants would be given a ‘dose’ of physical activity and the impact on their mental health (response) measured.
- Epidemiological research. Epidemiology is the study of the incidence, prevalence and control of health and disease across a population. In the context of this activity, epidemiological research would therefore be interested in patterns of mental health and physical activity across a population.
- Professor Taylor suggests that the more evidence there is for a positive link between physical activity and mental health, the more likely it is that healthcare services will be directed towards providing exercise as a treatment for mental health conditions. Unless evidence can be provided, the government will not invest in exercise as a treatment for such conditions.
- Professor Taylor suggests that although most people believe that exercise makes you feel better, the quality of research examining exercise and mental health is not always as good as it could be. This is often because it can be difficult to control physical activity.