We all know that physical activity is said to be good for our mental health – so why are so many of us ignoring the evidence? Dr Claire Wicks takes at look at the research.
Physical activity has been described as a "magic pill". It is suggested that if everyone took their weekly dose of 150 minutes of moderate to vigorous physical activity, we would be much healthier as a population.
The World Health Organisation (2020) advises that five million deaths each year are preventable through physical activity, and those who are insufficiently active have a 20-30% increased risk of premature death.
Physical activity is known to have numerous physical and mental health benefits for general and clinical populations, as well as for healthy development of children and cognitive functioning in adults. Physical activity can not only protect our health and wellbeing, but also help us to recover from illness.
In the UK, the National Institute of Health and Care Excellence recommends physical activity as a treatment option for some mental health disorders, including mild to moderate depression. The World Health Organisation also advocates physical activity as a complementary strategy alongside other treatment modalities to prevent and manage mental health conditions.
There have been at least 60 literature reviews of the relationship between physical activity and mental health, each discussing multiple individual studies. These individual studies can be categorised into three types of physical activity:
- Exercise (planned and structured activity in a purpose-built exercise environment, for the objective of improvement or maintenance of physical fitness);
- Recreational (physical activity undertaken outside of a gym or fitness facility and where the main objective is for leisure or recreation); and
- Mind-based (physical activity that incorporates a mindfulness or meditative component).
In the exercise category, depression is the most frequently investigated outcome (15 studies). Other outcomes include anxiety (7 studies), mental health (5 studies), schizophrenia (3 studies), post-traumatic stress disorder (2 studies), stress (2 studies), bipolar disorder (1 study), and wellbeing (1 study). Exercise was found to be beneficial for all outcomes except for stress where results are inconclusive. The research studies also indicate that undertaking moderate to high intensity exercise is more beneficial than low intensity exercise for individuals with depression.
In the recreational category, depression (4 studies), wellbeing (4 studies) and mental health more broadly (5 studies) have been considered. For depression: forest therapy, exergames, and virtual reality were all found to be beneficial. Campus outdoor recreation, allotment gardening, conservation activities, football and dance interventions all improved wellbeing. “Wildland” recreation, including hiking, backpacking, camping, orienteering and skiing improved self-esteem. Football-based interventions were associated with significant improvements in psychological, social, and physical health in adults and youths described as having mental health illness, problems, or issues. There are mixed findings for the benefits of golf on mental health, with some indication that it may decrease stress and anxiety.
In the mind-based physical activity category, the outcomes studied were depression (4 studies), mental health (4 studies), post-traumatic stress disorder (2 studies), and wellbeing (1 study). Qigong (a system of coordinated body-posture and movement, breathing, and meditation) was found to be effective at reducing depressive symptoms in both general and clinical populations. Yoga was beneficial for depression and mental health and had a similar effect on depression as medication. Tai chi was not found to be effective for reducing depressive symptoms. Compared to other types of physical activity, yoga had a large effect on schizophrenia and a small effect on mental well-being. Yoga decreased symptoms of post-traumatic stress disorder, including re-experiencing and hyperarousal. Yoga also had a small effect on wellbeing and a moderate effect on quality of life.
Across the review papers considered, there is substantial evidence to suggest that various types of physical activity have the potential to effectively treat a range of mental health conditions. The benefits of physical activity for the treatment of depression are particularly compelling. However, despite the mound of empirical evidence, public health guidelines, and interventions to get people moving (e.g. Couch to 5K), around one in three men and nearly one in two women are insufficiently active to maintain good health and wellbeing.
It seems promoting the health and wellbeing benefits of physical activity is not enough and more needs to be done to help individuals overcome barriers to living sufficiently active lifestyles. This is an ongoing challenge, but a worthy one not only because of the substantial mental health and wellbeing benefits available to individuals, but the huge potential societal cost-savings through reduced demand on public health services.
For more research on this topic see:
Claire Wicks, Jo Barton, Sheina Orbell, Leanne Andrews Psychological benefits of outdoor physical activity in natural versus urban environments: A systematic review and meta‐analysis of experimental studies - Wicks - 2022 - Applied Psychology: Health and Well-Being - Wiley Online Library