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Does Exercise Improve Your Mental Health

Recently, I purchased a new pair of running shoes. As I ran along Alki Beach in Seattle, it didn’t take long before my body started to release some upper body tension (likely caused from sitting in front of the computer!), and my mind dropped its thoughts about appointments, seminars, writing projects, and the usual pile of mundane tasks. Passing runners, bikers, walkers, and inline skaters, I wondered how many of these everyday exercise enthusiasts were dedicated to the maintenance of their mental health as much as their physical health. Does exercise improve your mental health?

photo placeholder. Original ink drawing by Imei Hsu.
photo placeholder. Original ink drawing by Imei Hsu.

After a cursory look at the latest articles and studies on topic of exercise and mental health, most of the authors agree on several items. One of these items is simple: while we don’t know WHY exercise improves mental health symptoms, they all agree that exercise is beneficial in the treatment of mental health disorders and distress.

Most articles focus on the relationship of exercise to depression and anxiety. Some ways exercise can help with depression and anxiety symptoms are:

– improving circulation (warming the body), which appears to be calming
– releasing “feel-good” brain chemicals, like norepinephrine and pain-killing endorphins
– reducing immune system chemicals that increase depression symptoms*
– improving self-esteem as exercisers reach particular markers of achievement, skill, or improved appearance.
– encouraging exercisers to socialize in public or small group settings

If I Exercise, Can I Get Off My Medication?
For those of you reading this blogpost in the hopes of finding “proof” that the “best” treatment for your anxiety or depression symptoms is exercise in lieu of other standard treatments, I implore you to educate yourself thoroughly on the subject. You won’t find a single article written by any vetted researcher or physician who will claim that s/he knows you can exclusively treat all mental health symptoms with exercise. In fact, what you will find are articles, dissertations, and journal pieces with the words, “appears”, “seems”, or “is likely to be related to” as ways to indicate an unclear and under-researched topic and relationship. Again, while researchers have observed improvements in mentally ill patients who exercise regularly, we’re still a long way from saying we know how to prescribe exercise like it’s a cure (blame it on the youth of this field).

By observation alone, researchers can point to the apparent benefits of exercise on mental health and distress. They just can’t prove the specific relationship between exercise and mental health improvement with statistically-significant causation: that is, they cannot scientifically outline exactly how exercise reduces the symptoms of mental health disorders such as depression and anxiety.

So What Now?
What does this mean for you if you are taking a medication to treat anxiety or depression, or your doctor has recommended that you start one? For starters, you can always speak to your doctor about your medications, their effects and side effects, and alternatives to psychotropic medication treatment, and in fact, I highly recommend that you do! These medications are powerful, and while the benefits may outweigh the costs, some of the costs are problematic and disturbing (click on the link to see some of the Mayo Clinic’s list of side effects for anti-depressants). You owe it to yourself to be thoroughly informed before starting any medication therapy.

Secondly, being on a medication does not mean you cannot begin an exercise program! Concurrent therapies like exercise, psychotherapy sessions, and medication are 1-2-3 approaches that have seen reasonable success in treating mental health distress. While you’re at it, you can also look into changes in your nutrition and sleep/rest cycles to see how you can improve how you feel when the worst of your symptoms flare.

Thirdly, the benefits of exercise on mental health disorders are not usually felt immediately. I think you should keep this in mind when you hit Week 2 of your brand, spanking-new exercise regimen, and your entire body shouts at you that it would rather stay in bed and self -medicate with chocolate.  Some of the articles perused indicate that the best mental health benefits are seen after about nine weeks of consistent exercise (and about now, you’re realizing why some people find it very convenient to either pop a pill, or binge on alcohol and “herbs”) . Consistent exercise is considered a minimum of thirty minutes of moderate to strenuous cardio-pulmonary activity three to five days a week, and some exercisers may find that this minimum is not enough to experience the “feel good” benefits. While a person is starting a new exercise program, this program does not substitute for medication or talk therapy. It’s more realistic to think of exercise as an adjunct and not a replacement to your current mental health treatment strategy, until exercise can become a more essential element of the overall treatment (and that option is a possibility for some people).

Most people will experience uncomfortable and dramatic side effects if s/he suddenly stops taking medication, such as nervousness, poor sleep and insomnia, agitation, and depression symptoms. Again, talk to your doctor about whether and when it is advisable to stop medication therapy, and devise a tapered plan along with a supportive treatment strategy.

As for myself, I will continue to inline skate, run on occasion, ride my bicycle in the summer, surf when I get the chance to travel to exotic beaches, and dance (as always). I openly admit that I participate in these activities as much for exercise as I do for the stress-relieving benefits that make my mind feel happy and free. Just because I don’t have scientific evidence that exercise will improve my mental health does not deter me from weighing the observational and physical benefits of regular exercise.

BTW, I think it might have been Madonna who once went on record to say that she thought sex was like exercise (at least, the way she had sex!). My Fitbit and the NikeFuel points system seem to indicate a similar thought. Wearers of these activity info-transmitting devices collect data that includes calories spent or points earned for sexual activity. Translation: yes, sex could be considered an activity to count calories burned and has mental health benefits (besides being loved on).  Just thought some of you might like to know!

Now it’s your turn. Do you have good enough reasons to discuss with your doctor about starting an exercise program? What are your personal barriers? Can exercise be an adjunctive therapy alongside your current mental health treatment strategy? Share your comments here [and you do not have to indicate whether you are in treatment for a mental health issue].

* For a deeper look at the relationship between an over-active immune system and depression, check out the late researcher Ronald Steven Smith’s work on biochemistry and neuroscience, including his unedited work on the relationship between cytokines and depression.

Disclaimer: I am not a physician, and I am not prescribing an exercise program for you. I am a Registered Nurse and a licensed mental health counselor (licenses publicly posted), and I practice from these two licenses, including discussions on the latest findings and professional opinions on a variety of subject matters.

Editor’s Note 04/26/2012: While I don’t adhere to the majority of Gizmodo’s articles, here’s one on earbuds for audiophile fitness users that was worth reading if you’re in the market for a new pair. There is measurable evidence that listening to music while exercising  can help people exercise longer and happier.  I don’t stand to profit by any recommendations of product on this site (except my own upcoming book!), but as a consumer geek, I like saving people money and time to find what works for them. Enjoy!


By Imei Hsu

Imei Hsu is a mental health counselor, active retired RN, AIP Coach and PN1-NC, writer, triathlete and arts promoter in the Seattle area and through online services. With 30+ years in healthcare (22+ years in mental health), Imei has a commitment to helping people discover insight into their health, relationships, and connecting. She is the owner of Seattle Direct Counseling and the blog, a presenter and speaker on a variety of psychological topics, and a positive force on the Internet. She launched her personal project, My Allergy Advocate, in 2018. Imei is a two-time Ironman Finisher (Mont-Tremblant 2016, Ironman Canada 2018); she also finished her first ultramarathon in 2017 and has gone on to race the 100K distance while preparing for 100 Mile trail races and a backyard ultra. You can find her running everywhere and eating all the thingz, watching movies, camping under the stars, and cooking real food.

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