Study Confirms Physical Exercise Should Be First Choice for Mental Health Treatment

In a funk? Do you: a) reach for a bag of potato chips, b) call a friend, c) pop an extra anti-depressant, or d) head for the gym to sweat out the sadness? For years, studies have shown that exercise is one of the best ways to treat a range of mental health issues. A new analysis of that whole body of research makes this clearer than ever. This new study, which was conducted by a team of 13 Australian scientists, was published in February in the British Medical Journal’s British Journal of Sports Medicine. As the researchers explored, pharmaceuticals are usually the first response to mental health issues worldwide, with lifestyle adjustments like exercise, sleep hygiene, and a healthy diet considered merely as complimentary choices, at best. Even when lifestyle changes are recommended, they are seldom prescribed to patients in treatment by medical doctors. A Vast Evidence Base In order to synthesize the evidence on the positive and negative effects of physical activity on depression, anxiety, and psychological distress in adults, the Australian researchers performed an “umbrella overview,” a comprehensive analysis of all the work that has been done on the subject to date. The idea behind an umbrella review of this type is to try to quantify the strength of the signal. One scientific study provides some direct evidence that a treatment is useful; but when hundreds of studies confirm each other, taken together, these studies more strongly suggest that a treatment or intervention may be widely effective and applicable. Since so much research has been done in the field of exercise and mental health, the Australian team sought to examine the totality of the evidence. To that end, they looked at nearly a hundred reviews, comprising over a thousand studies done, on over 100,000 participants. In other words, they conducted a “systematic [review] of systematic reviews, synthesizing a vast evidence base.” Exercise Best Treatment for Depression Mental health is often pushed to the fringe of health care, but half of all people experience some mental health distress at some point in their lives, and more than 10 percent of people worldwide are currently struggling with mental health. Anxiety is the most common problem—and seems to be becoming more pronounced among children and younger adults—while depression poses the greatest burden to normal life function. The Australian researchers discovered that exercise provided the best results when used for treating depression. More specifically, exercise was 150 percent more effective than pharmaceuticals or Cognitive-Behavioral Therapy (CBT). It was also better than psychological consultation or “talk therapy.” In fact, exercise was shown to reduce depressive symptoms by 42 to 60 percent, whereas talk therapy and pharmaceuticals only reduced symptoms between 22 percent and 37 percent. Exercise was shown to be the best treatment for both anxiety and depression, even though pharmaceuticals are the most commonly recommended treatment for both. Any Kind of Exercise Works Every kind of exercise worked. The numerous studies looked at many types and schedules of exercise, and they all worked—doing any movement regularly (including dancing, walking, and yoga) was a big improvement over doing nothing. The researchers, however, also found that short, intense bursts of exercise worked best. HITT—“high-intensity interval training”—has become a trend in recent years, and perhaps for good reason. A number of studies the researchers cited that focused on these brief “high-intensity interval training” (HIIT) workouts have shown stand-out results across the board. But for older people, a simple daily walk of 20 to 40 minutes was also found to be particularly effective. While going for a walk, unlike doing a short, intense exercise burst, may not seem as glamorous or result in breaking a sweat, it is a better option for people who can’t safely do intense exercise. And those who took a daily walk greatly improved their mental health with this moderate, regular activity. Good for Pregnant Women and People With Chronic Conditions According to this study, exercise was especially helpful to the mental health of certain populations, including pregnant and postpartum women, people suffering from HIV, and those with kidney disease. Because the researchers looked at so many different studies, very different populations and subsets were looked at individually, and these groups of people stood out in particular. But even people who were otherwise physically healthy showed excellent improvement in their mental health by exercising. The Exercise Cure? As positive as the results of this review were, exercise isn’t a panacea that cures all mental health issues. People who are severely depressed or mentally ill may not be able to exercise at all, and people suffering from mental health disorders because of congenital physical causes or later-in-life illnesses or injuries also may no

Study Confirms Physical Exercise Should Be First Choice for Mental Health Treatment

In a funk? Do you: a) reach for a bag of potato chips, b) call a friend, c) pop an extra anti-depressant, or d) head for the gym to sweat out the sadness?

For years, studies have shown that exercise is one of the best ways to treat a range of mental health issues. A new analysis of that whole body of research makes this clearer than ever.

This new study, which was conducted by a team of 13 Australian scientists, was published in February in the British Medical Journal’s British Journal of Sports Medicine.

As the researchers explored, pharmaceuticals are usually the first response to mental health issues worldwide, with lifestyle adjustments like exercise, sleep hygiene, and a healthy diet considered merely as complimentary choices, at best.

Even when lifestyle changes are recommended, they are seldom prescribed to patients in treatment by medical doctors.

A Vast Evidence Base

In order to synthesize the evidence on the positive and negative effects of physical activity on depression, anxiety, and psychological distress in adults, the Australian researchers performed an “umbrella overview,” a comprehensive analysis of all the work that has been done on the subject to date.

The idea behind an umbrella review of this type is to try to quantify the strength of the signal.

One scientific study provides some direct evidence that a treatment is useful; but when hundreds of studies confirm each other, taken together, these studies more strongly suggest that a treatment or intervention may be widely effective and applicable.

Since so much research has been done in the field of exercise and mental health, the Australian team sought to examine the totality of the evidence.

To that end, they looked at nearly a hundred reviews, comprising over a thousand studies done, on over 100,000 participants. In other words, they conducted a “systematic [review] of systematic reviews, synthesizing a vast evidence base.”

Exercise Best Treatment for Depression

Mental health is often pushed to the fringe of health care, but half of all people experience some mental health distress at some point in their lives, and more than 10 percent of people worldwide are currently struggling with mental health.

Anxiety is the most common problem—and seems to be becoming more pronounced among children and younger adults—while depression poses the greatest burden to normal life function.

The Australian researchers discovered that exercise provided the best results when used for treating depression. More specifically, exercise was 150 percent more effective than pharmaceuticals or Cognitive-Behavioral Therapy (CBT).

It was also better than psychological consultation or “talk therapy.” In fact, exercise was shown to reduce depressive symptoms by 42 to 60 percent, whereas talk therapy and pharmaceuticals only reduced symptoms between 22 percent and 37 percent.

Exercise was shown to be the best treatment for both anxiety and depression, even though pharmaceuticals are the most commonly recommended treatment for both.

Any Kind of Exercise Works

Every kind of exercise worked. The numerous studies looked at many types and schedules of exercise, and they all worked—doing any movement regularly (including dancing, walking, and yoga) was a big improvement over doing nothing.

The researchers, however, also found that short, intense bursts of exercise worked best. HITT—“high-intensity interval training”—has become a trend in recent years, and perhaps for good reason.

A number of studies the researchers cited that focused on these brief “high-intensity interval training” (HIIT) workouts have shown stand-out results across the board.

But for older people, a simple daily walk of 20 to 40 minutes was also found to be particularly effective.

While going for a walk, unlike doing a short, intense exercise burst, may not seem as glamorous or result in breaking a sweat, it is a better option for people who can’t safely do intense exercise. And those who took a daily walk greatly improved their mental health with this moderate, regular activity.

Good for Pregnant Women and People With Chronic Conditions

According to this study, exercise was especially helpful to the mental health of certain populations, including pregnant and postpartum women, people suffering from HIV, and those with kidney disease.

Because the researchers looked at so many different studies, very different populations and subsets were looked at individually, and these groups of people stood out in particular.

But even people who were otherwise physically healthy showed excellent improvement in their mental health by exercising.

The Exercise Cure?

As positive as the results of this review were, exercise isn’t a panacea that cures all mental health issues.

People who are severely depressed or mentally ill may not be able to exercise at all, and people suffering from mental health disorders because of congenital physical causes or later-in-life illnesses or injuries also may not be able to avail themselves of physical activity to improve their moods.

But a great deal of the overall mental health burden is from common, mild-to-moderate mood disorders that appear to respond surprisingly well to exercise.

Other studies have shown that in medical science, there tends to be a 17-year research gap between the time when something is noticed in the scientific literature and when it is put into practice in doctors’ offices.

Yet the Australian researchers concluded that putting exercise at the forefront of treatment, augmenting it with counseling where helpful and drugs when needed, would be the best way forward to help the majority of people with the most common mental health issues, saving more aggressive interventions for issues that require them.

Mental health professionals don’t usually study exercise. But that is a mistake. Other recent research has shown that playing ping pong (table tennis) can help people suffering from Parkinson’s disease and that daily low-intensity physical activity (in the form of 10,000 or more steps, which is the equivalent of almost five miles) is actually associated with increased total brain volume and with less brain aging compared to people who exercised less or did not exercise at all.

The logical conclusion from this Australian comprehensive review dovetails with these other studies: exercise—not pharmaceuticals—should be the first choice for treating depression, anxiety, and distress for most patients.

But you don’t need to wait for your doctor to greenlight your new exercise regime. Close your computer, lace up your sneakers, and hit the ground running, or walking. Either way, your brain will thank you.

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