It’s a well known fact, at least among those who work out, that exercising helps with mental wellbeing in many ways. However, what isn’t well understood is whether exercise can be a part of the cure for mental health problems. In fact, in an introduction to a research paper, Exercise For Mental Health, published in the Journal Of Clinical Psychiatry, the researchers say that, “the importance of exercise is not adequately understood or appreciated by patients and mental health professionals alike. Evidence has suggested that exercise may be an often-neglected intervention in mental health care.”
That paper was written in 2006, and 16 years later, sports psychologist and peak performance analyst Dr Chaitanya Sridhar says that the approach hasn’t changed much. However, she says that there has been a slight change in attitudes towards using fitness as part of mental health treatment. “The positive mood shift (from simple exercises) is so underestimated even today. We are still at a point where we care about how we look more than about how we feel. Psychological health seems to always lose to the quest for a perfect body when it comes to weighing the pros of exercising,” she says.
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Sridhar says that exercise makes you connect with your body like no other activity. She includes yoga and pranayam in this, as these are tools she has used in the past, alongside conventional physical activity, for treating athletes who have had eating disorders and anxiety. Sridhar has worked with the Indian Premier League (IPL) franchise Royal Challengers Bangalore, the Indian Super League (ISL) team Bengaluru FC, and the Indian hockey team, among other professional sports setups.
“The bigger worry during the lockdown was athletes losing their frame of mind due to a lack of physical activity, rather than losing their muscle mass. We made Covid the culprit but it helped us realise that the body is always catching up to the mind,” she says.
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Without trivialising common mental health issues like stress and anxiety, Sridhar says that she suggests using physical activity to aid the treatment of diagnosed issues like Attention Deficit Hyperactivity Disorder (ADHD) and depression. In fact, a study, Physical Exercise In Major Depression: Reducing The Mortality Gap While Improving Clinical Outcomes, published in 2019 in Frontiers In Psychiatry questioned why exercise wasn’t being used more as a supplement to treat depression. “A common misperception is that exercise is beneficial for depression mostly because of its positive effects on the body (“from the neck down”), whereas its effectiveness in treating core features of depression (“from the neck up”) is underappreciated. Other long-held misperceptions are that patients suffering from depression will not engage in exercise even if physicians prescribe it, and that only vigorous exercise is effective,” it states.
The basic science behind this is quite simple. Exercise changes the way hormones affect your system: it releases the right hormones, and this balances out the ones that can be problematic (like cortisol or thyroid). “When you workout, your brain naturally releases dopamine and serotonin; this helps in keeping you calm and content and regulates emotions in your body, manages stress and improves sleep. Exercising can also improve your cognitive ability since it makes you sharper, more alert, and improves your memory and learning capacities,” says Nicole Menezes, a sports psychologist and therapist based out of Mumbai. She is currently working with the U17 Indian Women’s Football Team, which is due to play in the FIFA U17 Women’s World Cup in India later this year.
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Menezes agrees that exercise should be married with therapy for the best results. She says that a combination of both “provides a safe space to share one’s concerns and feelings; trains them with healthy coping strategies to manage stressors and expands the window of tolerance.” When one starts getting results from working out, there is a huge boost to self-esteem, something that suffers most in depressive states. There is also a need for more therapists to recognise exercise as part of treatment.
“I was recommended to add exercise into my routine to reduce my anxiety and depressive symptoms,” says Menezes. “While the medications helped, its side effects led to weight gain and gastro-intestinal issues. As much as I resisted it, I added exercise to my everyday routine, making it my primary self care practice. Engaging in self care, which means showing up for my workouts even on my toughest days with zero motivation and energy, helped me reap the benefits of exercise. Post workouts, though I was sore, I experienced an instant change in my mood. I felt energetic, with a sense of efficacy and accomplishment which kept me from ruminating negative thoughts and worry.”
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Which brings us to how much exercise will trigger the good feels. Both Sridhar and Menezes say that even 2-5 hours of exercise a week, which includes activities like brisk walking, swimming, and cycling (and not necessarily going to the gym) is a great starting point. “Three months of working out helped my symptoms reduce drastically and soon I was off medication,” Menezes says.
There is no one-size-fits-all treatment for mental health. However, being sedentary has a high chance of increasing any symptoms you might be feeling, and exercise is a great way to refocus your energies on connecting with the body, says Sridhar. “When we look at cats or dogs or animals we live with domestically, we feel something is wrong with them when they stop moving around. Our species is meant to move, and the proof is in the fact that the body responds kindly to exercise. It alleviates guilt as well, when it comes to eating and there is a lot more respect for your own self when you workout and achieve.”
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