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MIND

When it comes to exercise and mental health, one size does not fit all

Exercise is an important part of mental-health care, but it’s not the panacea, says Amy Jones. It’s crucial we accept that everyone’s needs are different

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By Amy Jones on

A new study of 1.2 million people has found that people who exercise regularly feel stressed and depressed on fewer days than people who don’t. The study, led by scientists from Yale University and Oxford University, showed that exercising for 45 minutes three to five times a week had one of the biggest benefits, and that people who exercised had 1.49 fewer days of poor mental-health in the last month than the non-exercisers. There was an even bigger gap in participants who’d been diagnosed with depression – the exercisers had, on average, seven bad mental-health days compared with the non-exercisers’ 11 days.

It’s a really interesting study, and builds on a history of research into the benefits exercise has for mental health. It also found that exercising too much (more than 23 times a month and/or in sessions over 90 minutes) actually worsens your mood, and that the benefits of exercise were visible across all genders, races and ages. Team sports seem to have the biggest benefit for our mental health, followed by cycling, then going to the gym, then jogging and then good old walking. Adam Chekroud, who is assistant professor of psychiatry at Yale University, said they think they can even use the results of the study to try and match people with specific exercise regimes to help their mental health, which is an incredible step forward for mental-health care.

But, while exercise helps for a lot of people, it isn’t a fix-all. For some people, like me, exercise has not been at all revolutionary in helping me manage my mood. The idea that exercise is a great way to fight depression comes up a lot, and it always makes me feel sad because I’ve tried to use exercise to help my mental-health problems for the past decade and it’s never actually worked.

If I'm in a mentally healthy/strong period, then it's easy to exercise and enjoy it. At my lowest it's just another tool to punish myself mentally

For the period that I’m running or swimming, I might not have the physical symptoms of anxiety – usually because they’re overwhelmed by my body screaming “OH, GOD, WHY DOES THIS HURT SO MUCH” – but having to actively think about a body that is the source of so many of my feelings of self-loathing and inadequacy really doesn’t do wonders for my depression. I’m not the only one who feels like this. Kirsty explained that: “If I'm in a mentally healthy/strong period, then it's easy to exercise and enjoy it. I feel a sense of achievement. At my lowest it's just another tool to punish myself mentally – ‘I'm so slow/weak/pathetic/look a big fat mess/everyone's laughing/I can't achieve anything’ etc.”

This isn’t to negate the benefits it can have for some people. The point is, there isn’t a “one size fits all” solution when it comes to treatment for mental ill-health. While exercise is frequently recommended to people feeling mentally unwell, it can also blind people to other gaps in the care many of us urgently need. One woman, who has borderline personality disorder and a history of self-harm, went to visit her GP after being taken off antidepressants. When she described how she was feeling much worse, the doctor suggested she try yoga. A friend in Northern Ireland went to the GP and was told he had no chance of receiving therapy without going private, but they would offer him a free gym membership instead. In what world is it acceptable to take away therapy because a gym membership is good enough to fight his chronic depression? “My impression,” he says, “is that exercise is often presented as a panacea for mental-health issues, including by GPs, which seems to set people up for disappointment and threatening any marginal gains they do receive.”

And we also cannot forget that it’s really hard to motivate yourself to exercise when you’re depressed. Jacki, who has had anxiety and depression all her life, says, “Now, I walk everywhere because I know it helps my mood, but in the past I’ve been severely depressed and the thought of exercise has been overwhelming because I can’t even leave the house.” Several people said that when they felt low, they knew that exercise would make them feel better but were too mentally and physically exhausted to bring themselves to do it, and the guilt and stress they felt because they knew they should be exercising could last weeks. It’s unfortunately not as simple as “just go for a run and feel better”.

Exercise is an important part of mental-health care, but everyone is different – and what works perfectly for one person might not have the same effect on another

I’d also be interested in learning more about the ways the physical movement itself is beneficial, and how much of it is the other aspects of exercise. For example, the study found that team sports were the most beneficial to mental health, but that even activity such as spending time with children or doing the housework helped. I’d be interested to know how much of the improved mood was down to endorphins due to movement, and how much was down to spending time with other people or having a sense of achievement and a lovely, tidy house.

When talking to people about this, they frequently mentioned other aspects of exercise as the thing that they felt was really boosting their mood. Elena said that she started exercising to help her mental health and was “bored and unhappy just going to the gym, running. But my mental health improved massively when I took up boxing and had a specific goal (a fight).” Becca, meanwhile, had tried lots of types of exercise to help with eating-disorder tendencies, and found that weight lifting and tracking her progress was the thing that seemed to really click. “But to be honest,” she added, “I think that's got less to do with the exercise & more to do with the consistency, habit-building.” While Becca and Elena are almost certainly getting mood-boosting benefits from their increased heart rate and endorphins, they seem to also really value this sense of achievement and the structure of having a goal to work towards. Exercise is a great way to get these things, but so is knitting (which worked for me), or baking (which worked for Marian Keyes), or learning all the words to Britney’s first album (which worked for every teenage girl in the late 90s). There are many ways people can get these benefits, shouldn’t we shout about those, too?

Still, as this study shows, exercise definitely does help many people. Sarah, for example, said, “I find running does wonders for generally calming me down and cheering me up after a stressful/sad day” – and this is great! If anything can help you manage your mental health and keep you going, then Godspeed to you. We should be supporting and aiding people to exercise whenever and wherever possible, whether that’s through campaigns to encourage traditionally shy exercisers to give it a try, such as This Girl Can, or grassroots-organised walks, such as Bryony Gordon’s brilliant Mental Health Mates, because in the main people do feel better when they exercise.

Exercise is an important part of mental-health care, but everyone is different – and what works perfectly for one person might not have the same effect on another. Until we all have a fuller, rounder understanding on mental-health care – and, lest we forget, pressure the government to provide adequate, practical care – it’s important to remember that.

@jimsyjampots

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