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Physical Activity and Mental Health

Benefits and Obstacles For The Mentally Ill

By Mrten Bonnevier, IT-gymnasiet Sdertrn

2017
In recent years, there has been an increase in studies showing that there is a positive link
between physical activity, outdoor activity and mental wellbeing, but also that people with
mental health issues struggle with caring for their physical health. This research paper
answers why exercise and spending time in nature is beneficial to our mental health by
analyzing how they positively affect mood by releasing feel-good chemicals, stress by
negating stress hormones, self-esteem by promoting a sense of accomplishment, depression
and anxiety by boosting mood, ADHD by being an effective alternative to medication and
PTSD by relaxing the muscles and joints, as well as expound on the mental benefits of the
outdoors and why it is therapeutic to us. Some of the things covered are different kinds of
therapy centered on nature, such as Ecotherapy and the Attentional Restoration Theory.

The paper also answers what difficulties mentally ill people have with the various treatments,
showing that it is not only within the treatment where problems may lie, but also within the
stages of recovery before a treatment is even started; covering areas like therapy, the
difference between symptoms and causes, how treatments affect different illnesses in different
ways, mentioning a variety of eating disorders and personality disorders. An interview is also
included, as well as a section on overtraining.

Table of Contents
Introduction 4
Literature Review 4
What Counts As Physical Activity? 4
How Does Physical Activity Affect The Brain? 4
Impact On Our Mood 4
Impact On Our Stress 5
Impact On Our Self-Esteem 5
Impact On Depression and Anxiety 5
Impact On ADHD 6
Impact On PTSD and Trauma 6
Mental Benefits of The Outdoors 7
What Makes Nature So Therapeutic? 7
Obstacles For The Mentally Ill 8
Therapists 9
Symptom or Cause 9
Eating Disorders 10
Overtraining 10
Discussion 10
Bibliography / Works Cited 12
Introduction
Over the past few decades, our understanding of mental health has drastically changed. The
stigmas surrounding mental illness are slowly diminishing and it has allowed for more talks
about the issue. In recent years, more and more studies are showing that there is a positive
correlation between exercise and outdoor activity and mental wellbeing, but also that people
with mental health issues struggle with caring for their physical health. This paper aims to
answer how physical activity and spending time outdoors benefits us mentally and how they
relate to mental illnesses, and what obstacles people with mental health issues face when
struggling to look after their personal well-being. Its goal is to provide further information
about the benefits of an active lifestyle and give greater insight into the implications of living
with a mental illness.

Literature Review

What Counts As Physical Activity?


To start off, it is important to define how physical activity will be used in this paper. To put
it simply, physical activity is any movement of your body that uses your muscles and expends
energy. This can be any daily physical task (walking, household chores), purposeful exercise
or sports. It is recommended that the average adult person should do at least 150 minutes of
moderately intense physical activity per week to maintain normal physique.1

How Does Physical Activity Affect The Brain?

Impact On Our Mood


Physical activity has been shown to have a positive impact on our mood. According to
Michael Otto, a professor of psychology at Boston University, The link between exercise
and mood is pretty strong. Usually within five minutes of moderate exercise you get a mood-
enhancing effect.2 Exercise is a natural and effective way to treat stress. It relieves our
tension and boosts our mental energy as well as releasing feel-good endorphins.3 In studies
evaluated by scientists at Nova Southeastern University, researchers concluded that low- to
moderate intensity aerobic exercise produced positive results in mood improvement and

1
World Health Organization, Physical Activity: Factsheet No. 385
2
Psychological & Brain Sciences, Michael Otto Research Interests
3
Helpguide.org, The Mental Health Benefits of Exercise
psychological functioning.4 Some people experience that by exercising regularly, their daily
mood would increase and they started seeing themselves as generally happier people.

Impact On Our Stress


When something happens which makes us feel threatened or upsets our balance in some way,
our bodys defenses react and create a stress response, which may make us feel a variety of
uncomfortable physical symptoms and make us behave differently; and we may also
experience emotions more intensely. The most common symptoms are heartburn, having
trouble sleeping and sweating, just to name a few. The worry and discomfort of all these
symptoms can in turn lead to even more stress. Physical activity can be very effective in
relieving stress by helping negate the hormones released by our body during stress as well as
by relaxing our muscles. Since the body and mind are so closely linked, when your body feels
better so, too, will your mind.5

Impact On Our Self-Esteem


Exercise does not just have a positive impact on our physical health, but it can also help raise
our self-esteem, one of the most central concepts in all of psychology. Having a positive self-
esteem is critical to an individuals mental health. Being in shape makes us feel good about
our body. It shows that we are doing well at taking care of it, which makes us feel good about
ourselves. With our society being the way it is, having a large emphasis on body image and
how it defines us, a lot of people have high self-esteem when they know their body looks
good something exercise helps achieve.6 Exercise promotes a sense of accomplishment by
helping you to meet small successive goals. Each time you meet one of these goals, you get a
sense of accomplishment and improve your self-confidence.7

Impact On Depression and Anxiety


Physical activity can be an alternative treatment for depression. It has no direct side effects
and does not have the stigma that some people perceive to be attached to taking medication or
seeing a therapist. Regular exercise improve mood in people with mild to moderate
depression. It may also play a supporting role in treating severe depression. To most people
with depression, a common reoccurring thought is everything is pointless, so experiencing

4
Livestrong.com, How Does Exercise Affect Your Self-Esteem?
5
Helpguide.org, The Mental Health Benefits of Exercise
6
Livestrong.com, How Does Exercise Affect Your Self-Esteem?
7
Psychology Today, Build Your Self-Esteem with These 3 Simple Exercises
the results and changes that exercise brings could help people break away from that mindset.8
Physical activity can also reduce levels of anxiety in people with mild symptoms and may
also be helpful treating clinical anxiety.9 However, this only applies to moderate physical
activity. Although not many studies on the area have been conducted, results showed that
high-intensity exercise did not appear to decrease stress and anxiety in subjects and, in the
context of competition, instead appeared to increase anxiety.10

Impact On ADHD
People, especially children, with ADHD have been proven to benefit from even minor
exercise. For them, physical activity works in much the same way as ADHD medicine by
boosting the brains dopamine and serotonin level, which affect focus and attention. It has in
some studies shown to be even more effective than the prescribed ADHD medicine.11
Exercise can have the following benefits for adults with ADHD: Eases stress and anxiety,
improves impulse control and reduces compulsive behavior and increases levels of brain-
derived neurothropic factor, which is a protein involved in learning and memory.12 A 2014
study found that a 12-week exercise program improved math and reading test scores in a
group of children, but especially in those with signs of ADHD.13

Impact On PTSD and Trauma


People with PTSD tend to exercise less for a number of reasons. They tend to stay away from
activities that cause similar symptoms as anxiety (shortness of breath, increased heart rate
etc.). Most are also at a higher risk of developing depression, which causes low energy and
motivation to exercise. Lastly, people with PTSD tend to engage in more unhealthy behaviors
like drinking and drug use. For trauma victims, physical activity does not only help reduce
physical tension, but also gives them a break from difficult emotions or distracts them from
painful memories. Most importantly for them though, is the improved self-esteem and feeling
of personal control that exercise provides.14 By really focusing on the sensation of their
muscles and how their body feels when exercising, affected people can help their nervous

8
Harvard Health Publications, Exercise and Depression
9
American Psychological Association, The exercise effect
10
The Internet Journal of Allied Health Sciences and Practice, Depressed, Low Self-Esteem,
What Can Exercise Do For You?
11
Child Mind Institute, ADHD and Exercise
12
North Carolina State University, Exercise and ADHD
13
SpringerLink, A Randomized Trial Examining the Effects of Aerobic Physical Activity on
Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children
14
Verywell.com, The Benefits of Exercise for People with PTSD
systems undo the seizing up response that characterizes PTSD or trauma when they happen.15

Mental Benefits of The Outdoors


With so many methods of therapeutic healing available to us, many may overlook or
underestimate the mental benefits of having greater contact with nature. There is growing
evidence suggesting that time spent outside in natural environments is linked to stress levels
and cognitive development.16 Improved short-term memory, vision and concentration are just
a few of other proven benefits. Just images of serene environments seem to stimulate the mind
and relax the observer. According to a study conducted in 201517, people who looked at
grand, beautiful scenes of nature like lush jungles and giant waterfalls experienced a greater
boost in mood than those who looked at nature more common, like parks or gardens.
The sounds of nature can also help individuals recover from stressful situations, which was
shown in the visual study where people were put through a virtual reality stress test with half
of the participants exposed to forest sounds, while the second half were not. The former group
of people showed positive results with increased stress recovery afterwards, showing that
there is a link between natural sounds and reduced stress.18 Ecotherapy is a kind of therapy in
which people perform activities outside in nature, like working on a farm or different
conservation activities. It has been shown to effectively help those with early signs of mental
illnesses from deteriorating further.19

What Makes Nature So Therapeutic?


The restorative quality of nature is almost entirely mental. The only real physical benefits you
can gain are from natural locations that are far away from urban pollution, with fresher and
cleaner air, which is good for your lungs. The other effects have to do with your perception of
nature, how you interpret and react to it.20 The Attentional Restoration Theory is a concept
suggesting that urban environments experience an abundance of stimulation for the human
brain, which over time leads to cognitive fatigue for its inhabitants.21 According to the theory,

15
Helpguide.org, The Mental Health Benefits of Exercise
16
National Center for Biotechnology, The Great Outdoors? Exploring the mental health
benefits of natural environments
17
Frontiers in Psychology, An exploratory study into the effects of extraordinary nature on
emotions, mood, and prosociality
18
Physiology and Behaviour, Inducing physiological stress recovery with sounds of nature in
a virtual reality forest--results from a pilot study
19
Psychology Today, The Power of Nature: Ecotherapy and Awakening
20
Frontiers in Psychology, An exploratory study into the effects of extraordinary nature on
21
National Center for Biotechnology, The Great Outdoors? Exploring the mental health
what makes nature the healing place that it is is the stark contrast between the two
environments. Going from a place with high stimuli to a place with no stimuli gives the brain
a break and allows it to heal. Its not surprising that nature has a therapeutic effect when you
consider that the human race, along with all our evolutionary predecessors, have been closely
bonded with and reliant on it for all our existence. It is only in recent times that many of us
have been made or chosen to live in artificial environments. For us, contact with nature is
therefore like going back home, and fills us with the same sense of safety and belonging as
our own personal home does.

Obstacles For The Mentally Ill


Neurotypical people (people who do not suffer from a mental illness) usually do not have a lot
keeping them from exercising, except maybe the persistence to keep going and not revert to
being lazy. A person with a mental illness on the other hand, might struggle with things a
mentally healthy person take for granted which keeps them from being more physically
active. Many mental illnesses, especially depression, affect your motivation. They manipulate
your brain and convince you that theres no point in doing or trying anything. A commonly
known symptom of depression is losing interest in and motivation to do things you once
enjoyed.22 With exercise already being unappealing to most, just having the motivation to
start, let alone keep up a regular exercise routine can be impossible. Knowing exercise could
help, but feeling unable to do so often adds to the low self-esteem of depression. Motivation is
not the only factor in play. As mentioned earlier, people with anxiety disorders like PTSD
tend to avoid heavy physical activity because it puts their body into a state similar to one
experienced during a panic attack.23

During an interview, Robin Reeve who suffers from Borderline Personality Disorder, causing
symptoms similar to depression and anxiety, said:
Depression puts it into your head that exercise wont do anything to help,
despite the evidence. Theres also the anxiety of people being around you and
watching you while you are being physically active, judging you.
People who have tried alternative medications that did not work for them, with exercise being
one of the only therapies left may find themselves at a catch-22: exercise can help with their

benefits of natural environments


22
HEALTHYPLACE, When Depression Causes a Lack of Motivation
23
Verywell.com, The Benefits of Exercise for People with PTSD
anxiety or depression, but they are unable to exercise because of their anxiety or depression.
When youre depressed you tend to either oversleep or not sleep enough, which
means you feel tired and your body feels heavy, making the idea of performing
physical exercise unrealistic.

Therapists
Therapists or psychiatrists, for those seeing one, play a big role in deciding what medication
or prescription someone takes for their illness and how their recovery process ultimately turns
out. One of the struggles of living with a mental illness is finding what works for each
individual person. Some might need a specific combination of medications while alternative
therapy is a better pick for others.24 This can be a tough ordeal that, depending on the
therapist, can go on for quite some time until the right treatment is found. But they face the
same struggle when first finding a therapist. One bad or incompatible psychiatrist can turn a
person away from the mental health system entirely. Like Robin Reeve puts it:
Ive seen multiple therapists, without any one of them working out for me. I
guess my problem lies within my anxiety and paranoia caused by my disorder.
Its really hard to open up to these new people I dont feel any connection to and
talk about my problems with them

Symptom or Cause
A big issue for patients and doctors alike when trying to treat a mental illness is not being sure
of what is a cause and what is a symptom. While depression can have many causes or
triggers, a commonly believed theory is a lack of serotonin in the brain.25 As a
neurotransmitter, serotonin helps to relay messages from one area of the brain to another,
making it crucial for the bodys various psychological and bodily functions to operate
properly26. However, since not much about how depression affects our brain physically is yet
known, serotonin deficiency could also just be a symptom of depression. If this were the case,
using physical activity to help raise the serotonin levels in your brain would not actually help cure
the illness, but just alleviate the symptom of it. Therefore, in the case of these individuals, exercise
should not be seen as a long-term solution, but more of a temporary fix. Additionally, if you were
to stop your regular exercising, those same symptoms would resurface, as your serotonin levels
would drop as a result of your depression still being present.

24
WebMD, Depression: Finding a Doctor or Therapist
25
World Psychiatry, What has serotonin to do with depression?
26
Nationalencyklopedin, Serotonin
Eating Disorders
Mental illness in the form of eating disorders presents a more direct problem when trying to use
exercise to cure it: physical lack of energy. Those struggling with anorexia may literally lack the
energy required for even light exercise because of their malnutrition.27 When a patient has an
active eating disorder, it is generally ineffective to use exercise as an incentive to get him or her to
eat more. Even someone who really enjoys sports and claims they would do anything to keep
doing it, will probably not be able to eat enough to make it happen. The brain of an anorexic is
just not capable of overriding symptoms, no matter how alluring the reward of exercise may be.28

Overtraining
Like many things, physical activity is only good when done in moderation. Excessive exercise
may lead to a condition called overtraining syndrome, which occurs when the body (through
exercise) is pushed beyond its natural ability to recover. This may cause a number of physical
and mental problems, including but not limited to, reduced sexual desire and infertility,
mental and emotional stress, mild or clinical depression and anxiety.29 This is something
individuals suffering from mental illnesses using exercise as therapy need to watch out for, as
they run the risk of becoming obsessed with it and developing sports anorexia.
Hypergymnasia, as it is also called, is an eating disorder characterized by excessive and
compulsive exercise. Someone suffering from depression for example might find exercise a
very effective way to ease his or her symptoms. This causes them to become dependent on the
exercise, which can escalate into an addiction similar to drug abuse, eventually leading to the
person developing overtraining syndrome and undoing all the work of alleviating their
depression.3031

Discussion
One of the purposes of this research paper was to examine the positive effects of physical
activity and nature on the human psyche, as well as how they measure up as treatments for the
mentally ill, and judging from the research covered in the literature review section, it seems
almost all effects are positive. The two negative effects mentioned, high-intensity exercise

27
blog.drsarahravin, Exercise Caution: Physical Activity and Eating Disorder Recovery
28
National Eating Disorder Association, Anorexia: Overview and Statistics
29
philmaffetone.com, The overworking syndrome
30
National Eating Disorder Information Centre, Informal Feeding and Eating Disorder
Descriptions
31
WebMD, Compulsive Exercise: Are You Overdoing It?
causing increased anxiety in patients with preexisting anxiety and overtraining syndrome, are
really only effects of improper exercise and should not count. Properly balanced exercise
however, has no downsides and only affects both the body and mind in positive ways.
The general consensus concerning exercise as a form of treatment for various mental illnesses
seems to be that it is something more alternative, overlooked or even dismissed by many as
less effective, with medication and therapy being considered way more effective. But looking
at the results you can easily make the argument that exercise is, in some cases, just as
effective as medication. The research provided about ADHD showed that physical activity
had the same effect as medication, with the added benefit of being safer, as it has no
potentially negative side effects.

So why is physical activity not more widely utilized to combat these illnesses? There could be
multiple reasons. For some it might be because it is totally ineffective, people suffering from
eating disorders for example. It might be that many are quick to turn to medication because it
is easier than fitting exercise into their daily lives. Some might be afraid to use exercise
because of bad past experiences with it. It is also highly plausible that lazy or unskilled
psychiatrists just resort to prescribing medicine for an illness maybe better treated with
physical activity. Researching more about their behavior and perspective on mental illness
might be an interesting idea for another paper.
A different idea for future research could be looking further into the potential detrimental
effects of exercise and physical activity on the mentally ill - something this paper only
touched upon briefly while on the topic of overtraining. Researching the relationship people
suffering from Dissociative Identity Disorder, formerly and more commonly known as
Multiple Personality Disorder, have with physical activity could also be interesting. Does
having multiple personalities with perhaps more self-destructive thoughts and viewpoints
hinder ones ability to live healthily and exercise?

Just like the research on physical activity, the research on the effects of the outdoors showed
that there are indeed benefits and that it is valuable when it comes to treating mental illnesses,
as well as showing that there are no direct downsides. Lastly, the paper also achieved its goal
to answer what difficulties mentally ill people have with the various treatments, showing that
it is not only within the treatment where problems may lie, but also within the stages of
recovery before a treatment is even started.
Bibliography / Works Cited
Segal, Jeanne. The Mental Health Benefits of Exercise. Helpguide.org, December 2016.
Accessible: http://www.helpguide.org/articles/exercise-fitness/emotional-benefits-of-
exercise.htm
2016-12-29

Mental Health Foundation (2016) How to look after your mental health using exercise, 2016-
12-29
https://www.mentalhealth.org.uk/publications/how-to-using-exercise

Exercise for Stress and Anxiety. Anxiety And Depression Association of America, July 2014.
Accessible: https://www.adaa.org/living-with-anxiety/managing-anxiety/exercise-stress-and-
anxiety
2017-1-16

Taylor, Adrian. Physical Activity and Mental Health. Royal College of Psychiatrists,
November 2014. Accessible:
http://www.rcpsych.ac.uk/healthadvice/treatmentswellbeing/physicalactivity.aspx
2017-1-16

Weir, Kirsten. The Exercise Effect. American Psychological Association, December 2011.
Accessible: http://www.apa.org/monitor/2011/12/exercise.aspx 2017-2-10

Physical Activity: Factsheet No. 385. World Health Organization. June 2016. Accessible:
http://www.who.int/mediacentre/factsheets/fs385/en/ 2017-2-10

Faculty - Michael Otto Research Interests. Boston University - Psychological & Brain
Sciences. January 2017. Accessible: https://www.bu.edu/psych/faculty/mwotto/ 2017-2-11

Depression and anxiety: Exercise eases symptoms. MAYOCLINIC. Oct. 10, 2014.
Accessible: http://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-
and-exercise/art-20046495 2017-2-11

Crawford, Benna. How Does Exercise Affect Your Self-Esteem? Livestrong.com. Jun. 05,
2015. Accessible: http://www.livestrong.com/article/438937-how-does-exercise-affect-your-
self-esteem/ 2017-2-11

Jacobson, Rae. ADHD and Exercise. Child Mind Institute. Accessible:


https://childmind.org/article/adhd-and-exercise/ 2017-2-11

Tull, Matthew. The Benefits of Exercise for People with PTSD. Verywell.com. Jan. 7, 2016.
Accessible: https://www.verywell.com/exercise-for-ptsd-2797465 2017-2-11

Joye Y, Bolderdijk JW. An exploratory study into the effects of extraordinary nature on
emotions, mood, and prosociality. Frontiers in Psychology. Jan. 28, 2015 Accessible:
http://journal.frontiersin.org/article/10.3389/fpsyg.2014.01577/full 2017-2-11

Pearson, David G. Craig, Tony. The Great Outdoors? Exploring the mental health benefits of
natural environments. National Center for Biotechnology. Oct. 21, 2014. Accessible:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204431/ 2017-2-11

Taylor, Steve. The Power of Nature: Ecotherapy and Awakening. Psychology Today. Apr. 28,
2012. Accessible: https://www.psychologytoday.com/blog/out-the-darkness/201204/the-
power-nature-ecotherapy-and-awakening 2017-2-11

Annerstedt M, Jnsson P, Wallergrd M. Inducing physiological stress recovery with sounds


of nature in a virtual reality forest--results from a pilot study. Physiology & Behavior. Jun.
13, 2013. Accessible: https://www.ncbi.nlm.nih.gov/pubmed/23688947 2017-2-11

Phillips, Suzanne. Move It! How to Exercise When Youre Depressed. Livescience.com. Aug.
4, 2011. Accessible: http://www.livescience.com/15391-depression-exercise-benefits-
tips.html 2017-2-11

Ehrmantrout, Mike. When Depression Causes a Lack of Motivation. HEALTHYPLACE.


Mar. 18, 2015. Accessible:
http://www.healthyplace.com/blogs/recoveringfrommentalillness/2015/03/about-depression-
caused-lack-of-motivation/ 2017-2-11

Goldberg, Joseph. Depression: Finding a Doctor or Therapist. WebMD. Oct. 15, 2016.
Accessible: http://www.webmd.com/depression/finding-doctor-therapist#3 2017-2-11

Cowen, Philip J. Browning, Michael. What has serotonin to do with depression? World
Psychiatry. Jun. 4, 2015. Accessible:
http://onlinelibrary.wiley.com/doi/10.1002/wps.20229/full 2017-2-11

Melander, Arne. Serotonin. Nationalencyklopedin. Feb, 2017. Accessible:


http://www.ne.se/uppslagsverk/encyklopedi/l%C3%A5ng/serotonin 2017-2-12

Shamus E, Cohen G. Depressed, Low Self-Esteem: What Can Exercise Do For You?. The
Internet Journal of Allied Health Sciences and Practice. 2009 Apr 01;7(2), Article 7.
Accessible: http://nsuworks.nova.edu/ijahsp/vol7/iss2/7/ 2017-3-2

Maffetone, Phil. The overtraining syndrome. Philmaffetone.com. May. 6, 2015. Accessible:


https://philmaffetone.com/the-overtraining-syndrome/ 2017-3-2

Goldberg, Joseph. Compulsive Exercise: Are You Overdoing It? WebMD. Feb. 27, 2016.
Accessible: http://teens.webmd.com/compulsive-exercise 2017-3-2

Anorexia: Overview and Statistics, National Eating Disorder Association. 2014. Accessible:
https://www.nationaleatingdisorders.org/anorexia-nervosa 2017-3-2

Ravin, Sarah. Exercise Caution: Physical Activity and Eating Disorder Recovery.
blog.drsarahravin.com. Feb. 20, 2014. Accessible: http://www.blog.drsarahravin.com/eating-
disorders/exercise-caution-physical-activity-and-eating-disorder-recovery/ 2017-3-2

Hoza, B., Smith, A.L., Shoulberg, E.K. A Randomized Trial Examining the Effects of Aerobic
Physical Activity on Attention-Deficit/Hyperactivity Disorder Symptoms in Young Children.
SpringerLink. Sep. 10, 2014. Accessible: https://link.springer.com/epdf/10.1007/s10802-014-
9929-y?shared_access_token=nULq6MSfI9j_6Aluo4Qqkfe4RwlQNchNByi7wbcMAY4Iiw-
23Cs-
5OLtTjpVdJrfpxi_H27YYPLiYVkSQL2wyET0vM6fVJtrudoG2foTdIOK1J669bZPw3TmIY
eUU_k90I-aQ2dk705rTD2KV4unolEeMhPgIv6zYUu9UAn7TjI 2017-3-21

Krauss, Susan. Build Your Self-Esteem with These 3 Simple Exercises. Psychology Today.
Apr. 19, 2014. Accessible: https://www.psychologytoday.com/blog/fulfillment-any-
age/201404/build-your-self-esteem-these-3-simple-exercises 2017-3-21

Miller, Michael Craig. Exercise and Depression. Harvard Health Publications. June. 2009.
Accessible: http://www.health.harvard.edu/mind-and-mood/exercise-and-depression-report-
excerpt 2017-3-22

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