Exercise and Mental Health – Aclaíocht agus Sláinte Intinne

by Terry Brugha

“Messages regarding the positive benefits of physical exercise cannot be communicated often enough, especially with regard to their benefits in combatting depression…” This is a quote from a recent discussion in a sports medicine journal of a US study on one million members of the US population, published in Lancet Psychiatry.

A search using Google on the same topic will quickly yield numerous articles supporting the same case.  Visitors to a hill walking website will not be surprised to hear this. So what is there left for us to learn?

The research quoted above, and there are other studies like it, is based on asking many people about health and life style. There are also much smaller studies that test the idea that exercise is good for you. The value of exercise has been studied in experiments. One problem, which some of us know too well, is that it is difficult to get adults to change their life style and in this case increase the amount of exercise taken every week. Nevertheless, the evidence we do have is interesting and encouraging.

Physical and mental health are intertwined – ‘no health without mental health’. One high quality trial (experiment) showed no significant effects of being entered into an exercise training programme for moderate to severe clinical depression. But the results were uncertain because a lot of those randomised to the exercise programme did not undertake it as intended.

A finding of the US study was that group and team based sports activity was associated with a stronger benefit to mental health – for example in comparison to elite sport where the athlete is competing alone such as a swimmer or track runner.  In hill walking we often emphasise the team, which is a group, and its leadership. This may mean that joining a group or club and signing up to a leadership based structure is better for your mental health. (I do not know if this has been evaluated.)

The research also suggests that there may be harm in ‘too much’.  The link between doing neither too little nor too much physical exercise, described by statisticians as a U-shaped curve, has a lot of research support. This has been a consistent finding in surveys looking at physical exercise and physical health including ‘survival’ or how long a person lives.  It is also encouraging that the consensus favours no more than 150 minutes per week of moderate-to-vigorous physical activity when individuals exercise two or three times per week. This also goes with the advice I have had from a trainer to take off at least one day or two between each exercise session.  This gives muscles that undergo microscopic damage during training time to heal, leading to a build up in strength. I do not know whether taking breaks like this between training sessions also helps with mental health. However, excessive exercise is seen in eating disorders like Anorexia Nervosa. And evidence for the benefits of ‘scheduling pleasant activities’ to help with depression is encouraging.   

Excessive rest is becoming a leading concern of researchers looking at longevity.  Linked to this is weight gain and of course diet.  Although Irish children according to a recent report seem to be rather better than many of their European counterparts in this respect, there is also growing concern about weight gain and lack of exercise in children.  Talking of children, we know that the many complex factors that are associated with conditions like depression in adulthood begin in childhood.  Perhaps the link between team sport and childhood is one that is much easier to encourage with potentially promising benefits in the longer term.

The last year of sports coverage since the end of lock down has seen interesting if anecdotal evidence of the emotional benefit of group over individual competition. The joy of a winning team (and the mutually shared support of one another by the losers). The evident distress of elite gymnasts and tennis competitors has been noted.  So maybe there’s a lot more to this group based hill walking after all.

Go raibh maith agat Terry as é seo a roinnt linn. Thanks to Terry one of our members who has taken the time to compile this article.

Traolach Brugha. Professor of Psychiatry, University of Leicester