Exercise is not a Dirty Word

When I returned to work from maternity leave, I was struggling with weight issues and general poor health following a tough flu season. My mood also plummeted from over-work and family responsibilities.

Being a clinical psychologist, I worked hard at cognitive challenging and behavioural interventions but found it difficult to maintain. One critical factor that enhanced the above-listed strategies was exercise. For the first time in my life, I began to exercise with a different focus.

Instead of focusing on weight loss or physical health, I exercised for a sense of accomplishment and mindfulness. I didn’t watch the scales. I used a graduated approach of reward bundling. No matter how small the effort (e.g., just 10mins on the elliptical), I would take a shower for self-care or make time to get a nice cuppa afterwards. When I exercised, I would put on my favourite music and focused on being present in the moment (mindfulness) so that I could take a break from my daily stresses and worries.

With more exercise, my outlook also changed. I was more productive at work because I felt rested and healthy. Tasks that would take me three hours to complete at work when stressed and feeling low now took one hour if I integrated exercise into my weekly routine somewhere.

My self-care improved so people noticed that I looked healthier, which had little to do with weight loss. I had energy to chase after my children and complete domestic tasks. Importantly, I had the energy to do cognitive challenging and confront difficult situations (e.g., problem-solving, completing grant applications).

Is exercise for mental health supported by research evidence?

Exercise has had an interesting research history because it’s been hard to conduct well-controlled trials across different disorders. That said, we’ve known for a long time that exercise is linked to better wellbeing.  For example, in a recent survey of 1.2 million respondents, the results revealed that those who exercised had significantly fewer days of poor mental health compared to those who didn’t exercise¹. The largest associations between exercise and being well were observed in team sports, cycling, and aerobic activities.

The field has also been bolstered by emerging randomised controlled trials where we can be more certain about the positive impact of exercise on the mood disorders². There is strong evidence that exercise acts like a mild anti-depressant for non-chronic mood disorders.  According to the Black Dog Institute’s research, just one hour of exercise can prevent up to 12% of future cases of depression.

What does ‘exercise’ mean?

There is considerable debate about the definition of exercise and how much is enough³. When I present exercise to my clients, I explain that the meaning of ‘exercise’ is different across individuals. We do not have to subscribe to elite or ideal concepts of exercise for it to maintain or increase our wellbeing. If you have not been exercising at all, then a 10 min vigorous walk around the block is a great start and an achievement as you build up to harder sessions.

If you are already exercising, it’s great to push yourself a little further with new challenges. If you already run regularly, would it be good to join a running group or train up for a marathon? After all, the research also suggests that being with other people, such as team sports, is associated with the most days of good mental health¹. 

Carrot not the stick….

The second approach I take with myself and my clients is to consider how we motivate ourselves to get moving. It is important that we always feel proud no matter how small the effort to exercise, and how infrequent the exercise sessions.

Exercise is often associated with negative reinforcement: we force ourselves to exercise in order to reduce shame around our weight/physical health. Shame is a terrible motivator because it is linked to poorer motivation and wellbeing. While there is very limited research on negative reinforcement for exercise, I have always found that a better approach is positive reinforcement using self-compassion and internalised reward (e.g., “I’m grateful to have the time to do this boxing class. Well done to me for finding the time in this busy week!”).

The embodied mind?

I don’t always get out to the gym, but when I do, I always enjoy it. It rescued me from declining physical and mental health at a critical point in my life, especially when I was at risk of Type II diabetes following a difficult pregnancy. I’m just glad that the research is finally catching up with what we’ve all known for a very long time:

Exercise is not just about physical health. It can also set our minds free to be healthier and happier.  

More information

Check out the Black Dog Institute’s Exercise Your Mood program for more tips on how to use exercise for wellbeing.

References

1. Chekroud SR, Gueorguieva R, Zheutlin AB, et al. (2018). Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: a cross-sectional study. Lancet Psychiatry, 9, 739-746.
2. Rosenbaum, S., Tiedermann, A., Sherrington, C., Curtis, J., & Ward, P.B. (2014). Physical activity interventions for people with mental illness: A systematic review and meta-analysis. Journal of Clinical Psychiatry, 75, 964-974.
3. Cooney, G. (2018). Exercise and mental health: a complex and challenging relationship. Lancet Psychiatry, 9, 692-693.