A Summary of the article “Role of Physical Activity on Mental Health and Well-Being: A Review”
The review article by Mahindru et al. published in Cureus in January 2023, synthesizes current understanding regarding the physiological and psychological mechanisms through which exercise and physical activity positively impact mental health.
Background and General Effects
Physical activity is beneficial for a wide range of health outcomes, including physical strength, endurance, bone mineral density, and neuromusculoskeletal fitness. Globally, guidelines recommend 150 minutes of modest to vigorous physical exercise weekly to reduce the incidence of many chronic diseases by 20%-30%. Beyond the physical realm, the review notes that physical activity is positively associated with specific mental health traits. In nonclinical populations, the most significant positive effects observed have been on self-concept and body image. Generally, exercise is linked to a better mood and improved quality of life, while also decreasing stress tendencies, which are known to aggravate both mental and physical illnesses.
Mechanisms of Action
Regular physical activity is associated with several key physiological changes. Researchers state that regular physical activity improves the functioning of the hypothalamus-pituitary-adrenal (HPA) axis, which leads to a reduction of cortisol levels and the restoration of the balance of leptin and ghrelin. Furthermore, physical activity triggers the production of neurochemicals, including endogenous opioids and endocannabinoids, which are linked to pleasure, reduced pain sensitivity, and anxiolytic effects. Regular exercise also has immunomodulatory effects, optimising catecholamine and lowering systemic inflammation. For cognitive function, exercise has been shown to improve attention, focus, memory, and decision-making for up to two hours.
Impact on Specific Psychiatric Conditions
The review examines the role of exercise as an adjunctive treatment across several mental health disorders:
- Depression and Anxiety: Physical exercise may be a crucial part of treatment for less severe forms of mental illness, such as depression and anxiety. Exercise and physical activity are comparable, and sometimes more effective, than traditional antidepressants in improving depressive symptoms. The mechanism often invoked is the “endorphin hypothesis,” which posits that physical activity increases endogenous opioid peptides (like $\beta$-endorphin) produced by the pituitary gland, consequently reducing feelings of worry and hopelessness. While beneficial, exercise was found to be less effective than antidepressant treatment as an adjuvant therapy for anxiety disorders in a systematic review of randomised controlled trials.
- Schizophrenia: For this debilitating disorder, physical activity can help attenuate some psychotic symptoms and treat medical comorbidities that often accompany psychotic disorders, especially those resulting from the metabolic adverse effects of antipsychotics. Yoga, in particular, has been conceptualised as a beneficial complementary therapy due to its potential to improve endocrine function, weight management, and cognitive performance. A meta-analysis of 17 distinct studies found that frequent physical activity significantly reduces the negative symptoms associated with schizophrenia.
- Alcohol Dependence Syndrome: Physical exercise and yoga are helpful in managing cravings for substances, especially when other therapeutic options are unavailable. Exercise can act as an enjoyable replacement for the substance, relieve stress, and aid in managing common comorbidities such as hypertension and diabetes mellitus.
- Sleep: Consistent physical activity is shown to significantly improve both the quantity and quality of sleep. Both moderate and strenuous exercise can increase sleep quality, which is particularly important since sleep deprivation negatively impacts mood, cognitive ability, and immune function.
Conclusion and Research Gap
Overall, the review establishes that exercise provides adequate evidence of improving depressive and anxiety symptoms, significantly improving sleep quality, and aiding patients with alcohol dependence and schizophrenia. The authors highlight a dearth of literature in the Indian context and recommend that more research is needed to evaluate and implement interventions involving physical activity that are specifically tailored to the Indian population. Translating the existing evidence on the benefits of physical exercise into clinical practice is of paramount importance for the future of mental health treatment.
References
Mahindru, A., Patil, P., Agrawal, V., Mahindru, A., Patil, P., & Agrawal, V. (2023). Role of Physical Activity on Mental Health and Well-Being: A Review. Cureus, 15(1). https://doi.org/10.7759/cureus.33475
This post is based on Open Access research and is for informational purposes only.
