Thanks for coming to read my blog! This week, I am going to talk about the research on the link between exercising and mental health. This post is going to be a bit different than other posts – I am not going to look at just one paper but summarize a bunch of papers. There is a lot of research on this, and most of you probably have a pretty good sense of what the evidence says…
SPOILER ALERT – the evidence generally shows exercise is good for your mental health.
WOW NOVEL EH…however… did you see my word “generally“ there? There are some exceptions. I am also going to talk specifically about athletes and body-building at the end of the post (SPOILER ALERT – body building is an exception).
So, what does the evidence say?
In people with a mental illness, engaging in an exercise intervention has shown to reduce symptoms and increase quality of life. These effects seem to be largest for individuals with depression (in comparison to other mental illnesses..although benefits are seen across all mental health concerns). Exercising has shown comparable benefits to using medications or psychotherapy for people with mild to moderate depression. Exercise might improve symptoms without doing anything else for people with mild symptoms — however, the worse your symptoms are, the more help you need to feel better (aka you might need to engage in other lifestyle changes, medications, or psychotherapy). But, exercise is still helpful as an add-on to other strategies. There are lots of studies and lots of systematic reviews and reviews of reviews (reminder: systematic reviews usually reflect high quality evidence) that demonstrate this benefit (for example, review 1, review 2, review 3, review 4, review 5…okay I am going to stop now… just google “exercise and mental health review” if you want more). There is also evidence that exercise can improve/reduce symptoms of anxiety or depression in people without anxiety or depression (we can experience some symptoms of anxiety or depression without having anxiety or depression).
It is also important to note that you experience the mental health benefits independent from the physical benefits/weight loss. Often, our primary reason to work out is to lose weight BUT you don’t need to be losing weight to benefit psychologically from exercise… actually, you don’t even need to be losing weight to benefit physically from exercise.
You might be thinking “yah yah, I knew that already. This blog is a waste of my time”… BUT COOL YOUR JETS & DON’T LEAVE YET!
Okay it helps, but how does it help?
We don’t REALLY know. I was going to try to summarize and cite the evidence trying to answer this question but exercise does SO MANY THINGS and the brain is complicated. My super superficial and simplified summary of the evidence (that I am not going to cite… but if you are super curious here is one review –> HI I’M COMPLICATED):
- Most of the evidence looking at how exercise impacts the neurobiology of the brain is limited and done on animals BUT it seems to show that in the short term exercise might change the brain by increasing metabolism, increasing oxygen and blood flow, impacting certain chemicals in the brain (like norepinephrine which deals with alertness and dopamine and serotonin which impact your mood). Exercise also results in the brain releasing natural opioids (these are often referred to as endorphins) and endocannabinoids (yah your body makes its’ own version of morphine and cannabis) which may result in an exercise-induced euphoria. There’s also a bunch of other complicated brain things that happen immediately after exercise. In the long term, exercise might help your brain grow and repair itself and reduce inflammation/swelling in your brain…again, among a bunch of other super complicated brain things.
- It also is likely not just because of neurobiological changes in the brain but rather a combo of things like: getting up and dressed and out of the house, seeing and connecting with other people, spending less time on screens/social media, contributing to a sense of mastery, improving your self-concept and self-esteem, eating healthier, and sleeping better.
- We also don’t really know what type of exercise is best – aka aerobic exercise or weight training? High intensity or low intensity? We do know that people who are more consistent have better results but overall we just don’t have enough research yet. Right now, we will go with – whatever type of exercise you like the most is the best for you because you will be more likely to do it and keep doing it!
The “BUT” behind this research
If you personally do not experience a mental illness, you might be inclined to offer this as a suggestion to friends or family who are struggling. Yes, this would be an evidence informed suggestion (i.e. there is pretty good evidence exercise helps individuals with a mental illness). However, (1) people who have a mental illness commonly report mental health benefits of exercise as a primary motivating factor to exercise (75% in a meta-analysis), so they likely already know, and (2) there are multiple things that make it difficult for individuals with a mental illness to engage in exercise. Some of the barriers among people with a mental illness include (based on this meta-analysis):
- The actual symptoms of mental illnesses can be a barrier to exercising! This is the most commonly reported barrier.
- Some symptoms of depression that might make it hard to exercise include: loss of interest or pleasure in hobbies or activities, decreased energy/fatigue, aches/pains without a physical cause, feelings of hopelessness, low self worth/ self-confidence
- Some symptoms of anxiety that make it hard to exercise include: excessive recurrent and/or persistent anxiety or worry that is difficult to control, easy to fatigue, muscle tension, physical symptoms (like difficulty breathing, heart racing, or other physical aches/pains without a physical cause).
- Some medications for mental health concerns can make you tired.
- Tiredness/fatigue is one of the most common reasons (45%) which can be both a symptom and a side effect of medications!
- Lack of support is also a commonly reported barrier (50% reported this as a barrier).
- Things that are not commonly reported include physical limitations, feeling unsafe or afraid of injury, lacking interest, lacking time, or lacking exercise-related information.
- If you are the one struggling…
- recognize that it is totally tough to find the motivation and energy to workout and there is decent evidence that shows it will likely help if you do it!
- find a work-out buddy or get a personal trainer. Having a workout buddy or “supervision” has been shown to increase the likelihood of you getting to the gym!
- If you are the friend or family member…
- realize it isn’t easy for people with a mental illness to workout (let’s get real, it isn’t easy for most people to have the time and motivation to workout…but it is even more difficult for people who are struggling).
- offer to be a work-out buddy and follow through!
What I meant when I said “generally”
So generally speaking, exercise improves mental health. But there are some exceptions.
HI ALL YOU MEATHEADS…
Urban dictionary definition of meathead #1 – “An enormously muscular guy who cannot hold a conversation about anything other than weight-lifting and protein shakes.”
Urban dictionary definition of meathead #2: “Typically a rather muscular person who walks around with their arms out to their side.”
Urban dictionary definition of meathead #3: “ Meatheads are unaware of the majority of the English language and often communicate with others by using phrases such as “bro”, “dude”, and “sweet”. The dead giveaway of a meathead is if their attire includes a sleeveless muscle shirt, athletic shorts, and a lanyard for their car keys. If you ever find yourself in a setting with multiple meat heads, be prepared for frequent high fives, chest bumps, and hand pounds.
…Can you guess what those exceptions are? Athletes.
Athletes have some defining features:
- mental and physical demands of the sport or activity itself
- pressure to succeed
- increased public scrutiny on social media
- reduced social networks due to relocation or time/lifestyle commitment to sport
- risk of injury prematurely ending career/competition
- risk of overtraining and burn out (signs of overtraining: persistent muscle soreness, racing heart rate, getting sick and injured more often, feeling irritable or depressed, losing motivation, difficulties sleeping, decreased appetite, and seeing plateaus or declines in your performance…Solution? DON’T SKIP REST DAY)
Although the evidence is of low quality and limited, what is available demonstrates an association between being an athlete and being more vulnerable to mental health concerns (Hi! I’m the systematic review on this..apparently I have decided that all of my URL links are going to say hello today).
Athletes are more likely than the general population to experience depression or anxiety. This is more likely for athletes who are injured or retired (makes sense given studies have found exercise withdrawal is related to anxiety and depression and there is some evidence about exercise addiction) or those who are having performance difficulties (makes sense due to the pressure to win and succeed). Evidence on other mental health concerns is a bit more all over the place and less consistent. However, eating disorders were more common in females and more common among sports requiring lean body shape (cough bodybuilding cough). Related to substance use, athletes are more likely to binge drink in offseason than the normal population but in general are less likely to use other illicit substances (likely due to drug testing).
A bit more about body-building…
For those that don’t know, judging for all fitness categories is based on balance, symmetry, muscularity and presentation – aka athletes are judged on how good they look compared to the person next to them. Training typically involves 8-20 weeks of “prep” which usually involves a personalized meal, exercise, and supplementation plans (and sometimes… probably more than sometimes…steroids). This type of training results in cycles of weight loss (i.e. for the purposes of a competition, both fat loss and water loss through food and water restriction and increased exercise) and weight gain (i.e. due to reintroduced water, reduced training, increasing food intake for off-season muscle gain and maintenance, and binge eating post-competition). Aka athletes might go from one extreme (stage lean) to another (winter bulk). See my other blog post for research on hormonal changes after one of these competitions.
There is some evidence that demonstrates high rates of body dysmorphic disorder or muscle dysmorphia – aka being super super super self conscious about a muscle or body parts that impedes functioning (Wolke & Sapouna, 2008), body dissatisfaction (Blouin & Goldfield, 1995), substance abuse (Blouin & Goldfield, 1995; DuRant, Rickert, Ashworth, Newman, & Slavens, 1993), low self esteem (Blouin & Goldfield, 1995), general psychological distress (Andersen et al., 1995), and previous trauma including bullying (Wolke & Sapouna, 2008) and sexual assault (Gruber & Pope, 1999) among fitness competitors. However, there are other studies that have found many competitors do not meet criteria for body dysmorphic disorder and may not experience disordered body image (Pickett, Lewis, & Cash, 2005; Wolke & Sapouna, 2008).
There are things associated with being involved in a body-building competition that may contribute to mental health and wellbeing of competitors. The training is time consuming, and has been known to strain social relationships and work performance (the research). Also, let’s get real, we use social media EXCESSIVELY and social media use and screen time have been associated with negative mental health effects including low self-esteem and feelings of social isolation and symptoms of depression (click here). We are also constantly being evaluated on our physiques – by ourselves, our coaches, and people on social media. Additionally, using stimulants, on top of time-consuming exercise and screen time, negatively impacts sleep which is SO CRITICAL for good mental health (sleep is important).
That being said, body-builders might be a particularly vulnerable group of peeps to begin with. There are lots of stories (note I said stories and not research) about people choosing to do a body-building competition to overcome their eating disorder, substance abuse, anger issues/legal issues, traumatic histories, etc. Some people say body-building has changed their life for the better. There are also many people who say the competitions and preps caused them to develop an eating disorder or depression. There also a lot of people who use drugs – some report using cannabis to help with bulking and sleep, some use hard drugs instead of alcohol since there are no calories, and of course, many use steroids to help with muscle growth and fat loss. Now, arguably (very arguably) the people using drugs/steroids for bodybuilding may have been using harder drugs before bodybuilding and their use now might be less harmful than what they were doing before… but we really do not have enough evidence to know what is really going on.
Does body-building help people who were struggling before?
Does body-building lead to the development of mental health concerns and substance use?
Are there particular groups and types of people that benefit and other groups or types of people who are at risk from body-building?
At this point. We really don’t know but, hopefully, there will be more research on this soon.
I want to know your story.
Why did you choose to do body-building? How has body-building impacted you? I really want to feature people’s stories and experiences – both the ups and the downs. I plan to do this anonymously. PLEASE consider telling your story – you can change some details so people won’t know who you are (including me) or you can choose to share your name alongside your story. TELL YOUR STORY HERE (I can’t tell who you are when you fill out this form).
TAKE HOME MESSAGES
- Exercise improves your mental health – whether you have a mental health concern or not.
- Just because you may not be losing weight, does not mean you are not benefiting psychologically & physically from exercising (…that was a lot of negatives).
- It is not simple or easy to exercise if you are struggling. Having a workout buddy or a personal trainer might make it easier to start and keep working out.
- We don’t really know why exercise helps but we have lots of educated guesses – and really, does it matter why?
- Athletes are at a higher risk of experiencing mental health concerns.
For me I would say the gym is my therapist. When I am consistently going to the gym, I am eating healthier, sleeping better, my mood/emotions are better and more stable, I’m more productive in other aspects of my life… and when I don’t go to the gym for a couple days all of that reverses. Body-building and weight lifting got me through a really difficult situation and time in my undergrad – there was a time when I was barely getting out of bed to even go to class, wasn’t hanging out with friends, withdrew from family, was calling in sick to work to lie on my bed… and then I started weight lifting. I attribute a very large proportion of my recovery to weight-lifting/body-building (on top of great friends and family).
As for working out re: competing in body-building – I have mixed emotions. For some aspects I think it was beneficial and for others I think it was not. My self-confidence has increased dramatically (and not just when I was stage lean), I liked having a structure and a goal, I met a great group of people and connected with people I never would have had I not done the show, and the show day was fun! I do not regret doing the show. However, I really do not know if I am going to do it again. I am not upset about my “post-show body” or “off-season body” (aka not being 10% body fat) but I am worried I would be if I continued competing. Physically, I think the show was harmful for me – both hormonally and in terms of muscle mass (yes, I lost LOTS of muscle) and injuries. I also do not want to ever use steroids – and sadly, to win and make money in body building, using steroids is very advantageous and therefore very tempting if you keep competing.
SO THERE YOU GO…
Take care of yourself – emotionally and physically. Find your balance.
Exercise does improve mental health, so try your best to figure out how to integrate exercise into your routine. And if you’re an athlete or a competitor, acknowledge your limits – take your rest days, do not underestimate your support system (family, friends, teammates), and realize when exercise becomes more harmful than helpful.
And most importantly, if you are struggling, know there is help and things can get better. Reach out and talk to someone – a friend, a family member, a doctor or a counsellor.
Asking for help is not a sign of weakness, but a sign of strength.
Sending positive vibes and virtual hugs,
The Fitnerd – Jillian
Please consider telling your story here. It asks for your email, but does not save your email.
P.S. I do have a couple good resources of my Resources & Tips Page,
P.P.S. I will be posting some photos from the body positivity shoot on my instagram and on my blog within the next week!