Physical Activity and Mental Health
Withdrawn April 2018

This leaflet is for anyone who wants to know:
- how being active can make you feel better
- how exercise can help depression
- how active you need to be to feel better
- how to get more active safely.
Introduction
Exercise keeps our hearts and bodies healthy.
But how?
We often talk about the mind and body as
though they are completely separate – but they aren't. The mind
can’t function unless your body is working properly – but it also
works the other way. The state of your mind affects your body.

So – if you feel low or anxious, you may do
less and become less active – which can make you feel worse. You
can get caught in a harmful cycle:
Why bother with exercise?
To work properly, your body needs regular
exercise - and most of us feel good when we are active.
Until the last 100 years or so, you had to be
quite active to just live your everyday life. Now, in modern
Western societies, so much of what we used to do is done by
machines. We drive cars, so we walk less, vacuum cleaners make
cleaning easy, and washing is done by a machine. At work we may not
even have to move around in the office - it’s enough to sit at the
computer. It doesn’t help that modern high-energy foods make us put
on too much weight – or that, (in the West at least), food has
never been cheaper or easier to buy.
So how can you start to get more active, day
to day? You may be turned off by the word ‘exercise’ because:
- I’ve never done it
- I wasn’t good at sports at school
- I would feel silly
- Other people would make fun of me
- It won’t help unless it hurts - ‘No pain, no
gain’
- It’s sweaty and uncomfortable
- I’m too tired
- I would rather do something else
- It’s expensive
- I think it will make me feel worse
- I don’t have anyone to do it with
- I don’t know where, when or how to
start.
But - it doesn't have to be about running
around a track or working out in a gym. It can just be about being
more active each day – perhaps just walking more, or taking the
stairs rather than the lift. If medical problems stop you from
doing one thing, there may be others that you can do.
What happens if you don’t do very much?
Some people can get away with doing very
little and live to a ripe old age – but most of us can’t. Broadly
speaking, the less you do, the more likely you are to end up
with:
- low mood / depression
- tension and worry.
If you keep active, you are:
- less likely to be depressed, anxious or
tense
- more likely to feel good about yourself
- more likely to concentrate and focus
better
- more likely to sleep better
- more likely to cope with cravings and
withdrawal symptoms if you try to give up a habit, such as smoking
or alcohol
- more likely to be able to keep mobile and
independent as you get older
- possibly less likely to have problems with
memory and dementia.
So - don’t worry about not doing enough – get
started by building a bit more physical activity into your daily
life now. Even a small change can boost your morale, give you a
sense of achievement and help you to feel better in yourself.
What might work for me?
Activity should:
- Be enjoyable – if you don’t
know what you might enjoy, try a few different things
- Help you to feel more
competent, or capable. Gardening or DIY projects can do
this, as well getting you more active.
- Give you a sense of control
over your life – that you have choices you can make (so it isn’t
helpful if you start to feel that you have to exercise).
The sense that you are looking after yourself can also feel
good.
- Help you to escape for a
while from the pressures of life.
- Be shared. The
companionship involved can be just as important as
the physical activity.
Why does exercise work?
We are not yet exactly sure. There are several
possibilities:
- Most people in the world have always had to
keep active to get food, water and shelter. This involves a
moderate level of activity and seems to make us feel good. We may
be built – or “hard wired” - to enjoy a certain amount of exercise.
Harder exercise (perhaps needed to fight or flight from danger)
seems to be linked to feelings of stress, perhaps because it is
needed for escaping from danger.
- Exercise seems to have an effect on certain
chemicals in the brain, like dopamine and serotonin. Brain cells
use these chemicals to communicate with each other, so they affect
your mood and thinking.
- Exercise can stimulate other chemicals in the
brain called “brain derived neurotrophic factors”. These help new
brain cells to grow and develop. Moderate exercise seems to work
better than vigorous exercise.
- Exercise seems to reduce harmful changes in
the brain caused by stress.
How much exercise is enough for me?
- Firstly – any exercise is better than
none.
- BUT a
moderate level of exercise seems to work
best.
- This is roughly equivalent to walking fast,
but being able to talk to someone at the same time.
- You need to do about 30 minutes of moderate
physical exercise on at least 5 days of every week. This can be
done in one 30 minute session or broken up into shorter 10 or 15
minute sessions.
- This can not only lower the risk of heart
disease, diabetes and cancer, but also seems to help depression –
so you get a double benefit.
- Don’t start suddenly - build more physical
activity into your life gradually, in small steps.
When should I exercise?
As regularly as you can. There will be days when you just don’t
feel like exercise – you may feel tired or be too busy or
anxious about something. If you keep to your routine and exercise
at times like this, you will almost certainly feel
better. Why?
If you are tired, exercise tends to give you energy. If you are
worried, it can take your mind off your concerns for a while. Even
if you can’t 'exercise', a 15 minute walk can help you to clear
your mind and relax. You may find it helpful to listen to music at
the same time.
It’s best not to do too much in the evening. Being active will
generally help you to sleep but, if you exercise late in the
evening, you may find it difficult to settle.
Eating and energy levels
Caffeine and high energy snacks will boost your energy
quickly - but after an hour or so you will probably feel more
tired than you did before. A short walk will boost your energy
level for much longer.
Exercise and Coping
If you are active you will probably find it easier to deal with
life’s problems and challenges. So - if those problems stop you
from regularly exercising, it’s worth remembering that finding time
for exercise may well help you to deal with such problems.
Exercise can also help you to cope better by improving how you
feel about yourself and getting you together with other people.
How well does exercise work for
depression?
For mild depression, physical
activity can be as good as antidepressants or psychological treatments like
cognitive behavioural therapy (CBT).
It can certainly be harder to get active when you are depressed.
But being active lifts your mood and gives you a sense of being in
control and in touch with other people.
In some areas in the UK, GPs (family doctors) can prescribe
exercise.
What's the downside?
Not much. If you are normally very
active, you may get depressed if, for any length of time, you can't
exercise because of an injury. If this does happen, you can carry
on with exercises using those parts of your body that are not
injured. This will help you to keep fit, feel more in control and
keep in touch with other people. It can help to set yourself
targets – both for the next few days and longer, for the next weeks
or months.
Some people with eating disorders use exercise
to lose too much weight.
Some athletes (such as those in weight-related
sports like horse racing, boxing and gymnastics) are more likely to
develop eating disorders.
Physical exercise can cause injuries and some
health problems – but you are much more likely to get ill if you
don't keep active. If in doubt, ask your doctor.
Getting down to it
Any physical activity needs to be something
that you can do regularly. But lots of things can stop you,
especially if you feel depressed. You may feel that you:
- don't have the energy
- don’t feel confident enough
- don’t know anybody to exercise with
- don’t have the right clothes
- can’t afford it
- just aren’t the ‘exercise or sporty
type’
- won't feel any differenrt for doing it.
Exercise can be about playing sport or doing
hard-core exercise – if you want that. For other people, it is just
about being more physically active and sitting around less. It
doesn’t have to be hard – but try to do something every
day.
Some things aren't expensive – walking is free
and jogging just needs a pair of trainers (cheap ones are fine). If
you have a bike already, try cycling to work (or for any regular
journey) – you may even save some money.
If you haven’t been active for a while, doing
too much when you start can make you more tired – particularly if
you also have a health problem (including depression) that makes
you tired. One day you may have the energy to be really active but
feel completely exhausted the next.
Whatever you choose to do, start with
something easy – like walking round the block. Build your level up
gradually, perhaps by just doing a minute or two more – or a few
metres more - each day. Try to do something most days, even if you
feel tired.
Start by working out how much you do already – you can use a
pedometer to show you how many steps you take every day. Or you
could keep a diary for a few days of how long you spend doing
active things. Then set yourself some goals. Make sure they
are:
S – Specific (clear)
M – Measurable – you will know when you’ve
achieved them
A – Achievable – you can achieve them
R – Relevant – they mean something to you
T - Time-based – you set yourself a time limit
to achieve your goals.
They need to be things you can see yourself doing – and take
pride in, so you feel good about yourself. You may be able to do it
on your own, or with some help from others.
Nobody’s perfect. You will have setbacks when you can’t meet a
short term goal, or just feel too tired to do anything. Recognise
it when it happens, but don’t worry about it. Tomorrow is another
day and short term setbacks don’t matter in the bigger picture of
your longer-term goals. And, if you need to, do ask someone else to
give you a hand.
References
Further information
Mental
Health Foundation
A MHF report entitled ‘ Up and Running’
focused on exercise as a way to treat depression. A version
is available for both patients and practitioners.
Walking for
health
Tel: 01242 533337; email: whiinfo@naturalengland.org.uk
A nation-wide scheme of group walks backed by the British Heart
Foundation and Natural England. The website offers information and
support to all, from complete beginners to health/leisure
professionals. The initiative supports over 400 local health walk
schemes – find your nearest using the Walk Finder.
The Ramblers
Association
Tel: 0207 339 8500; email: ramblers@ramblers.org.uk
Britain's biggest walking charity. Contact
them to find out more about where to walk in your area, how to
locate your nearest walking group and additional information about
how to include children, walk in urban areas and advice for people
with disabilities.
Paths for
all
Covers walking schemes across Scotland. Use
the website to find a local health walk in your area. It also
offers support and information about resources and grants for
setting up your own walking club.
Keep Fit
Association
Tel: 01403 266000; email: kfa@keepfit.org.uk
Find out about keep fit aerobics classes, and
search for classes across the UK from 65 nation-wide Local
Associations.
Spogo: the sports and fitness
finder
This website allows you to search for sports
facilities anywhere in England. You can browse an interactive map
of the country, search for facilities in your local area, or use
the name and address of a specific facility to find out more
information.
English Federation of Disability
Sport
Organisation that supports and promotes sport for people with
disabilities.
Sustrans
Provide advice on cycling opportunities locally and further
afield, including the National Cycle Network.
This leaflet reflects the best available evidence at the time of
writing.
The RCPsych is grateful to Professor Adrian Taylor, School of
Sport and Health Sciences, University of Exeter, for writing this
leaflet.
Produced by the RCPsych's Public Education Editorial Board.
Series Editor: Dr Philip Timms.
Withdrawn April 2018 Royal College of Psychiatrists. This
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