Over the past two decades the global burden of disease has shifted from communicable to non-communicable diseases such as cancers, heart diseases, orthopaedic problems and diabetes, especially among older adults. People with these conditions are often prone to experiencing depression, stress and anxiety.  Mental health conditions can occur at any point in life and require long-term support. Intervention is usually in the form of medication that is prescribed for a prolonged period of time and known to have side effects.  Moreover, in our society, we stigmatize the concept of mental health and avoid talking about it openly, but do we consider taking other measures that also have remedial effects on mental health? People prefer quick results or aren’t aware of other alternatives most of the times. Although medications give instant relief, which is necessary in times of extreme distress, we ought to consider other alternatives which are gaining interest in the past few years. Physical activity is receiving much research attention in this domain. 

Depression, stress and anxiety are prevalent conditions that incur high cost of healthcare and reduces quality of life. Evidence suggests physical activity and exercise as potential treatments to counter such issues. Most benefits have shown to come from supervised sessions with professionals because of relevant and customized training. Although the above is ideal, seeking professional advice or exercising on their own is a suitable option too. While low levels of physical activity are associated with a higher risk of depression, structured exercise is an effective treatment for mood disorders. It is recommended that exercise could be a first line treatment in people with mild to moderate levels of depression. In cases of severe distress, exercise might not have immediate effects and hence could be an add on in the treatment. Besides exercise, a suitable environment when exercising would possibly have additional benefits. There is growing evidence on the exposure to green (publicly accessible areas with natural vegetation) and blue (outdoor water environments) spaces which is associated with mental and physical well-being. Nature based exercising offers the opportunities to connect with nature, attain social support and engage in purposeful activity, which are hypothesized to be potential factors behind its observed benefits. To give some perspective, effective nature- based interventions were offered for between 8 and 12 weeks, and the optimal dose ranged from 20 to 90 minutes. Improvements in mood in people with dementia have also been observed following exposure to nature gardens for only 20 minutes and the greatest benefits are associated with an outdoor exposure to nature of 80–90 minutes. Hence people can gain health benefits from modest amounts of regular engagement with nature.

While this treatment alternative sounds fairly simple, there is ongoing research on the possible mechanisms behind the positive effects of exercise on mental health. To name a few, Physical activity and distraction- Focusing on the task at hand, distracts you from your stressful thoughts, allowing some quality time for yourself. It is similar to the concept of mindfulness, where you try to concentrate in the present and temporarily avoiding unpleasant thoughts and feelings. It could also be an outlet to help manage the stress levels of daily life.

Physical activity and social interaction- Outdoor activity offers the opportunity for interaction and social support among individuals and induces feelings of belongingness.

Physical activity and mastery- Being physically active poses a challenging task, especially for people not accustomed to exercising regularly. Hence, adopting regular physical activity may increase self-confidence, gives a sense of independence and success which can translate over into other areas of one’s life.

Physical activity and sleep- Exercise regularly for better sleep. Although you should bear in mind to avoid exercising late in the evenings as your body will be aroused and would affect the quality of your sleep.

Physical activity and brain derived neurotrophic factor (BDNF)- BDNF is a protein present in high concentration in the brain and is responsible for neural development and functioning. Among many psychiatric conditions that are associated with lower levels of BDNF, depression is one of them. Physical exercise enhances these levels and thus an improvement in mood.

Anti-inflammatory effects of physical activity- Depression, anxiety and psychosis are associated with a low-grade systemic .

Anti-inflammatory cells produced during exercise, inhibit the production of other inflammatory cells.

This alternative of exercising does not have a hard and fast rule and should be carried out in accordance with your medical professional. While for those who aren’t seeking any professional advice, you can adopt this course of action according to your convenience and suitability. However, research provides the following guidelines:

At least 30 minutes of moderate intensity aerobic activity at least 5 days per week for a total of 150 minutes

OR

At least 25 minutes of vigorous aerobic activity at least 3 days per week for a total of 75 minutes

OR a combination of the two

AND

Moderate to high intensity muscle strengthening activity at least 2 days per week for additional health benefits.

It is not always practical for people to find the time to participate in a 30-min bout of exercise during the workday. But breaking down 30 min of exercise into short bouts of exercise that can be performed during 5-min breaks could be a more feasible approach. Small incremental improvements in the form of sitting less, moving more, spending time outdoors for example gardening also make a difference. One should bear in mind to interrupt sedentary behaviour while simultaneously stimulating physical activity. Physical activity is not only considered as a form of treatment but has a protective effect on mental health as well.

Kimberly Dias