TABLE OF CONTENTS

The global health statistics on mental health are damming and paint a picture of both ‘doom’ and ‘gloom.’ heightened by the current COVID-19 Pandemic. According to research, an estimated Seven Hundred and Forty-two (742) million people in 2017 were living with some form of mental health disorder, which represented one (1) in Ten (10) persons globally (Saloni et. al. 2021). Fast track to 2018 (one of the latest statistics) with a reported Nine Hundred and Seventy (970) million people globally having a mental health or substance abuse disorder (Our World in Data, 2018).  The number is expected to rise even higher in 2020 and 2021. 

In Jamaica, my home country, the reported incidences of mental health issues have increased over time with over Ninety Thousand (90,000) visits to public health facilities for mental health conditions reported in 2013 and 2014 (Jamaica Gleaner, 2016 as seen in Pan American Health Organization – PAHO Report). This number was increased to One Hundred and Eight Thousand (108,000) and one Hundred and Thirty-two Thousand (132,000) visits recorded in 2015 and 2016 respectively (Jamaica Gleaner, 2016 and Ministry of Health, 2017).  Additionally, it is said that about Three (3%) percent of the population suffers from depression, which is a form of mental disorder, with women reportedly experiencing the condition more than men (Global Burden of Disease Database, 2017).

Mental health disorders are complex and can take varied forms according to the World Health Organization’s (WHO) International Classification of Diseases (ICD-10). The definition incorporates disorders such as depression, anxiety, bipolar, schizophrenia and even eating disorders.  Further, while mental health disorders can afflict anyone, of any age or ethnicity, global reports indicate that half of all mental health illnesses commence at the age of Fourteen (14) years.  

Furthermore, suicide is said to predominantly affect individuals within the age range of Fifteen to Twenty-nine (15-29) years of age (World Health Organization – WHO).  To this extent, research indicates that persons who suffer from severe mental health conditions usually have a shorter life span due to premature death, at least Ten (10) years early (WHO).

While particular pharmaceutical regimens are in place to help with the management of mental health disorders, increasing research has shown that physical activity can have a profound effect on one’s mental health and well-being.  As such, increasing research indicates exercise as an alternative or adjunct treatment as it relates to one’s mental health and well-being, especially for mild and moderate cases of depression and anxiety. Anxiety and Depression are regarded as two (2) of the most recorded incidences of mental health, globally. Let’s Discuss!

You can read more about exercise and its benefits in this article:

• Exercise, it is more than just for weight loss!

The Discussion

Mental health is defined as how one thinks, feels and behaves when coping with life (National Institute of Mental Health, 2007).  ManderScheid et al. (2010) went on further to define it as any condition that affects one cognition, emotion and or behaviour in general.  Mental disorders can take the form of a severe condition if it greatly interferes with or limits one or several major life activities, or milder, if otherwise (Substance Abuse and Mental Health Services Administration -SAMHSA, 2020).  

On the other hand, mental illness speaks to all diagnosable mental disorders, which are defined as any health conditions that are characterized by changes in mood or behaviour that bring about some form of distress or impaired functioning (United States Department of Health and Human Services – USDHHA, 1999, p.4)

Mental health is a serious issue not only in Jamaica but globally.  While the epidemiology of mental illnesses as it relates to Jamaica and other Caribbean Nationals is only recently being studied and documented (Hickling, 2005), research is indicating that it is trending upwardly and is expected to be even higher, particularly due to the current pandemic. 

To bring the expected climbing trends into focus, a documented study in 1990, conducted in Kingston Jamaica (La Grenade-Fletcher, 1990), indicated that Thirty-two (32) of Ninety-eight (98) patients then (or 33%) reported non-psychotic psychiatric problems while another study by (Gordon, 1984) found a significant number of patients reportedly suffering from non-psychotic psychiatric issues like depression and anxiety, particularly, among University students. 

Additionally, a most recent report in 2017, suggested that Eighteen (18%) percent of Jamaicans between the ages of Thirteen to Seventeen (13-17) years of age attempted suicide, while those between the ages of Fifteen to Thirty-four (15-34) years of age reportedly have the highest prevalence of depression (Global School Health Survey, 2017).

Globally, it is estimated that over Nine Hundred and Seventy (970) million individuals have a mental health disorder (Our World in Data, 2018). Anxiety, one of the most common forms of mental illnesses in the world affects about Two Hundred and Eighty-four (284) million people (Our World in Data, 2018), with depression, bipolar etc. being denoted as the leading cause of disability in the USA (U.S. Burden of Disease Collaborators, 2013). While anyone can become afflicted with a mental disorder, it is purported that these disorders afflict females more than males, a ratio of 11.9% to 9.3% respectively (Our World in Data, 2018).

Nonetheless, while mental health disorders can be complex, particularly as it relates to severe psychosis, research has shown that physical activities can be a beneficial tool in the management of one’s mental health and overall well-being (Stathopoulou et. al. 2006).  Several researches have shown that exercise was able to contribute to the improvement of symptoms including mood, concentration, alertness, quality sleep and pattern of sleep as well as psychotic symptoms (Alexandratos, 2012).  

In this article, we will be exploring how exercise and physical activities, in general, can positively impact one’s mental health and well-being particularly, as it relates to incidences of depression, anxiety and positive mood.  The investigation will also incorporate exercise benefits on quality sleep and one’s self-esteem, which can impact one’s overall state of mental health. 

You can read more on exercise and mental health as well as how to create an effective fitness routine here:

• Exercise, it is more than just for weight loss!
• How to create that ‘hiit’ fitness routine

Benefits of Exercising and Mental Health:

• Managing Depression
• Managing Anxiety
• Helping with Positive Mood, Quality Sleep and Positive Self-Esteem.

Exercise and Depression

Depression is defined as a state of feeling hopeless or a sense of defeat (Landers, 1997).  Some other researchers describe it as a feeling of ‘down’ or ‘blue’ even when the circumstances indicate otherwise (for example, a happy occasion), but the individual still feels down and gloomy. (Landers, 1997).  All of us feel ‘depressed’ or down at times, however, someone who feels this way most of the time may be considered ‘depressed.’

Depression is a prevalent occurrence in our society.  According to Kessler et al. (1994), a researcher in the United States of America (USA), clinical depression affects about 2-5% of Americans, annually. The statistics are somewhat similar to that of Jamaica, with a Pan American Health Organization (PAHO) report of 2019 denoting that the condition affects about 3% of Jamaicans with women being affected more than men.  

Globally, the disorder is said to affect an estimated 5.0% of adults (Institute of Health Metrics and Evaluation, 2019).  It is reported to be the leading cause of disability worldwide and thus a major contributor to the overall burden of diseases, globally (WHO).  Depression can lead to suicide, and as such, a serious concern among many nations.

The typical treatment for depression is anti-depressants along with the cost associated with treating someone with the disorder. As such, more and more countries are finding alternative therapies to manage the condition, less costly. This is where the increasing research on exercising and its benefits for depression can play a role. 

Exercise has been proposed as one of the alternative approaches to treating depression (Hales and Travis, 1987; Martinsen, 1987, 1990).  Many researches as far back as 1905 have shown that there is a positive relationship between exercise and decreased depression (Franz and Hamilton, 1905; Vaux, 1962).  In fact, over One Hundred (100) studies have been conducted from as early as the 1900s, investigating this phenomenon (Landers, 1997). 

Several meta-analyses have consistently shown the positive effects of exercise, acute or chronic on depression (Landers, 1997). These researches have shown that exercise can have an anti-depression effect on the body from as little as the first session, which becomes greater as an individual continues through with a particular routine (Craft, 1997; North et. al. 1990).  The effects were said to be effective, irrespective of one’s age, gender and the form of depression being experienced.  However, more lasting effects were realized if the exercise programme lasted for at least nine (9) weeks (Craft, 1997; North et. al. 1990). 

Therefore, the researchers contend that high-intensity interval training (HIIT) routine or longer duration workouts performed over an extended period were more effective, and could render patients being considered medically rehabilitated (North et al. 1991).  It must be noted though, that for this research, most of the patients were suffering from moderate or mild depression.  Nonetheless, more studies would be needed to explore the effects of exercise on patients with severe depression.  

This is due largely to some of the inconsistencies that have been found as it relates to comparing exercise to more traditional treatments employed for depression such as psychotherapy and behavioural interventions (i.e. relaxation and meditation).  However, a study by North et al. (1990) purported that exercise had the potential to decrease depression more than relaxation therapies. The results were similar to those that would have been experienced via psychotherapy (Craft, 1997).

To this extent, healthcare providers are encouraged to view exercise as an alternative or adjunct treatment for depression, especially, seeing that in addition to decreasing depression, persons will experience other benefits such as the reduced risk of the incidences of heart disease and obesity, which can lead to the prevalence of other life-threatening conditions.

Exercise and Anxiety

Anxiety is defined as a state of well-being which is characterized by self-doubt and hesitation (Lazarus and Cohen, 1977).  The condition is classified as severe when this state of ‘self-appraisal’ persists over a long period.  Anxiety can be of two (2) types – Trait and State. Trait anxiety is the general predisposition to respond to many situations with high levels of anxiety while state anxiety is much more specific and speaks to one’s anxiety at a particular moment in time (Smith, 1989).

While the incidences of anxiety or mental health are often unreported, the latest report from PAHO-IRIS on mental health in Jamaica purports that over 4% of Jamaicans suffer from anxiety with the condition being prevalent in persons between the ages of Twenty to Thirty-four (20-34) years of age, especially for most new cases and Thirty-five to Fifty-nine (35-59) age groups in general (PAHO – IRIS, 2019). Other estimates around the world appear a bit higher with the United States having an estimated 7.3% of its adult population suffering from the disorder (Regier et. al. 1988).  

The African Region, which is said to have a bit lower rate of anxiety, reported a 2.9% among its population, which was similar to that of the European Region (WHO Report, 2017). According to the World Health Organization (WHO), worldwide reports of anxiety are 3.6% or about Two Hundred and Sixty-four (264) million people suffer from the disorder.  The report further contends that females are inflicted more than males with reportedly 4.6% women and 2.6% men, globally (WHO Report, 2017).

In an examination of Twenty-seven (27) narrative reviews by researchers conducted between 1960 and 1997, it was found that over Eighty-one (81%) percent of those researchers concluded that physical activity/exercise resulted in a reduction of anxiety (Landers and Petruzzello, 1994).  Additionally, there were no or very little conflicting data presented in these reviews (Landers, 1997).  Further, the remaining research (19%) indicated that exercise did reduce anxiety, but some results were conflicting.  However, all the research showed that a relationship existed between exercise and anxiety reduction.

Research has also shown that persons will experience better effects for anxiety from exercises such as aerobic (e.g. running, swimming and cycling) as opposed to non-aerobic ones such as strength and flexibility training (Kugler et al. 1994; Petruzello et. al. 1991). The best results were experienced when this type of exercise was performed for Ten (10) weeks and even greater when performed over Fifteen (15) weeks. (Kugler et al. 1994). Anxiety is usually reduced Four to Six (4-6) hours after exercise, before returning to pre-exercise levels (Landers and Petruzzello, 1994). Nonetheless, exercise is denoted as a useful technique for managing anxiety especially, since other benefits of exercise can be gained.

Exercise and Positive Mood, Quality Sleep and Positive Self-Esteem

Exercise has also shown to have a positive effect on positive mood, one’s self-esteem and quality of restful sleep.  However, the research on positive mood is not fully known due to this being a new and novel area to be explored.  Research does contend that meta-analysis would be as encouraging as those on other aspects of one’s mental health.  

Nevertheless, research relating to self-esteem has been abundant and has shown that exercise can increase one’s physical self-concept or self-esteem, not only in one particular gender but across genders and age groups (Calfas and Taylor, 1994; Gruber, 1986; McDonald and Hodgen, 1991; Spence et al. 1994).  As it relates to children, research shows that aerobic exercise has a greater effect on their self-esteem (Gruber, 1986).  According to research, exercise can significantly increase total sleep time as well as quality and restful sleep (O’Connor and Youngstedt, 1995; Kubitz et al. 1996). 

What are the types of Exercises and Duration for Mental Health?

Research has shown that all types of physical activity can positively impact one’s mental health.  However, aerobic exercises, which include jogging, swimming, cycling, gardening and even dancing have been shown to help with both depression and anxiety.  Aerobic exercises have also shown to be able to enhance self-esteem, both in adults and children. 

While walking has been proven a very beneficial exercise for one’s overall mental health, research has shown that mixed types of exercises such as weight training and yoga can be more beneficial than walking alone (Alexandratos, 2012). Additionally, research has shown that persons who engaged in acute bouts of exercise went to sleep quicker, slept longer as well as had more restful sleep than persons who did not exercise (Kubitz et al. 1996). 

Exercise intensity and duration for statistical differences vary across studies. This is due largely to the methods used to measure exercise-related mental gains such as self-reports and other behavioural analyses. However, exercising at least three (3) times per week for at least thirty (30) minutes at moderate intensity has been proven sufficient, particularly as it relates to both depression and anxiety.  Nonetheless, if time is a major factor, research has shown that exercise duration of at least Twenty-one (21) minutes was effective at reducing both trait and state anxiety (Petruzello et. al. 1991). 

Illustrative Summary

Here is a summary of Some of the main benefits of Exercise and Mental Health.

Let’s Sum Up!

Mental health is a global issue trending in the realm of a global crisis if it is not taken seriously both at the country level and worldwide.  While the disorder can take many forms and has been largely unreported over the years, increasing research is now being published highlighting its effects on individuals and the country’s economy.

Although treatments such as psychotherapy, medication, hospitalization and even lifestyle changes in the form of self-help resources have been employed to treat or manage varying mental health issues, one of those presumably helpful tools that have been largely underutilized is exercise.  Nonetheless, research has shown that exercise does have a positive link to one’s mental health.  

Several studies have shown that exercise can significantly decrease depression and anxiety as well as improve one’s mood, positive self-esteem and quality sleep.  As such, exercises such as aerobic and strength training can indeed improve one’s physical appearance but have been shown to be able to help with the management of mental health issues as discussed throughout this article.  Nonetheless, its effects on more severe mental health issues warrant further research.

A little movement count? Therefore, in addition to medical guidance and other therapies used in the treatment and management of mental health disorders, it wouldn’t help for us to simply move our bodies, regularly and in purposeful ways. 

Remember, physical activities go well beyond just planned workout sessions, but any activity that involves bodily movement, for example, playing, completing work chores and recreational activities, etc, counts in this category (World Health Organization, 2011). So, Get Your Fit On!

To further help you on your mental and overall health journey, why not check out these other posts on exercising:

• • Exercise, it is more than just for weight loss!
  • How to create that ‘hiit’ fitness routine.
  • Don’t Tuck It In! – Here are 5 exercises to strengthen and tone the Abs at home.
  • Want Sexy Arms? Here is a list of 5 Exercises to give you that sculpted look.
  • The Mighty Plank – One Exercise, Many Benefits – Here are Five (5) Reasons to add it to your Exercise Routine.

Editor’s Note: Article updated on July 9, 2024.

References

• Allen EA, Gordon AI. Psychiatric morbidity and related factors in West Indian students. West Ind Med J. 1984;33(4):252–7.
• Alexandratos, Kristy & Barnett, Fiona & Thomas, Yvonne. (2012). The Impact of Exercise on the Mental Health and Quality of Life of People with Severe Mental Illness: A Critical Review. British Journal of Occupational Therapy. 75. 48-60. 10.4276/030802212X13286281650956.
• Calfas, K.J., & Taylor, W.C. (1994). Effects of physical activity on psychological variables in adolescents.  Pediatric Exercise Science, 6, 406–423.
• Craft, L.L. (1997). The effect of exercise on clinical depression and depression resulting from mental illness: A meta-analysis. Unpublished master’s thesis, Arizona State University, Tempe.
• Franz, S.I., & Hamilton, G.V. (1905). The effects of exercise upon retardation in conditions of depression.
• Gruber, J.J. (1986). Physical activity and self-esteem development in children. In G.A. Stull & H.M. Eckert (Eds.), Effects of physical activity and self-esteem development in children. (The Academy Papers No 19, pp.  30–48). Champaign, IL: Human Kinetics Publishers.
• Hales, R., & Travis, T.W. (1987). Exercise as a treatment option for anxiety and depressive disorders. Military Medicine, 152, 299–302.
• Hickling FW. The epidemiology of schizophrenia and other common mental health disorders in the English-speaking Caribbean. Rev Panam Salud Publica. 2005 Oct-Nov;18(4-5):256-62. doi: 10.1590/s1020-49892005000900005. PMID: 16354422.
• Institute of Health Metrics and Evaluation. Global Health Data Exchange (GHDx).  http://ghdx.healthdata.org/gbd-results-tool?params=gbd-api-2019-permalink/d780dffbe8a381b25e1416884959e88b (Accessed 1 October 20, 2021)
• Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshelman, S., Wittchen, H.U., & Kendler, K.S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Co-morbidity Survey. Archives of General Psychiatry, 51, 8–19.
• Kubitz, K.K., Landers, D.M., Petruzzello, S.J., & Han, M.W. (1996). The effects of acute and chronic exercise on sleep. Sports Medicine, 21(4), 277–291.
• Kugler, J., Seelback, H., & Krüskemper, G.M. (1994). Effects of rehabilitation exercise programmes on anxiety and depression in coronary patients: A meta-analysis. British Journal of Clinical Psychology, 33, 401–410. Landers, D.M., & Petruzzello, S.J. (1994). Physical activity, fitness, and anxiety. In C. Bouchard, R.J. Shephard, & T. Stevens (Eds.), Physical activity, fitness, and health. Champaign, IL: Human Kinetics Publishers.
• La Grenade-Fletcher J. Non-psychotic psychiatric morbidity in general practice: implications for service delivery and training. [Dissertation]. Mona, Kingston, Jamaica: University of the West Indies; 1990.
• Landers, D. M., & Petruzzello, S. J. (1994). The Effectiveness of Exercise and Physical Activity in Reducing Anxiety and Reactivity to Psychosocial Stressors. In H. A. Quinney, L. Gauvin, & A. E. Wall (Eds.), Toward Active Living: Proceedings of the International Conference on Physical Activity, Fitness, and Health (pp. 77-82). Human Kinetics Publishers Inc..
• Landers, Daniel. (1997). The Influence of Exercise on Mental Health. President’s Council Phys Fitness Sports Res Dig. 2.
• Lazarus, R.S., & Cohen, J.P. (1977). Environmental stress. In I. Altman & J.F. Wohlwill (Eds.), Human behavior and the environment: Current theory and research. New York: Plenum Press.
• Manderscheid, Ron & Ryff, Carol & Freeman, Elsie & McKnight-Eily, Lela & Dhingra, Satvinder & Strine, Tara. (2010). Peer Reviewed: Evolving Definitions of Mental Illness and Wellness. Preventing chronic disease. 7. A19.
• Martinsen, E.W. (1987). The role of aerobic exercise in the treatment of depression. Stress Medicine, 3, 93–100.
• Martinsen, E.W. (1990). Benefits of exercise for the treatment of depression. Stress Medicine, 9, 380–389.
• McDonald, D.G., & Hodgdon, J.A. (1991). The psychological effects of aerobic fitness training: Research and theory. New York: Springer-Verlag.
• North, T.C., McCullagh, P., & Tran, Z.V. (1990). Effect of exercise on depression. Exercise and Sport Science Reviews, 18, 379–415.
• O’Connor, P.J., & Youngstedt, M.A. (1995). Influence of exercise on human sleep. Exercise and Sport Science Reviews, 23, 105–134.
• Petruzzello, S.J., Landers, D.M., Hatfield, B.D., Kubitz, K.A., & Salazar, W. (1991). A meta-analysis on the anxiety-reducing effects of acute and chronic exercise. Sports Medicine, 11(3), 143–182.
• Regier, D.A., Boyd, J.H., Burke, J.D., Rae, D.S., Myers, J.K., Kramer, M., Robins, L.N., George, L.K., Karno, M., & Locke, B.Z. (1988). One-month prevalence of mental disorders in the United States. Archives of General Psychiatry, 45, 977–986.
• Smith, R.E. (1989). Conceptual and statistical issues in research involving multidimensional anxiety scales.  Journal of Sport and Exercise Psychology, 11, 452–457.
• Spence, J.C., Poon, P., Dyck, P. (1997). The effect of physical-activity participation on self-concept: A meta-analysis (Abstract). Journal of Sport and Exercise Psychology, 19, S109.
• Stathopoulou G, Powers M, Berry A, Smits J, Otto M (2006) Exercise interventions for mental health: a quantitative and qualitative review. Clinical Psychology: Science and Practice, 13(2), 179-93.
• Vaux, C.L. (1926). A discussion of physical exercise and recreation. Occupational Therapy and Rehabilitation, 6 , 30–33.