Running to the Top: Exercise and Mental Health

An apple a day keeps the doctor away! We've probably been given this advice or know of others who have been given this advice time and time again… to eat healthier, and more important, to exercise. While exercise is not necessarily the cure-all for the world's infections and diseases, it plays an important role in supporting and maintaining good health.

Depression is one of the leading causes of disability worldwide. Depression is associated with morbidity (eg, cardiovascular disease) and premature mortality. There are several mechanisms of action involved in the pathophysiology of depression which include, but are not limited to, inflammation, oxidative stress, genetics, and psychosocial factors.

Available literature indicates that physical activity may reduce the odds of developing depression. One meta-analysis reported 17% lower odds of developing depression among individuals who had higher levels of physical activity. However, this value changes depending on various factors across separate studies (eg, target population, thresholds of physical activity, exposure variables). A recent meta-analysis of 15 prospective cohort studies identified a dose-response relationship along a continuum between physical activity and the risk for depression.

Exercise may influence several pathways involved in the biology and pathophysiology of depression (eg, neuroendocrine and inflammatory pathways, neural plasticity). Exercise is also purported to improve psychosocial and behavioral aspects related to depression.

For example, physical activity has been suggested to improve self-esteem, like body image; provide an outlet for coping and stress; and increase social activity. It has also been suggested that physical activity, and by extension, the effect of the environment, may provide benefits (eg, being in a green space). Taken together, results of this study have important implications for recommendations by health practitioners, as even activity levels below public health recommendations may impart significant mental health improvements.

However, it can be challenging to embrace change or embark on a "fitness journey." To avoid becoming overwhelmed and/or quitting, it's important to take things one step at a time and start with a goal. Identify the objectives for this journey. Find activities that are enjoyable for you. You don't need to start with the hardest exercise; just find something that is pleasurable and something you would look forward to doing, like gardening or walks with friends.

It's important to avoid framing this journey as a chore and instead see it as a vehicle to drive good health. Try to have positive associations with these activities. Next, find a way to stay accountable, whether that's through a friend, a planner, or a tracker.

Also, setting reasonable goals with a sufficient timeline is important. For example, rather than waking up at 4 AM to go running for 3 hours, start with small steps. Be realistic about the journey and stick to the plan, even if you miss a day. Being flexible and riding with the ups and downs is part of the journey. Staying consistent and ensuring that your routine is manageable is key. Celebrate the small victories along the way!

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About Leanna Lui

Leanna M.W. Lui, HBSc, completed an HBSc global health specialist degree at the University of Toronto, where she is now an MSc candidate. Her interests include mood disorders, health economics, public health, and applications of artificial intelligence. In her spare time, she is a fencer with the University of Toronto Varsity Fencing team and the Canadian Fencing Federation.

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Leanna M.W. Lui. Running to the Top: Exercise and Mental Health - Medscape - May 12, 2022.

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