Exercise and Mental Illness
Exercise is an essential part of one’s daily life, whether it consists of lifting weights, running, playing a sport, or simply walking. Most individuals incorporate exercise in their schedules without even realizing it, while others make it their entire persona. In fact, in modern times, people have made themselves known on social media as fitness influencers who provide valuable health information to teenagers and young adults who desire a satisfactory physique or lifestyle. Despite the amount of resources that these rising athletes and dedicated individuals possess, there is one specific issue that acts as a barrier: mental illness.
Mental illnesses are health conditions that directly relate to neurological changes. Essentially, a person’s thinking process, which would typically use positive, normal levels of emotional and logical thinking, changes. Their emotions become extreme, they may not be able to think straight, or both of these may occur simultaneously. However, mental illnesses are not just limited to alterations in emotional and logical thinking. Similar to physical injuries that athletes suffer from, or any physical disease or condition for that matter, mental illnesses may lead to changes in physical behavior.
Anxiety Disorders Negatively Alter Physical Behavior and Health
As stated in the article “Effects of Anxiety on the Body” by Kristeen Cherney, PhD, chronic anxiety, which consists of extreme feelings of anxiety lasting for a minimum of six months, has numerous effects on the human body, such as breathing problems. When people participate in activities or sports that incorporate long periods of running, such as track, soccer, and American football, they must breathe in a way that enables them to minimize the loss of breath, exhaustion, and fatigue. However, as soon as a panic attack happens, the individual who would be running at their normal pace, instead runs at a slower pace due to the consequential rapid, shallow breathing. Over time, with frequent panic attacks, the consistent change in breathing affects a person’s long-term improvement in running. In the article “EXERCISE INTOLERANCE: CAUSES, SYMPTOMS AND RESPIRATORY MUSCLE TRAINING” by Patrick McKeown, who lists the causes, symptoms, and training of exercise intolerance, it is stated that having a disproportionate pattern in breathing may lead an individual to lack the endurance needed for physical exercise, indicating that they may be suffering from a negative trait called exercise intolerance. This occurs when a person’s body may not be able to handle the high levels of muscle pain and tension during a workout, which may be caused by inefficient breathing.
Another effect of chronic anxiety disorder is extreme fatigue, which is an extreme tiredness that a person experiences throughout their day. This effect of anxiety has two agenda-related and one applicable effect on one’s lifestyle. Firstly, if an individual experiences great fatigue spontaneously, they may not be able to exercise at a desired time. For example, someone wanting to engage in a sport or physical activity at noon may experience an overwhelming feeling of fatigue at that time, and may lead to the rescheduling of their physical activity to later in the same day or even the next day. This interrupts the person’s usual exercise schedule and can have unusual effects on their body, including developed exercise intolerance. Additionally, If the person were to commit to an exercise, despite fatigue, with the belief that they shouldn’t interrupt their usual schedule, they may exert less effort in their exercise performance, yielding weaker results, a high risk of injury, and ultimately leaving them with negligible improvement. Lastly, great levels of fatigue may interrupt a person’s sleep schedule by encouraging them to relax their body and recover early in the day. If this occurs and the person wastes their valuable time during the day recovering or sleeping, they may miss out on exercise.
A study from Harvard University conducted by John J. Ratey, an expert in neuropsychiatry, summarizes some of the effects of anxiety on the body. Firstly, chronic anxiety increases the risk of acquiring mental illnesses, such as depression, long-term dips in one’s emotional health that occur at abnormally high intensities. This consequently leads to detrimental effects, in addition to the disproportionate breathing and extreme fatigue that the person already suffers from. People with this mental illness “find it difficult to get started or get motivated, or continue to exercise on a long-term basis…” (“Depression and Exercise”, p. 10).
Other than the risk of acquiring additional mental illnesses, the effects of anxiety may induce risk of acquiring type II diabetes, as well. During a fight-or-flight response or panic attack caused by anxiety, the high levels of stress may stimulate the release of many hormones, such as glucagon, adrenaline, and cortisol, which increase blood sugar levels. These hormones may cause insulin resistance, or improper functionality of insulin, a hormone that lowers blood sugar levels. Consequently, hyperglycemia (excessive amounts of glucose or sugar in the blood) occurs and the person is susceptible to acquiring diabetes mellitus. However, stress from anxiety is not just an underlying cause of type II diabetes, but it is also an effect of the condition. Diabetes distress is a feeling of overwhelmingness that someone experiences when their daily life with diabetes becomes too much for them to manage. This worsens the impact of diabetes on the body and consequently may lead to life-threatening symptoms, such as from DKA (diabetes-related ketoacidosis), a complication of diabetes that sprouts when the body can’t produce sufficient amounts of insulin. When someone experiences excessive symptoms due to the worsening of diabetes, they may suffer from DKA and are at risk of death. Individuals exposed to these symptoms should seek medical attention as soon as possible and mitigate any factors that contribute to their stress in order to reduce or stop the development of their diabetes.
Exercise And Endurance Positively Alters Effects of Anxiety Disorder
Although anxiety disorders may have negative effects on exercise and physical health, such as fatigue from overstimulation and risk of diabetes due to insulin malfunction and excess of hyperglycemia-provoking hormones, exercise has a contradictory impact on anxiety. In fact, exercise has proven to be the most efficient non-medical treatment for anxiety disorder. There are various neurological effects of exercise that prove its effectiveness in reducing a person’s overall stress levels and improving their mental health.
Recent studies have shown that when a person incorporates aerobic exercise regularly in their schedule, their sympathetic nervous system and hypothalamic-pituitary-adrenal, or HPA, axis reactivity declines. Essentially, the human body responds less dramatically to external stimuli like danger and stress. The sympathetic nervous system has a role in responding to stressful circumstances and is responsible for the fight-or-flight response of the body, releasing high levels of both adrenaline and cortisol in the process that risk diabetes. The HPA axis also releases hormones that increase cortisol levels in the body when it is exposed to stress. If the sensitivity of both of these systems is reduced, then the body wouldn’t contain abnormal levels of cortisol or adrenaline, and an individual would not risk diabetes or suffer from effects not only from anxiety but from regular stress alone.
Focusing on the HPA axis and its effects, studies have shown that changes in the HPA axis sprouting from exercise and physical activity have controlled human anxiety. For example, exercise alters the rate that the corticotropin-releasing factor and adrenocorticotropic hormone releases from the brain. Chronic stress, or chronic anxiety has been proven to cause low levels of peripheral cortisol and increased levels of glucocorticoid receptors. These both simply mean that the reactivity of the system is increased. Studies on animal figures show that regular aerobic exercise can be a substitute for antidepressants, as they reduce serotonergic and noradrenergic levels, which have similar functions to glucocorticoid receptors. For example, after running for a lengthy period of time, an animal is shown to have increased levels of norepinephrine in their hippocampus and frontal cortex; they are also shown to have increased serotonergic neural activity. A lack of serotonergic and noradrenergic in the brain is associated with a slow synthesis rate; however, after exercise, this synthesis rate increases after exercise and the brain can restore regular amounts of these two hormone levels.
Referring back to the antidepressant effect of regular aerobic exercise proven in animal studies, there is an additional, more neurological piece of evidence that serves as an antidepressant, as well. Brain-derived neurotrophic factor is a neurotrophin in the brain that when in low amounts can cause depressive and anxiety-related behaviors. Increasing this neurotrophin ultimately causes antidepressant and anti-anxious symptoms; moreover, one way to increase the factor is to participate in physical activity. One study measured two groups of rats that, respectively, did and did not participate in running. The results showed that the BDNF levels increased in the rats who did participate in running as opposed to the rats who did not. Another study examined the effects of aerobic exercise in young adult men who showed healthy standing; it was stated that “physical exercise caused an average ~ 32% increase in sBDNF levels relative to baseline…” (Matthew T. Schmolesky, David L. Webb, and Rodney A. Hansen, p. 1) In both animals and humans, BDNF levels increase from aerobic exercise, helping mitigate anxiety-related symptoms.
Summarizing an additional animal study, exercise has been proven to increase hippocampal neurogenesis, or the development of neurons in the brain. This mitigates the effects of anxiety as it counters the negative effect (neurodegeneration) that high levels of glucocorticoids have on the brain. Mentioned before, increased levels of glucocorticoids are caused by chronic anxiety. Proven in a study that compared levels of vascular endothelial growth factor (VEGF), e-selectin (CD62E), endostatin, fibroblast growth factor, and matrix metallopeptidase-9 after exercise, VEGF levels are higher after an individual partakes in physical activity. Additionally, physical activity has been proven to increase the release of positive-inducing hormones called “endorphins,” which essentially upregulate the mood and energy levels of an individual.
Benefits of Endurance Training and Familiarity of Anxiety Symptoms
Some authors state that the effects of exercise on the body may amplify the symptoms of anxiety. However, long-term aerobic exercise, nevertheless short-term aerobic exercise, actually increases the tolerance of that person to anxiety symptoms. When someone realizes that the symptoms they feel are common in a healthy habit like exercising, they see their disorder as less intimidating and adapt in such a way that mitigates anxiety.
Exercise has been proven to improve an individual's ability to control their life and environment for the better, or self-efficacy. In moderate amounts, physical activity allows individuals to train for endurance, which, in the sense of mental spirit, persuades that person to believe that they can take on any challenge they commit to overcome. For example, someone who may do calisthenics training finds themselves getting stronger, doing the same exercises that they weren’t able to effectively complete beforehand. Eventually, they adapt to the exercises and find that their increased self-efficacy ultimately alleviates their anxiety symptoms.
Through the various hindrances that anxiety has on one’s physical activity and health, as well as the benefits that exercise has on anxiety, it is shown that there is a correlation between the two variables. There is minimal evidence that anxiety can offer positive effects during exercise and when reaching their goals, as, according to one article focusing on just the feeling of anxiety, it may trigger the brain to release goal-seeking inducing chemicals. However, this point would indicate that there is a mutual relationship between anxiety and physical activity, which is false. There is enough evidence to disprove this theory and according to recent studies, there seems to be a parasitic-like relationship that will continue to be upheld through further research and experiments.
Written by: Ahad Rahman
Works Cited
Njoku, I. (2022, November). What is mental illness? American Psychiatric Association.
https://www.psychiatry.org/patients-families/what-is-mental-illness
Cherney, Kristeen, PhD (2022, May 17). Anxiety Disorders: Causes, Types, Symptoms, & Treatments. Healthline. https://www.healthline.com/health/anxiety#What-is-anxiety? https://www.healthline.com/health/anxiety/effects-on-body
Exercise Fatigue. (n.d.). Jacksonville Orthopaedic Institute.
https://www.joionline.net/trending/content/exercise-fatigue#:~:text=Fatigue%20is%20often%20restricted %20to
Exercise Intolerance: Causes, Symptoms, how to Overcome. (2023, January 16). Oxygen Advantage®. https://oxygenadvantage.com/science/exercise-intolerance-symptoms-causes/#:~:text=Sometimes%2C%2 0exercise%20intolerance%20can%20occur
MD, J. J. R. (2019, October 24). Can exercise help treat anxiety? Harvard Health. https://www.health.harvard.edu/blog/can-exercise-help-treat-anxiety-2019102418096#:~:text=The%20toll %20of%20anxiety%20can
Services, D. of H. & H. (n.d.). Depression and exercise. Www.betterhealth.vic.gov.au. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/depression-and-exercise#:~:text=Peop le%20with%20depression%20may%20find
Stress and diabetes. (n.d.). Diabetes UK.
https://www.diabetes.org.uk/guide-to-diabetes/emotions/stress#:~:text=Stress%20alone%20doesn%27t%2 0cause
Clinic, C. (2023). Diabetes: What It Is, Causes, Symptoms, Treatment & Types. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/7104-diabetes#:~:text=You%20may%20develop%20additio nal%20symptoms
Clinic, C. (2024). Hypothalamic-Pituitary-Adrenal (HPA) Axis: What It Is. Cleveland Clinic. https://my.clevelandclinic.org/health/body/hypothalamic-pituitary-adrenal-hpa-axis#:~:text=The%20HPA %20axis%20produces%20a
Cleveland Clinic. (2022, June 6). Sympathetic Nervous System (SNS): What It Is & Function. Cleveland Clinic.
https://my.clevelandclinic.org/health/body/23262-sympathetic-nervous-system-sns-fight-or-flight#:~:text= Your%20sympathetic%20nervous%20system%20is%20best%20known%20for%20its%20role
Anderson, E., & Shivakumar, G. (2013). Effects of Exercise and Physical Activity on Anxiety. Frontiers in Psychiatry, 4(27). https://doi.org/10.3389/fpsyt.2013.00027
Vyas, S., Rodrigues, A. J., Silva, J. M., Tronche, F., Almeida, O. F. X., Sousa, N., & Sotiropoulos, I.
(2016). Chronic Stress and Glucocorticoids: From Neuronal Plasticity to Neurodegeneration. Neural Plasticity, 2016, 1–15. https://doi.org/10.1155/2016/6391686
Mayo Clinic . (2020, August 18). Exercise and stress: Get moving to manage stress. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-2004446 9#:~:text=Exercise%20increases%20your%20overall%20health
Song, B., Azhar, L., Ka, G., Marzolini, S., Gallagher, D., Swardfager, W., Chen, C., Ba, J., Herrmann, N., & Lanctôt, K. L. (2023). The effect of exercise on blood concentrations of angiogenesis markers in older adults: a systematic review and meta-analysis. Research Square (Research Square). https://doi.org/10.21203/rs.3.rs-2468576/v1
Are There Potential Benefits to Having Anxiety? (n.d.). Verywell Mind.
https://www.verywellmind.com/benefits-of-anxiety-2584134#:~:text=Anxiety%20can%20create%20stres s%2C%20but
Why You Should Try Calisthenics. (n.d.). Cleveland Clinic. https://health.clevelandclinic.org/calisthenics
Schmolesky, M. T., Webb, D. L., & Hansen, R. A. (2013). The Effects of Aerobic Exercise Intensity and Duration on Levels of Brain-Derived Neurotrophic Factor in Healthy Men. Journal of Sports Science & Medicine, 12(3), 502–511. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3772595/
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