Does exercise improve mental health?

Keep it gentle!

Some fifteen years ago I spent a few weeks as a patient on a psychiatric ward. It was an interesting experience and there’s more I’d like to say about it, but for now let’s stick with exercise.

Even in those dark ages there was evidence that regular exercise tends to improve mood. Here is a more recent example of such research. I was aware of this, although I used to go over the top by training hard at running and climbing, so I was excited to see an exercise bike in a corner of the ward office. I asked if I might use it. The answer was a definite negative. To use dangerous equipment like that you must first be assessed and then supervised by a qualified physiotherapist. Hmmm. Okay, so let’s do that. Really? Are you sure you want to exercise? Well we have a gym elsewhere in the hospital; it might be possible for you to use it. We’ll investigate.

I was lucky, or maybe I kept asking. After only a week a very helpful physio came to see me for a chat, and the next day I was being shown how to use a range of simple kit in the gym. I was a qualified athletics coach, but procedure was procedure and everything had to be explained. I could live with that. After that introduction I was able to visit the gym three times a week, and once I felt up to going out I went for long walks on the other days. The medication I was on made me feel seriously weird – and continued to for the whole two years I was required to stay on it – but gentle exercise made this more bearable. It gave me a change of scenery. Even if I’d only been able to use an exercise bike on the ward it would have enabled me to experience a different environment inside my body.

Our bodies are structured to need regular exercise. Without it no surprise we tend to feel down. One of the problems with depression is the way it discourages you from doing anything that might help. Obviously there is a danger that a patient will overdo it and strain something. More likely is that without encouragement they’ll give up within a week because at first exercise feels bad. Isn’t a psychiatric ward the obvious place to introduce patients to regular gentle exercise with supervision and encouragement? Not everyone with depression may be able to try this, but why is it ignored? Why aren’t psychiatric patients encouraged to at least go for a daily walk?

The local psychiatric hospital is purpose-built and fairly new. I hear it has an exercise room, but you guessed it: patients may not use it unless supervised, and the staff don’t have time.

The level of exercise we’re talking about here is something that increases your rate of breathing a bit but does not have you gasping for air. The aim is to reach twenty minutes a day. If muscles feel sore the next day then take a day off. Walking is great, and if you’re not used to regular walks do not try jogging. Swimming is great. Going to a gym can be good, and gets you amongst non-depressed people. If agoraphobia keeps you indoors try stepping on and off the first step of the stairs (alternating legs) until you begin to feel a bit tired, or consider buying/borrowing an exercise bike – beware of the really cheap ones because they wobble too much. Whatever you try, start gently.

Five minutes walking slowly, or one minute on an exercise bike may be enough for the first day. Try to find someone you can tell about what you’re trying to do so you can brag about every little improvement. Obviously if you’re frail or living alone be careful not to injure yourself – maybe there’s someone could visit for half an hour a day to be with you as you exercise.

This article was prompted by a BBC news item about three times world boxing campion Duke McKenzie who runs exercise classes based around non-contact boxing exercises for mentally ill people. His work is succeeding. Here is the link.

And if the way you live with depression is trying to understand someone else who is depressed, why not identify when they’re having a good day and gently coax them into giving exercise a try. Do it with them!

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