Dr. Suzanne B. Phillips

Licensed Psychologist, Psychoanalyst, Diplomate in Group Psychology, Certified Group Therapist, Author, Radio Host and Media Consultant Covering a Wide Range of Psychological Topics

Post: Exercise for Mental Health: Reasons to Start and Reasons to Stop

mature manDespite the fact that more than 86% of Americans believe exercising for fitness improves a person’s odds of a long and healthy life by “a lot,” only 28% report they actually get as much physical exercise as they should. Some people can’t start; some start and stop; and some can’t stop.

Adding to the exercise benefits for improving physical health, the most recent publication of the Monitor of the American Psychological Association underscores the mounting evidence of exercise benefits on mental health. So clear is the impact of exercise on the body-mind connection that it raises the question of how psychologists might use it as part of their treatment arsenal or at the very least motivate their patients to exercise.

As closer look at some of the findings may provide the tipping point for starting, stopping and moderating exercise in a way that benefits physical and mental health.


Long Term Depression and Relapse Prevention

  • Adding to earlier research that found exercise effective in ameliorating depression, one new study assigned sedentary adults with major depressive disorder to one of four groups including supervised exercise, home-based exercise, antidepressant therapy or a placebo pill. After four months, the antidepressant groups and the exercise groups had the highest rates of remission.
  • Significantly, follow-up after a year found that those who had continued with regular exercise had the lowest depression scores, suggesting that exercise is important in preventing relapse.

A take home point for those who might want to start exercising is the value of “supervised exercise” to provide motivation, support, companionship and feedback.

This could take the form of a personal trainer, a group or a buddy exercise experience.

Consistently people report they would not have exercised had there not been a trainer waiting or a friend on the way.

In this day of social media, a“ home-based exercise” can be enhanced by text, and email reminders or special I-phone apps that bring the reminder and the workout steps or motivation to you.

 The Diabetes-Depression Loop

  • A unique study addressed the problem that the rates of clinically significant depressive symptoms and major depressive disorder are higher among adults with diabetes than the general population.
  • In this study adults with depression and diabetes were in a 12-week exercise and Cognitive Behavioral Therapy (CBT) Program. The results showed that those who exercised showed improvements in depression and blood sugar levels compared with controls.
  • The mind-body connection addressed here is crucial as there is no way to determine if the sedentary lifestyle, which becomes so dangerous, begins with the depression or diabetes.

As discussed in the blog, “Exercise for Depression: Strategies to Make it Possible,” some applications for beginning and continuing exercise might include:

  • Start slowly with something you like doing (walking and talking to a neighbor, walking the dog, walking to music).
  •  According to exercise psychologists, people give up on exercise because it is too much too soon for their body or they don’t see immediate results.
  • Pew Research surveys found that the major factor that differentiated those who kept exercising from those who stopped was the“ fun factor.” People who made exercise a lifestyle choice found something to do that they enjoyed.

Panic and Anxiety

  • Jasper Smitts and Otto, co-authors of the 2011 book, Exercise for Mood and Anxiety, reasoned that people with anxiety and panic not only react with the fight/flight responses of sweating, dizziness, racing heart etc. but have a sensitivity to these symptoms which further exacerbates the panic and anxiety.
  • In their study, 60 volunteers with sensitivity to panic participated in a 12-week exercise program and showed improvements in anxiety sensitivity compared to a control group. Essentially the volunteers had come to associate those same bodily symptoms with safety instead of danger.
  • Another factor that may have contributed to the re-definition of anxiety symptoms is the increased sense of mastery and body control, which the participants had from the 12-week exercise program.

Even at the start of exercising, long before the weight drops or the muscles pop, the very accomplishment of walking 3 blocks instead of one, of walking stairs without being out of breadth, of less ankle swelling etc. offers success for an achievable goal that in turn reduces the sense of helplessness and bodily fears.

Findings Suggest that Exercise Buffers the Brain From Stress

Theories explaining this impact from exercise include the impact of released neurochemicals as endorphins and and serotonin; normalizing sleep which affects body rhythms and the nervous system functioning; and exercise as a meaningful activity that buffers stress by enhancing a sense of accomplishment.

Attention Fatigue (ADHD)

A study intending to examine if walking in a natural winter setting would relieve attention fatigue in adults, found based on pre and post memory scales, mood profiles and self reports that 20 minutes of walking in any outdoor setting, be it a wooded trail, neighborhood or parking lot, provided a significant benefit for short-term memory, tension reduction, depression, anger and fatigue.

  • Given that “no time in the schedule” is the number one reason people report for not exercising, the benefit from 20 minutes of walking outdoors is cause to button-up or find a sunny place to make your move.
  • It also invites thinking about the powerful impact of family walks or parent/ child walks – particularly as we recognize the overscheduled program of children, and the number of children who deal with attention deficit disorder (ADD) and attention deficit hyperactive disorder (ADHD).
  • In this highly connected, technology driven culture, the walk in nature may offer what research suggests as needed time without stimulation to allow the brain to synthesize information, and make connections between ideas. 

Unable to Stop – Exercise Addiction

Given that 7 out of ten American Adults don’t exercise regularly despite the proven health benefits, a group that is often overlooked includes those who have stopped physically or mentally benefiting from exercise. They are the obligatory exercisers for whom exercise has become an addiction.

One man who came to see me with considerable anxiety and despair because his second marriage was ending, mentioned in passing that he awakened every morning at 4:30AM to go to the gym and exercise for 90 minutes. This effort he made to stay in shape also required that he eat certain foods different from what the family was eating, that he be in bed sleeping by 9PM and expand his workouts on the weekends. The cost was an eroded relationship with his wife, very limited family time with his children and considerable fatigue. What was dramatic was that he considered his exercise routine as a necessity for reducing stress in his life – he had never factored this into his problems.

David Linden in his 2011 book, The Compass of Pleasure considers that exercise can activate the pleasure circuit and like food, nicotine or gambling become a substrate for addiction. He notes that exercise addicts display all of the hallmarks of substance addicts: tolerance, craving, withdrawal and the need to exercise “ just to feel normal.”

Exercise addiction is a chronic loss of perspective of the role of exercise in a full life.

Do You Have An Exercise Addiction?

Here are Some Warning Signs:

  • By passing family, friends, events and emotional connections in favor of hours of exercise.
  • Exercising despite illness, injury, fatigue or bodily needs.
  • Continual increase in time, miles or intensity such that exercise takes up all free time.
  • Withdrawal symptoms like anxiety, irritability, and depression when circumstances prevent working out.
  • Inability to see value in unrelated activities and pursuit of the sport or exercise even when it is against his/her best interest.
  • Concern of family and friends for you physical and mental health.
  • Interest in talking only about training or exercise related issues or events.

Reflective of the way in which exercise addiction reverses the physical and mental health benefits of exercise, Jane E. Brody in her blog “ Fit is One Thing: Obsessive Exercise is Another,” reports that the obligatory exercisers often suffer anxiety, apathy, chronic fatigue, decreased appetite, depression, hostility, mental exhaustion, mood changes, changes in values and beliefs, diminished self-image, impaired concentration, emotional isolation, sore muscles and disturbed sleep.

Moderation Strategies

  • Much as it is important to start exercise slowly, it is important to reduce addictive exercising in small steps.
  • Given the thought of stopping often feels untenable, it is worth remembering that your goal is not stopping; but rather, healthy moderation that protects you from stopping due to physical or emotional damage.
  • Consider keeping a log of exercise, family, partner, work and recreational time for a week. Take note of the balance – it reflects the priorities in your life.
  • Consider reducing the intensity and time of your workouts by using a shorter alternative routine (weight lifting, stretch class, etc.) on alternative days.
  • Exercise addiction is often reduced by adding more of a social component that makes it less ritualistic and excessive. On the weekend substitute a workout with a dance class or bike ride with your partner, friend or children.
  • Consider utilizing the help of a trainer, coach or physical therapist to guide you back to a balanced and healthy use of exercise.
  • Recognize if you need professional help.
  • Exercise addictions often reflect a desperate need to be in control or to buoy self-esteem by non-ending goals. They go unnoticed because they are fueled by denial and a dependence on “ the fix” which seems to give you what you need but in the end takes all that you have.

Despite our belief in its benefits- Starting or Moderating Exercise is not easy.

 Most of us will do things that are not easy for those we love.

Take the first step – this one’s for you!

Mature man photo available from Shutterstock.