Summary: Recently an article was published that stated exercise should be the new primary prescription for mental health disorders, however, as of right now there are a number of reasons why this should not be the case. While exercise has shown proven benefits in individuals with various disorders, only depression has adequate evidence to suggest exercise can potentially replace psychotherapy or medication. Until more thorough research is conducted on a multitude of disorders, exercise needs to be promoted along with traditional therapies or done on a case by case basis if it is to be the sole treatment.
Source: Neuroscience News
With regards to the article ‘Exercise is the new primary prescription for those with mental health problems’ written on May 23, 2019, I believe it is very important for exercise to be brought to the forefront of mental health treatment, as there are many known benefits. However, I do not think it can be said yet that exercise should be the primary or sole treatment for mental health disorders for a number of reasons.
Exercise can certainly be beneficial for individuals with mental health disorders. To focus on a few benefits, the symptoms of disorders such as depression and schizophrenia can improve with exercise, as well as cardiorespiratory fitness and quality of life. Only depression, however, has adequate evidence to suggest exercise has a comparable effect to therapy and medication; studies have shown exercise alone is beneficial to participants with depression, and when compared to typical treatment options, exercise can either work similarly to these treatments or can be more advantageous.
That being said, I think the public should understand the importance of checking the sources of information used in an article before believing something to be fact. Although the original article quotes David Tomasi, the lead researcher of the study, saying psychiatry facilities should include exercise as the primary treatment for mental health disorders, nowhere in the study does it state this, yet the article ran with this statement as the title. What the article does state is the patients self-reported they felt better both mentally and physically and had the intention of continuing to exercise following the implementation of an exercise program in addition to nutrition sessions; 93.2-96.8% of individuals believed exercise improved their mood and 97.6-100% believed they would continue to exercise after the program.
The finding of this study alone cannot be relied on for a new mental health prescription, due to the lack of consistency within this area of research and the lack of reliability of the study. There are many questions that arise from reading this study that I believe need to be answered before it can influence treatment prescription: what role did the nutrition portion of the program play in the patients’ perceived mood changes? Did the fact that the exercise room was the only shared area on the ward that had natural light and scenery decorations affect mood and desire to exercise? At what intensity were the patients performing exercise? Were the patients taking medication during this study? What about long-term effects and adherence rates to exercise prescription? Would a follow-up study find different results? How would the results compare using objective data? Can this be generalized to other patient populations? The answers to these questions could be different compared to what another study finds, but as a consideration: a meta-review about exercise and severe mental illness found exercise for major depression and schizophrenia to be most beneficial at a moderate to vigorous intensity, overall 17.2% of depression patients and 26.7% of schizophrenia patients dropped out of interventions, and in some follow-up studies there was no longer a significant exercise effect reported. These are all factors to consider when prescribing exercise as a treatment for mental illness disorders, and additional factors that have not gotten enough attention include training of professionals and cost.
As a kinesiology student, I understand how important physical activity is for all individuals, including those with mental health disorders. Unfortunately, the research does not provide enough evidence overall to state that exercise should be the primary source of treatment. Ultimately, until all the details are worked out, exercise needs to be promoted along with other traditional therapies, such as psychotherapy and medication or should be done on a case by case basis in consultation with medical professionals if it is to be the sole treatment.
Thanks to Catherine Murrin for providing this rebuttle.
The image is in the public domain.
Kvam, S., Kleppe, C. L., Nordhus, I. H., & Hovland, A. (2016). Exercise as a treatment for depression: A meta-analysis. Journal of Affective Disorders. doi: 10.1016/j.jad.2016.03.063
Stubbs, B., Vancampfort, D., Hallgren, M., Firth, J., Veronese, N., Solmi, M., … Kahl, K. G. (2018). EPA guidance on physical activity as a treatment for severe mental illness: A meta-review of the evidence and position statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental. European Psychiatry doi: 10.1016/j.eurpsy.2018.07.004.
Tomasi, D., Gates, S., & Reyns, E. (2019). Positive patient response to a structured exercise program delivered in inpatient psychiatry. Global Advances in Health and Medicine. doi: 10.1177/2164956119848657