In Germany, if a person presents to their doctor with symptoms of mild depression they are likely to be handed a prescription... for exercise. Studies have shown that exercise can produce the same modulating effect on mood in mild depression as taking an anti-depressant medication.
So in the face of increasing evidence that exercise is good for boosting our mental health, what are some of the psychosocial factors that could be at play here?
Is it that physical activity has a positive effect on body weight and structure which leads to positive feedback from peers, leading to improved self image and ultimately improved mental health? This is known as the self image hypothesis.
Or is it the social aspects from relationships established in a team between members and the resulting mutual support that makes a difference This is the social interaction hypothesis.
Or is it a combination of factors? Not all exercise involves teams - much sport is performed by individuals.
A recent study from the Netherlands sought to examine the relationship of these two hypotheses in relation to exercise and adolescent mental health.
In the study over 7000 Dutch students aged between 11 and 16 completed validated surveys looking at their level of physical activity, mental health problems, body weight perception and participation in organised sports. In addition they gathered data about the age of the adolescents, gender, socioeconomic status, whether they lived at home with their parents and whether they lived in an urban area.
What the researchers found was that body image and social interaction do play a part in explaining the association between physical activity and mental health even without considering the physiological changes that exercise brings about in the brain.
Those adolescents who described poor self image i.e. too fat or too thin were found to be at higher risk of both internalising problems (e.g. depression and anxiety) and externalising problems (e.g. aggressive behaviour or substance abuse). Those who participated in organised sports were found to be at a lower risk of mental health issues.
This study is important as it highlights the need to encourage our children and adolescents to participate regularly in sport to help mitigate some of the risks they face of developing mental health problems.
Yet, the current education system in Australian high schools in particular still appear to be blinkered in accepting the need for the schools to play an active role in encouraging their students to be actively engaged in sport at school: to embed lifelong healthy habits that exercise is fun and a normal part of everyday living to keep us healthy. Too often the excuse is given that the curriculum is full and parents expect their children to be studying hard to do well academically, so the "unnecessary" extras such as P.E. are pared back.
Worse still, risk aversion and fear of litigation from accidents or injuries has led in some instances to removing certain play or sports activities from schools altogether.
In an era where mental health issues are looming ever larger and where depression is now set to become the leading cause of disability in the world by 2020 surely now is the time to ensure that our young people are safeguarded from mental illness by getting the message across that exercise isn't just about being physically healthy, it's about maintaining our mental health as well.
The lead researcher Monshouwer said "we think that these findings are important for policy makers and anyone who works in healthcare or prevention. Our findings indicate that physical activity may be one effective tool for the prevention of mental health problems in adolescence."
What do you think?
Karin Monshouwer, Margreet ten Have, Mireille van Poppel, Han Kemper, Wilma Vollebergh. “Possible Mechanisms Explaining the Association Between Physical Activity and Mental Health: Findings From the 2001 Dutch Health Behaviour in School-Aged Children Survey.” Clinical Psychological Science, September 7, 2012.