Physical Activity and Mental Health

Description[edit | edit source]


Physical activity is a world-wide recognised health topic. Individuals and health professionals are becoming increasingly aware of its benefits as well as the implications faced through inactivity. Along with the physical benefits research has shown physical activity to have a positive impact on individual’s mental health. People with mental health disorders experience higher rates of disability and mortality[1], further research in this area is required.

Definition[edit | edit source]

The World Health Organisation (WHO) defines mental health to be; ‘A state of complete physical, mental and social well-being, and not merely the absence of disease’.[2]

Looking specifically at mental disorders the World Health Organisation (WHO) defines this to be; ‘A broad range of problems, with different symptoms’.[3]

NICE (National Institute and Care Excellence) guidelines suggest that the most common mental health disorders range from depression to anxiety disorders. These conditions are recognised as ‘common’ as they affect more people than any other mental health conditions.[4] 

Prevalence[edit | edit source]

  • 1 in 4 people in the UK experience mental health problems in any year.
  • Mental health disorders relate to the largest source of global economic burden projected to cost £1.6 trillion[5]
  • Half of all mental disorders start before the age of 14
  • In England women presented with a higher prevalence of common mental disorders than men (19.7% compared to 12.5%)[6].
  • Approximately only 50% of people diagnosed with mental health disorders receive professional help[7].
  • In the united states, more than 50% diagnosed with mental health disorders at a point in their life, each year 1 in 5 experience mental health disorders.
  • 1 in 25 people in the US experience and live with serious mental illnesses such as schizophrenia, depression.
  • For children, 1 in 5 experience mental illness at some point in their life experience serious mental health problems.
  • According to the national institute of mental health

Benefits of Physical Activity [edit | edit source]



Many people find physical activity to be enjoyable, it can increase confidence and help gain back a sense of control. Physical activity can also encourage social interaction by being in situations with likeminded people.[8] It can help bring about social support which in turn can improve individual’s confidence and sense of achievement,[9]


Studies have been found to show the positive impact physical activity can have on an individual's overall mood.[10] Levels of a neurotransmitter called serotonin which affects mood are shown to increase the following exercise. This rise in serotonin is suggested to help prevent the development of some physical or mental disorders.[11]


Physical activity is shown to improve levels of self-esteem and acceptance. Studies suggest patients should participate in activities which have low levels of stress and competitiveness to help improve their psychological well-being.[12]


Evidence shows that exercise is effective in improving depressive symptoms.[13] Aerobic exercise[14], resistance, and strength training have been found beneficial in improving an individual’s condition.[15] Physical activity is reported to have effects in both clinical and non-clinical settings. Greater improvement is recognised in a clinical environment with those suffering from serious mental illness.[16]


Participants of physical activity benefit from improved cardiovascular and muscle fitness. Maintaining bone strength and aiding functional health. It can reduce individual’s risk of developing several conditions such as hypertension, chronic heart disease, stroke, diabetes, breast/colon cancer, and depression.[17]

Mechanism of effect[edit | edit source]


There are numerous hypotheses that attempt to determine the mechanism of the effect of physical activity on mental health. These can be identified as being psychological or physiological. Research on the hypotheses is limited and it is thought that the true effect is though a combination of psychological and physiological mechanisms.

Psychological[edit | edit source]


Distraction thought to be achieved through individuals moving away and diverting themselves from stressful stimuli which in turn achieves the improved effect associated with exercise.[18][19]


Many people find physical activity to be challenging. By getting into a routine involving physical activity individual's mood and self-confidence will improve.[18]

Physiological[edit | edit source]


This is thought to be where exercise increases the availability of neurotransmitters in the brain. Research is limited in this area.[20]


Physical activity releases endogenous opioids.[21] Physical activity positively impacts common mental disorders and depressive symptoms through the increased release of beta endorphins following exercise. Endorphins are connected to a positive mood and an overall greater sense of well-being.[20]


Thermogenesis relates to the production of the body. Physical activity increases body temperature. Exercise is thought to release a greater sense of relaxation and improved mood.[9]

Barriers to Physical Activity[edit | edit source]

Even with knowing the benefits of physical activity and how it can improve lives, many people still face barriers preventing them from doing it. Barriers can be recognised as either physical, psychological, or socio-ecological.[22][23][24]

Physical Psychological Socioeconomic

Physical illness




Poor motivation

Low self-confidence

High cost

Lack of access to facilities

Lack of time

Lack of social support

Insufficient information/knowledge

Poor environment

High crime rates

We all put up barriers to exercise even when we are aware of the potential benefits. Those suffering from mental illness are no different, however, there are additional factors that may prevent an individual from engaging with physical activity.

  • Physical image - Specifically regarding, excessive body weight. Susceptibility to gain weight may not be from inactivity but can stem from medications.[25][26]
  • Fatigue - Evidence has identified that tiredness and fatigue can be due to medications.[25]
  • Environment - People fear they will be recognised by others in their neighborhood or community for their mental disorder and fear stigmatisation.[26]

Treatment[edit | edit source]

Medication[edit | edit source]


Those with common mental health disorders are found to have symptoms which reduce the likelihood of physical activity.[27]Side effects of medications can also be a barrier to physical activity. There are a variety of different medications individuals can take for their mental health conditions; antidepressants, anti-anxiety, stimulants, antipsychotics, and mood stabilisers.

Possible side effects associated with medication are: nausea, vomiting, weight gain, sleepiness, loss of appetite, headaches, and blurred vision.[28] Both typical and atypical drugs are identified with affecting certain neurotransmitters within the brain which can cause individuals to increase in weight.[29] Determining the correct medications for individuals can sometimes be a long process especially when trying to identify doses. In several cases, individuals report being in periods of sedation this increases times of physical inactivity.[26]

Cognitive Behavioral Therapy[edit | edit source]

Cognitive behavioral therapy (CBT) is a form of talking therapy which helps individuals change the way they think and what they do. It is shown to have positive effects on a variety of mental health disorders[30]. The approach is split into 5 areas; situation, thoughts, emotions, physical feelings, and actions.[31] This therapy can stop the negative cycle many individuals may find themselves in and allow them to manage their conditions better.[32]

Many individuals with depression find their behaviors related to increased time of inactivity, this in turn can lower mood. CBT therapy can help alter behaviors and see an increase in levels of physical activity by doing things which are likely to bring about pleasure and feelings of achievement.[33][34]

Public health[edit | edit source]


Public health interventions are implemented to try and tackle physical inactivity, there are numerous ways in which this can achieved, for example:

Point-of-Decision prompts

Information provided directly to individuals through signs. These are generally found in stairwells or next to elevators.[35] These signs can be motivational, educational and inspirational.[36]

Community campaigns

Communities are engaged to take up exercise through media, activities and other strategies. Support groups and risk factor screening are employed by community projects.[37]

Mass media campaigns

Campaigns use media, television, radio, cinemas and the internet to encourage physical activity.[35]

Classroom-based health education

Interventions conducted in an educational environment such as school, university or work. These classes attempt to educate individuals about the importance of physical activity and the implications of being inactive.[35][38]

Resources[edit | edit source]

A number of different tools/interventions have been developed to help tackle physical inactivity.

Scot-PASQ (Scottish Physical Activity Screening Question)

Determines an individual's thoughts around physical activity and what they currently do. If individuals show acceptance to increase physical activity to determine if either brief advice or intervention are implemented. Those who are not ready are given information through physical activity leaflet.[39]

National Physical Activity Pathway

Following Scot-PASQ screening health professionals can use to this pathway to provide advice or implement an intervention to help encourage inactive individuals to increase the level of physical activity they complete.[40]

Lester Positive Cardiometabolic Health Resource

This framework is for individuals with psychosis who are taking antipsychotic medication, it helps to recognise any risk these individuals may have with cardiovascular and type 2 diabetes.[41]

Examples[edit | edit source]

Walking Football groups

These groups see individuals 50 years and older compete in football. The walking style of the game allows those with even mobility issues to take part. Improves both physical and mental health.[42]

Get Active

Aims here involve improving individuals self-esteem, work within communities help develop social inclusion and see that recreational facilities are equipped to support people with mental disorders.[43]


Scottish Mental Health Association are working to educate leaders to become more informed in mental health and be able to publicise how exercise can improve individual’s mental health.[43]

Branching out

A programme which has been developed involving Scottish forestry. Those individuals who use mental health services can attend a 12 week course in which physical activity is encouraged. Individuals learn about conservational work and bushcraft techniques. Skills such as photography are also developed.[44]

Resources[edit | edit source]

The Motivate2Move website, created by Wales Deanery, has a comprehensive section on physical activity and Mental Health.

CDC, learn about mental health.

References[edit | edit source]

  1. World Health Organisation, 2013. Mental Health Action Plan 2013-2020 [online]. World Health Organisation. [viewed 24 August 2016].
  2. World Health Organisation, 2016. Health Topic – Mental Health [online]. World fckLRHealth Organisation. [viewed 24 August 2016].
  3. World Health Organisation, 2016. Health Topic – Mental Disorders [online]. World Health Organisation. [viewed 24 August 2016]. Available from:
  4. NICE, 2011. Common mental health problems: identification and pathways to care [online]. National Institute of Health for Care and Excellence. [viewed 24 August 2016].
  5. Mental Health Foundation, 2015. Fundamental Facts about Mental Health [online]. Mental Health Foundation. [viewed 24 August 2016]. Available from:
  6. McManus, S. et al., 2009. Adult psychiatric morbidity in England, 2007; Household survey [online]. National Centre for Social Research. [viewed 24 August 2016].
  7. World Health Organisation, 2016. WHO Regional Committee for Europe 63rd session [online]. World Health Organisation. [viewed 24 August 2016].
  8. Royal College of Psychiatry, 2012. Physical Activity and Mental Health [online]. Royal College of Psychiatrists. [viewed 24 August 2016].
  9. 9.0 9.1 Fox KR. The influence of physical activity on mental well-being. Public health nutrition. 1999 Mar;2(3a):411-8.
  10. Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Current opinion in psychiatry. 2005 Mar 1;18(2):189-93.
  11. Young SN. How to increase serotonin in the human brain without drugs. Journal of psychiatry & neuroscience: JPN. 2007 Nov;32(6):394.
  12. Shamus E, Cohen G. Depressed, Low Self-Esteem: What Can Exercise Do For You?. Internet Journal of Allied Health Sciences and Practice. 2009;7(2):7.
  13. Blumenthal JA, Smith PJ, Hoffman BM. Is exercise a viable treatment for depression?. ACSM's health & fitness journal. 2012 Jul;16(4):14.
  14. Wang PW, Lin HC, Su CY, Chen MD, Lin KC, Ko CH, Yen CF. Effect of aerobic exercise on improving symptoms of individuals with schizophrenia: a single blinded randomized control study. Frontiers in psychiatry. 2018 May 15;9:167.
  15. Blackdog Institute, 2012. Exercise and Depression [online]. Blackdog Institute. [viewed 24 August 2016]. Available from:
  16. Rebar AL, Stanton R, Geard D, Short C, Duncan MJ, Vandelanotte C. A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health psychology review. 2015 Aug 7;9(3):366-78.
  17. World Health Organisation, 2016. Media Centre - Physical Activity [online]. World Health Organisation. [viewed 24 August 2016]. Available from:
  18. 18.0 18.1 Morgan WP. Affective beneficence of vigorous physical activity. Medicine & Science in Sports & Exercise. 1985 Feb.
  19. Guszkowska M. Effects of exercise on anxiety, depression and mood. Psychiatria polska. 2004 Jul 1;38(4):611-20.
  20. 20.0 20.1 Craft LL, Perna FM. The benefits of exercise for the clinically depressed. Primary care companion to the Journal of clinical psychiatry. 2004;6(3):104.
  21. Peluso, M. A. M. & Guerra De Andrade, L. H. S. 2005. Physical Activity and Mental Health: the association between exercise and mood. Clinics [online]. 60(1), pp. 61-70. [viewed 24 August 2016]. Available from:
  22. Firth J, Rosenbaum S, Stubbs B, Gorczynski P, Yung AR, Vancampfort D. Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis. Psychological medicine. 2016 Oct;46(14):2869-81.
  23. Manaf H. Barriers to participation in physical activity and exercise among middle-aged and elderly individuals. Singapore Med J. 2013;54(10):581-6.
  24. Schutzer KA, Graves BS. Barriers and motivations to exercise in older adults. Preventive medicine. 2004 Nov 1;39(5):1056-61.
  25. 25.0 25.1 National Institute of Mental Health, 2016. Mental Health Medications [online]. National Institute of Mental Health. [viewed 24 August 2016]. Available from:
  26. 26.0 26.1 26.2 Shor R, Shalev A. Barriers to involvement in physical activities of persons with mental illness. Health promotion international. 2016 Mar 1;31(1):116-23.
  27. McDevitt J, Snyder M, Miller A, Wilbur J. Perceptions of barriers and benefits to physical activity among outpatients in psychiatric rehabilitation. Journal of Nursing Scholarship. 2006 Mar;38(1):50-5.
  28. Harvey SB, Hotopf M, Øverland S, Mykletun A. Physical activity and common mental disorders. The British journal of psychiatry. 2010 Nov;197(5):357-64.
  29. Robson, D. & Gray, R. 2007. Serious Mental Illness and physical health problems: A discussion paper, International Journal of Nursing Studies [online]. 44, pp. 457-466. [viewed 24 August 2016]. Available from:
  30. Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analysesCognit Ther Res. 2012;36(5):427-440.
  31. Royal College of Psychiatry, 2013. Cognitive Behavioural Therapy [online]. Royal College of Psychiatrists. [viewed 27 August 2016].
  32. Mental Health Foundation, no date. Cognitive Behavioural Therapy [online]. Mental Health Foundation. [viewed 27 August 2016].
  33. Martinsen EW. Physical activity in the prevention and treatment of anxiety and depression. Nordic journal of psychiatry. 2008 Jan 1;62(sup47):25-9.Available from:
  34. Fordham B, Sugavanam T, Hopewell S, Hemming K, Howick J, Kirtley S, das Nair R, Hamer-Hunt J, Lamb SE. Effectiveness of cognitive–behavioural therapy: a protocol for an overview of systematic reviews and meta-analyses. BMJ open. 2018 Dec 1;8(12).
  35. 35.0 35.1 35.2 Kahn EB, Ramsey LT, Brownson RC, Heath GW, Howze EH, Powell KE, Stone EJ, Rajab MW, Corso P. The effectiveness of interventions to increase physical activity: a systematic review. American journal of preventive medicine. 2002 May 1;22(4):73-107.
  36. CDC, 2015. Motivational Signs [online]. Centres for Disease Control and Prevention. [viewed 24 August 2016].
  37. CDC, 2011. Strategies to Prevent Obesity and other Chronic Diseases – The CDC Guide to Strategies to Increase Physical Activity in the Community [online]. Centres for Disease Control and Prevention. [viewed 24 August 2016].
  38. Saucedo-Araujo RG, Chillón P, Pérez-López IJ, Barranco-Ruiz Y. School-Based Interventions for Promoting Physical Activity Using Games and Gamification: A Systematic Review Protocol. International Journal of Environmental Research and Public Health. 2020 Jan;17(14):5186.
  39. Physical Activity and Health Alliance, 2012. Scottish Physical Activity Screening Question (Scot-PASQ)[viewed 24 August 2016].
  40. NHS Health Scotland, 2012. NHS Physical Activity Pathway: Practitioner Guidance [online]. NHS Health Scotland. [viewed 24 August 2016]. Available from:
  41. RCPSYCH, 2014. NAS Resources [online]. Royal College of Psychiatrists. [viewed 24 August 2016]. Available from:
  42. Paths for All, no date. Walking football [online]. Paths for All. [viewed 27 August 2016].
  43. 43.0 43.1 SAMH, no date. Get Active [online]. Scottish Association for Mental Health. [viewed 27 August 2016].
  44. Foresty Commission Scotland, no date. Branching Out [online]. Forestry Commission Scotland. [viewed 27 August 2016].