It’s been three years since the arrival of the global pandemic.
If you had told me then we would be here now, living with Covid-19 in the community, I’m not sure I would have wanted to hear that.
But here we are, in a slightly discombobulated state of not quite believing it’s really been that long and knowing some things have changed as a result forever.
One positive to have come from this global upheaval has been a shift towards getting outside on a regular basis.
During the lockdowns, many people told me this was the one thing that helped preserve their sanity.
Was this true for you?
There were people pounding the pavement with their kids, prams, and dogs. Others hopping on their bikes for a cycle ride around the neighbourhood. I’d never seen so many out and about on foot while complying with the requirement to be mask-wearing and physically distancing.
Those of us in Lifestyle Medicine have been banging on about the importance of exercise for physical and mental health and wellbeing for a long time.
And there is a wealth of scientific evidence supporting the fact.
But our reality is, despite knowing how important it is, and all the great work being done in many quarters, we’re not doing enough, and the prevalence of mental distress, anxiety, depression, loneliness, and burnout continues to rise.
Did you know depression is the leading cause of disability in the world?
The rate of antidepressant prescribing has been continuing to rise over the last 10 years.
Australia has the unenviable position of being the second highest user of antidepressants, among OECD countries per capita, after Iceland – one in seven to ten of us.
With the antidepressant Sertraline (Zoloft) being in the top ten of all drugs prescribed on the PBS.
It’s time to flip the script and do things differently.
There will always be a place for antidepressants in the treatment of moderate to severe depression. But in many instances prescriptions are being handed out for mild depression, where alternative methods may be as, or more efficacious.
If you were told that exercise is as effective as an antidepressant in this situation, but without potential side effects like emotional blunting and sexual dysfunction, what would you rather do?
In 2022, a systematic review found there was no difference between prescribing exercise or pharmacological interventions in reducing depressive symptoms in adults with mild to moderate depression.
I get that finding the motivation to do the exercise can be hard, especially when you’re feeling low, but the good news is, even a moderate amount of exercise can make a significant difference.
So, if you’re not a gym junkie and you hate activewear, it’s OK.
The messiness of life doesn’t always warrant medication.
Is part of our reliance on pills the fact that being handed a prescription for treatment, validates the fact you’ve not been well?
But grief, loneliness and financial or other forms of stress, will often be helped more by a more different approach. Understanding that negative emotions are part of life can also help build resilience and coping skills.
Which is why exercise prescriptions are becoming more common.
How exercise impacts the brain.
Like antidepressants, exercise changes the brain, increasing neuroplasticity and neurogenesis in the hippocampus, the part of the brain that typically shrinks in depression. This is also why aerobic exercise is so important too for healthy ageing and memory.
Unlike taking a course of medication, the bonus here being that consistency of practice leads to a new healthy lifestyle that serves to boost your mood and protect against future episodes of depression.
As you get fitter and healthier, you’ll feel more motivated to keep up with your new regime and it’s been shown to assist in improving your overall day-to-day functioning.
The bidirectional benefit of exercise and mental wellbeing.
In their latest publication, Brendan Stubbs and his team examined the association of mental wellbeing and physical activity during the pandemic and found that physical activity promotes mental wellbeing, and maximising mental wellbeing was the greatest benefit to being physically active.
What does an exercise prescription look like?
It varies, but it’s been shown that engaging in supervised group exercise works well.
It’s also going to depend on an individual’s concurrent medical comorbidities and what your access to community sport and recreational facilities, parks, etc., is like.
ALL physical activity counts.
The aim is to build up to x3-4 30-minute sessions per week for 9 weeks, undertaking a mixture of aerobic and non-aerobic activities.
New research from South Australia has shown that a 12-week program (or less) was the most effective at reducing symptoms of depression, anxiety or distress.
It’s a global shift.
Prescribing exercise is now recognised as having to a moderate to large benefit on those living with depression with the World Health Organisation (WHO) recommending it as an adjunct treatment.
In the UK exercise is seen as a first-line treatment. GPs are advised to offer therapy, exercise, mindfulness meditation before antidepressants are prescribed.
In Australia and New Zealand, psychiatrists see exercise as step-zero treatment meaning that medication and psychotherapy is only offered if there is an inadequate response to exercise first.
And now Australian GPs are being advised to do the same.
Sometimes it’s the little things that can make the biggest difference.
A little bit of regular exercise is what works.
Whether you undertake several one-hour sessions a week or take a series of exercise “snacks” it doesn’t matter.
Look for something you’d like to try and give it a go.
This isn’t about being chosen to represent Australia at the Olympics.
But it is your opportunity to do something positive for yourself, your wellbeing and happiness.
So, if taking the dog out for a 30-minute walk works for you, you have the perfect mood booster and of course the dog is going to love going out too.
How do you use physical activity in your life to stay mentally fit and well?
My new book Thriving Mind: How to Cultivate a Good Life (Wiley) is available online and at all good bookstores.
If you’re looking for someone to speak at your event or help your business, department or team develop a high level of mental fitness, let’s set up a time to talk.