Exercise as Medicine for the Mind

A common concept we’re taught in exercise science is that “exercise is medicine”, and learning the physiology behind this claim has not only led me to believe it, but advocate the concept to my friends and family. The physical benefits of exercise are evident, and examples include the reduction or possible reversal of atherosclerosis, metabolic syndrome, and improved mobility via improved joint, muscle, and bone health. Lesser known to the public are the benefits that exercise has on mental health, which is accomplished through alleviating depressive symptoms and lowering anxiety. Unlike the physical benefits of exercise, the mental benefits are achieved through more psychological means, like social interaction, enjoying your sport/ physical activity, gaining confidence, as well as releasing natural endorphins. Mental health is important to me both personally and as an aspiring physician, and thus I want to understand as many ways as possible to improve the mental wellbeing of my patients and others.

Artifact A: Notes taken in EXSC 410

In my Psychology of Physical Activity class, EXSC 410, I learned about the ways that exercise interacts with human psychology. Mid-way through the course, we spent two lectures on the topics of stress’ relationship with physical activity, as well as the relationship between depression and physical activity. This stood out to me because I understood the concept loosely at the time, but not really the causes, effects, or actual psychology behind stress and depression.

I took notes on these two lectures before later consolidating them as a study guide. The first lecture focused on stress; I learned that stress is akin to a bell curve, and that too little or too much both lead to lower qualities of functioning. At these moderate levels, homeostasis is less threatened; furthermore, stressors can be defined as positive or negative, with examples being a job promotion versus job demotion respectively. For most individuals, stress is either moderate or in excess, and thus the lecture aimed to show that exercise is beneficial in reducing stress in two three ways. Exercise can reduce the reactivity of stressors (meaning they affect us to a lesser extent), and exercise can lead to faster recovery from negatively stressful events. Combining these methods of prevention and recovery directly lead to the third reduction method, which is reducing allostatic load. Similar to homeostasis, allostasis aims to reduce stress by adapting to the stressor. The amount that allostasis has to work to cope with stressors is the allostatic load, and an increased allostatic load correlates with increased prevalence of illness and/or chronic disease.

Depression is more complex than stress, and is characterized by many types of symptoms. Our lecture focused on major depressive disorder (MDD), and we learned that the prevalence of MDD has been steadily rising for the past 50 years; suspected reasons for this include social isolation, sleep deprivation, nutritional issues, physical inactivity, chronic disease, and chronic stress. Because all previously mentioned examples can both cause and be caused by chronically elevated stress, there is a compelling relationship between stress and depression. Because these examples are often faced by college students, this was particularly troubling to me given the increasing number of my peers experiencing depressive symptoms. Disturbances in appetite and sleep cycle back to exacerbate the underlying causes, and difficulty concentrating, remembering information, as well as losing energy/ motivation directly impact academic achievement. At the time of this class in Spring 2019, I was struggling with my own depressive symptoms, and seeing everything I experienced get mentioned in lecture really drove the message home that exercise has positive outcomes on depression as well. Exercise/ physical activity helps to prevent the onset of depressive symptoms, and helps to reduce the symptoms in those diagnosed with depression. The exact mechanism of this relationship isn’t clearly defined, but rather multiple hypotheses suggest various methods of achieving positive outcomes.

Over the Summer of 2019, my role in student government garnered me an invitation to the annual South Eastern Conference Exchange. The conference was held at the University of Georgia in Athens, GA, (UGA) and lasted 3 days; on the second day, we split up into various workshops, and I was the only student from the University of South Carolina to attend the Mental Health Workshop, which was hosted by UGA. Student government leaders from each school attended, and the 2-3 dozen of us spent the majority of the time bouncing ideas off of one another, hoping to take new ones back to our home universities. To ensure I would gather all of these ideas, I compiled a handwritten list.

Artifact B: Notes taken during the SEC Exchange workshop

UofSC’s student government does a lot with mental health programming, but while representing my school’s ideas, I failed to brainstorm new ideas involving exercise/ physical activity. My EXSC 410 class taught me how physical activity directly correlates to improved stress and depressive symptoms, thus making it a very worthwhile contribution to the mental health discussion. I regret not remembering what I learned in class during the conference’s workshop, but when I reorganized the list digitally for later use, I added in ideas about adding exercise/ physical activity. Even now reflecting on the class, the concept of exercise benefitting mental health is instilled internally, yet I kept forgetting to articulate the idea to others when mental health discussions were held. Because of this, I have learned to pass forward what I learned from those two lectures, so that future student governments could consider the idea and potentially implement it into their programming.

Learning how to mitigate the detriments of stress and depression is important to me, because of my own struggles with chronic stress and a depressive episode, as well as seeing declining mental health in some of my friends. Mental health is complex both psychologically and physiologically, but knowing that physical activity can contribute to lessening the symptoms means exercise is a tool that deserves to be added to the toolboxes of organizations and individuals committed to mental health advocacy. In conjunction with therapy and/ or medication, any small step toward reducing stress and depressive symptoms is the right step forward. Learning how exercise benefits mental health is important to being a future physician, because patients and families are likely to experience stress, hopelessness, or risk factors for depression. As a doctor, I would want to recommend physical activity if it’s possible based on the patient and/or family’s situation, and if it is possible, the most simple and low-intensity means to prevent elevated stress from worsening. At a minimum, I’d advocate for maintaining social interaction with or without physical activity, because social isolation/ loneliness exacerbates stress and depressive symptoms. My first priority is my patient’s health, but if I can help it, my second priority is doing what I can to help their mental health too; mind over matter is powerful in a healthier state of mind.