What is this magical prescription you speak of and where can I get some?
Exercise! The beautiful thing is that you can use this prescription anywhere you go and any time. Whether it's doing some light stretching during a meeting, taking a walk outdoors, or adding small ankle or wrist weights as you go about your day to increase the load on limbs, there's a way.
How much exercise do I need?
The Canadian Society for Exercise Physiology Guidelines lays out how much time the average Canadian adult should aim to spend exercising each week. While it's important to open a conversation with your primary care provider before starting any new exercise regime, adults should aim to achieve 150 minutes of moderate to vigorous aerobic exercise per week.
This includes at least two days that include strength training using weights or activities that place load on the tissues. Keep in mind that you can split up the exercise into shorter intervals such as 30 minutes five days a week.
Does exercise benefit all mental health or just certain conditions?
This is a bigger answer than the current research has, but we'll take a look at a few conditions.
- ADHD. A study from 2014 recruited 221 children and assigned them to a 9-month exercise program after school. At the end of it, these children showed increased cognitive performance and executive control. Other studies have shown the ability of exercise to improve attention and encourage the growth of areas of the brain that influence decision-making and executive function.
- Anxiety. Older reviews had trouble pinpointing the impacts of exercise on anxiety, but the most recent meta-analysis published in 2018 indicates that vigorous exercise is beneficial for anxiety. However, researchers noted that high-intensity exercises are not realistic for everyone to follow.
- Depression. A 2019 study out of the Harvard T.H. Chan School of Public Health demonstrated a 26% reduced risk of becoming clinically depressed with 15 minutes of running, or an hour of walking every day. This intervention also had the benefit of reducing the risk of relapse.
- Stress. Exercise has been shown to help influence hormones such as cortisol and adrenaline, chemicals heavily associated with the stress response. It also encourages the production of agents known as endorphins which help to elevate mood and have natural painkilling properties. Additionally, exercise influences the endocannabinoid (eCB) system including one specific eCB known as anandamide which crosses into the brain and helps elevate mood.
What if I've injured myself and have been instructed to rest?
It is important to listen to your primary care provider who makes suggestions in the best interest of your long-term function and health. Some herbal remedies have benefits on mental health, in some cases, comparable to pharmaceuticals.
Passiflora incarnata is one such herbal remedy that may help. In adults experiencing nervousness or anxiety, the plant better known as Passion Flower has been shown to increase the resistance to stress and overall quality of life.
The patients in the study also showed improvements in areas such as restlessness, exhaustion, fear, lack of concentration, nausea, trembling, and palpitations. In another impressive study, Passiflora incarnata was shown to be as effective as oxazepam in the treatment of generalized anxiety disorder and helps guide future research into how herbal remedies can augment the treatment of mental health conditions.
Another option to consider is St. John's Wort (Hypericum perforatum) in the treatment of mental health conditions such as depression. In a Cochrane Review of 29 clinical trials with a total of 5,489 patients, 18 comparisons to placebo, and 17 comparisons to standard anti-depressants, St. John's Wort was superior to placebo in patients with major depression, as effective as antidepressants and had fewer side effects than standard antidepressants.
Friends of mine practice meditation when they make time during the day, but I'm not sure it's actually doing anything...
While the research was certainly slim decades ago, it has come a long way since then. A group of physicians from John Hopkins University sifted through almost 19,000 studies on meditation – you read that right, 19,000! That is a lot of literature. They selected the most useful studies for a meta-analysis and determined that meditation helped to significantly improve anxiety, depression, and the sensation of pain after only 8 weeks of practicing. There was also data supporting the ability of the practice to improve stress and one's quality of life associated with an individual's perception of health.
Meditation is meant to be individual and calming, it is not meant to add psychological stress to your day. If you are someone who can't sit still for an extended period of time, that there are ways!
There are many different videos online that can guide you through the practice so you can tailor your session to your preference. Maybe you want to complete a body scan, maybe a session that can be done at your desk that targets your breathing, or one's that include gentle yoga into your session.
References:
https://bmchealthservres.biomedcentral.com/articles/
https://chadd.org/wp-content/uploads/2018/06/ATTN_06_12_Exercise.pdf
https://www.cochraneprimarycare.org/pearls/st-john's-wort-effective-depression
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1809754
https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2720689
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632802/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724411/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498975/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703784/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333702/
https://pediatrics.aappublications.org/content/134/4/e1063.full#sec-8
