For people experiencing mental illness, the challenge to stay active and healthy can be a vicious cycle.
Symptoms of mental illnesses such as depression and anxiety can make it difficult to exercise, eat well and keep up a balanced lifestyle. And yet poorer physical health can worsen symptoms of poor mental health, making it a difficult pattern to break.
This is a problem that leads to a bigger and most distressing trend. Research published in World Psychiatry shows that people experiencing severe mental illness have a life expectancy 15-25 years lower than the general population.
The research also shows that this mortality gap can be mostly attributed to lifestyle-related diseases like type 2 diabetes, obesity and cardiovascular disease.
Australians in general are falling short of the recommended minimum amount of physical activity. But people living with mental illness are even more likely to lead sedentary lifestyles, and to have poor physical fitness compared to the general population.
The side effects of medications used to treat mental illness can also contribute to a poorer state of physical health. Other factors including poor diets, smoking and substance use can also play a role.
“Being active can play an important role in treating mental illness. But barriers like fatigue, social anxiety and poor self-esteem may limit participation in exercise.”
Exercise and mental health
The benefits of exercise and physical activity go beyond weight management and the treatment and prevention of lifestyle diseases. Being active can also play an important role in improving symptoms of mental illness including depression, anxiety, psychotic disorders and post-traumatic stress disorder.
But although most of us know that exercise provides a range of benefits, simply telling people to ‘be more active’ is usually not enough to achieve any long-term behaviour change.
For many of those experiencing symptoms of mental illness, the reality of engaging in such activities may seem unrealistic. Barriers like fatigue, social anxiety and poor self-esteem may limit participation in exercise.
So how can we help our friends, family or clients to start being more active? Firstly, it’s important to set the record straight about physical activity:
1. Physical activity and exercise are two terms commonly used interchangeably, despite having key differences. Physical activity refers to any movement that you do, be it walking to the bus stop, grocery shopping, or gardening. Exercise is a form of physical activity that is planned and structured.
2. There is no one exercise that is best for your mental health, and for those who are not meeting minimum recommendations, any activity is better than none. However, activities that are more physically exerting may have a greater effect on mood.
3. If weight loss is your primary motivation, then exercise alone will not be enough. As they say, “You can’t out-run a poor diet.”
“If participating in structured exercise sounds daunting, working on increasing your daily physical activity is an essential and realistic first step.”
How to get moving more
If participating in structured ‘exercise’ sounds daunting, working on increasing your daily physical activity is an essential and realistic first step. Strategies like getting off the bus a stop early and walking the rest of the way to work, taking stairs rather than escalators and taking some time to stand up and move around during a full day of sitting are a great start.
When you are ready to work more exercise into your routine, here are some tips to get you going:
1. Start low and go slow. Choosing activity that is at an appropriate level is important. Motivation gets lost when exercise becomes too easy or is too difficult. When you are comfortable with the intensity of the exercise, then it may be time to progress.
2. Choose exercises you are familiar with.
3. Reminders, calendars and other motivational tools like pedometers or Fitbits can be helpful.
4. Incorporate variety into your exercise program.
5. Review your progress and explore what works, what doesn’t and what strategies you can use to overcome this.
6. Choose a setting that you are comfortable with. For example, some may find gyms intimidating so may prefer the living room or backyard.
7. Ask friends and family to get involved with you.
8. Seek support. Exercise specialists like accredited exercise physiologists can help develop an ideal program that will suit the individual needs. Take a look at Exercise and Sports Science Australia.
9. Most importantly, try to find something you enjoy! It’s much easier to get out there when you don’t hate it.
For many years the treatment of severe mental illness has been focused solely from the neck up. The good news is this is changing. Mental health teams incorporating physical health specialists like exercise physiologists and dietitians are now bringing a holistic approach to treatment, ensuring that physical health is no longer ignored.