Running for Mental Health

While mental health conditions are becoming less taboo to talk about, they are still not discussed as regularly as physical ailments; even though mental health conditions affect a large number of Americans every year. Approximately 1 in 5 adults experience some form of mental illness in a given year. Only 41% of adults in the U.S. with a mental health condition received mental health services in the past year (nami.org). There are many reasons someone may not seek out professional help. Fortunately, there are many lifestyle factors that can be changed to help combat mental health conditions. A major factor is regular exercise, specifically running!

Running & Depression

According to the World Health Organization, depression is the leading cause of disability worldwide. In 2015, it was estimated that 16.1 million adults in the U.S. and Canada had at least one depressive episode. This group only included people who met the classic definition for a major depressive episode: a period of at least two weeks during which they experienced depressed mood and at least four other symptoms indicating changes in functioning. This definition potentially leaves out people with chronic depression, children, and teens, meaning the number of Americans affected by depression could be higher. 

With so many struggling with depression, there have been many studies that have looked at how to treat depression and what treatments work the best. In his book Running Is My Therapy, Scott Douglas touches on numerous studies that support the idea that regular exercise can improve depressive symptoms. Two of the studies are:

• A Norwegian study followed almost thirty-four thousand subjects over the course of nine to thirteen years. Those who did not regularly exercise were 44% more likely to develop depression than those who exercised for one to two hours a week. This study ruled out the idea that people who were sedentary are that way because they have depression.
• A study by Duke University divided 202 adults with major depression into four groups for treatment: supervised exercise in a group setting, unsupervised home-based exercise, the antidepressant Zoloft, or a placebo pill. They found that 41% of the subjects no longer met the clinical standards for major depression after the 4 month treatment, both of the exercise groups improved equally to the subjects who took the antidepressants. After a year they followed up and found that subjects who continued to exercise during the year, had the biggest decrease in depressive symptoms. 

These are just two of many studies that have supported the idea that exercise can be as effective as antidepressants and psychotherapy in reducing depressive symptoms.

The most important thing to know about running and depression is that it really helps over time. To get the benefits I discussed above you have to run (or exercise) regularly because it is actually causing structural changes in the brain and that takes time. Running increases levels of neurotransmitters serotonin and norepinephrine, and neurogenesis - the creation of new brain cells, all of these changes are what antidepressants are said to change as well. Running produces neurogenesis and neuroplasticity (improvements in the brain’s communication network), it helps neurons to fire and work together. Neurogenesis from running also occurs in the prefrontal cortex. Increased activity in the left side of the prefrontal cortex has been identified in stress resilient people. When you go for a run and push yourself, activity in the prefrontal cortex is increased; over time that builds a better ability to regulate itself. Meaning exercise results in a process of stress resilience and improves your body and mind’s ability to handle stress. 

You are building a healthier brain every time you lace up your shoes and get out the door. 

Running & Anxiety

Anxiety disorders are the most common mental illnesses in the U.S. and affect about 18.1% of the adult population (even more when you include adolescents), with it estimated that about 29% of Americans will develop an anxiety disorder at some point in their life. Only 36.9% of those 40 million (18.1%) receive treatment for their anxiety disorder. That means around 14.75 million adult Americans receive treatment and 25.25 million adult Americans do not.

It’s important to highlight the difference between an anxiety disorder and worrying about things. Anxiety itself is not bad. You can think of anxiety as a spectrum. Normal levels of anxiety live on one end of the spectrum and may be present as low levels of fear, agitation, apprehension, muscle tension and sweating, or doubts about your ability to complete a task. Symptoms of normal anxiety do not negatively interfere with day to day life or daily functioning. On the other end of the spectrum is clinical levels of anxiety, which are diagnosable disorders that occur when anxiety levels rise enough to rapidly decrease performance and cause impairment in daily functioning. 

Even though anxiety is more common than depression, there is less research about anxiety and whether or not exercise is an effective treatment. The reason for this being that anxiety is more heterogeneous in nature compared to depression, making it difficult to define the parameters. 

Douglas discusses many research articles that show aerobic exercise can reduce symptoms of anxiety. One study showed that regular exercisers were at less risk of being diagnosed with anxiety, however, this could also show that people with anxiety might be less likely to exercise regularly. Similarly, another study found that those who already had an anxiety disorder and began doing aerobic exercise regularly saw improvements in reducing anxiety symptoms. 

Regardless, exercise has been shown to have many mental and physical benefits.

Benefits of Running (regular exercise) for Anxiety & Depression

• Regular running is considered an effective stand-alone treatment for some types of depression and anxiety.
• Regular running causes changes in the brain similar to those associated with antidepressant medications.
• Exercise done in conjunction with typical treatment produces BETTER results than the treatments done in isolation. 
• Regular running encourages and helps instill certain ways of thinking and behaving. These habits of mind and body are connected to common interventions for depression and anxiety:
• Talk therapy
• Cognitive behavioral therapy
• Strong social connections
• Good self-care practices
• Improved executive function
• Ability to plan and organize, take in information and act on it by making goal oriented decisions. 
• Improved ability to multitask
• Increased attention span, focus, and stamina 
• Decreased risk for Alzheimer’s and dementia 

Our advantage from running is two-fold. First, we naturally practice some of these therapy techniques as runners. Second, being slightly familiar with different kinds of treatment makes success with them more likely if we decide to seek professional help. Furthermore, these benefits follow us as we age, the longer we stay regularly active the longer the benefits last. So how much do you have to run to get these benefits?

How Much Do I Need to Run?

Everyone wants to find the quickest fix for ailments, whether physical or mental. So how much time do you need to spend exercising to get the benefits for your mental health? 

The American College of Sports Medicine recommends 150 minutes of light to moderate aerobic exercise per week. Unfortunately, only 21% of the US population gets the recommended amount each week. 

Douglas’ research on running and mental health have led him to believe that as little as two runs a week can give the benefits discussed above. Workouts longer than 30 minutes were found to have more benefit. However, the most important behavior was determined to be consistency. 

There are a lot of people who aren’t getting any help managing their anxiety and/or depression. Cost of mental health services, availability of services, or lack of medical insurance are a few of the many different reasons someone may not seek out help. If you find yourself dealing with a mental health condition, I strongly encourage you to seek out help from a mental health professional, but I realize that is not always an option. Making sure you are exercising regularly is one way to start improving mental and physical health, and the more years you spend exercising regularly the greater the benefits!

Happy Training!
Sierra
Tunnel Marathons Personal Trainer

MORE FACTS about mental health from https://www.nami.org/learn-more/mental-health-by-the-numbers

• Approximately 1 in 25 adults in the U.S. (11.2 million) experiences a serious mental illness in a given year that substantially interferes with or limits one or more major life activities.
• Approximately 1 in 5 youth aged 13–18 (21.4%) experiences a severe mental disorder at some point during their life. For children aged 8–15, the estimate is 13%.
• 1.1% of adults in the U.S. live with schizophrenia.
• 2.6% of adults in the U.S. live with bipolar disorder.
• 6.9% of adults in the U.S.—16 million—had at least one major depressive episode in the past year.
• 18.1% of adults in the U.S. experienced an anxiety disorder such as posttraumatic stress disorder, obsessive-compulsive disorder and specific phobias.
• Among the 20.2 million adults in the U.S. who experienced a substance use disorder, 50.5%—10.2 million adults—had a co-occurring mental illness.
• Only 41% of adults in the U.S. with a mental health condition received mental health services in the past year. Among adults with a serious mental illness, 62.9% received mental health services in the past year.
• Just over half (50.6%) of children with a mental health condition aged 8-15 received mental health services in the previous year.
• African Americans and Hispanic Americans each use mental health services at about one-half the rate of Caucasian Americans, and Asian Americans at about one-third the rate.
• Half of all chronic mental illness begins by age 14; three-quarters by age 24. Despite effective treatment, there are long delays—sometimes decades—between the first appearance of symptoms and when people get help.

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