Always having dreamed of becoming a professional football physiotherapist, Dr Brendon Stubbs’ passion has revolved around fitness for as long as he can remember. Even though he did not end up in that exact role, he found immense satisfaction in his work as a physiotherapist, until his career took an unexpected turn when his job placed him in a mental health hospital.
“In the world of physical therapy, I had learned how to mend the body when it was injured, whether it was a broken bone, a dislocated joint, or post-stroke care. But what struck me was how little I knew about the mind,” Dr Stubbs recollects the eye-opening experience. “Working in the mental health hospital, surrounded by individuals in dire need of treatment, made me realise the profound impact that exercise and movement can have on people who are at their lowest points.”
While the philosophy that a sound mind equates to a sound body and that movement is beneficial for mental health is a commonly known fact, what has fuelled his dedication over the past two decades, is the development of a robust, credible scientific evidence base to support the claim. A prominent researcher and academic in the field of mental health and physical activity, Dr Stubbs has made significant contributions to the study of how physical activity and exercise can benefit individuals with mental health conditions.
Amid the ongoing Dubai Fitness Challenge, Khaleej Times spoke to the researcher to understand what qualifies as exercise, how it can be used as a complementary treatment for various mental health disorders, including stress, depression, anxiety and the impact of physical activity on ageing. Edited excerpts from an interview:
The notion that exercise impacts our overall wellbeing has become a well-known fact. How does scientific evidence support the claim and where does the research stand currently?
First and foremost, let’s delve into prevention. Our insights stem from groundbreaking multinational studies, one of which involved over 50,000 participants worldwide. Over a span of roughly seven and a half years, we aimed to explore the relationship between physical activity and the risk of future depression, particularly among individuals who began with good mental health. The findings were significant, indicating that those engaging in higher levels of physical activity were approximately 15 per cent less likely to develop depression in the future.
Moreover, individuals adhering to recommended government guidelines of 150 minutes per week exhibited a 30 per cent reduced risk of future depression. These results held true across age groups, gender, and geographical locations. Furthermore, we’ve conducted studies examining individuals genetically predisposed to depression, revealing that higher levels of physical activity decrease the likelihood of depression development, even among those with the same genetic predisposition. The key takeaway here is that your genetic factors and physical activity both play pivotal roles in mental health prevention, making exercise a critical component in promoting better mental health.
How does exercise help in the treatment of mental health conditions?
Remarkable strides have been made in integrating exercise into mental health treatment. Many now recognise the value of including exercise in the treatment plans for individuals grappling with depression and anxiety. In a study conducted by our colleagues in the Netherlands, 140 individuals experiencing their first episode of depression were randomly assigned to either running therapy, involving two to three weekly sessions over four months, or conventional antidepressant medication. The results were nothing short of groundbreaking. Exercise, in this real-world context, demonstrated efficacy on par with medication in improving mental health outcomes. However, exercise also yielded additional benefits in terms of physical health, unlike medications, which often come with side effects such as weight gain, alterations in blood glucose and lipids, and changes in waist circumference, exercise proved more favourable for physical well-being.
We’ve also made substantial progress in unravelling the science behind why exercise makes us feel better and how it ameliorates our mental health. While many attribute this effect to endorphins, our research has shown that it goes beyond this simplistic explanation. We conducted MRI scans, revealing that exercise promotes changes in brain regions associated with depression and cognitive conditions. For instance, the hippocampus, a vital area for memory consolidation and emotional processing, was found to grow in individuals engaged in long-term exercise. We also observed enhanced activity in other brain regions crucial for emotional processing, such as the prefrontal cortex. Additionally, exercise triggers the release of brain-derived neurotrophic factor (BDNF), often described as ‘brain fertiliser’. BDNF aids in the growth and connection of new brain cells.
What, according to you, qualifies as exercise/physical activity?
The World Health Organisation emphasises the importance of physical activity, suggesting that individuals should aim for 150 to 300 minutes of moderate or vigorous physical activity each week. This may seem like a daunting figure, and it’s true that more than 50 per cent of people do not meet this guideline. However, it’s essential to remember that even small changes can have a significant impact. So, if the idea of achieving that recommended amount feels overwhelming, you’re not alone.
Taking gradual steps is crucial, especially if you’re dealing with mental health challenges. To put it simply, physical activity encompasses any bodily movement that increases energy expenditure. This includes activities like dancing, yoga, Pilates, paddle sports, or even going for a run. It’s important to dispel the misconception that exercise always entails going to the gym or engaging in intense, high-speed workouts. In fact, our research, conducted in collaboration with ASICS, has shown that just 15 minutes and nine seconds of physical activity can lead to a meaningful improvement in people’s mental health. You don’t need to push yourself to the limits or exercise for extended durations to experience these benefits.
Stress, depression are some of the common mental health challenges faced by people across the globe. How can movement help us release pent-up emotions?
Life can often be filled with stress and challenges, and our brains and bodies need to process these emotions effectively. Without an appropriate outlet, these emotions can build up within us. Exercise offers a powerful means to maintain the ‘sound mind, sound body’ narrative and help us navigate these challenging emotions that we encounter daily. Physical activity serves as an effective way to soothe our nervous systems and facilitate the processing of these emotions. One of the mechanisms contributing to this effect is the release of chemicals like dopamine and cortisol, which are associated with reward and stress responses at a basic level.
These benefits extend to individuals dealing with mood disorders, including depression. Exercise provides a means for people to reconnect with their bodies, fostering a sense of presence and belonging. For those struggling with depression, motivation for everyday tasks can be a challenge, and they may often feel disconnected from their own bodies. Exercise acts as a conduit to re-establish a connection and helps individuals rediscover their sense of belonging within their bodies, ultimately contributing to a more harmonious state of mind and body.
How does physical activity impact the ageing process?
There is compelling evidence demonstrating that engaging in exercise, including strength training and improving your cardiorespiratory fitness, offers not only mental health benefits but also increases your overall lifespan. More importantly, it contributes to a longer and healthier life. Regular exercise plays a crucial role in maintaining the strength of your muscles, bones, heart, lungs, and all your vital organs, including the brain. When you neglect physical activity and subject your body to minimal stress over time, these essential structures — such as the heart, lungs, and various areas of the brain — gradually begin to deteriorate without your awareness.
Consequently, as the years pass, you may find yourself less mobile, struggling to play with your grandkids, and facing difficulties with everyday tasks like walking to the local shops or climbing stairs. However, by consistently engaging in a healthy amount of exercise, you not only preserve your independence but also enhance your capacity to maintain a fulfilling and active lifestyle.
It’s worth noting that the benefits of exercise extend far beyond just preventing future mental health issues. They encompass a reduced risk of heart disease, certain types of cancers, and more. However, for many individuals, the idea that exercising today could lower their risk of a heart attack by a small percentage in 30 years may not provide enough motivation. That’s why it’s important to derive a daily sense of enjoyment and accomplishment from physical activity to sustain the habit.