Sport against mental illness?

After a conflict with another person, we often feel tired and exhausted. Persistent headaches quickly make us impatient and irritable. And: When we are depressed, we often have no desire at all to move and to be active in sports. Everything points to the fact that our psyche and our body are closely linked. Those affected by mental illness often find themselves in a vicious circle: their symptoms prevent physical exercise, which in turn stands in the way of improvement. This is exactly where sports therapy comes in.

Effects of mental illness on exercise behavior

Whether it’s depression, obsessive-compulsive disorder, anxiety disorder or burnout, these and many other mental illnesses can prevent sufferers from engaging in physical activity through a range of symptoms. Examples include:

Low mood: it often brings with it a lack of drive and inactivity. Instead of getting up and going for a spin on the bike or working up a sweat together at the club, sufferers tend to feel the need to withdraw and take it easy. Even a short walk around the block often seems almost impossible when the mood is depressed.

Demotivating thoughts: Depressive thoughts, such as comparing the current life situation with a past one and with fellow sufferers, can put sufferers under a lot of pressure. Such demotivating thoughts also lead to a lack of energy and drive. The prospect of success is not infrequently assessed as low (“That little bit of sport won’t change anything anyway”).

Lack of energy: Particularly in the case of lack of energy, sufferers make the mistake of withdrawing and spending the evening on the sofa. It is precisely this behavior that makes sufferers feel even worse and reinforces the feeling that they need to isolate themselves.

Anxiety: Particularly in the case of excessive anxiety, many people are more alert to physical changes. Reactions during exertion such as increased sweating, high pulse and rapid breathing are interpreted as signs of an anxiety situation. The concern quickly arises of not being able to withstand the strain, of having overtaken oneself or of experiencing a loss of control.

Lack of self-confidence: Fears or expectations of failure make it difficult to face new challenges. This, in turn, prevents venturing into a new sport, starting a new beneficial habit, or testing one’s performance limits and experiencing the sense of accomplishment that comes with it. Lack of self-confidence can also lead to avoidance of comparative situations with other people.

Why exercise is so important, especially for mental illnesses

The aforementioned effects of mental illness on physical activity behavior seem so paradoxical – because it is at this point that physical activity would be helpful. On a biological level, physical activity has been shown to stimulate the release of happy hormones (endorphins or serotonin), leading to a better mood. Factors such as changes in muscle tension, body temperature or blood flow, as well as the effect of messenger substances in the brain, also play a role. In addition, sport has a positive influence on the perception of competence, self-efficacy and self-confidence. Those who exercise too little also lose the ability to perceive their natural needs such as fatigue, hunger or thirst. A vicious circle!

Two forms of physical activity

Basically, there are two forms of physical activity to maintain or improve mental health:

Preventive exercise:

  • Can counteract the loss of mental health resources
  • Regular physical training leads to less hormones being released even in stressful situations
  • Stressful situations are consequently experienced in a more relaxed and self-determined manner

Physical activity as a therapy component:

  • It is never too late to start or increase physical activity
  • Physical activity has been shown to be helpful at any stage of an existing mental illness.

The (re)start

Especially with regard to demotivating thoughts, it is important to become aware of the cause of these thoughts. It is best to get used to new movements or movements that have not been practiced for a long time in a familiar environment. It is also a good idea to find a sports group that is at your own performance level. This reduces the worry of not being able to keep up with the others and increases the chance of positive experiences. Equally important is to cut yourself some slack and reward yourself when a workout is completed. Since demotivating and perfectionistic thoughts are often related, it makes sense to choose a sport that has always been enjoyable and is not too focused on competitive thinking. The goals should not be set too high, especially at the beginning; even a short sporting activity can be enough to gain new energy. If lack of energy is the predominant symptom, it is advisable to start with a short session of sports such as yoga or Thai Chi, which also have a relaxing and stress-reducing effect. It is often also helpful to inform the coach or other fellow athletes about one’s anxiety symptoms. Here, they can be supported by repeatedly confirming that body signals such as sweating or racing heart are completely normal reactions and are no cause for concern. Professional support can also be useful in the case of a lack of self-confidence, which can make it easier to start new sports or to get back into them.

After a good introduction to exercise, it is important to find a routine. For example, training can take place on fixed days of the week at specific times, so that it is no longer necessary to give much thought to whether you should really go to the gym. In addition, it is important to always be aware of the successes you have already achieved and the positive effects that sport brings.

Physical activity: what can I do on an outpatient basis?

Outpatient physical activities can be carried out according to the motto: “What gives the most pleasure”. The classics are swimming, running, cycling, climbing or even dancing. Most of the sports listed are inexpensive and can be done flexibly in terms of location and time. Even gardening and extensive cleaning of the apartment represent a physical activity. Especially in the case of severe physical or psychological problems, it is advisable to seek the guidance of certified trainers, fitness facilities or clubs. Some health insurance companies now also offer participation in health courses. As far as duration and frequency are concerned, the right balance should be found. Basically, two to three hours a week are recommended, divided into several units of at least ten minutes. Even a normal walk increases blood flow to the brain by as much as 15 percent, so light physical training is enough to keep you mentally active as well.

Physical activity in the therapy facility

Exercise therapy can also be carried out on an inpatient or day-care basis in a hospital or rehabilitative facility. In this case, the work is less preventive, and those affected usually have therapy-resistant, chronic and severe disorders. Several professional groups work together with the patient under medical supervision and offer a wide range of therapeutic exercise. In addition to physiotherapy, this can also include classical massage or group therapy. It is particularly important during an inpatient stay to provide those affected with further steps to take after discharge. This can mean, for example, an outpatient connection with regular monitoring of progress.

  • Oertel, Viola; Matura, Silke: Exercise and Sport against Burnout, Depression and Anxiety. Berlin, 2017.
  • Jetzinger, Julia: Exercise therapy for inpatient burnout patients. Vienna, 2014.

Categories: Therapy

Verena Klein
Author Verena Klein
"LIMES Schlosskliniken specializes in the treatment of mental and psychosomatic illnesses. With the help of the blog, we as a clinic group would like to examine the various mental illnesses in more detail and present different therapies as well as current topics."

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