Let’s Talk Exercise and Mental Health - MHSD Day 16

21-Day Mental Health Stigma Detox Day 16: Let’s keep moving forward! This is one of my absolute favorite topics, speaking as Founder Will H. Hansen I briefly touched on it in our company story as exercise for the purpose of proving mental health has been incredibly powerfully personally since childhood. Without intending it to at first, this benefit to mental health has also been such a common focus and the most rewarding and powerful part of seeing changes in personal training or performance clients, and group fitness students over the last 7 years. Especially when in combination with nutrition coaching, lifestyle changes, and in collaboration with a psychiatric care team when needed. Anyway, just passing along some sweet info we’re jazzed up about!

Let’s Talk Exercise and Mental Health: 

“Just exercise, you’ll feel better.”

Uhhhhh, Why? How?

Most of us hear the phrase over and over, “go for a walk/to the gym/for a run, you’ll feel better…” Often, that’s the last thing we want to hear if we’re not doing well. There’s a lot of truth to it though, so let’s get into it!

A meta-analysis (a study looking at many other related studies) in the journal Depression and Anxiety analyzed 11 studies with 455 adult patients with clinical depression. They found that with an average of 45 minutes of moderate-intensity aerobic exercise performed 3x / week, over an average of 9 weeks that there was a significantly large overall anti-depressant effect. These outcomes even held when participants could do whatever form of exercise they preferred!

So aerobic exercise helps, but what about weight lifting and other resistance training? Another meta-analysis published in the journal Sports Medicine, across 16 studies with a total of 922 participants looked for answers.

Study author Brett Gordon reported that: “RET (resistance exercise training) significantly reduced anxiety in both healthy participants and those with a physical or mental illness, and the effect size [how much it helps] of these reductions is comparable to that of frontline treatments such as medication and psychotherapy[*]… RET is a low-cost behavior with minimal risk and can be an effective tool to reduce anxiety for healthy and ill alike.”
*Medication and psychotherapy are also very valid, and with stigma and cost limiting access, accessible strategies like exercise are crucial!

Many antipsychotic medications, particularly atypical antipsychotic medications, are known to lead to weight gain. As a result, those on these medications benefit especially from exercise interventions. Improvements in weight control, fitness level, ability to tolerate exercise, blood pressure, and energy levels are common.
These improvements have been seen with as little as 30 minutes of brisk walking 3x per week, and could be done all at once, or split into 10-minute increments.

But how does it work in the brain? One of the most promising links between exercise and mental health is the molecule Kynurenine. Let’s dive in…
During conditions of high inflammation, the amino acid tryptophan is broken down into kynurenine, instead of it’s normal product, serotonin. This leads to a build-up of kynurenine in the brain, which is associated with depression and schizophrenia.

Exercise stimulates more significant expression of the enzyme KAT (Kynurenine Aminotransferase), converting kynurenine into kynurenic acid (Kyna), which has neuroprotective effects. Exercise directly impacts the brain through this pathway and is an especially important intervention for stress-induced depression, which has a tight link to kynurenine build-up.

Regular exercise over time builds up resiliency to kynurenine toxicity and stress-induced depression. It improves the ability of skeletal muscle to express the enzyme KAT. One study found that those with a history of training saw greater KAT expression and it took only 3 weeks for sedentary adults to see improved KAT expression, among other benefits!

See visual version on Instagram.

1 - “Aerobic exercise for adult patients with major depressive disorder in mental health services: A systematic review and meta-analysis.” Morres, ID, Hatzigeorgiadis, A, Stathi, A, et al. Depression& Anxiety. 3 January 2019; 36: 39– 53. doi:10.1002/da.22842

2 - “Resistance exercise linked to reduced anxiety” Lisa Rapaport, Reuters Health, September 22, 2017

3 - “The Effects of Resistance Exercise Training on Anxiety: A Meta-Analysis and Meta-Regression Analysis of Randomized Controlled Trials.” Gordon, B.R., McDowell, C.P., Lyons, M. et al. Sports Med 47, 2521–2532 (2017). doi:10.1007/s40279-017-0769-0

4 - “Exercise for mental health.” Sharma, Ashish et al. Primary Care Companion to the Journal of Clinical Psychiatry vol. 8,2 (2006): 106. doi:10.4088/pcc.v08n0208a

5 - “Acute and chronic effects of exercise on the kynurenine pathway in humans - A brief review and future perspectives.” Alan J. Metcalfe, et al. Physiology & Behavior 2018 Oct 1;194:583-587. doi: 10.1016/j.physbeh.2018.07.015.

6 - “Kynurenines: Tryptophan's metabolites in exercise, inflammation, and mental health.” Cervenka I, Agudelo LZ, Ruas JL. Science Mag, AAAS 2017 Jul 28;357(6349):eaaf9794. doi: 10.1126/science.aaf9794.

7 - “Tryptophan-Kynurenine Metabolites in Exercise and Mental Health.” Valente-Silva P., Ruas J.L. (2017) in: Spiegelman B. (eds) Hormones, Metabolism and the Benefits of Exercise. Research and Perspectives in Endocrine Interactions. Springer, Cham. doi: 10.1007/978-3-319-72790-5_7

8 - “Endurance exercise increases skeletal muscle kynurenine aminotransferases and plasma kynurenic acid in humans” Maja Schlittler, Michel Goiny, et al. 15 May 2016, American Journal of Physiology - Cell Physiology, Vol. 310, No. 10, doi: 10.1152/ajpcell.00053.2016