When you’re the parent of a teen with a mental health disorder, many of the treatment centers you find when you seek support for your teen include physical activity and exercise as a complement to treatment with psychotherapy and medication, but that begs the question: does physical fitness and exercise really help teen mental health?
Two studies published recently – Physical Fitness and Risk of Mental Disorders in Children and Adolescents and How Does Physical Activity Improve Adolescent Resilience? – can help parents understand why most treatment centers use some type of exercise or physical activity in their treatment plans to improve teen mental health. The first discusses the relationship between fitness, activity, and the risk of developing mental health disorders, while the second discusses how fitness and exercise can improve the psychological and emotional resilience commonly associated with improved wellbeing and mental health.
Exercise: It’s Not Treatment, But It Helps
First, let’s state the obvious: exercise makes most of us feel better. Even people who don’t like to work out or feel the burn in any organized manner feel better after moderate activity like walking, moving around the house, or engaging in basic activity at work.
Therefore, on a basic level, exercise improves overall wellbeing, which includes the state of our mental health.
But we all know that already. What parents need to know are specific facts. The first study we mention above fills that need. Here’s the research objective:
To examine the association between physical fitness and mental disorder risks.
To achieve their objective, the research team, based in Taiwan, collected data from two sources: Taiwan National Student Fitness Tests and National Health Insurance Research Database.
The research team divided participants into two groups:
- The first group, used to examine the impact of fitness on anxiety and depression, included data from 1,996,633 participants
- The second group, used to examine the impact of fitness on attention-deficit/hyperactivity disorder, included data from 1,920,596 participants
- Participants were age 10 -11 at study initiation. Researchers followed up at 3 and 6 years after initiation.
Next, they assessed the following categories of fitness:
- Cardiorespiratory fitness (CF): 800 meter run time
- Muscular endurance (ME): bent-leg curls
- Muscular power (MP): standing broad jump
Then they calculated the prevalence of the following mental health symptoms across the four categories of fitness:
- Anxiety
- Depression
- Attention-deficit hyperactivity disorder (ADHD)
Let’s take a look at what they found.
Physical Fitness, Exercise, and Teen Mental Health: The Results
For female participants, improved cardiovascular fitness (CF), determined by a 30-second improvement in 800m running times, was associated with reduced risk of:
- Anxiety
- Depression
- ADHD
In male participants, improved cardiovascular fitness (CF), determined by a 30-second improvement in 800m running times, was associated with reduced risk of:
- Anxiety
- ADHD
For female participants, enhanced muscular endurance (ME), determined by an improvement of at least 5 leg curl-ups per minute, was associated with decreased risk of:
- Depression
- ADHD
In male participants, enhanced muscular endurance (ME), determined by an improvement of at least 5 leg curl-ups per minute, was associated with decreased risk of:
- Anxiety
- ADHD
For female participants, improved muscular power (MP), determined by a 20-cm increase in broad jump distance, was associated with reduced risk of:
- Anxiety
- ADHD
In male participants, improved muscular power (MP), determined by a 20-cm increase in broad jump distance, was associated with reduced risks of:
- Anxiety
- Depression
- ADHD
Here’s how the study authors characterize these results:
This study highlights the potential protective role of cardiorespiratory fitness, muscular endurance, and muscular power in preventing the onset of mental disorders. It warrants further investigation of the effectiveness of physical fitness programs as a preventive measure for mental disorders among children and adolescents.
That’s important information for parents to know. Improved fitness is associated with symptom reduction related to anxiety, depression, and ADHD. That’s why providers include physical fitness and physical activity in treatment plans at most teen mental health treatment centers.
How Does Exercise Impact Teen Mental Health?
We’ll start with the general information we have about the impact of exercise on mental health and wellbeing from a biological/physiological perspective, then we’ll discuss the results of the second study we discuss in the introduction to this article.
Decades of research document the positive effect of physical activity on mood. We’ll draw on research published here, here, here, and here. Those studies show the biological effects of physical activity include the following:
- Increased cerebral blood flow
- Improved neuroplasticity
- Enhanced neurogenesis
- Improved oxygen consumption in brain
- Increased oxygen to cerebral tissue
- Increased expression of endocannabinoid receptors
- Increased levels of neurotransmitters:
- Serotonin
- Beta-endorphins
- Dopamine
- Norepinephrine
- Increased expression of the neurotransmitter modulator, BDNF
- Increases size/volume of hippocampus, which improves cognition and spatial memory
- Preserves white and gray matter in the frontal, temporal, and parietal cortexes
Those biological effects, which include changes to brain structure and function, combine to improve overall brain health, which, in turn, promotes positive mental health. In addition, improvements in the expression of specific neurotransmitters improve mood, cognition, and the ability to tolerate stress/distress, which can lead to improved overall mental health.
That’s the biological /physical side of the equation – but it’s not the whole story.
Physical Activity and Psychological Resilience
Now let’s take a look at the second study we mention in the introduction, called “How Does Physical Activity Improve Adolescent Resilience?” Researchers conducted a survey of 1,732 high school students with four questionnaires: the Physical Exercise Questionnaire, Basic Psychological Needs in Exercise Scale, General Self-Efficacy Scale, and the Resilience Scale.
After examining data from the four surveys and applying sophisticated statistical analyses to confirm the validity of the results, the research team found physical activity affects psychological resilience directly and indirectly:
- Directly: physical activity satisfies basic psychological needs
- Indirectly: satisfaction of basic psychological need increases self-efficacy
Those results are entirely logical, from our point of view, and align well with what we know about the impact of physical activity on brain structure and function. Basic psychological needs refer to:
Autonomy
This refers to the ability to make independent, personal decisions based on our personal values and beliefs.
Competence
This refers to the ability to apply knowledge and skill in order to perform tasks, from the simple to the complex.
Relatedness
This refers to the ability to feel connected, attached, and experience a sense of belonging to other people or groups of people.
When we consider the fact that self-efficacy refers to the belief in our ability to perform a task or goal, we can see that the benefits of exercise and physical activity have the potential to create a positive physical and psychological feedback loop. When we satisfy our basic psychological needs through behavior, we increase our ability to believe we can accomplish the tasks before us, which increases our ability to accomplish those tasks. This, in turn, increases the likelihood we can meet our basic psychological needs, which further increases the belief we can accomplish the tasks before us.
That’s a virtuous cycle that can only help improve mental health: it’s not treatment itself, but it does help. In that way, we think of exercise the way we think of healthy eating. Sticking to healthy eating habits promotes a solid physical and psychological foundation for positive mental health. Exercise does something similar: it promotes a healthy brain and body, and it promotes psychological and behavioral patterns that promote and act as protective factors for positive mental health.
