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Mental health not only encompasses psychological conditions and a person’s emotional and social well-being, but it also impacts stress management and may affect thoughts, feelings, and actions. Mental health challenges such as depression and loneliness may contribute to elevated risks of chronic disease and mortality.^1-4 Many research studies have found significant associations between modifiable lifestyle factors, including nutrition and exercise, and the improvement of depression symptoms.^5-8 Specific to exercise, how does physical activity impact other components of mental health like loneliness, social isolation, anxiety, and stress?

Physical Activity and Mind-Body Exercises: Addressing Anxiety and Stress

Studies suggest that among people of all ages, promoting physical activity may protect or improve mental health, including perceived stress, anxiety symptoms, and general well-being.^9-12 A 2019 systematic review and meta-analysis found that among children and adolescents, physical activity was associated with lower levels of stress and greater psychological well-being, including satisfaction with life and happiness.⁹ In addition, greater amounts of sedentary time in this population significantly lowered psychological well-being.⁹ A 2024 systematic review and meta-analysis found that among older adults, resistance training exercise programs significantly improved both depressive and anxiety symptoms.¹⁰

While high-intensity interval training has suggested positive effects on mental well-being,¹¹ lower-intensity mind-body exercises have also shown benefits for general mental health, including anxiety symptoms.^13,14 A 2023 meta-analysis of 23 studies compared the mental health effects between a tai chi intervention and non-mindful exercise controls (e.g., aerobic activity, resistance exercise, walking) and found significant small to moderate effects on anxiety, depression, and general mental health after the intervention.¹⁴

Social Isolation & Loneliness: The Benefit of Exercise

Social isolation and loneliness have both been associated with negative health outcomes, including increased risk of chronic diseases such as cardiovascular disease and type 2 diabetes³ and with an increased risk of mortality among older adults.⁴ Recent observational studies have highlighted the potential benefit of exercise interventions for those experiencing social isolation and for reducing loneliness.^15-17 An observational study conducted during the COVID-19 pandemic and published in 2023 found that among adults over 60 years of age, those who practiced more physical activity reported fewer changes in mood and lower levels of confusion, depression, and fatigue during periods of social isolation.¹⁵ In addition, results from a 2024 meta-analysis of randomized controlled trials and observational studies suggested that group-based exercises, specifically, may be associated with small reductions in loneliness in older adults;¹⁷ however, due to the low certainty of evidence, more research is needed in this area.

Conclusion

As illustrated above, research studies continue to highlight the significant mental health benefits of modifiable lifestyle factors such as physical activity. Considering a patient’s lifestyle factors and imbalances helps to identify potential underlying causes of mental or physical health issues. And understanding the mental, emotional, and spiritual components of a patient’s health journey is a foundational aspect of the patient-centered, whole person approach of functional medicine care.

Learn more about mental health and how functional medicine and lifestyle-based approaches that include physical activity can help at IFM’s Bioenergetics Advanced Practice Module (APM).

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References

1. National Institute of Mental Health. Understanding the link between chronic disease and depression. US Department of Health and Human Services. Updated 2024. Accessed July 9, 2024. https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health
2. Zhang Z, Jackson SL, Gillespie C, Merritt R, Yang Q. Depressive symptoms and mortality among US adults. JAMA Netw Open. 2023;6(10):e2337011. doi:1001/jamanetworkopen.2023.37011
3. Christiansen J, Lund R, Qualter P, Andersen CM, Pedersen SS, Lasgaard M. Loneliness, social isolation, and chronic disease outcomes. Ann Behav Med.2021;55(3):203-215. doi:1093/abm/kaaa044
4. Barnes TL, Ahuja M, MacLeod S, et al. Loneliness, social isolation, and all-cause mortality in a large sample of older adults. J Aging Health. 2022;34(6-8):883-892. doi:1177/08982643221074857
5. Recchia D, Baghdadli A, Lassale C, et al. Associations between long-term adherence to healthy diet and recurrent depressive symptoms in Whitehall II Study. Eur J Nutr. 2020;59(3):1031-1041. doi:1007/s00394-019-01964-z
6. Wu Y, Zhang L, Li S, Zhang D. Associations of dietary vitamin B1, vitamin B2, vitamin B6, and vitamin B12 with the risk of depression: a systematic review and meta-analysis. Nutr Rev. 2022;80(3):351-366. doi:1093/nutrit/nuab014
7. Xie F, Huang T, Lou D, et al. Effect of vitamin D supplementation on the incidence and prognosis of depression: an updated meta-analysis based on randomized controlled trials. Front Public Health. 2022;10:903547. doi:3389/fpubh.2022.903547
8. Pearce M, Garcia L, Abbas A, et al. Association between physical activity and risk of depression: a systematic review and meta-analysis. JAMA Psychiatry. 2022;79(6):550-559. doi:1001/jamapsychiatry.2022.0609
9. Rodriguez-Ayllon M, Cadenas-Sánchez C, Estévez-López F, et al. Role of physical activity and sedentary behavior in the mental health of preschoolers, children and adolescents: a systematic review and meta-analysis. Sports Med. 2019;49(9):1383-1410. doi:1007/s40279-019-01099-5
10.  Cunha PM, Werneck AO, Santos LD, et al. Can resistance training improve mental health outcomes in older adults? A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res. 2024;333:115746. doi:1016/j.psychres.2024.115746
11.  Martland R, Korman N, Firth J, Vancampfort D, Thompson T, Stubbs B. Can high-intensity interval training improve mental health outcomes in the general population and those with physical illnesses? A systematic review and meta-analysis. Br J Sports Med. 2022;56(5):279-291. doi:1136/bjsports-2021-103984
12.  Wang C, Tian Z, Luo Q. The impact of exercise on mental health during the COVID-19 pandemic: a systematic review and meta-analysis. Front Public Health. 2023;11:1279599. doi:3389/fpubh.2023.1279599
13.  Lin J, Gao YF, Guo Y, et al. Effects of qigong exercise on the physical and mental health of college students: a systematic review and meta-analysis. BMC Complement Med Ther. 2022;22(1):287. doi:1186/s12906-022-03760-5
14.  Yin J, Yue C, Song Z, Sun X, Wen X. The comparative effects of tai chi versus non-mindful exercise on measures of anxiety, depression and general mental health: a systematic review and meta-analysis. J Affect Disord. 2023;337:202-214. doi:1016/j.jad.2023.05.037
15.  Andrade A, D’Oliveira A, Dos Santos KM, et al. Impact of social isolation caused by the COVID-19 pandemic on the mood profile of active and sedentary older adults: physical activity as a protective factor. Front Public Health. 2023;11:1221142. doi:3389/fpubh.2023.1221142
16.  Yu DS, Li PW, Lin RS, Kee F, Chiu A, Wu W. Effects of non-pharmacological interventions on loneliness among community-dwelling older adults: a systematic review, network meta-analysis, and meta-regression. Int J Nurs Stud. 2023;144:104524. doi:1016/j.ijnurstu.2023.104524
17.  Shekelle PG, Miake-Lye IM, Begashaw MM, et al. Interventions to reduce loneliness in community-living older adults: a systematic review and meta-analysis. J Gen Intern Med. 2024;39(6):1015-1028. doi:1007/s11606-023-08517-5