PA, wellbeing and mental health

Question 1

Define mental health

Answer 1

“Mental health is a state of wellbeing in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community” (WHO, 2024)

Question 2

What is mental health influenced by?

Answer 2

The National Institute of Mental Health has found that mental health is influenced by a combination of biological (e.g. genes that predispose individuals - e.g. schizophrenia), environmental (how individuals grow up, what they are exposed to, e.g. trauma), psychological (e.g. thinking patterns and coping mechanisms) and interacts with many areas of overall health

Question 3

Why is it important to address mental health?

Answer 3

WHO predicts that by 2030, mental illness will be no.1 disease that poses biggest non-communicable mortality threat with cost of $2.5trillion

Question 4

Define psychological wellbeing

Answer 4

“… defined as the combination of feeling good and functioning well; the experience of positive emotions such as happiness (hedonia) and contentment as well as the development of one’s potential, having some control over one’s life, having a sense of purpose, and experiencing positive relationships (eudomonia).” (Ruggeri et al., 2020)

Question 5

Give the four dimensions on mental health and wellbeing

Answer 5

1. Flourishing (optimal mental wellbeing with low mental ill-being) - 34% population
   - Resilient to experiencing mental health conditions
   2. Reactive (optimal mental wellbeing with severe mental illness) 16%
      
      • Experiencing high wellbeing despite being diagnosed with a mental illness
   3. Flat (low mental ill-being with low mental wellbeing) 24%
      
      • Vulnerable to poor health outcomes; not fulfilling their potential
   4. Languishing (low mental wellbeing, severe mental illness) 26%
      
      • Vulnerable to develop mental health conditions (e.g. severe anxiety)

Question 6

What are the 5 steps to mental wellbeing as listed by the NHS?

Answer 6

• PA recognised as important B to better mental wellbeing

1. Connect with others
2. Be physically active
3. Learn new skills
4. Give to others
5. Pay attention to the present - mindfulness practice

Question 7

Give a study that suggests a relationship between PA and mental health

Answer 7

1.2 million people reported their activity levels for a month and rated their mental well- being

People who exercised had 1.5 fewer “bad days” a month than non-exercisers

Concluded regular physical activity lasting 45 minutes three to five times a week can reduce poor mental health - particularly important for team and aerobic sports

Question 8

Give some well evidenced benefits of PA in relation to mental wellbeing

Answer 8

○ Reduced risk of anxiety and depression
○ Improved mood / reduction of negative mood  Improved sleep quality / duration
○ Improved self-esteem and self confidence
○ Increased energy
○ Improved concentration
○ Improved stress response / management
○ Greater concentration

Question 9

Why is the relationship between PA and mental wellbeing a direction of improvement rather than a causal relationship?

Answer 9

Unsure as to whether PA causes better mental wellbeing or if those who have higher sense of wellbeing engage in PA

Question 10

What are the three mechanisms that underlie PA improvement on mental health?

Answer 10

1. Biological - ‘happy’ hormones/ neurotransmitters (endorphins, serotonin, dopamine), PA link to brain function and structure of hippocampus
2. Psychological - increases self esteem (linked to better body image) and reduces levels of psychological stress
3. Social - socialising/ interacting/ engaging with others - social connection and sense of identity

Question 11

Briefly describe a systematic review that evaluates the effect of PA on depression, anxiety, self-esteem and cognitive functioning in young people

Answer 11

Biddle et al (2019)

• Depression had limited evidence but PA is beneficial over no intervention
• Anxiety - PA can reduce symptoms of anxiety. Inactive adults consistently report higher levels of anxiety (one of strongest relationships identified)
• With anxiety, see increased cardiorespiratory physiology - increased HR, BP, BR
• Exercise increases physiological measures but in controlled environment, helps individuals identify sensations
• Self-esteem - PA can lead to significant improvements in self-esteem (e.g. body image and physical self worth)

    ○ Overall, physical activity is likely to have positive psychosocial outcomes for young people
    ○ The effects seem strongest for self-esteem and those who are physically active seem less likely to suffer from mental health problems and may have enhanced cognitive functioning
    ○ Evidence on depression is also promising but remains an underdeveloped area of enquiry, although all participants are likely to gain significant benefits, such effects are likely to be greater in those who have poorer mental health at baseline

Question 12

Briefly describe a study that investigates the relation between PA and subjective-wellbeing but give some limitations

Answer 12

Buecker et al (2020)

• Overall effect showed a small, but positive relationship between physical activity and wellbeing (mood)
• Physical activity was most strongly associated with positive affect/emotions
• Limitations include reliance on self-report - question validity and honesty of pps, subjective measure
• Hundreds of q’aires that measure mental health in different ways - difficult to pool results and make conclusions

Question 13

What are the two conventional mental health treatment methods?

Answer 13

• Psychotherapy (e.g., Cognitive behavioural therapy (CBT), rational emotive behavioural therapy (REBT), acceptance commitment therapy (ACT)) - speak through emotional and B issues with trained psychologist
• Medication (e.g., Selective serotonin re-uptake inhibitors (SSRIs)) - no.1 treatment for anxiety and depressions - attempt to balance neurotransmitters to increase neural functioning and coping

Question 14

What are the limitations of the two conventional mental health treatment methods?

Answer 14

• Medications treat symptoms but not root cause - individ may not be able to cope without
• Side effects of medications (lethargy, fatigue, low motivation)
• Psychotherapies have long waiting lists - issue with accessibility, if want to be seen sooner must pay

Question 15

Briefly describe ‘green exercise’ as therapy - include a supporting study

Answer 15

Mnich et al (2019)

• Feel better after exercise outside vs inside
• Benefits of PA still seen - enhance mood and emotions
• Immersed in outdoor, natural environments
• Lower cortisol in outdoor sessions vs indoor (randomised control)
• Relates to attention restoration theory

Question 16

What are the two types of attention?

Answer 16

1. Directed attention - requires effort and can become exhausted over time
2. Involuntary attention - natural and effortless

Question 17

How does attention restoration relate to green exercise as therapy for poor mental health?

Answer 17

• Natural environments engage involuntary attention - can lead to feeling rejuvenated, calm, reduced stress and relaxed
• Supported by self-report research