In this weird COVID 19 era we are finding many more people out running, largely because there is not much else they can do, but aside from that people need to exercise for their mental health. We have looked at the many benefits of running over the years so I thought we would delve a little more into the effects on mental health. Medical research tells us that people with low levels of cardio vascular fitness are at greater risk of developing depression.

We have seen recently that the prevalence of mental health issues have increased significantly with the recent lock downs combined with the economic effects of COVID.

Aerobic exercise and the endorphins (which are opioids that the body produces during exercise) that come with it is one of the best things we can do for our mental health. We all know the great benefit aerobic exercise has on our cardio vascular system and keeping weight at a healthy levels, but what is less discussed is there are many studies that have shown a clear link between aerobic exercise and its effect as an anti depressant. It is often hard to get out of bed and start a run but when you finish, you almost always feel better for the experience, having hit the restart button that allows you to approach the day ahead with a better mind, or alternatively if running later in the day to clear the mind from the day you have just experienced. In Australia, official guidelines include exercise as a first line of treatment in the management of depression, just as exercise is also a front line treatment for sufferers of osteo-arthritis..

In a world where we are currently being constantly reminded that we can only partake in activities that are essential, running can be as essential to one’s mental health as any medication you may be prescribed. It is amazing how prevalent depression and anxiety are in society and they often co exist. In the US up to 10 per cent of their population meet the diagnostic criteria for depression, and about 20 percent for anxiety. If you stop and think about those numbers in relation to the US population, we are talking about in excess of 30,000,000 people!!!

Of course, we all have bad days where we may feel down about life at times and these feelings may even last several days and that is normal. What distinguishes that from depression is when those feelings stop you from being able to carry on life normally. People describe that they can’t get out of bed the next day, or aren’t motivated to be able to get out and train or go to work etc. Therapists largely look for how relatively normal feelings of lethargy or agitation start to interfere with a person’s normal functioning.

We know running can be an extremely useful way to help manage this but what if the persons mental health actually prevents them from even having the motivation to run? Rather than running just for the sake of running, try and have a goal/ event that you train for. Organizing to run with someone ( even in the COVID world and Stage 4 lockdown that we find ourselves in, it is permitted to train with one other person) is another way to help ensure you get out the door and go for that run.

So what is it about running that makes it good for our Mental Health ?

Endorphins are linked to what we often call “the runners high”. Endorphins, which as mentioned above are opioid neuropeptides, attach to opioid receptors in the brain. They have the effect of decreasing pain and producing feelings of euphoria and are released naturally at higher levels when running. The release and subsequent attachment of these endorphins to receptors in the brain means that running can help us shift from being miserable to content.

Several studies found that higher blood levels of post run endorphins correlated to improved mood. These higher levels of endorphins in the brain were found to be aligned with the athletes’ reports of euphoria. However it is not just the endorphins produced that make running such a great thing to assist in our mental health.

Regular running appears to result in growth or stimulation of the hippocampus in your brain. The hippocampus is a region of your brain embedded deep in the temporal lobe (in front of your ear). It is important in regulating motivation, emotion, learning, and memory. People who suffer from depression have often been shown to have smaller hippocampuses in their brain. On top of that, running produces similar chemical changes to those produced by anti depressants, balancing chemicals in your brain called neurotransmitters that effect mood and motivation (You may have heard of Serotonin or Dopamine – both common neurotransmitters).

Neurotransmitters like these can be thought of as your body’s chemical messengers in that they are the molecules used by the body to transmit messengers from nerve cells to muscles. Running has been shown to increase levels of these neurotransmitters and help with the formation of new neural pathways and much of this activity happens in the hippocampus. If running helps result in a larger better functioning hippocampus and can increase the production of neurotransmitters that aid in overcoming depressive thoughts, you can see how beneficial it can be in aiding our mental health. On top of that, factor in the improved cardio vascular effect and weight loss that comes with it, and you can see why in Stage 4 COVID restrictions we are still allowed to run.

The general thought processes that go with running are also thought to be a factor. Running is a distraction for our mind and allows us to have a sense of purpose and achieve goals that make us feel satisfied. Instead of focusing on all the possible outcomes of a particular situation you are all of sudden in the moment and focusing just on the effort that you are putting in and the gaol that you are trying to achieve. You are out breathing in fresh air, getting your dose of Vitamin D. It is now thought that aerobic exercise results in long term structural changes in the brain and how we process thoughts, both of which help with mood swings and may help us better process how we deal with emotions that can lead to depressive states.

When we run it would appear that we process thoughts differently to when we are sitting around mulling over problems. Many runners will tell you that thinking about their work or other issues when trying to sleep will cause them all sorts of grief and prevent sleep and generally just make things worse. Thinking about the same problems when running would not result in the same outcomes.

It is thought that a more positive feedback loop happens in the brain as we focus on the immediate task in front of us, eg running up the next hill or getting through the next 30 sec effort etc. As a result all the catastrophising that we tend to do when focusing on the big picture issues confronting us that cause us to slip into depressive states, can tend to evaporate or at least not seem such a big deal that can’t be dealt with.

Normal daily tasks such as walking or going up stairs have been shown to not produce the same effects but other strenuous activities such as squash or football training etc may have similar benefits, it just hasn’t been researched closely and in our current world we can all easily go for a run but we can’t do most other activities.

According to WHO (World Health Organisation) depression is the leading cause of disability and poor health worldwide. On top of that the Australian Bureau of Statistics found that 67% of Australians were overweight or obese in their 2017/18 National Health Survey. The effects from running described above would appear to be better than most other forms of exercise. Certainly, exercise needs to be quite strenuous to have the maximum effect.
The important thing if you are starting from scratch is to progress your passage towards becoming another addicted runner very slowly to avoid becoming a different statistic, an injured runner. If you are keen to learn a bit more about running and building a running program, we have several physiotherapists at SSPC with extensive experience in dealing with runners and writing programs. You can see Jenny or Rob at East Bentleigh and Dane or Anna at Parkdale/ Mentone.

All these benefits aside I have always preached that running is one of the most cost effective and efficient activities you can do. No other sport allows you to gain such effective outcomes from 30 minutes out of your day. Put on a pair of shoes ( you could argue you don’t even have to do that), walk out your front door and come back 30 minutes later and you have just made a huge difference to the quality of your life.

I was motivated to write this piece by Scott Douglas, a prolific author and regular runner after reading one of his books “ Running is My Therapy”- Well worth a read. The above is largely my summary of his book plus a few other papers that I sourced in writing the article.

Rob O’Donnell
SSPC Physiotherapist