6 mental health conditions that exercise improves

Working out has a powerful impact on your mental health—here's how

By Heidi Borst | Jan. 4, 2023 Medically reviewed by Chad Shaffer, MD

You’re likely aware that exercise is vital for physical health and wellness—reducing the risk of many chronic diseases. But did you know it’s just as important for your mental health? Regular physical activity has profound mental health benefits, according to the U.S. Department of Health and Human Services. It’s an effective way to manage anxiety, depression, and stress. Whether you prefer hitting the gym, participating in organized sports, or going for a walk outdoors, regular exercise can help manage the symptoms of common mental health conditions. Here’s what you need to know about the benefits of exercise on mental health.

RELATED: Exercise and chronic disease

How does exercise impact the brain?

Physical activity has numerous mental health benefits; on the flip side, lack of exercise (or living a sedentary lifestyle) is associated with poor mental health, says Aaron Sternlicht, LMHC, a therapist and addiction specialist at Family Addiction Specialist in New York. “Consistent regular exercise over time has been found to have the best long-term mental health benefits,” Sternlicht says.

How exactly does exercise for mental health work? It triggers neurobiological and behavioral mechanisms that work together to improve mood and/or mitigate mental health symptoms, explains Sternlicht. Physical activity also releases mood-boosting and stress-reducing neurotransmitters—such as dopamine, norepinephrine, and serotonin—that can boost mood and reduce stress, worry, agitation, and other such conditions. Finally, exercise increases blood circulation to regions of the brain that trigger a reduction of stress and boosts mood.

And those are just the physiological effects of exercise on the brain. “Exercise also helps with distraction from negative thoughts, social interaction, sleep, self-esteem, self-efficacy, discipline, routine, and confidence, all of which in turn are beneficial for mental well-being,” says Sternlicht.

6 mental health conditions that exercise improves

Exercise is an essential part of our well-being. It boosts metabolism, reduces anxiety, improves sleep, and produces endorphins, says Alex Dimitriu, MD, a double board-certified doctor in psychiatry and sleep medicine and founder of BrainfoodMD. “For all of my patients, I recommend SEMM: sleep, exercise, meditation, and the Mediterranean diet,” Dr. Dimitriu says. “I have seen substantial improvements to both sleep and mood stability from exercise routines.”

And research shows that exercise has a beneficial effect for individuals with specific mental health conditions. Here are the top six.

Depression
ADHD
Anxiety
Bipolar Disorder
OCD
PTSD

Exercise and depression

Depression is one of the most common mental disorders worldwide. According to Sternlicht, symptoms of depression include:

Feeling low on most days
Losing interest in activities that you once found enjoyable
Sleeping too much
Low energy and/or constant fatigue
Changes in appetite (eating too much or too little)
Changes in weight (weight gain or loss)
Difficulty concentrating
Decreased interest in social activities or sex
Thoughts of suicide

“If you are experiencing these symptoms, please seek out a mental health professional,” Sternlicht advises.

According to the National Institutes of Mental Health, 21 million Americans have experienced at least one major depressive episode, defined as a period of low mood and other signs of depression that lasts two weeks or more. If you’re experiencing depression, exercise could be part of a successful plan to prevent or alleviate your symptoms. A 2017 study published in the American Journal of Psychiatry found that regular exercise had a protective effect against depression. And a 2022 meta-analysis of 15 studies published in JAMA Psychiatry showed that exercise had significant mental health benefits with a reduced risk of depression.

What type of exercise is best to combat depression? Both aerobic exercise and resistance training have been shown to be effective, says Sternlicht. While exercise doesn’t have to be lengthy or intense to be effective, consistent exercise over time is associated with a greater reduction of depressive symptoms, he says. “Moderate intensity exercise for 20 minutes, three times per week is sufficient to reduce symptoms of depression,” advises Sternlicht.

Exercise and ADHD

Attention deficit hyperactivity disorder (ADHD) is defined as consistent inattention and/or hyperactivity-impulsivity that impedes on daily functioning or development in at least two settings such as school, work, home or social settings, says Sternlicht.

Symptoms of inattention include:

Making careless mistakes
Difficulty sustaining attention during tasks
Becoming easily distracted
Poor listening
Difficulty with organization
Forgetfulness

Symptoms of hyperactivity and impulsivity include:

Fidgeting
Excessive talking
Difficulty waiting
Inability to stay seated
Interrupting or intruding on others

When it comes to ADHD, research indicates that exercise helps reduce impulsivity, improve attention, and boost executive functioning—all of which can help improve symptoms, says Sternlicht. According to Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD): “Moderate to intense exercise actually provokes changes in many of the same neurochemicals (norepinephrine and dopamine) and brain structures as popular prescription ADHD medications.”

The best kind? Cardiovascular exercise like brisk walking, biking, running or swimming—anything that gets the heart pumping—for a minimum of 30-40 minutes for four to five days a week. Complex movements such as martial arts, ballet, ice skating, gymnastics, rock climbing, and mountain biking are even more beneficial. That’s because they activate a broader range of areas in the brain to improve focus and concentration.

Exercise and anxiety

It’s normal to feel anxious from time to time—say, when you’re running late or stressed on the job. But when anxiety is chronic, an anxiety disorder is likely at play. According to the National Institute of Mental Health, anxiety disorders include general anxiety disorder, panic disorder, social anxiety disorder, and phobia-related disorders.

Common symptoms include:

Restlessness
Nervousness
Difficulty sleeping
Irritability
Avoidance of anxiety triggers
A sense of impending doom
Difficulty concentrating

Physical symptoms may occur as well, such as:

Increased heart rate or breathing
Sweating
Trembling
Muscle tension
Weakness/tiredness/fatigue
Gastrointestinal issues

Both aerobic exercise and resistance training have been shown to be effective in mitigating symptoms of anxiety, says Sternlicht. But research indicates that high intensity exercise is more effective than low-intensity exercise. That’s because intense exercise encourages a person to endure mental and physical discomfort, which can help them learn to cope with the symptoms of anxiety, he adds.

Exercise helps to markedly reduce anxiety as people will often feel they blow off steam, agrees Dr. Dimitriu. “I often recommend a mix of cardio and weight training about four to five times per week, at about 30-45 minutes per session,” Dr. Dimitriu says. “The cardio could be walking, but intensity helps if you can tolerate it.”

Exercise and bipolar disorder

Bipolar disorder is a serious mental illness marked by unusual mood changes. People with bipolar go through “down” periods of feeling sad and hopeless, to feeling “up” periods of feeling very happy, elated, or irritable. Individuals with bipolar phase between up (manic), down (depressive), and inactive (normal) states. Manic phases last at least seven days or are severe enough to warrant hospitalization, and depressive phases last two weeks or more.

Symptoms of a manic episode include:

Feeling elated
Feeling jumpy/wired
Irritability
Racing thoughts and/or talking very fast
Needing less sleep
Feeling grandiose
Risky behavior

Symptoms of a depressive episode include:

Feeling sad, hopeless, or worthless
Loneliness and isolation
Forgetfulness
Talking slowly or not feeling like talking
Little energy
Sleeping too much
Changes in eating habits (eating too much or not enough)
Lack of interest in things you normally enjoy
Thoughts of death or suicide

According to Shawna Newman, MD, a psychiatrist at Northwell Health’s Lenox Hill Hospital in New York, aerobic exercise is optimal for bipolar disorder as it’s effective preventively. Research indicates that individuals with bipolar are more likely to be sedentary, and the benefits of physical activity are significant.

One small study showed that regular exercise has mood-enhancing effects for bipolar patients. A 2016 literature review found that exercise has an impact on both the physical and mental health parameters of mood disorders. Regular exercise helps improve pain tolerance, enhances sleep, and improves mood, all of which enhance the day-to-day functioning of individuals with bipolar.

“The rule of thumb is 30 minutes of vigorous aerobic exercise, 150 minutes a week—that’s about five days a week—at a minimum,” advises Dr. Newman. “I think if you are vulnerable to depression you probably need a bit more.” Still, no exercise should be undertaken unless it’s approved by your doctor first, she says. Once you’re cleared, try walking, jogging, biking, or swimming.

Exercise and OCD

Obsessive compulsive disorder (OCD) is characterized by uncontrollable thoughts, or obsessions, and rituals, or compulsions, that interfere with your life.

Common obsessions include:

Fear of germs or contamination
Fear of losing or misplacing an item
Worries about harm to yourself or others
Unwanted forbidden thoughts involving sex or religion
Aggressive thoughts toward yourself or others
Needing things arranged in a precise way

Common compulsions include:

Excessive cleaning and/or hygiene rituals, like handwashing
Checking on things over and over
Compulsive counting
Arranging things in a precise way

According to research, evidence for exercise as an effective way to manage OCD symptoms is promising. In fact, a 2019 randomized controlled trial published in the Journal of Affective Disorders found that individuals with OCD who engaged in regular aerobic exercise for 12 weeks experienced an increase in positive mood as well as a reduction in compulsions and anxiety.

Dr. Newman recommends regular aerobic exercise at moderate intensity (at least 30 minutes, five days per week—but more is better) for patients with OCD. If your health or fitness level limits you to more gentle movements, she says that slower forms of exercise like yoga, stretching, dance, and tai chi can also be helpful; they just won’t have the same profound effects.

Exercise and PTSD

Post-traumatic stress disorder (PTSD) can happen after you experience a shocking, scary, or dangerous event, according to the National Institute of Mental Health. PTSD symptoms are chronic, and include the following:

Re-experiencing symptoms

Flashbacks
Nightmares
Scary thoughts

Avoidance symptoms

Staying away from places and things that remind you of the traumatic event
Avoiding your feelings and thoughts about the event

Arousal and reactivity

Startling easily
Difficulty sleeping
Feeling on-edge
Angry outbursts

Cognition and mood

Difficulty remembering facts about the event
Negative thoughts about yourself and/or the world
Feelings of guilt or blame
Loss of interest in activities you used to enjoy

But exercise can help the symptoms of PTSD. “Potential mechanisms by which exercise could exert a positive impact in PTSD include exposure and desensitization to physiological sensations that mimic symptoms of PTSD,” says Sternlicht. These sensations include rapid heart rate. Other potential mechanisms for how exercise helps include improved cognitive function and exercise-induced neuroplasticity.

Research has shown that a combination of aerobic, resistance, strength and yoga exercises have the greatest positive effect on PTSD symptoms, but all of these types of exercise are effective at reducing PTSD symptoms, Sternlicht says.

Developing an exercise routine for mental health

So what exercise is best for mental health? Although studies have focused primarily on aerobic exercise, there is growing evidence to suggest that both aerobic exercise and resistance/strength training are beneficial for mental health.

“While high intensity exercises may be more beneficial for certain individuals or for certain mental health problems, moderate exercise can be just as effective in many cases,” Sternlicht says, adding that further research is needed to determine what forms of exercise—and at what intensity, frequency and duration—are most effective in reducing specific mental health issues.

When it comes to developing a routine you’ll stick with, Sternlicht offers the following tips:

Find your why: What’s your motivation for engaging in exercise? Think of a push, something that exercise can help you cope with, as well as a pull, something that you want to achieve—like a better quality of life.
Choose what works for you: Adherence is key, so find a form of exercise that you can be consistent with long term. Factor in any physical constraints you may have, what exercise intensity is appropriate, and time and budget limitations.
Make a specific plan: When you’ve established a concrete exercise program, you’re more likely to stay consistent. This could mean scheduling specific times for exercise on your calendar, setting out your workout clothes, setting an alarm, or scheduling your meals accordingly.
Pick an activity you enjoy: Research shows that individuals are far more likely to stick to an exercise routine if they enjoy it, so if you hate going to the gym, go for a hike, a walk, a bike ride, or try taking up a sport. To prevent burnout or boredom, mix up your routine.
Search out social support: Having a workout partner can not only help with accountability, but it provides you with emotional support—when you become discouraged, your exercise buddy can help motivate you.
Set realistic goals: Doing so will make you more likely to follow through, but make sure that your goals are realistic and achievable—overly ambitious goals can lead to burnout, feelings of failure, and even giving up.
Chart your progress: Keeping track of your progress helps maintain motivation, so keep track of things like the duration, intensity, or frequency of exercise and physiological changes like decreased weight, improved energy levels, and less stress.
Reward yourself: When you reach a goal or stick to your exercise routine for a certain period of time, reward yourself. That way, you’re reinforcing the behavior.