If you're dealing with depression or anxiety, you're probably aware of the recommendation to be more active. With our minds and bodies powerfully connected, physical activity can have an immediate impact on a person's overall sense of well-being.
This is due in part to changes that take place in the brain during exercise. The so-called 'runner's high' is caused by a potent cocktail of hormones - possibly including a neurotransmitter called anandamide, from the Sanskrit word for 'bliss'. On top of this, staying active is likely to boost self-esteem, serve as a distraction from negative thought spirals, and improve your quality of sleep.
Of course, exercise is no more a 'cure' for mental health problems than it is for physical ones. However, many people find that physical activity is an essential part of managing their condition.
"If you're more active there's good evidence to suggest that at most ages, for both men and women, there's a trend towards lower rates of depression," says Stephen Buckley, head of information for Mind. "In fact one study has found that by increasing your activity levels from doing nothing, to exercising at least three times a week, you can reduce your risk of depression by up to 30%."
Find an activity you like
Unfortunately, many people with depression and anxiety can face extra hurdles to getting active. For instance, you may lack confidence, or struggle with motivation. Some people take medication that drains their energy levels, while others have accompanying physical conditions that limit what they can do. On top of this, tiredness is a major feature of depression. And while exercise can, counter-intuitively, reduce tiredness, that isn't always much help for someone struggling getting out the door.
It can feel like a catch-22 situation - you need a mental boost to start exercising, but you need to exercise to get that mental boost.
For this reason, it's particularly crucial to find an activity you like and can stick to, even when it's challenging. In our Patient survey of 281 healthcare professionals, doctors said they'd recommend a wide variety of exercises for people with depression and anxiety, reflecting how personal this decision can be.
At the top of the list were gymnastics/dance/Zumba (recommended by 69% of doctors), followed by cycling (69%) and yoga/Pilates (68%). The least recommended exercises were skiing/snowboarding (43%), skateboarding/rollerblading (42%) and rugby (38%).
"It is interesting that the GPs surveyed seem to favour activities like cycling and Zumba," says Buckley. "Perhaps this is because both are flexible activities, which can be done alone or in a group, and either in a formal setting (with an instructor) or just for fun. It's clear, however, that more research is needed to help us understand if some forms of physical activity have greater benefits than others for people with mental health problems."
As he points out, while all types of exercises can bring mental health benefits, different people will gel with different activities. Mind has an online quiz in collaboration with Sport England, which suggests some possibilities and may help you feel more positive about getting started.
"A team sport might be best for you if you value a strong social element, or if you find your depression is draining your motivation. If, on the other hand, you find being with others a struggle, an activity like running might work better," he says. "Don't feel that you have to stick at something that's not working for you. There are hundreds of activities you can do and you're much more likely to keep doing it if it's fun."
On your bike
Cycling, which was the second most recommended activity in our survey, may be particularly advisable because it involves spending time in nature. Research has found that exercising can be as effective as antidepressants in treating mild to moderate depression - above all when you exercise outdoors.
"This recommendation from doctors adds to comprehensive evidence that there is a clear and direct link between physical activity and good mental health," says Dr Ruth Anderson, Great Britain Cycling Team lead psychologist. "Getting out on a bike for just a relatively short period of time is a fantastic way to combat the stress of everyday life and enhance your psychological well-being."
The mind-body connection
Yoga and Pilates, third on our list, are often classed as mind-body exercises, meaning they are good for both your physical and your mental health.
"The mindfulness of the movements, the breathing and the relaxation techniques are great for anyone suffering from anxiety, depression or stress," says Lynne Robinson, founder and director of Body Control Pilates and author of The Pilates Bible and Pilates for Life. "The mind and body are reunited through movement. You can work out in a safe, supportive, social environment - classes are not competitive and, most important of all, they are fun!"
Consider the risks
Unfortunately, people with mental health problems are at greater risk of developing physical health problems too (often due to having a poor diet, smoking or drinking too much). This means staying active is crucial. As Buckley explains, there is no wrong time to start exercising as long as you are physically able, with the caveat that you consider any risks.
"For example, you might be taking medication, experience anxiety or panic attacks, or be at risk of over-exercising," he says. "With this in mind it's worth taking real care when planning what type of activities you try and what routine you want to draw up. You can get additional advice on this from your GP or through sources of trustworthy advice like the Mind website."