Depression, anxiety, post-traumatic stress… why sport is beneficial for mental health

Sport is (also) serious. We are of course thinking of its benefits, which are widely documented, in terms of physical health. What is less known is that it participates in the treatment of even severe mental illnesses. A top athlete and psychiatrist, Dr Jérôme Palazzolo has been firmly convinced of this for a long time.

Sport and mental health: is the highlighting of the links recent?

No way. The first written sports prescription for this indication was made by Hippocrates, the father of medicine, around 460 BC.

Why, then, this renewed interest?

Quite simply, because many articles have recently been published providing scientific evidence of the benefits of sport for mental health. They were able to be provided thanks to functional imaging techniques in particular, and to the assays of neurotransmitters.

When we talk about these benefits, are we essentially referring to the well-being provided by physical activity?

No, it goes way beyond that. It has been shown that sport acts on severe disorders such as depression, anxiety disorders, post-traumatic stress disorder, and even psychotic disorders, with an improvement in both physical and mental health. Beneficial effects on neurocognitive disorders such as Alzheimer’s disease and related diseases have also been demonstrated.

First written sports prescription for this indication around 460 BC

What happens in the brain?

High-intensity physical activity lasting more than 30 minutes (running, swimming, cycling, etc.) causes a veritable explosion of neurotransmitters (NT) in the brain, and in particular endorphins, which cause pleasure and relief – with effects comparable to those of morphine. These same NTs are also responsible for addiction to sport. In subjects who are victims, and who practice sport out of need more than pleasure, we find endorphin levels even higher than those observed in drug addicts! Are also secreted dopamine, the hormone of immediate pleasure, and serotonin, which regulates morale, and improves the management of anxiety.

What is the “price” to pay in terms of practices to obtain tangible benefits?

The benefits are immediate after half an hour of sport; but for significant effects, the practice must be renewed regularly. It should be considered as a “chronic treatment”, by practicing physical activities at least 300 minutes per week, the objective being to regularly nourish the neurons with neurotransmitters.

How does the practice of sport fit into the overall management of mental disorders?

A meta-analysis [combinaison de résultats d’une série d’études indépendantes sur le sujet, Ndlr] showed that regular physical activity produced effects as significant as psychotherapy or antidepressant treatment, for example. This obviously does not mean that sport can replace therapy and medication. But it is important that it is part of the management of mental disorders. You should know that physical activity in the broad sense is already used in CBTs (cognitive and behavioral therapies) with the aim of behavioral activation, to help the patient get back into action.

Mental illness is sometimes accompanied by a certain apathy, aggravated in some cases by medication. There are also all those who have no appetite for sport, or suffer from addictions. How do you convince them to take up sport?

It is obvious that one cannot ask someone who has never practiced sport, who smokes, consumes a lot of alcohol, to stop everything and go to the gym every day! The injunction, as we know, does not give any result in any case. What is done is to ask the patient to activate with a specific purpose, to “rate” their degree of pleasure and fulfillment, when they engage in activities as simple as walking to the sea, for example. The goal is to get him to have more and more fun. We do what we call sports reinforcement, to induce appropriate behavior; little progress and effort is complimented to improve their self-image.

What is the main difficulty?

Be able to adjust to the person’s abilities. On the interest of working, not in a downward dynamic: “Done!”but WITH the person, by adapting the program to what they want and feel capable of doing.

It has been shown that sport acts on severe disorders such as depression, anxiety disorders, post-traumatic stress disorder, and even psychotic disorders. Photo N.-M..