I have already written one piece about exercise and the bodymind, including its basic effects on psychological functioning, and the problem of global indolence but because the research literature is so large I only scratched the surface. Here I intend to expand on the topic in a more inclusive fashion by covering more aspects and even then, some are purposely left out. To say there is a veritable mountain of research into the psychological effects of exercise would be an understatement as it has such a long and rich history. Other aspects of exercise and psychological functioning are not included here are exercise effects on disability conditions, personality, perception, and motor behavior. I focus on what I consider are the “biggies” from the perspective of Somatic Psychology as well as from personal experience. Body image, cognitive functioning, mood, and well-being are the things I am most interested in right now at this stage of life along with maintaining balance and flexibility. Exercising for a reasonable duration of time consistently and at an appropriate intensity level appears to be one of the most effective ways of enhancing the health of the bodymind.
Mens sana corpore sano: “A healthy mind in a healthy body”
The above phrase is quite famous in the history of medicine and physical culture. It was coined by the ancient Roman poet, Juvenal (55-128 AD), as the first item in a list he made of all things desirable for a good life. A key part of having a healthy body, as we all know, is physical exercise, which also contributes to having a healthy mind. Exercise and its effects on the human psyche have been discussed for more than 2,000 years with very strong interest in the subject appearing in the nineteenth-century—an era thick in hyperbole but very thin in evidence—after which it falls under the scrutiny of science beginning in the 1920s. Sports psychology arises in 1950s and the rest, as they say, is history (Layman 1974).
There is now an extensive body of literature exploring the positive effects of exercise via physiological changes on mood states such as anxiety, stress and depression. The current hypothesis is that this occurs by complex physiological and biochemical mechanisms including increased endorphin, mitochondrial, and neurotransmitter[1] activation along with the stimulation of the hypothalamic-pituitary-adrenal (HPA) axis[2] which is influenced by the thermogenic hypothesis[3]. Studies find that long-term exercise of moderate to intense aerobic activity results in an exponential rise of three kinds of neurochemicals: neurotransmitters, neurotrophins, and neuromodulators. Even a single exercise session increases these biochemicals (Bhattacharya, Chatterjee, & Roy, 2022). Two theories attempt to account for the changes in brain chemistry. The endorphin hypothesis and the monoamine hypothesis (Craft & Perna, 2004). There are several other hypotheses used to explain the psychological effects. These are the distraction hypothesis[4] and the self-efficacy hypothesis[5]. As exercise reduces inflammation, it enhances mood (Mikkelsen et al., 2017). (See Basso & Suzuki, 2016/2017 for a more complete review).
The situation in which the exercise experience occurs helps to mediate its effects. Outdoor exercise is very good especially in the morning. Working out in the morning builds vigor and confidence while evening exercise increases relaxation and detachment. Exercising increases a sense of self-achievement. Exercise provides helps to improve psychological health but the context in which it occurs increases the benefits such as relaxation, vitality, happiness, self-esteem, and stress reduction (White et al., 2023). Studies of aerobic exercise report that positive effects are usually realized in sessions of moderate length and moderate to intense levels of exertion (Ferrer-Uris et al., 2022; Klaperski et al., 2019).
Main Areas of Psychological Impact
Physical exercise seems to generate a holistic halo effect on bodymind functioning affecting physical and mental health in a variety of ways. The primary areas of effect, and this is for the sake of simplified discussion—and from my own area of interest: somatic psychology—are body image, cognitive health, mood, and well-being.
Body Image
Body image is a multidimensional construct that reflects one’s thoughts, feelings, evaluations and perceptions of one’s own body. Body schema is the actual physical experience of being embodied. One is based on perception and the other on sensations. Body image can be improved in a variety of ways including enhancing one’s positive self-perception and sense of self-efficacy (personal power). Changes in body image come about more from a change in self-perception rather than changes in one’s body. One example comes from a research study which found a correlation between exercise-related changes in body image and perceived fatness was larger than the correlation between changes in body image and actual fatness (Martin-Ginis et al., 2005). Another study of young adult female exercises showed that body image changes related to changes in perceptions of body fat, aerobic endurance, and aerobic self-efficacy, but not with actual physical changes (Martin-Ginis et al., 2014; also see Salci, 2017). In short, body image can be improved even after a single session of aerobic activity (Béres, Czeglédi, & Babusa, 2017).
Indeed, changes in body image are more strongly linked to perceived rather than actual changes in one’s body (Martin Ginis et al., 2005). Further, an exercise training study of undergraduate women showed that body image changes were related to changes in perceptions of body fat, aerobic endurance, and aerobic self-efficacy, but not with actual physical changes (Martin Ginis et al., 2014).
A meta-analysis of 121 published and unpublished studies found that:
- exercisers have a more positive body image than non-exercisers;
- exercisers who received coaching had a more positive body image than non-exercisers;
- exercisers has significantly raised body image scores after a single exercise session (Hausenblas & Fallon, 2007).
A more recent meta-analysis of 182 quantitative, 26 qualitative, and 2 mixed-methods studies of sport or physical activity (formal or informal) also concluded that participation in physical activity and sport related more to positive body image than negative. Negative body image related to less physical activity and vice versa (Sabiston et al., 2019).
Exercise and its positive effects on body image appears especially powerful for women. One experimental study measured the body image and emotional state of female exercisers immediately after exercise and at random points throughout the day they exercised. Subjects had less body dissatisfaction and more positive feelings following exercise compared to the scores taken at random points in time (LePage & Crowther, 2010). Another study of young adult female exercises showed that body image changes related to changes in perceptions of body fat, aerobic endurance and self-efficacy, but not with actual physical changes (Martin-Ginis et al., 2014; also see Salci, 2017). In short, body image can improve even after a single session of aerobic activity (Béres, Czeglédi, & Babusa, 2017).
Cognitive Health
The relationship between exercise and cognitive ability is very complex and the knowledge we have, while promising, is still quite limited. Despite this, the overall literature on exercise and thinking consistently reports three key effects:
- improvements in cognitive activity in the prefrontal cortex
- enhanced positive mood
- lowered stress level
One example of how exercise improved cognitive ability is found in Rasmussen & Laumann (2013) in which academic performance and mood in adolescents improved after exercise. Some evidence indicates that stand-alone sessions of intense exercise improve long-term and associative memory. The hippocampus is responsible for these functional abilities along with the learning and recall of motor skills (Basso & Suzuki, 2016/2017). My own cursory inspection of the literature found three cognitive functions of great interest: executive functioning, memory improvement, and attention.
Many studies on cognitive ability have used aerobic exercise as an experimental intervention. Unfortunately, until now, the research evidence lacks agreement on its effects on thinking. A recent study sought to correct this weakness and found that aerobic exercise provided improved cognitive performance for most subjects, but especially for those with lower cognitive scores at pre-test (Ishihara et al., 2021). This is a very provocative finding.
Dementia Delay
Risk factors for dementia and Alzheimer’s disease include ageing, genetic history, level of medical care, and lifestyle. About one-third of dementia cases are caused by controllable factors such as physical inactivity, smoking, and hypertension. Exercise has emerged as an important regimen to positively influence brain health including cognitive decline and dementia (Alty, Farrow, & Lawler, 2019).
The first trial finding positive statistical significance for exercise and cognition among older adults with some degree of cognitive dysfunction showed that the benefits of physical activity may be long-lasting (Frith & Loprinzi, 2018). The main positive effects for exercise are more cognitive and behavioral efficacy, reduced stress and improved sleep, a reduction in dementia risk factors such as chronic, non-communicable diseases, increase in brain blood flow, angiogenesis[6], neurogenesis[7], synaptogenesis[8] and synaptic plasticity[9] in the brain memory-related region, and reduced neuroinflammation. However, designing standard clinical and experimental studies that will show the relation between physical activity and dementia involves many variables and will be a very complex undertaking (Gholamnezhad, Boskabady, & Jahangiri, 2020).
Attention
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) show have substantially impaired attentional control, cognitive processing, and motor control. Medication is mainly used to treat symptoms, but CAIM alternatives are preferred by parents, children, and psychiatrists. Physical exercise is a growing drugless treatment option. While there is a dearth if random control trial studies, the current evidence indicates that exercise is great benefit for ADHD (Ng et al., 2017; Welsch et al., 2021). One study of 43 children with ADHD—32 boys and 11 girls between seven and 12 years—participated in a 12-week exercise program. The results were that programmed exercise improved their cognitive functioning (Ziereis & Jansen, 2015). Aerobic exercise has also been tested and proved a valuable treatment intervention (Ahmed & Mohamed, 2011).
Mood
There is a growing wealth of research regarding the positive effects of exercise on mood through physiological and biochemical mechanisms as mentioned earlier above. A group of studies have shown that attitude changes from the distraction hypothesis and the self-efficacy hypothesis positively impact mood change while exercise reduces inflammation contributes to mood stabilization and elevation (Mikkelsen et al., 2017).
Anxiety
Generalized Anxiety Disorder (GAD) affects about 5.8 percent annually is composed of a group of bodily and mental symptoms. Allopathic treatment of GAD usually takes about three months or more. The primary concern about anxiety is that it can impair daily functioning and lead to chronic health issues and even suicide (Taylor, 2000). While medications and psychotherapy are usually offered, patient response and remissions rates are poor. Worse, people with GAD often feel stigmatized by others around them for being psychologically or morally weak. This prevents many people from seeking help. Many people pursue complementary and alternative integrative medicine (CAIM) treatments to relieve anxiety and stress with exercise and massage being popular options (Rapaport et al., 2022). Exercise programs—especially those utilizing aerobic exercise—have helped to reduce anxiety with high-intensity exercise being more beneficial than low intensity types (Aylett, Small, & Bower, 2018).
Aerobic exercise appears to be very beneficial in relieving anxiety. One meta-analysis of research studies using aerobic exercise and a control group. The exercise subjects realized lower anxiety levels as compared to the control groups. Plus, high-intensity exercise is more effective than low intensity regimens (Aylett, Small, & Bower, 2018).
Depression
Major depression by far is the largest mental health issue affecting 5-10 percent of the population. It is estimated that about 17 percent of the adult population will experience a major depressive episode at some point in their lifetimes. Depression is more common in the middle-aged and elderly. Treatment is generally with antidepressant medications and very limited psychotherapy. Scientists first became interested in the relationship between exercise and depression starting in the early 20th century. Initial studies even then found moderate-intensity exercise could result in a less depressed mood. Research then and now pointed out that exercise effects may be long lasting. For example, depressed adults in a fitness program had substantial improvement in mood than their control group after 12 weeks of exercise training. The exercise group maintained many of these gains after the 12-month follow-up period (DiLorenzo et al., 1999). Studies find that long-term exercise of moderate to intense aerobic activity results in an exponential rise of three kinds of neurochemicals: neurotransmitters, neurotrophins, and neuromodulators. Even a single exercise session of exercise increases these biochemicals (Bhattacharya, Chatterjee, & Roy, 2022). Other studies have found exercise alleviates depressed mood (Singh et al., 2023).
Exercise is now looked to:
- help treat mental illness
- cope with and manage mood fluctuations
- improve the quality of life
- safeguard against future episodes (Biddle, Fox, & Boutcher, 2000).
Research also suggests that the benefits of exercise involvement may be long lasting. Depressed adults who took part in a fitness program displayed significantly greater improvements in depression, anxiety, and self-concept than those in a control group after 12 weeks of training (BDI reduction of 5.1 [fitness program] vs. 0.9 [control], p < .001). The exercise participants also maintained many of these gains through the 12-month follow-up period (DiLorenzo et al., 1999).
Stress
As has been already discussed, exercise relieves stress-related symptoms such as physical and mental tension, anxiety while improving the ability to focus and mood as well… all major signs of stress. See Edenfield & Blumenthal (2011) for a detailed overview of exercise and stress.
Schizophrenia
A meta-analysis of research into the effects of exercise on schizophrenia analyzed several dozen articles published between 1978 and 2008. The studies selected for analysis yielded a study base that was 64 percent male with a mean age of 39 from in-patient, outpatient, and residential care who engaged in any form of physical activity lasting from three to 20 weeks in duration. Measures include general mental health, psychological well-being, quality of life, social competence, physical self-efficacy, body image and mood. Overall, findings were mixed but strong enough to suggest exercise has some positive impact on schizophrenia (Holley et al., 2011).
Well-Being
The Holistic Well-Being Paradigm proposes that health is a state of total wellness balanced by four integrated and indivisible components: physical, intellectual, emotional, and spiritual aspects of daily living[10]. The paradigm asserts that each part of the whole person must be addressed rather than just confining treatment to problematic aspect as is traditionally practiced in Western medicine[11] (Seaward, 2015). Appropriate physical exercise, positive emotions, good self-esteem, living a balanced life, having trustful relationships, and having a sense of belonging are all important factors for health. Two other aspects related to the sense of health are being able to use the body as a tool to accomplish desired actions and as an energy source to be tapped for physical and mental activities (Randell et al., 2016).
A South African study into exercise and well-being is of particular interest. It examined psychological well-being within the context of public health. The relationship between physical exercise and wellness was measured in 25 health club exercisers over a two- to six-month time frame. Sub-measurements of well-being included mood, lifestyle, life satisfaction, sense of coherence, fortitude, stress management, coping and total well-being. Subjects exercised for an average of 30 minutes a day at least three times a week. The main findings were that regular exercise was associated with significant improvements in total well-being score and especially in mood, sense of coherence, fortitude, stress and coping. (Edwards, 2006).
An unusual study of 15 male college students with a control group used the brain scan method of voxel-based morphometry (VBM)[12]. The exercisers worked out for 30 aerobic sessions. Magnetic resonance imaging scans and psychological tests were administered pre- and post-exercise sessions. VBM analysis compared changes in gray matter in the two groups. Results found no change in the gray matter content of the exercise group, but did find a significant decrease in the insular regions of the control subjects. The exercise group did realize strong improvement in their psychological scores. These findings imply that aerobic exercise may slow loss of gray matter in the insular cortex which, in turn, improves psychological well-being (Gondoh et al., 2009).
Closing Thoughts
A healthy mind in a healthy body. Exercise isn’t just about building muscle or losing weight. It has holistic effects on the bodymind regarding thinking, mood, attention, and general mental health. It seems to me that given all of these findings, personal trainers are now able to tailor exercise programs to address not just target areas of the body, but psychological factors like anxiety, self-esteem, and improved brain health. And, in looking at all of these positive effects on so many levels, I feel increasingly guilty for not exercising as much as I should, but I do find it is helping to build my motivation. I think I’ll hit the gym today.
Paul Shane, Ph.D., LMT
Director, Academic Content
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[1] Neurotransmitters involved are glutamate, GABA, serotonin, dopamine, and epinephrine and norepinephrine.
[2] The HPA axis is the systematic activities of the hypothalamus, pituitary gland, and adrenal cortices working together as a neuroendocrine system to modulate the body’s responses to stress via feedback loop responses.
[3] The thermogenic hypothesis is the idea that an increase in core body temperature following exercise alleviates depression (Craft & Perna, 2004).
[4] The distraction hypothesis suggests that physical exercise serves to divert a person’s attention away from worries and depressing thoughts (Leith, 1994).
[5] The self-efficacy hypothesis asserts that exercise builds a depressed person’s sense of personal empowerment and personal effectiveness (deVries, 1981; Baghbani, Arabshahi, & Saatchian, 2023).
[6] Angiogenesis is the formation of new blood vessels.
[7] Neurogenesis is the production of new nerve cells in the brain.
[8] Synaptogenesis is the production of new nerve contact junctions.
[9] Synaptic plasticity is the ability of the brain to generate new patterns of nerve contact junctions.
[10] Well-being is a complex concept with multiple facets and subjective feelings and self-evaluation. See Steele (2019) for a good overview.
[11] The World Health Organization (WHO) defines health as the harmony among the body, mind, and the connection to society with no sense of dysfunction. It says further that health is determined by wellness, often termed well-being, which is the integration of the various aspects of being human: physical, psychological, spiritual, social, occupation, and environmental (WHO, 2013). Therefore, health and wellness are holistic processes balancing the parts to make a well-functioning whole.
[12] VBM is a neuroimaging technique that compares regional brain volume and tissue concentration differences between groups of brain images using a statistical analytic tool.