THE NUANCE

What’s the Best Type of Exercise for Your Mental Health?

Not all forms of physical activity are equal, and more isn’t always better.

They say you can’t run from your problems. But if your problems are psychological, perhaps you can. A lot of research has shown that exercise is protective against a variety of mental health conditions.

“In general, exercise interventions — regardless of type, frequency, or duration — help relieve psychiatric symptoms,” wrote the authors of a 2022 research review in the journal Sports Medicine.

A 2018 Lancet Psychiatry study came to a similar conclusion. After analyzing public health data form more than 1 million Americans, its authors found that people who exercised regularly had 43% fewer days of poor mental health in a given month than individuals who did not exercise.

‘We found that certain exercises were much more strongly associated with reduced mental health burden than others.’

Those benefits held up whether people did or did not have a history of a disorder diagnosis, the study found. Controlling for age, race, gender, marital status, income, education, employment status, BMI, and self-reported physical health also did not wipe out the observed correlation between exercise and a reduction in mental illness burden.

“[Exercise] feels good, it improves self-image, and it produces numerous effects in body and brain that could be antidepressant,” says Dr. John Krystal, MD, one of that study’s authors and a professor of psychiatry and neuroscience at Yale University.

Krystal gave me a few examples of how exercise could combat mental health problems at a physiological level.

“Exercise and exercise-related weight loss reduce inflammation in the body, which may decrease neurotoxic inflammation in the brain,” he says. Exercise has also been shown to be “neurotrophic,” he says, which means it can helpfully encourage the growth of new nerve cells or tissues. (His comments reminded me of the work of Harvard Medical School’s Christopher Palmer, who recently made the case that mental and metabolic disorders may both stem from mitochondrial impairments, and that exercise may be beneficial for both because it improves mitochondrial health.)

But not all types of exercise are equal when it comes to combating mental health challenges.

“We found that certain exercises were much more strongly associated with reduced mental health burden than others,” wrote Krystal and his coauthors on the Lancet Psychiatry study.

People who got their exercise in the form of popular team sports — soccer, tennis, volleyball, basketball, softball, etc. — reported the lowest self-reported mental health burden. “Reinforcing social bonds, getting people to focus on objectives that are beyond themselves, and providing opportunities to win” are aspects of team sports that may provide mental health advantages over and above those of mere physical activity, Krystal says, citing the work of Steven Southwick and Dennis Charney.

Cycling ranked second in his study, followed by aerobic or gym exercises (weigh-lifting, Pilates, calisthenics classes, etc.). Like team sports, those activities were associated with a greater than 20% reduction in mental health burden. (While the authors didn’t include yoga in their main analysis, they did a post-hoc analysis that found yoga landed among the top activities in terms of its psychological benefits.)

Running or jogging, walking, hiking, recreational activities (such as golf or fishing), and winter/water sports (skiing, swimming, etc.) also led to meaningful reductions in mental health burden, although the benefits were not quite as robust.

‘Exercise triggers parallel biological, psychological, and social processes that feed on each other and help people to better manage stress and recover from depression.’

The 2022 Sports Medicine research review came to similar conclusions. Some exercise was always better than no exercise, it found, but certain forms appeared to be more therapeutic than others.

That study’s authors drilled down on specific types of mental health problems and found some notable inter-exercise differences. Among people with a diagnosed anxiety disorder, resistance training (weightlifting, body-weight training, resistance-band work, etc.) was associated with the greatest benefit. People with depression got the most from “multimodal” activities that combined aerobic and resistance training — such as Pilates — while mind-body interventions like yoga or tai chi were optimal for those with PTSD. (That study was based on global health research and did not include team sports.)

Finally, there’s evidence that more exercise is not always better.

Returning to the Lancet Psychiatry study, Krystal and his coauthors examined how different durations and frequencies of exercise correlated with mental health burden. The sweet spot they identified was 30 to 60 minutes of exercise performed three-to-five days per week.

“Extreme ranges of more than 23 times per month, or longer than 90 minutes per session, were associated with worse mental health,” they found.

It’s not that more exercise is somehow harmful to a person’s mind; they speculated that people who fall into the heavy exercise camp may have more “obsessive” characteristics or traits, which can contribute to mental health challenges.

“The bottom line,” Krystal told me, “is that exercise triggers parallel biological, psychological, and social processes that feed on each other and help people to better manage stress and recover from depression.

He added, “In a world where people seem to agree on few things, almost everyone agrees that engaging in regular exercise is good for you.”

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