Promote brain plasticity and keep your mind at ease by taking your daily “exercise pill”

As with many oth­er physi­cians, rec­om­mend­ing phys­i­cal activ­i­ty to patients was just a doc­tor chore for me – until a few years ago. That was because I myself was not very active. Over the years, as I picked up box­ing and became more active, I got first­hand expe­ri­ence of pos­i­tive impacts on my mind. I also start­ed research­ing the effects of dance and move­ment ther­a­pies on trau­ma and anx­i­ety in refugee chil­dren, and I learned a lot more about the neu­ro­bi­ol­o­gy of exercise.

I am a psy­chi­a­trist and neu­ro­sci­en­tist research­ing the neu­ro­bi­ol­o­gy of anx­i­ety and how our inter­ven­tions change the brain. I have begun to think of pre­scrib­ing exer­cise as telling patients to take their “exer­cise pills.” Now know­ing the impor­tance of exer­cis­ing, almost all my patients com­mit to some lev­el of exer­cise, and I have seen how it ben­e­fits sev­er­al areas of their life and livelihood.

We all have heard details on how exer­cise improves mus­cu­loskele­tal, car­dio­vas­cu­lar, meta­bol­ic and oth­er aspects of health. What you may not know is how this hap­pens with­in the brain.

Brain plasticity and growth

Work­ing out reg­u­lar­ly real­ly does change the brain biol­o­gy, and it is not just “go walk and you will just feel bet­ter.” Reg­u­lar exer­cise, espe­cial­ly car­dio, does change the brain. Con­trary to what some may think, the brain is a very plas­tic organ. Not only are new neu­ronal con­nec­tions formed every day, but also new cells are gen­er­at­ed in impor­tant areas of the brain. One key area is the hip­pocam­pus, which is involved in learn­ing and mem­o­ry and reg­u­lat­ing neg­a­tive emotions.

A mol­e­cule called brain-derived neu­rotroph­ic fac­tor helps the brain pro­duce neu­rons, or brain cells. A vari­ety of aer­o­bic and high-inten­si­ty inter­val train­ing exer­cis­es sig­nif­i­cant­ly increase BDNF lev­els. There is evi­dence from ani­mal research that these changes are at epi­ge­net­ic lev­el, which means these behav­iors affect how genes are expressed, lead­ing to changes in the neu­ronal con­nec­tions and function.

Mod­er­ate exer­cise also seems to have anti-inflam­ma­to­ry effects, reg­u­lat­ing the immune sys­tem and exces­sive inflam­ma­tion. This is impor­tant, giv­en the new insight neu­ro­science is gain­ing into the poten­tial role of inflam­ma­tion in anx­i­ety and depression.

Final­ly, there is evi­dence for the pos­i­tive effects of exer­cise on the neu­ro­trans­mit­ters – brain chem­i­cals that send sig­nals between neu­rons – dopamine and endor­phins. Both of these are involved in pos­i­tive mood and motivation.

Exercise improves clinical symptoms of anxiety and depression

Researchers also have exam­ined the effects of exer­cise on mea­sur­able brain func­tion and symp­toms of depres­sion and anx­i­ety. Exer­cise improves mem­o­ry func­tion, cog­ni­tive per­for­mance and aca­d­e­m­ic achieve­ment. Stud­ies also sug­gest reg­u­lar exer­cise has a mod­er­ate effect on depres­sive symp­toms even com­pa­ra­ble to psy­chother­a­py. For anx­i­ety dis­or­ders, this effect is mild to mod­er­ate in reduc­ing anx­i­ety symp­toms. In a study that I con­duct­ed with oth­ers among refugee chil­dren, we found a reduc­tion in symp­toms of anx­i­ety and PTSD among chil­dren who attend­ed eight to 12 weeks of dance and move­ment therapies.

Exer­cise could even poten­tial­ly desen­si­tize peo­ple to phys­i­cal symp­toms of anx­i­ety. That is because of the sim­i­lar­i­ty between bod­i­ly effects of exer­cise, specif­i­cal­ly high-inten­si­ty exer­cise, and those of anx­i­ety, includ­ing short­ness of breath, heart pal­pi­ta­tion and chest tight­ness. Also, by reduc­ing base­line heart rate, exer­cise might lead to sig­nal­ing of a calmer inter­nal phys­i­cal envi­ron­ment to the brain.

It is impor­tant to note that the major­i­ty of stud­ies exam­ined the effects of exer­cise in iso­la­tion and not in com­bi­na­tion with oth­er effec­tive treat­ments of clin­i­cal anx­i­ety and depres­sion, such as psy­chother­a­py and med­ica­tion. For the same rea­son, I am not sug­gest­ing exer­cise as a replace­ment for nec­es­sary men­tal health care of depres­sion or anx­i­ety, but as part of it, and for prevention.

There are oth­er perks besides the neu­ro­bi­o­log­i­cal impacts of exer­cise. When going out for a walk, one gets more expo­sure to sun­light, fresh air and nature. One of my patients befriend­ed a neigh­bor dur­ing her reg­u­lar walks, lead­ing to reg­u­lar taco Tues­days with that new friend. I have made some great friends at my box­ing gym, who are not only my moti­va­tors, but also a great sup­port­ing social net­work. One might pick a dog as their run­ning mate, and anoth­er might meet a new date, or enjoy the high ener­gy at the gym. Exer­cise can also func­tion as a mind­ful­ness prac­tice and a respite from com­mon dai­ly stres­sors, and from our elec­tron­ic devices and TV.

By increas­ing ener­gy and fit­ness lev­el, exer­cise can also improve self-image and self-esteem.

Practical ways for a busy life

So how can you find time to exer­cise, espe­cial­ly with all the addi­tion­al time demands of the pan­dem­ic, and the lim­i­ta­tions imposed by the pan­dem­ic such as lim­it­ed access to the gyms?

  • Pick some­thing you can love. Not all of us have to run on a tread­mill (I actu­al­ly hate it). What works for one per­son might not work for anoth­er. Try a diverse group of activ­i­ties and see which one you will like more: run­ning, walk­ing, danc­ing, bik­ing, kayak­ing, box­ing, weights, swim­ming. You can even rotate between some or make sea­son­al changes to avoid bore­dom. It does not even have to be called an exer­cise. What­ev­er ups your heart­beat, even danc­ing with the TV ads or play­ing with the kids.
  • Use pos­i­tive peer pres­sure to your advan­tage. I have cre­at­ed a group mes­sag­ing for the box­ing gym because at 5:30 p.m., after a busy day at the clin­ic, I might have trou­ble find­ing the moti­va­tion to go to the gym or do an online work­out. It is eas­i­er when friends send a mes­sage they are going and moti­vate you. And even if you do not feel com­fort­able going to a gym dur­ing the pan­dem­ic, you can join an online work­out together.
  • Do not see it as all or none. It does not have to be a one-hour dri­ve to and from the gym or bik­ing trail for a one-hour work­out vs. stay­ing on the couch. I always say to my patients: “One more step is bet­ter than none, and three squats are bet­ter than no squats.” When less moti­vat­ed, or in the begin­ning, just be nice to your­self. Do as much as pos­si­ble. Three min­utes of danc­ing with your favorite music still counts.
  • Merge it with oth­er activ­i­ties: 15 min­utes of walk­ing while on the phone with a friend, even around the house, is still being active.
  • When hes­i­tant or low on moti­va­tion, ask your­self: “When was the last time I regret­ted doing it?”

Although it can help, exer­cise is not the ulti­mate weight loss strat­e­gy; diet is. One large brown­ie might be more calo­ries than one hour of run­ning. Don’t give up on exer­cise if you are not los­ing weight. It is still pro­vid­ing all the ben­e­fits we discussed.

Even if you do not feel anx­ious or depressed, still take the exer­cise pills. Use them for pro­tect­ing your brain.

Arash Javan­bakht, M.D., is the direc­tor of the Stress, Trau­ma, and Anx­i­ety Research Clin­ic (STARC) at Wayne State Uni­ver­si­ty. This arti­cle was orig­i­nal­ly pub­lished on The Con­ver­sa­tion.

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