Sports therapies for mental illnesses stay happy without pills

Sport not only prevents diseases, but is now also used in the therapy of mental illnesses such as depression, anxiety disorders or schizophrenia. How much can sport really help? Does it only increase well-being or can it even replace medication?

The figures from the World Health Organization (WHO) are worrying: According to their mental health report published in June 2022, almost one billion people worldwide are living with a mental illness – almost one in eight people in the world.

According to the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN), more than one in four adults in Germany meets the criteria for a mental illness within a year. The most common are anxiety disorders, depression or disorders caused by alcohol or drug use.

A huge burden, primarily for the sick, but also for society and the health system.

Running therapies for depression

It is no secret that regular exercise and sport not only help prevent civilization diseases such as cardiovascular disorders, diabetes, severe corona courses or even mental illnesses . What is less common, however, is how successfully sport can also be used in therapy.

Forest runs and jogging against depression – aren’t we moving in dangerous homeopathic waters? On the contrary: More and more practices and therapists are now offering running therapy. 

Numerous studies show that endurance sports such as jogging, walking or cycling are particularly suitable for treating mild depression. They increase the level of the reward hormone serotonin, reduce the release of stress hormones and thus ensure greater well-being.

“When they walk, patients realize that they can do things on their own. In the eight weeks in the forest, there are often more symptom improvements than after many sessions in the practice,” says Diana Stöckel, psychological psychotherapist and trained walking therapist: “These people take every step on their own. So they can’t be that bad , as you think.”

A spokeswoman for the German Depression Aid Foundation emphasizes that running therapy is a suitable support in the treatment of depression and anxiety, especially in groups: “The regular appointment provides structure and counteracts listlessness.

The all-clear for those who don’t like jogging: Other sports such as swimming, dancing or yoga can also help to cope with mild or moderate depression with the right training plan.

 A Norwegian study even came to the conclusion that East Asian martial arts had a better effect than working out on the home trainer. The following applies here: The more satisfying the sport is subjectively perceived, the better.

Endurance training is as effective as pharmacotherapy or psychotherapy

Studies show it works. According to the Swiss Society for Sports Psychiatry and Psychotherapy, endurance training of 40 to 60 minutes three times a week for at least 10 weeks has even.

An Australian research team recommends at least three training sessions per week of 30 minutes each at moderate to vigorous intensity for at least eight weeks.

Endurance training several times a week as an add-on therapy is also useful in the inpatient treatment of depression and has a “significantly positive effect on the depressive symptoms”.

Sport can even work wonders in the treatment of schizophrenia, which often has its origins at a young age: In a meta-study, the European Society for Psychiatry (EPA) found a reduction in psychopathological symptoms of schizophrenia with regular physical activity of moderate to high intensity for at least 90 minutes per week proven. 

According to the EPA, at least 150 minutes of moderate-to-high aerobic exercise per week is effective in the therapeutic management of schizophrenia patients.

Sport is not a substitute for medication or therapy

The advantages of sports and exercise therapy are obvious: Not only is it usually cheaper than medication that is expensive in research and production. In addition, training coordinated by a doctor can counteract the side effects of drug therapy –

for example, counteract weight gain due to antidepressants. In addition, psychologists suspect a positive effect of the feeling of self-control and power after overcoming the weaker self.

And: Exercising as an activity offers urgently needed distraction from symptoms and self-destructive thought patterns. If depressed people are made painfully aware of their illness every time they swallow a pill, sport can be therapy and fulfillment at the same time.

So should there be a prescription for running shoes instead of medication in the future? It’s not that easy.  Rather, movement must take place in addition to a treatment.

When doctors become fitness trainers

Sport doesn’t work as well as therapy for everyone. And: Depending on the physical condition, sports therapy is not free from side effects. “If I have severe high blood pressure or an eating disorder – sport can also have negative consequences,” says Professor Andreas Ströhle, head of psychiatry at the Berlin Charité.

It is all the more important that those who are ill do not stop taking medication on their own and seek salvation alone in the woods. Instead, it is important to discuss the possibilities of sports therapy with the attending doctor or therapist and thus create a medically supervised sports program.

What is an opportunity for the sick is a new challenge for the medical staff.  explains US sports medicine physician Anne K. Swisher of West Virginia University hand, ‘just pop some pills’ – no serious doctor would do that.”

In practice, this means a difficult balancing act for doctors and therapists, who are suddenly asked to create exercises and training units or control training. And this despite the already fatal bottleneck in the care of mental illnesses.

With depression in the future to the physiotherapist?

In Bavaria, doctors interested in running have taken matters into their own hands and set up local running initiatives for sick people.

Across Germany, a consortium of health insurance companies and research institutions is investigating ways to close the psychological care gap in Germany through sports therapists

 “This prepares the therapists optimally for caring for the patients. For example, talking to them about what they expect from the therapy – and how they can achieve this goal,” explains Dr. Andreas Heissel from the University of Potsdam, who helped develop the training. 

The therapy staff would also benefit from raising awareness: “It is important that they recognize and reflect on their own behavioral patterns. This not only makes them better, but also happier. We are surprised how much the therapists accept the offer, open up and get involved.”

For mentally ill people, initiatives like these are one thing above all: good news! Anyone who suffers from mild or moderate depression has a further perspective on recovery in the sports therapy offers Severely depressive patients are still dependent on conventional treatment, but they benefit from the capacities freed up by sport.

One thing is certain: whether sports therapy, drug treatment, psychotherapy or a combination of all of the above – anyone who has decided on treatment has already taken the most important step.


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