Stress is a normal part of day to day life however people manage stress in different ways, and different people may report varying levels of stress dependent upon how they deal with stress and their emotional resilience. The Oxford English dictionary defines stress as “A state of mental or emotional strain or tension resulting from adverse or demanding circumstances” and another definition selected for use by Hackney [3] is “a real or interpreted threat to the physiological or psychological integrity of an individual that results in physiological and/or behavioural responses”.
Chronic stress can pose a significant threat to human health, particularly in this modern age, and can be related to other unhealthy behaviours such as smoking, snacking, consumption of alcohol and substance mis-use [1]. In one of the largest surveys of stress undertaken by the UK’s Mental Health Foundation in 2018, they reported that 74% of people surveyed had felt ‘so stressed they felt overwhelmed or unable to cope’. Therefore, it is paramount that education and services are offered in order to aid the public to manage stress effectively and increase their resilience to stress.
As a Physiotherapist, I am strongly in favour of exercise prescription for many conditions, and this goes significantly beyond rehabilitative and post-injury reasons. Unfortunately, a large number of the UK population do not meet national physical activity guidelines, which have been advised for both physical and mental health reasons. There are many benefits of exercise in human health, and one of these benefits is to aid in the reduction of, or management of stress. It has long been known that exercise reduces the incidence of stress related psychiatric disorders [1, 2, 6] and these include common mental health disorders such as anxiety and depression, which are often related to an inability to manage feelings of stress effectively [8].
Exercise can be a significantly useful adjunct in the management of stress [4], and is an important component of self-care. It has even been found that a combination of stress management training combined with home exercise is significantly more effective in reducing depression and anxiety in chemotherapy patients, compared with either intervention alone or usual care [5], again highlighting the importance in incorporating exercise within stress management programmes for a huge number of public and healthcare populations.
Understanding the specifics of the positive impact of exercise in stress management is not completely clear, and is likely not down to one single process, but multifactorial [4] and likely even more useful together with other positive lifestyle changes [3], which is something I am particularly interested in my role as a Certified Health Coach, nutritional therapist, weight loss advisor and stress management trainer.
Although exercise in itself causes a stress response within the body, it can actually be tremendously useful in the management of stress and the reduction or management of stress hormones such as cortisol. If we keep setting off our fight-or-flight response then we can actually deplete cortisol levels which leads to cortisol dysfunction. The cortisol response to common stressors is often found to be lower in those who undertake regular physical activity than those who are sedentary (i.e. do no or very little exercise).
The ‘Fight-or-Flight’ response is a normal response in humans to potentially dangerous situations (e.g. coming face to face with an angry wild dog), however, for many people this response that is designed to protect us often goes in to over-drive as we respond to common, daily, non-dangerous stressors with a full-on stress response (e.g. being late for work, an important meeting, presenting etc). This may create a chronic increase in these stress hormones, which in turn can have a negative impact on many systems of the body including the cardiovascular system and musculoskeletal system, resulting in chronic health conditions such as cardiovascular disease and high blood pressure, and result in a stroke or heart attack. Not only does exercise aid these systems in improved management of stress hormones and maintaining homeostasis, it also helps to improve the function of the cardiovascular system through exercise training, for example improving the strength and function of cardiac muscle (the heart).
One of the most important factors in the introduction of regular physical exercise in to one’s life is to make sure that one takes a progressive approach, which is something I always take in to account within my professional practice as a physiotherapist. In this regard it can be useful to employ the services of a qualified health professional or personal trainer, or start with a programme such as the popular ‘Couch to 5k’, which offers a graded approach to running. Overtraining can be counter-productive and actually cause a reduction in a person’s resilience to stress and poor health, which is why gradual increases in activity in order to allow your body to adapt is very important.
So, how much exercise will aid in stress management? As a general guide, if you aim to reach the target of the UK’s physically activity guidelines (these are also the same in the USA), i.e. 150 minutes of moderate intensity exercise a week or 75 minutes of vigorous intensity exercise a week, this should be adequate to have a positive effect on stress [4]. In addition to this it is also advised to undertake two resistance/strength training sessions a week for musculoskeletal health benefits, again incorporated in the 2019 UK Physical Activity Guidelines, although the evidence for positive benefits of exercise on mental health and stress is stronger in the aerobic exercise field [3], as well as Tai Chi and Yoga.
Overall, the positive implications of incorporating regular, progressive physical activity in to one’s lifestyle is beneficial for multiple reasons, but importantly in this case, for the management of stress as an adjunct in a structured stress-management programme.
References
Gerber M. & Pühse U. (2009). Do exercise and fitness protect against stress-induced health complaints? A review of the literature. Scandivavian Journal of Public Health, 37: 801-819.
Greenwood B. & Fleshner M. (2011). Exercise, stress resistance, and central serotonergic systems. Exerc Sport Sci. Rev. 39 (3): 140-149.
Hackney A. (2006). Stress and the neuroendocrine system: the role of exercise as a stressor and modifier of stress. Expert Rev Endocrinol Metab. 1 (6): 783-792
Jackson E. (2013). Stress Relief: The role of Exercise in Stress Management. ACSM Health & Fitness Journal, 17(3): 14-19.
Jocobsen P. et al (2013). Effects of self-directed stress management training and home-based exercise on quality of life in cancer patients receiving chemotherapy: a randomized controlled trial. Psycho-oncology, 22: 1229-1235.
Manger T. A. & Motta R. W. (2005). The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression. International Journal of Emergency Mental Health, 7(1): 49-57.
Mental Health Foundation (2018), Mental Health Statistics: Stress, Viewed Thursday 8th October 2020 <https://www.mentalhealth.org.uk/statistics/mental-health-statistics-stress>.
Mind (2017), How to manage stress, Viewed Thursday 8th October 2020 <https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/what-is-stress/>.
UK Government (2019), UK Chief Medical Officers Physical Activity Guidelines, Viewed Thursday 8th October 2020 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/832868/uk-chief-medical-officers-physical-activity-guidelines.pdf>.
Please note: This article is intended to be for educational purposes only, and does not constitute medical advice or replace professional assessment or personalised advice.
I do not hold responsibility for the information on any links to external websites within this article and information within these links/websites may change at any time or no longer be accessible. Any website pages/links added are also for education purposes only.
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