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Physical exercise and mental health: can we also care for the mind through the body?

9 min read

Pessoa a apertar os atacadores antes de praticar exercício físico
Photo: Tirachard Kumtanom / Pexels.

When we think about physical exercise, we often associate it with weight loss, muscle strength or the prevention of cardiovascular disease. However, its effects are not limited to the body. Physical activity can also influence mood, sleep, anxiety, energy and the way we relate to ourselves.

For a long time, physical health and mental health were treated as relatively separate areas. Today, we know that this division is artificial. What happens in the body influences our psychological experience, just as emotional distress can affect sleep, appetite, tension, fatigue and the ability to move.

It is in this context that exercise has increasingly been recognised not only as a form of prevention, but also as a possible complement in the treatment of some psychological difficulties.

What does research tell us?

The relationship between exercise and mental health has been studied across different populations, ages and forms of physical activity.

A broad review published in the British Journal of Sports Medicine, bringing together results from more than a thousand studies and almost 80,000 participants, concluded that physical activity may contribute to reducing symptoms of depression and anxiety.

In the specific case of depression, a review of 218 studies involving more than 14,000 participants found benefits in activities such as walking, running, strength training, yoga and dance. The authors argued that exercise should be considered alongside other evidence-based interventions.

This does not mean that exercise has the same effect for everyone, or that it can automatically replace other treatments. It does mean, however, that it should not be seen merely as generic advice to adopt a “healthy lifestyle”. In some situations, movement can be a clinically relevant part of care.

How can exercise help?

There is no single explanation for the effects of exercise on mental health. Its benefits seem to result from a combination of physical, psychological and social processes.

Physical activity influences biological systems involved in the regulation of stress, mood, energy and sleep. It may also help release accumulated physical tension and increase a sense of vitality.

However, its effects are not limited to what happens in the brain. Exercise can also introduce structure into everyday life, create a pause from worries and provide a concrete experience of achievement.

When someone is going through a depressive period, for example, simple tasks can feel too difficult. Leaving the house and walking for a few minutes may represent a small experience of action at a time dominated by a sense of immobility.

That movement does not, by itself, solve the origin of the suffering. It may, however, help temporarily interrupt the cycle between isolation, inactivity and worsening mood.

It can also gradually increase the perception of capability. Being able to walk a little further, learn an exercise or maintain some regularity allows concrete changes to be observed. For someone who feels they have lost control over several areas of life, these small signs can matter.

When done in a group, exercise can also promote social contact, shared commitment and a sense of belonging. For some people, these elements are as relevant as the physical activity itself.

Does exercise need to be intense?

Not necessarily.

Some studies suggest that moderate or higher intensity activities may produce stronger effects on certain depressive symptoms. However, this does not mean that only intense exercise is useful.

Lighter activities can also bring benefits, especially for people who are sedentary, have physical limitations or are going through a period in which energy and motivation are reduced.

The most effective activity will often be the one the person can actually do with some regularity.

For someone who does not exercise, starting with short walks may be more realistic than immediately setting a demanding plan. A goal that is too high can turn an attempt at self-care into a new source of guilt or failure.

Movement should not be used as punishment, moral obligation or proof of willpower. Telling someone who is depressed that they should simply “get up and exercise” ignores the fact that lack of energy, loss of pleasure and difficulty initiating tasks are part of the problem.

What is the best type of exercise?

There is no universally superior activity for every person.

Aerobic exercise, such as walking, running, swimming or cycling, is among the most studied forms. Strength training has also shown benefits, as have activities that combine movement, breathing and attention, such as yoga.

Dance can add pleasure, expression and social contact. Team sports can support a sense of belonging, while individual activities may be more suitable for people who prefer more autonomy or less social exposure.

Walking is a particularly accessible option. It does not necessarily require specific equipment, can be adapted to each person’s pace and is relatively easy to integrate into daily life.

Research on walks in natural spaces has found improvements in mood, wellbeing, anxiety, stress and the tendency to remain caught in repetitive thoughts. Even so, it is not necessary to live near a forest. A garden, a park or a quieter urban route may already create a meaningful difference.

The choice of activity should take into account physical condition, health status, preferences, available resources and the possibility of maintaining the practice over time.

An activity that is theoretically effective, but constantly distressing or impossible to integrate into routine, is unlikely to be sustainable.

Why is it so difficult to start?

When we are well, it may seem that exercising depends only on decision and discipline. However, many psychological difficulties directly affect the processes needed to begin and maintain an activity.

Depression can reduce energy, motivation and the ability to anticipate pleasure. Anxiety can make a gym, a group class or even leaving the house feel threatening. Low self-esteem can increase fear of judgement. Fatigue and sleep disturbances can make any plan more difficult to sustain.

A cycle may then form: the person feels worse, moves less, becomes more isolated and loses even more energy and confidence.

For this reason, vague recommendations such as “you have to exercise” may be unhelpful and increase guilt. Often, it is necessary to divide the goal into smaller steps, identify concrete obstacles and adapt the activity to the person’s reality.

How can someone start realistically?

It is not necessary to begin with big goals. It may be more useful to choose an activity that is simple, specific and possible to repeat.

A ten- or fifteen-minute walk, taking a few stairs, dancing at home, cycling or doing light exercises are also forms of movement.

Instead of setting the goal “start exercising”, it may be more concrete to decide to walk for ten minutes after lunch, twice a week. Modest and specific goals are usually easier to start and evaluate.

It may also help to:

  • choose an activity that feels at least minimally pleasant;
  • connect it to an existing routine;
  • do it with another person;
  • prepare clothes or any necessary material in advance;
  • notice how you feel before and after the activity;
  • accept that some days and weeks will be less regular.

Missing one day does not mean that the previous effort has lost its value. During periods of greater distress, lack of exercise should not become another reason for self-criticism.

Starting slowly is still starting.

Can exercise replace psychotherapy or medication?

Exercise can produce important improvements, but it should not be presented as an automatic replacement for psychotherapy, medication or other forms of healthcare.

The decision depends on the intensity and duration of symptoms, the presence of risk, medical conditions and each person’s history.

In some mild situations, exercise may be one of the main strategies used. In moderate or severe cases, it is usually more appropriate to integrate it into a broader plan, which may include psychological support, medical assessment, medication, social support or changes in life circumstances.

Anyone already taking medication should not reduce or stop it simply because they have started exercising, without first speaking to the healthcare professional responsible.

Likewise, people with cardiac, respiratory, joint or other limitations may need medical advice before beginning a more demanding activity.

Exercise does not remove the causes of suffering

Exercise can contribute to mental health, but it does not automatically remove the circumstances at the origin of suffering.

A walk does not solve an abusive relationship, unsustainable working conditions, financial difficulties, discrimination, traumatic experiences or a psychological disorder that requires care.

Nor should it be presented as an exclusively individual responsibility, as if someone who remains depressed or anxious simply had not tried hard enough.

Mental health is influenced by biological, psychological, social and economic factors. Movement can help, but it does not replace safety, support, stability or access to appropriate care.

When sadness, anxiety, isolation, sleep changes or loss of interest persist and interfere with work, studies, relationships or self-care, it is important to seek professional help.

Caring for the mind through the body does not mean reducing psychological suffering to a physical issue. It means recognising that body and mind are part of the same experience and that, sometimes, beginning to move one can help create space for the other to breathe too.

References

Ma, J., Lin, P., & Williams, J. (2024). Effectiveness of nature-based walking interventions in improving mental health in adults: A systematic review. Current Psychology, 43, 9521–9539. https://doi.org/10.1007/s12144-023-05112-z

Munro, N. R., et al. (2026). Effect of exercise on depression and anxiety symptoms: Systematic umbrella review with meta-meta-analysis. British Journal of Sports Medicine, 60(8), 590–601.

Noetel, M., Sanders, T., Gallardo-Gómez, D., Taylor, P., del Pozo Cruz, B., van den Hoek, D., et al. (2024). Effect of exercise for depression: Systematic review and network meta-analysis of randomised controlled trials. The BMJ, 384, e075847. https://doi.org/10.1136/bmj-2023-075847

Shin, W. S., Kim, J. J., Lim, S. S., Yoo, R. H., Jeong, M. A., Lee, J., & Park, S. (2021). Effect of nature walks on depression and anxiety: A systematic review. Sustainability, 13(7), 4015. https://doi.org/10.3390/su13074015

Wilson Ferreira Santos is a psychologist registered with the Portuguese Psychologists Association, professional licence no. 25219.

These texts sit alongside a clinical practice centred on a careful and humane reading of psychological experience.

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