How Fitness Helps Mental Health

Written by Oliver Greenwood: BSc(Hons) Applied Sport & Exercise Science. This post was verified and uploaded by Ben.

-- 

Mental health amongst athletes and military personnel is often been seen as a taboo subject that wasn't often discussed.

We take a look further in to how mental health issues can affect quality of life and how sport may be able to improve mental health. 

Introduction

This article looks into mental health and how fitness may help battle this. The key themes that will be discussed is the burden on life mental health causes, the self concept and finally, the effect football intervention may have on mental health.

The Quality and Burden on lifestyle mental health causes

In the last two decades, there has been a spotlight on the effects that physical activity (PA) has on mental health (Bell et al., 2019).

Diet and exercise

The reason for this is the current Physical Activity levels of individuals suffering for MHI show that the majority are inactive (Johnstone et al., 2009), with only 30% of the population being classed as regularly active (Lindamer et al., 2008).

The UK government guidelines recommend 150 minutes of moderate intensity exercise every week (Hanson et al., 2013). Low PA levels can be put into this category of the burden on lifestyle that MHI causes (Walker et al., 2015).

This burden of lifestyle mental health has can have detrimental effects on an individual, as in some cases there could be a reduced life expectancy of up to 20 year (Walker et al., 2015). 

Within this population there are many factors that could lead to a reduced life expectancy. One factor that can cause this is the suicide risks with Walker et al., (2015) reporting estimates of 8.9% of schizophrenia patients risk committing suicide, 11.2% for depression sufferers and 7.7% for serve mental illness patients.

When these numbers standalone they are very high rates of suicide risk, furthermore, when compared with the 120 million depression sufferers (Lepine and Bridley 2011) this rate of risk is far too high.

Another factor that can lead to a reduced life expectancy is a sedentary lifestyle which is high among mental health sufferers (Roick et al., 2007). Poorer diet has also been reported in mental health sufferers (Fleischhacker et al., 2008).

Chronic diseases

This sedentary behaviour lifestyle and poor diet can cause a whole host of problems including; obesity, cardiac disease and type ll diabetes, however, these can be countered by an increase in PA (Unick et al., 2011).

This shows the importance of using football to intervene and combat the negative effects of a sedentary lifestyle.  

How does mental health as a burden on lifestyle effect the quality of life of a mental health sufferer? In the previous section, the difficulties of low PA levels, poorer diets and a sedentary lifestyle faced by people with poor mental health were highlighted.

Next, the psychological effects that mental health causes on quality of life are discussed. 

Psychological effects

There are many effects that mental health has on quality of life. One effect is that it can impair social and role functioning (Piskulic et al., 2012).

What is meant by this is that individuals aren’t as able to engage in social situations, which could be caused by this increase of anxiety and pressure they put on themselves, then this leads to a total withdraw from social settings (Piskulic et al., 2012).

This impairment of role functioning means not being able to be the best a person can (Piskulic et al., 2012). This can be either in the work setting or even as parent or grandparent, which will be a hard pill swallow knowing you can be better physically, but mentally there is something stopping an individual from achieving being their best self (Hargreaves et al., 2017; Matthews, 2000).

The autonomy of an individual is also affected by mental illness (Matthews, 2000). Kant (1999) defines autonomy as follows:

‘the will is the property of the will by which it is a to itself'.

This loss of autonomy effects the sufferer as they will be unable ‘self-govern’ leading to a loss of control over the MHI (Matthews, 2000).

The loss of control over the MHI impairs one’s identity (Kant, 1999). What is meant by this is that due to this loss of control the individual ‘forgets who they are’ and the sense of freedom (Kant, 1999).

This is because the MHI becomes a strong part of their identity and if not treated correctly they could start to become the MHI (Kant, 1999).

The last burden on life that is going to be reviewed is the lack of competence which is a sense of not being able to achieve (Ryan et al., 2008). This has a massive effect on self-esteem and loss confidence that has transpired from MHI (Ryan et al., 2008).

From this it is clear to see harmful psychological impact that quality of life has on mental health sufferers. This again reiterates the importance to review the evidence of the impact football interventions may have to help aid the mental health recovery process.   

The Self

The impacts of quality of life leads to the self-concept which is defined by Carl Jung as follows:

“maintained that the self gradually develops by a process of individuation, which is not complete until late maturity is reached. Alfred Adler identified the self with the individual’s lifestyle, the manner in which he or she seeks fulfilment” 

- (Jung, Horney and Allport, 1958).

There are many different theories around which perspective the self fits into; in the context of this review, the social perspective is most relevant.

The social psychology perspective is described as the looking glass self (Cooley, 1902). This is how a person’s self grows from social interpersonal interactions and perception of how others view them (Cooley, 1902), so it is possible from these interactions it is likely develop feelings about oneself (Cooley, 1902).

As previously stated above social withdrawal and role functioning (not being able to be one’s best self) are a burden on life. However, the self can explain this by if an individual has perceived these interactions as negative the perception of how others view them becomes their own identity, which could lead to a reduced self-esteem and/or confidence (Denissen et al., 2008).

With this in mind, there is an increase in the chance of social withdrawal and a reduction in role functioning (Watson and Nesdale, 2012). This then links to the lack of competence due to the lower levels of confidence and self-esteem (Ryan, 2008).

The self describes this is a low self-efficacy this is the beliefs of an individual about their own capabilities, which are determined by one’s thoughts, feeling and motivation to behave (Bandura, 2010).

Self-efficacy quickly then leads onto autonomy (Bandura, 2010). When autonomy is low the person suffering from a mental illness will find it hard to self-govern (Matthews, 2000), this is because of the low levels of self-efficacy as the individual feels like they can’t achieve (competence) (Bandura, 2010).

This leads to a reduced motivation to take action meaning the individual will let the mental illness take over (Bandura, 2010; Kant, 1999). However, the self-concept helps to explain why this happens which helps to put interventions in place to increase competence and autonomy (Bandura, 2010).

From this moment is gathering on how these three themes are interlinked and to why there is a need for alternative treatment as medication can’t resolve these psychological processes.

Football and mental health

Football is a global game that affects billions of people around the world (Heun and Pringle, 2017), from the world famous to the less privileged.

The impacts of the sport are highly significant on the lives of the spectators and fans who either attending matches or watching on TV (Heun and Pringle, 2017). Football has often been described as a defining characteristic of an individual’s self-identity (Heun and Pringle, 2017).

The reason of this is during the early getting to know you conversation “which team do u support” is a common question which can increase awareness of a town or city anywhere in the world (Heun and Pringle, 2017).

Camaraderie

The passion, loyalty and togetherness of supporting a football club has induced individuals to investigate the physical and mental health of supporters and participants.

McKeown, Roy and Spandler (2015) suggested that football produces a feeling of solidarity and togetherness between fans and players. Furthermore, Pringle (2004) proposed that football creates a sense of belonging.

Nielsen et al., (2014) explained why football participants are intrinsically motivated to compete through the self-determination theory. In accordance to the theory there is an intrinsic need for autonomy and competence.

Therefore, people feel intrinsically motivated to take part in activities that satisfy these needs (Friedrich and Mason 2017). Furthermore, Nielsen et al., (2014) argued that team sports such as football fulfilled these needs, along with an increase in social interactions which generates positive perceptions of social interactions and in turn increases an individual’s intrinsic motivation.

This is important as it ultimately increases adherence (Nielsen et al., 2014). This presents football with great opportunity to enhance autonomy and competence which are lacking in mental health patients.   

Football has the potential to increase interaction with others through training or a rehabilitation of social skills which enables social inclusion (Friedrich and Mason 2017).

Darongkamas et al., (2011) made it clear that a fundamental part of football interventions on mental health was the perceived inclusion. The reason for this is to benefit the participants mental health and social skills by meeting other’s individuals undergoing a similar situation.

The effect of this can increase a person’s sense of belonging and acceptance within a community, these are all values of social inclusion (Darongksms, 2011). 

Football holds a clear potential for increasing psychological health as it has a broad appeal but more specifically to males (Friedrich and Mason, 2018). This group is often hard to reach despite there being high numbers of MHI (Friedrich and Mason 2017).

Health Services Engagement

This is because they are reluctant to seek and engage with mental health services (Friedrich and Mason, 2017). Therefore, football is an attractive hook to increase engagement for this population (Friedrich and Mason 2017).

Robertson et al., (2013) reiterates that football is an attractive sport for men and has the potential to be used intentionally to increase engagement in positive health activities.

However, the role of stereotyping within men’s football shows that this type of intervention could have its downsides (Friedrich and Mason 2017). While football-based interventions are supposed to help men open up and increase self-esteem, it could become be counterproductive and run the risk of increasing stereotypes and gender equalities that already play a negative role in men’s mental health (Friedrich and Mason 2017).

Another reason football interventions may be counterproductive is because it is a win or lose game (Friedrich and Mason 2017). The competitive nature of the game may also conflict with roles of therapy (Friedrich and Mason 2017).

Conclusions

Overall, this article provides an original insight into the alternative treatment methods to aid the recovery for mental health patients. This article also reviews the burden on lifestyle that mental health causes an individual.

Football has been shown to be an effective treatment method for mental health as it increases interpersonal connections.

This article will be beneficial towards mental health recovery as it enhances the understanding of the challenges mental health patients face.

References:

Bandura, A. (2010) Self‐efficacy. The Corsini encyclopedia of psychology, pp.1-3. Available at: https://onlinelibrary.wiley.com/doi/10.1002/9780470479216.corpsy0836

Bell, S.L. Audrey, S. Gunnell, D. Cooper, A. and Campbell, R. (2019). The relationship between physical activity, mental wellbeing and symptoms of mental health disorder in adolescents: a cohort study. International Journal of Behavioral Nutrition and Physical Activity, 16(1), p.138. Available at: https://research-information.bris.ac.uk/en/publications/the-relationship-between-physical-activity-mental-wellbeing-and-s

Cooley, C.H. (1902) Looking-glass self. The production of reality: Essays and readings on social interaction, 6, pp.126-128. Available at: http://www.csun.edu/~hbsoc126/soc1/Charles%20Horton%20Cooley.pdf

Darongkamas, J. Scott, H. and Taylor, E. (2011) Kick-starting men's mental health: An evaluation of the effect of playing football on mental health service users' well-being. International Journal of Mental Health Promotion, 13(3), pp.14-21. Available at: https://discovery.ucl.ac.uk/id/eprint/10071436/1/1-s2.0-S1755296618300255-main.pdf

Denissen, J.J. Penke, L. Schmitt, D.P. and Van Aken, M.A. (2008) Self-esteem reactions to social interactions: evidence for sociometer mechanisms across days, people, and nations. Journal of personality and social psychology, 95(1), p.181. Available at: https://www.research.ed.ac.uk/en/publications/self-esteem-reactions-to-social-interactions-evidence-for-sociome

Fleischhacker, W.W. Cetkovich-Bakmas, M. De Hert, M. Hennekens, C.H. Lambert, M. Leucht, S. Maj, M. McIntyre, R.S. Naber, D. and Newcomer, J.W. (2008) Comorbid somatic illnesses in patients with severe mental disorders: clinical, policy, and research challenges. The Journal of clinical psychiatry, 69(4), pp.514-519. Available at: https://pubmed.ncbi.nlm.nih.gov/18370570/

Friedrich, B. and Mason, O. (2018) Applying positive psychology principles to soccer interventions for people with mental health difficulties. Psychology, 9, pp.372-384. Available at: https://discovery.ucl.ac.uk/id/eprint/10046037/

Friedrich, B. and Mason, O.J. (2017) “What is the score?” A review of football-based public mental health interventions. Journal of public mental health. Available at: https://pubmed.ncbi.nlm.nih.gov/29721035/

Hanson, C.L. Allin, L.J. Ellis, J.G. and Dodd-Reynolds, C.J. (2013) An evaluation of the efficacy of the exercise on referral scheme in Northumberland, UK: association with physical activity and predictors of engagement. A naturalistic observation study. BMJ open, 3(8), p.e002849. Available at: https://pubmed.ncbi.nlm.nih.gov/23913772/

Hargreaves, J. Lucock, M. and Rodriguez, A. (2017) From inactivity to becoming physically active: The experiences of behaviour change in people with serious mental illness. Mental Health and Physical Activity, 13, pp.83-93. Available at: https://pure.hud.ac.uk/en/publications/from-inactivity-to-becoming-physically-active-the-experiences-of-

Heun, R. and Pringle, A. (2018) Football does not improve mental health: a systematic review on football and mental health disorders. Global psychiatry, 1(1), pp.25-38. Available at: https://www.researchgate.net/publication/324480702_Football_does_not_improve_mental_health_a_systematic_review_on_football_and_mental_health_disorders

Johnstone, R. Nicol, K. Donaghy, M. and Lawrie, S. (2009) Barriers to uptake of physical activity in community-based patients with schizophrenia. Journal of Mental Health, 18(6), pp.523-532. Available at: https://www.research.ed.ac.uk/en/publications/barriers-to-uptake-of-physical-activity-in-community-based-patien

Jung, C.G. Horney, K.D. and Allport, G.W. (1958) Self (definitions). Collected works, 6, pp.460-461. Available at: http://mkc.ac.in/pdf/study-material/psychology/2ndSem/chapter-4-unit-4-sem2-pdf-AG.pdf

Kant, I. (1999) Metaphysical elements of justice: Part I of the metaphysics of morals. Hackett Publishing. Available at: https://www.google.co.uk/books/edition/Metaphysical_Elements_of_Justice/OhNR-xIkSVoC?hl=en

Lépine, J.P. and Briley, M. (2011) The increasing burden of depression. Neuropsychiatric disease and treatment. 7(Supply 1), p.3. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131101/

Lindamer, L.A. McKibbin, C. Norman, G.J. Jordan, L. Harrison, K. Abeyesinhe, S. and Patrick, K. (2008) Assessment of physical activity in middle-aged and older adults with schizophrenia. Schizophrenia research, 104(1-3), pp.294-301. Available at: https://pubmed.ncbi.nlm.nih.gov/18550338/

Matthews, E. (2000) Autonomy and the psychiatric patient. Journal of applied philosophy, pp.59-70. Available at: https://pubmed.ncbi.nlm.nih.gov/11758594/

McKeown, M. Roy, A. and Spandler, H. (2015) ‘You'll never walk alone’: Supportive social relations in a football and mental health project. International journal of mental health nursing, 24(4), pp.360-369. Available at: https://clok.uclan.ac.uk/11353/1/YNWA%20pre-publication%20final%20accepted.pdf

Nielsen, G. Wikman, J.M. Jensen, C.J. Schmidt, J.F. Gliemann, L. and Andersen, T.R. (2014) Health promotion: The impact of beliefs of health benefits, social relations and enjoyment on exercise continuation. Scandinavian journal of medicine & science in sports, 24, pp.66-75. Available at: https://pubmed.ncbi.nlm.nih.gov/24944133/

Piskulic, D. Addington, J. Cadenhead, K.S. Cannon, T.D. Cornblatt, B.A. Heinssen, R. Perkins, D.O. Seidman, L.J. Tsuang, M.T. Walker, E.F. and Woods, S.W. (2012) Negative symptoms in individuals at clinical high risk of psychosis. Psychiatry research, 196(2-3), pp.220-224. Available at: https://pubmed.ncbi.nlm.nih.gov/22445704/

Pringle, A. (2004) Can watching football be a component of developing a state of mental health for men? The journal of the Royal Society for the Promotion of Health, 124(3), pp.122-128. Available at: https://journals.sagepub.com/doi/10.1177/146642400412400313

Robertson, S. Zwolinsky, S. Pringle, A. McKenna, J. Daly-Smith, A. and White, A. (2013) ‘It is fun, fitness and football really’: a process evaluation of a football-based health intervention for men. Qualitative Research in Sport, Exercise and Health, 5(3), pp.419-439. Available at: https://eprints.whiterose.ac.uk/132233/

Roick, C. Fritz-Wieacker, A. Matschinger, H. Heider, D. Schindler, J. Riedel-Heller, S. and Angermeyer, M.C. (2007) Health habits of patients with schizophrenia. Social psychiatry and psychiatric epidemiology, 42(4), pp.268-276. Available at: https://pubmed.ncbi.nlm.nih.gov/17370043/

Ryan, R.M. Patrick, H. Deci, E.L. and Williams, G.C. (2008) Facilitating health behaviour change and its maintenance: Interventions based on self-determination theory. The European health psychologist, 10(1), pp.2-5. Available at: http://selfdeterminationtheory.org/SDT/documents/2008_RyanPatrickDeciWilliams_EHP.pdf

Walker, E.R. McGee, R.E. and Druss, B.G. (2015) Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA psychiatry, 72(4), pp.334-341. Available at: https://pubmed.ncbi.nlm.nih.gov/25671328/

Watson, J. and Nesdale, D. (2012) Rejection sensitivity, social withdrawal, and loneliness in young adults. Journal of Applied Social Psychology, 42(8), pp.1984-2005. Available at: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1559-1816.2012.00927.x