This week is Mental Health Awareness Week in the UK. Each year a different theme is chosen and this year the Mental Health Foundation have chosen physical activity. Their website says that “This year’s Mental Health Awareness Week aims to shift our motivation for physical activity to something we choose to do to increase our wellbeing”.
This makes sense, as it has become conventional thinking in recent years that exercise and other physical activity can increase the production of endorphins in the brain. And of course exercise doesn’t necessarily mean a 5 mile run – as this helpful page from the MHF website explains physical activity can include housework, gardening, going for a walk etc.
Unfortunately this theme for the week doesn’t seem to have been properly thought through. For a start the message being promoted through social media already seems to have shifted from ‘choosing to do physical activity to increase wellbeing’ to ‘exercise will help your mental health problems’. The Twitter hashtag #letsgetphysical is being used to enthuse about the benefits of gym visits rather than gardening. This isn’t the fault of the MHF of course, but it could have been foreseen and it isn’t helped by the MHF’s use of the the quote “It is exercise alone that supports the spirits, and keep the mind in vigor” (Marcus Tullius Cicero) in their leaflet about physical activity.
Another problem with having physical activity as the week’s theme is that there are many people who have both mental illness and physical disabilities. Whilst a lot of these people will be able to undertake some form of physical activity there will be a significant number who can’t. And what of those whose mental illness is severe enough that they struggle to get out of bed, let alone go for a walk? As I understand it the idea that physical activity can help mental health only seems to apply to relatively mild conditions.
In fact, increased physical activity can actually have a detrimental effect on some people with mental illnesses. Those with ‘invisible’ disabilities such as CFS and fibromyalgia may well find that increased physical activity increases their fatigue which could put them at greater risk of depression. Speaking as someone who struggles to walk for more than a few minutes and at times finds it impossible to do any kind of housework, being repeatedly told that I need to increase my levels of activity is unhelpful as it makes me reflect on my increasing loss of mobility and lowers my mood. Those who suffer from eating disorders may also find this advice counter-productive, if not downright dangerous.
Some have already complained that this focus on physical activity as a kind of panacea for mental illness is almost akin to victim-blaming. There are already tweets under the #letsgetphysical hashtag asking why, if exercise is so good for mental health, sufferers wouldn’t get off their backsides and just do it? (Note again the confusion between exercise and physical activity). The implication seems to be that those who aren’t out pounding the pavements in order to beat their mental illness obviously don’t want to get better. This is damaging.
The final problem I want to discuss is that for some people exercise and other physical activity simply isn’t that effective. Some years ago I was enrolled in an ‘exercise prescription’ programme where I was able to use a local gym and go to classes for a pound a time. It was good and I enjoyed it – but it did nothing to help my crippling depression. For me, medication and a great support network are the most effective form of treatment and I know I’m not alone.
I’m not saying that the MHF shouldn’t have chosen this as their theme for Mental Health Awareness Week; it’s obviously quite successful in getting people talking and I’m sure there are many who will be helped by the message. However those who cannot partake in physical activity and those for whom it is a risky or ineffective treatment are being ignored and excluded by the very organisations that are supposed to support them.
Oh and one last thing. The #letsgetphysical hashtag means that I’ve been humming Olivia Newton-John for the last 36 hours. Not cool, MHF. Not cool.