Adrian Taylor, Professor of Health Services Research, recently took part in a live interview for the Breakfast Show on the Voice of Islam Radio Station on 4th October 2023.
Adrian’s interests include designing and evaluating health behaviour change interventions to promote physical activity, mental health and well-being, particularly for clinical populations in health and community care settings. He has a strong interest in reducing health inequalities and promoting diversity in research.
Adrian has published over 120 peer reviewed journal articles and book chapters. He co-founded and was Editor in Chief of the international journal, Mental Health & Physical Activity (from 2008-2022), having taken it to the top 25% of over 150 Psychiatry journals in the world. He is a Fellow of both the British Association of Sport & Exercise Science, and The Royal College of Physicians of Edinburgh.
He has led a number of large randomized controlled trials to determine the effects of physical activity on particularly mental health outcomes such as depression and anxiety and substance misuse, and well-being among people with coronary obstructive pulmonary disease, obesity, hypertension, diabetes, osteoarthritis, and the elderly (e.g., Parkinson’s patients). Systematic reviews of the short and long-term effects have contributed to health policy guidelines across the world.
Adrian answered the following questions during the interview:
1. To begin with, could you explain how physical activity can affect our mental health?
This is a common question and it isn’t a simple answer. The most popular answer is that in response to exercise there are changes in our brain chemicals such as dopamine which are associated with acute improvements in mood. However, not everyone experiences these effects and certain conditions while exercising may weaken or strengthen the mood enhancing effects. Some people can become addicted to exercise because the effects on mood are consistently positive, and withdrawal symptoms follow in the absence of exercise. But only 2-3% become addicted to exercise.
Otherwise, when physical activity is done which makes you feel competent (sense of achievement), allows a sense of control (over frequency, duration, intensity, where and when to exercise, and who with), and involves social connection is more likely to involve sustained physical activity and longer-term effects. Competitive sport can remove some of these psycho-social enhancers and intensive training can become aversive and leads to avoidance for some people.
Similar and additional mechanisms linked to physical activity can be involved for different dimensions of mental health and well-being such as addictions, dementia and anxiety.
Another major way in which physical activity improves mental health is through improvements in physical health. Loss of weight, improved strength, reduced risk of falls, stamina and fitness all come with physical activity and then contribute to an enhanced sense of well-being.
2. You co-led an intervention on treating depression with exercise. Could you perhaps share what you discovered about the benefits of exercise from your research?
While there is strong evidence that exercise programmes with good adherence can improve depression, but the challenge is to motivate people with low mood to take up and continue to be physical activity. Undoubtedly, some people report improved mood but not everyone. When researchers establish an intervention to test its effects on depression it would be unethical to compare it with no treatment (i.e., usual care withheld), so the study design would be exercise v usual care. This tends to weaken any observed effects of exercise. So, in our study we did our very best to develop an NHS physical activity intervention in the TREAD study which would hopefully reduce depression more than usual care. Unfortunately, the findings showed that adding physical activity counselling to usual care didn’t have any great beneficial effect.
We have conducted a pilot study (BAcPAc) in which physical activity was not overtly promoted, but suggested as an alternate to sitting, for people with depression. This showed lots of promise but has not turned into a bigger study yet.
3. Are there any negative side effects of physical activity in relation to mental health?
If someone engages in physical activity and they start to compare with others who they perceive as ‘better’ than them or they are unable to do the things they used to when younger a negative set of thoughts can further contribute to low mood. For a very small proportion of people exercise can take over as more important than other things such as family and work, and requires money that is unsustainable.
4. What are some examples of lifestyle changes that can help improve our mental health?
Changes in physical activity, diet, reducing or quitting substance use, improved sleep and mixing with others can all improve mental health.
The number one thing is to find physical activity that can be done on a regular basis and will be sustainable. Replacing a drive to work with active commuting (e.g., walking, cycling) might be easier than paying for a gym membership or choosing an expensive hobby, and save fuel costs. Doing physical activity in a park or natural environment can also enhance the mental health benefits.
Adrian is part of the PROGROUP team looking at how a group-based behavioural intervention can be an effective model of care for Tier 3 services.