# Exercise as it relates to Disease/The effects of physical activity on young adults mental health
## What Is The Background To This Research?

Previous studies have indicated that physical activity can be a management tool for those suffering with mild-to-moderate mental health disease, such as depression and anxiety. Exercise is used commonly to relieve the emotions associated with these disorders and is considered a form of coping mechanism for many young people. This is because anxiety and depression are the most prevalent mental health challenges faced by young adults within modern society, with one study suggesting that at least 60% of undergraduate university students were suffering with some form of this disease. According to these studies, young adults with increased stress may be the ones most at risk of developing mental health complications, which can have an detrimental relationship with their physical activity levels due to a variety of factors. Factors such as loss of motivation can lead to increased sedentary time, negatively impacting mental health.

## Where Is The Research From?

Physical activity and mental health in a student population is a study conducted in Gloucestershire, South West England. The cohort partaking in this study were (males = 20; Females = 80) recruited via opportunity sampling from the facility of education, humanities and sciences at the University of Gloucestershire. 90% were traditional age students and the mean age was 20.4. The entire sample spoke English as a first language and none were injured. All participants consented and agreed to partake in physical activity.

## What Kind Of Research Was This?

The research involved with this study were two questionnaires, one being the Hospital Anxiety and Depression Scale (HADS) and the other being the Physical Activity Questionnaire. Both these questionnaires identify depression and anxiety levels and types. 'HADS', is a 14 item self-report questionnaire with seven questions identifying anxiety and the other seven questions relating to depression. The scoring system will rate the participants answers, the maximum score for each sub-scale is twenty-one and the scoring system goes as follows: 0-7 is indicative of clinical symptoms of anxiety and depression, 8-10 indicate mild symptoms, 11-14 are moderate symptoms and scoring higher is equal to severe symptoms. The questionnaire is relevant to a student population because it was established to uncover symptoms of mental illness in non psychiatric hospital patients.
The Physical Activity Questionnaire assesses the correlation between PA and cardiovascular fitness on mental health and mood. The questionnaire is applied assuming increased physical activity, decreases mental illness. It works via a self-report system where participants exercise for a month recording data such as volume, frequency and type of exercise, it is then calculated to the nearest minute. The exercise is then categorised with a numerical value reflecting oxygen uptake per minute. The more strenuous the exercise, the greater the value when compared to more sedentary exercise. The total physical activity score is then calculated by multiplying the activity type by the total amount of minutes.

## What Does The Research Involve?

Participants answered the criteria best reflecting their mental health. The research has been published in the Mental Health Journal, within the domain Taylor and Francis Online. The Authors are Philip Tyson, Kelly Wilson, Diane Crone and Richard Brailsford. The lead author Phillip Tyson has published 30 papers and 3 books all in mental health The reputation of the lead author is well known in Wales psychology institutes and the majority of his papers have been very well received.
The methodology of using self-report questionnaires usually does not completely cover the individualism and complexities of each person's mental health struggles, however, the 'HADS' questionnaire is well-received for its original purpose of diagnosis. Further follow up for each individual taking the questionnaire, for instance an interview process would help legitimise the results further.
The level of research two questionnaires provides is not sufficient at obtaining legitimate results. Further layering an interview process with the original questionnaires would help, but also sampling from a larger size using snowball and opportunity sampling would be a more accurate way to create legitimate results.
The appropriateness of the title should also be considered when understanding this study. The study claims to look at the mental health of university students, however only elaborates on depression and anxiety scales. There are many other mental health struggles that plague young adults in society that deserve more attention when placed under the banner of 'mental health'

## What Were The Basic Results?

Anxiety and Depression Cohort Scores:
* The basic scores for anxiety within the student cohort were 8.5 (SD = 3.9; Range = 1 - 19.) This anxiety score reflects a mild-to-moderate anxiety level according to the 'HADS' questionnaire. The depression mean score was 3.6 (SD = 2.7; Range = 0 - 14), which is significantly lower than the mean anxiety score, demonstrating that more students are likely to suffer from acute anxiety rather than depression. 6% of students within this study fall within the severe anxiety category, with no students suffering from severe depression.
Student Anxiety and Depression :
| | Mean | SD | Range |
| Anxiety: | 8.5 | 3.9 | 1 - 19 |
| Depression: | 3.6 | 2.7 | 1 - 14 |
Physical Activity Scores:
* The students were split into 3 non overlapping groups with accordance to their PA levels, the groups were high, medium and low. All students were the same age. (F=1.6) (P=20) After the students physical activity scores were recorded, they were correlated with the previous 'HADS' scores.
Student Physical Activity Scores :
| Physical Activity | Physical Activity Score | 95% Confidence Interval |
| Low (n=34) | 3.26 | 0.56-5.97 |
| Medium (n=33) | 68.45 | 107.97–156.51 |
| High (n=33) | 554.94 | 444.48–665.40 |
Association Between Mental Health And Physical Activity:
* The data presented associates lower physical activity with higher depression and anxiety levels. The cohort displayed a negative correlation with mental health and exercise that is; as physical activity goes up, anxiety and depression levels go down. The findings are consistent with other studies in this field of interest. The research was then further confirmed through a correlation analysis.

## What Conclusion Can We Take From This Research?

The conclusions drawn from this study are that physical activity can have a significant positive impact on depression and anxiety levels in university students. However, results demonstrate that a cause and effect relationship is not entirely present with PA and mental health. Furthermore, management of anxiety levels in this small university population may be hindered by worry or judgement from friends and peers. Finally, to reiterate there is still a lack of acknowledgement of other mental health disorders and struggles apart from anxiety and depression.

## Practical Advice

While anxiety and depression can be manageable for some people by using PA, that does not mean other methods of management cannot be considered. Taking good care of yourself through your diet and lifestyle choices can have a very positive impact on mental health. It is exceptionally important to meet the physical activity guidelines of 150 - 300 minutes per week to help improve symptoms. Finally based on the results of this study and many others, students should look towards finding exercise that suits them, making it enjoyable rather than a task.

## Further Information/Resources

Beyond Blue Australia
Treatment For Anxiety Disorder
Mindfulness In Australia
Lifeline
Headspace
Depression and Anxiety in Young Adults Further Study/Reading

## References

* ↑ Paluska S, Schwenk T. Physical Activity and Mental Health. Sports Medicine. 2000;29(3):167-180.
* ↑ Black Dog Institute | Science. Compassion. Action. [Internet]. Black Dog Institute. 2021. Available from: https://www.blackdoginstitute.org.au/
* ↑ Inam, S.N., Saqib, A., Alam, E. (2003). Prevalence of anxiety and depression among medical students of a private university. Journal of the Pakistani Medical Association, 53(2), 44–47.
* ↑ Zigmond, A., Snaith, R.P. The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavia, 1983;67, 361–370.
* ↑ Thirlaway, K., Benton, D. Participation in physical activity and cardiovascular fitness have different effects on mental health and mood. Journal of Psychosomatic Research, 1992;36(7), 657–665.
* ↑ Tyson P. Philip J Tyson [Internet]. Research Gate. 2021. Available from: https://www.researchgate.net/profile/Philip-Tyson
* ↑ Onwuegbuzie A, Leech N, Collins K. Interviewing the Interpretive Researcher: A Method for Addressing the Crises of Representation, Legitimation, and Praxis. International Journal of Qualitative Methods. 2008;7(4):1-17.
* ↑ Kirchherr J, Charles K. Enhancing the sample diversity of snowball samples: Recommendations from a research project on anti-dam movements in Southeast Asia. PLOS ONE. 2018;13(8):e0201710.
* ↑ Firth J, Gangwisch J, Borsini A, Wootton R, Mayer E. Food and mood: how do diet and nutrition affect mental wellbeing?. BMJ. 2020;:m2382.
* ↑ Australian Government, (2019) Physical Activity and Sedentary Behaviour Canberra. Health AGDo