A smart wellbeing strategy doesn’t separate physical and mental health

The research shows physical and mental health influence one another deeply, so it’s best to have a holistic approach.

A company’s HR Department has a dilemma. Their budget will allow for only one of two wellbeing initiatives: gym membership for every employee or one-on-one counselling for every employee who desires it. Which would benefit the company and its people the most?

Gym membership would look great in a job ad and more physically fit employees would be a boost to staff energy and productivity. However, you can’t compel employees to use the gym appropriately or even at all, so it’s possible you’d just be throwing money away.

Counselling has its own trade-offs. On the plus side it’s more targeted – the counsellors will cater their help to the specific needs of the counselled. The downside is that this resource is often viewed as crisis management, so employees who aren’t in crisis but showing risk signs of burnout (and are already experiencing reduced performance) won’t be helped. Also, like gym membership, uptake is not guaranteed.

Based solely on the above, it seems if you were advising the HR Department you could make an argument either way. But what you should really be telling them is they’ve made a basic error.

Our language may separate physical and mental health, but everything we know about both says the influence they have on each other is profound. So, what the HR Department should be doing is thinking holistically.

How physical health influences mental health

Most people have heard, or believe intuitively, that good physical health helps you have better mental health. Turns out most people are right.

In an article that’s been cited over 1,000 times, Exercise and Mental Health, the researchers outline study after study that show physical activity helps the mind.

● In two different research papers, one on cancer patients and another with people suffering from end stage renal disease, participants who were assigned regular exercise routines saw significantly improved mood levels and reduced anxiety.

● Another study assigned individuals with post-traumatic stress disorder two weeks of stationary bike exercise and found reductions in the severity of their PTSD.

● Even a single bout of activity seems to make a difference. Different studies looked at the effect of one-shot exercise and yoga sessions and found many benefits, including decreased anxiety and stress and increases in self-reported mood.

● It helps the young. One Icelandic study found that an after-school exercise program “successfully decreased crime rate and depression”.

● It also helps the old. A meta-study looking at the elderly with dementia and cognitive impairment found that training improved cognitive function and positive behaviour.

So, it seems clear exercise is doing something, but how is it doing it?

On a physiological level, the researchers discuss various potential mechanisms, including how exercise increases endorphins, mitochondrial function, neurotransmitter production (such as serotonin and dopamine), and reduces of inflammation in various ways (with chronic inflammation being linked to poor mental health).

Our fictional HR Department might be impressed by all that, but being smart and business-minded, they ask, “could we achieve any of these benefits with a workplace intervention?”

Thankfully, a meta-analysis published in Public Health focused specifically on this. While it said more research is required before anything declarative is said, it did look at five studies of specific workplace interventions and assess three as “high quality”.

1. For six weeks, employees attended one or more weekly 60-minute lunchtime yoga classes led by an instructor. They also received a guided yoga CD for home practice. At the end, participants were compared to a control group that had no intervention. Those who did yoga felt less anxious, confused, and depressed. They also reported having a “greater sense of life purpose” and felt “more confident during stressful situations”.

2. Seventy-five individuals with desk jobs took part in a four-month long lunchtime walking intervention. They experienced a self-reported decrease in fatigue at work, alongside increases in “perceptions of health, subjective vitality and work performance”. The researchers checked in again four months after the intervention and found those changes were sustained.

3. A different walking intervention found that employees who were the least physically active benefitted the most, showing that their increase in step-counts aligned with “improved quality of life and well-being and work productivity.”

Given all the above, it seems that not only companies, but our whole society would have improved mental health if we all got out there and exercised.

This demands the question, wait, why aren’t we just doing that?

How mental health influences physical health

Have you ever told a person experiencing clinical depression, “maybe try running?” Or have you ever been experiencing anxiety or depression and felt the wherewithal to do an hour of yoga or pilates?

Good mental health depends on so much more than a good mood. It’s a product of a person’s upbringing, their history of trauma or lack thereof, their coping mechanisms, and so on.

Arguing whether good mental health or good physical health is more important can be a bit like a chicken and egg argument.

Firstly, you could say good mental health is an effective foundation for the desire and ability to exercise. Secondly, perhaps the benefits from exercise are not just physiological, but are also derived from psychosocial sources – it’s not just your effort at the gym that matters, it’s the socialising you do while there.

Indeed, in Exercise and Mental Health, the researchers discuss this very thing and examine ways in which exercise could improve mental health through psychological mechanisms.

The first is that exercise gives people a distraction, a “mental time out”. The paper mentions a study from 40 years ago that gave three groups different distractions – exercise, meditation, and resting quietly in a reclining chair. Each group reported similar levels of anxiety and stress reduction.

The other psychological mechanism the paper discusses is the “mastery/self-efficacy” hypothesis. Here exercise gives people a sense of proficiency that lifts their mood.

Other researchers have tried to tackle the chicken and egg problem more directly.

A study published in Social Science and Medicine analysed the interrelationship between physical and mental health. Like the exercise study, it found that physical activity was linked to better mental health.

But it wasn’t a one-way street.

The researchers write, “Better physical and mental health status… leads to more physical activity which in return has a positive association with better mental health and physical health.”

They also found very tangible ways the two interact. For example, poor past mental health made it more likely you’d be a smoker, which impacts poor present physical health.

A holistic approach

At Healthy Business, we pride ourselves on seeing wellbeing in its entirety – a concept that captures more than fitness or mood. Our flagship wellbeing solution, HealthCi, a holistic program that delivers one-on-one health coaching and addresses an individual's state of health across the following four pillars: mental, physical, sleep and energy, and lifestyle.

If you’d like to find out more about tailored wellbeing solutions for your workforce, get in touch today.