Good physical health reduces mental medication use

Norwegian prescription database links fitness to mental health meds.

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This study investigates the relationship between individuals’ physical fitness levels and their use of mental health-related medications. The aim is to determine whether maintaining good physical shape has an impact on the frequency of medication use for mental health conditions.

“People who are in better shape take fewer anxiety and depression medications,” said Linda Ernstsen, an associate professor at NTNU’s Department of Public Health and Nursing. The research used data from the Trøndelag Health Study (HUNT), where 250,000 residents voluntarily shared their health information since 1984. This data helped estimate people’s fitness levels. The study focused on data from HUNT3, collected from 2006 to 2008, and compared it with information from the Norwegian Prescribed Drug Registry, which tracks medication distribution in Norway.

Ernstsen said, “Being in better physical shape appears to reduce the need for anxiolytic drugs and antidepressants.”

In a prior study, researchers discovered that people in good physical shape during the second HUNT study had fewer symptoms of depression when they participated in HUNT3 ten years later. However, they didn’t find a link between physical fitness and anxiety.

However, a new study approach, which examined the medications obtained by HUNT3 participants from pharmacies as late as 2018, revealed this connection.

Yet, there’s a limitation. The researchers can only see which medications were given to people by pharmacies. They can’t confirm whether individuals took the pill since they cannot monitor what’s in their medicine cabinets.

According to first author Audun Havnen, an associate professor at the Department of Psychology at NTNU, “Nevertheless, there is reason to believe that people who are prescribed medication have more symptoms than those who do not see a doctor.”

Exercise has the most significant impact on men and young people. While being in good shape benefits everyone, it helps men more than women, and its effects are less specific for older individuals. However, this doesn’t mean women and older people shouldn’t exercise.

We can wonder what comes first: does being physically healthy prevent anxiety and depression, or do people with anxiety and depression exercise less, making them less fit?

To ensure that the study’s participants didn’t already have anxiety or depression when it began, the researchers excluded those who had taken anxiety or depression medication before and for three months after HUNT3. They also considered symptoms of anxiety and depression in their analysis. This means that the people studied were likely not experiencing anxiety or depression at the beginning of the study.

So, if you’re not keen on exercising, there are no shortcuts; you have to start unless you choose not to exercise. But is there no other option?

The results show that improving your physical shape, even from poor to moderate, can have a protective effect. Any physical activity is beneficial, but it’s best to engage in activities that make you breathless and sweaty. Norwegian health authorities recommend 150-300 minutes of moderate-intensity exercise per week. If short on time, aim for 75 minutes of high-intensity or moderate high-intensity training—every minute of physical activity matters.

The study demonstrates a strong link between physical fitness and the use of mental health-related medications. Individuals in better physical shape tend to need fewer such medications, indicating that prioritizing physical fitness can be an effective way to support mental health and reduce the dependence on medicines for addressing anxiety and depression.

Journal reference:

  1. Audun Havnen,  Ekaterina Zotchevaetal., Cardiorespiratory fitness and incident use of anxiolytics and antidepressants in adults. A linkage study between HUNT and the Norwegian Prescription Database. Journal of Affective Disorder. DOI: 10.1016/j.jad.2023.07.029.
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