- According to recent research, staying active and outside is important even during a pandemic.
- Less anxiety and depression were seen in people who exercised more during lockdowns.
- It was also shown that people who spent more time outside had lower levels of anxiety and despair.
- While halting virus transmission is important, such studies may help governments reconsider some mitigation methods that harm mental health.
Throughout 2020 and 2021, the level of COVID-19 lockdowns, curfews, and pandemic mitigation measures varied among countries.
The United Kingdom, for example, authorized only one exercise session per day during the first lockdown in March 2020, such as going for a walk, run, or bike ride. Turkey, on the other hand, made no allowances for outdoor exercise and only allowed people to leave their houses to buy for essentials. Many states in the United States chose a different approach, allowing people to spend as much time as they wanted outside.
The authors of a recent study published in the journal Preventive Medicine wanted to see what impact such variances would have had on people’s mental health, particularly during the initial wave of the epidemic when authorities imposed lockdowns.
During the epidemic, they discovered that physical exercise and time spent outside were linked to improved mental health.
During lockdown, measuring anxiety and depression
The research, which included people from Hawaii, Colorado, Georgia, the mid-Atlantic regions, and Southern and Northern California, was led by the healthcare corporation Kaiser Permanente (KP).
In April 2020, the researchers polled more than 20,000 people, and they polled them at least three more times until July 2020. Participants, who were all registered in a KP plan, were asked about their lifestyles, submitted their electronic health information, and provided biospecimens.
The majority of those who responded were retired and obeyed stay-at-home directives. The bulk of the women were white and over 50 years old.
The researchers discovered that people who exercised or spent more time outside had lower anxiety and sadness levels after examining the data.
In addition, they discovered the following:
- Over time, the individuals reported reduced anxiety and sadness symptoms.
- Females and younger people scored higher on anxiety and depression, but Asian and Black people scored lower.
- Those who did not participate in any physical exercise throughout the lockdown had the greatest levels of depression and anxiety.
The people who had increased their time spent outside by the most amount also had the highest anxiety levels, according to the study. This was true across the board for all demographic groupings. The researchers were baffled by this discovery.
Physical activity is beneficial to one’s mental health.
Deborah Rohm Young, Ph.D., lead author and director of the Kaiser Permanente Southern California Department of Research & Evaluation’s Division of Behavioral Research, told Medical News Today that she expected more physical activity, as well as more time outdoors in nature, to be linked to lower depression and anxiety scores.
Dr. David A. Merrill, adult and geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, said, “The data is very clear that the mind and brain are healthier when we spend more time […] in nature, but [also] just outdoors in general.”
“There are studies that show that less time outdoors leads to brain atrophy, over time and with age,” he noted.
Dr. Bert Mandelbaum, a sports medicine specialist, orthopedic surgeon, and co-chair of medical affairs at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, told MNT that the research was thorough and looked at a variety of factors before reaching a result.
“At the end of the day, exercise activities and being outside are healthy behaviors that optimize people’s lives and decrease anxiety and depression,” he said.
Dr. Young, on the other hand, brought up certain discoveries that surprised the panel.
“I was surprised to observe that the depression/anxiety scores improved over time and also that both increasing and decreasing the amount of time spent outdoors was associated with higher depression and anxiety scores,” she said.
Dr. Merrill admitted that interpreting the data was difficult and entailed a lot of guesswork.
According to him, one reason for the inconsistencies might be the lack of pre-pandemic baseline levels of physical activity as well as depression or anxiety ratings.
One of the limitations that might explain why more time outside was related with a greater level of anxiety, according to Dr. Young, was not knowing how much time the respondents spent in nature prior to the pandemic.
“It could be that people who spent less time outdoors did so because of adhering to the stay-at-home orders and felt deprived of their ability to be outdoors. Or that people who reported spending more time outdoors did so because they were experiencing poor mental well-being,” she said.
Dr. Mandelabum, on the other hand, believes that this should not detract from the study’s major finding.
“I would focus more on the fact that [more people] improved by going outside, being in nature, and exercising in a high intensity way, which optimizes anxious and depressed states. [T]he real conclusion is the importance of physical activity and being outdoors,” he said.
Anxiety, depression higher in the youth, females
Other findings, according to Dr. Young, were mainly in line with previous studies.
“Many previous studies have shown that females had greater levels of anxiety and sadness than males. “A lot of studies have also suggested that older persons have better mental health than younger adults,” she told MNT.
The latter was attributable to individuals having experienced more hardship and having greater stress management experience, according to the study.
The new study, according to Dr. Merrill, sheds light on an important topic. Since the pandemic, he and his colleagues have observed a disproportionate number of teenage patients with mental health issues, he added.
“The research backs up what mental health specialists dealing with these groups have seen: that younger individuals, in especially, have suffered with interruption of their typical activities during the pandemic, [having been forced to] stay at home and prevented from going out in public.” “The data shows that these limits have a considerable detrimental impact on people’s well-being,” he told MNT.
“Living through that disappointment of not being able to do something as normal as going to the park can be a very big setback for a young person who otherwise may have been just having a nontraumatic, normal upbringing and a normal life.”
– Dr. David A. Merrill
Racial differences in lockdown’s mental impact
Dr. Young was taken aback by the racial disparities in depression and anxiety ratings.
“When compared to white people, Asian Americans report lower levels of despair and anxiety.” On the other hand, Black people tend to score higher than white people, so this was surprising, and I don’t believe it reflects the broader population,” she explained.
She believes this result is due to the fact that just 2.3 percent of the cohort is made up of Black individuals.
“The evidence speaks for itself when it comes to the differences in depression and anxiety levels by race and ethnicity. Dr. Merrill stated, “There is no definitive reason.”
The techniques employed by the study to quantify anxiety and depression levels, according to Dr. Mandelbaum, might explain the result.
“The data, as well as the techniques and objective assessments, revealed cultural and ethnic inequalities.” It might be deceptive to look at those in a nonbinary way. I believe the tools are restricted because if you have ten people in a room, each from a different country, you will see how different people understand the same question, even though it is asked in the same language. “It’s quite difficult [to improve] these technologies across multiple cultures or languages,” he remarked.
Meanwhile, Dr. Merrill believes the findings may represent a reality that is often neglected by ethnic minorities.
“If you’re already more under stress based on systemic exclusion, or marginalization, [the pandemic may not have had] such a big impact. For a population who is already under stress, if you add on more stress, there may be less of a change compared with a group that has enjoyed privilege or a stress-free life. In the U.S., that kind of seems to be the reality,” he explained.
Preparing for the next public health crisis
Future pandemics will require greater preparation and consideration of people’s mental health, according to the study. This might influence choices on whether or not to close off outdoor places, for example.
Dr. Young admitted that all governments had struggled to combat a new pathogen.
“I’m sure we all would like to have consistent messaging throughout the pandemic, but as the knowledge changes, so do the recommendations,” she said.
However, the outcomes of the study show that physical exercise or spending time outside might help people preserve their physical and mental health even during an active pandemic.
“Governments should promote physical activity and spending time in nature during pandemics. Public health messages have been consistent about getting vaccinated, staying masked-up, frequent hand washing, and maintaining physical distancing. It would be great if they can include positive messages like going for brisk walks.”
– Dr. Deborah R. Young
Although there were many unknowns during the first lockdown regarding what constituted risky behavior, several studies have proved that going outside is not as dangerous as experts originally assumed, according to Dr. Merrill.
“I think keeping public health decisions away from political battles and focusing on the science, the data, including this new information that we’ve learned, can help minimize the negative impacts of the decisions that are made,” he said.
“[M]aking good use of the data and sharing information about what’s been learned can help decrease anxiety and prevent the imposition of unnecessary restrictions that don’t actually increase our safety and health but do significant harm. Hopefully, we can consider this a lesson learned and do better [in the future].”