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Exercise and Recovery: The Foundation of Total Health

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT
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The comprehensive health benefits of a regular exercise routine are well-documented. The importance of staying active, keeping fit, and participating in some type of moderate-to-vigorous physical activity several times a week has been repeated so often by health professionals and media figures over the past twenty years it’s almost become white noise.

We’ve heard it so much that by now it’s basic common sense. Everyone knows you’re supposed to work out if you want to stay healthy and live a long, happy life. Not as often as you can – too much exercise can be bad – but let’s be honest. Most of us don’t have that problem. Most of us should get more exercise than we do. Various sources recommend different amounts and types of exercise for optimal health. Generally speaking, though, we’ve all heard it’s best if we combine generous doses of moderate aerobic activities with smaller doses of more intense activiites. We know we should walk, ride bikes, or job most days of the week. We also know a couple days a week of resistance training or high-intensity interval workouts such as CrossFit or cardio kickboxing are the iciing on the cake.

The Mayo Clinic says we need two and a half to three hours of aerobic exercise per week and about an hour to an hour and half of weightlifting-type activities a week. That comes out to roughly half an hour a day. You don’t need presidential commissions, special school initiatives, or daytime talk show hosts to tell you that anymore. We all know the pillars of health are a balanced, healthy diet, regular exercise, and consistent, quality sleep. These three things support one another and create mutually reinforcing positive cycles that lead not only to good physical health, but also to balanced emotional health and overall well-being.

How Exercise Helps Recovery

Regular exercise is a fundamental element of physical and emotional health. No one disputes this anymore. It stands to reason, therefore, that regular exercise should also be a fundamental element of the treatment of and recovery from substance, mood, and behavior disorders. Some mental health professionals used to dispute this, but no longer. Scores of studies published over the past twenty years show regular exercise helps people in treatment and recovery do the following:

  • Reduce stress
  • Relieve anxiety
  • Reduce drug and alcohol craving
  • Develop healthy coping mechanisms
  • Alleviate symptoms of co-occurring disorders
  • Find pleasure without drugs or alcohol

Clearly, those are all positives. In the big picture they amount to two important things. First, a smoother recovery. Second, reduced rates of relapse. But we’re going to back up for a moment and look at an even bigger picture: the effect of exercise on overall health. Not in broad platitudes, though. The media, your friends, and doctors on TV have that covered. Instead, we’re going to remind you of the very real and very specific health benefits of regular exercise for the general population. After that, we’ll circle back and discuss how exercise helps people struggling with substance use or mental health disorders.

What Exercise Does for Your Body

Let’s have a look at what science tells us regular exercise does for you. In 1996, the Surgeon General of the United States released a comprehensive, 300-page report called “Physical Activity and Health.” In a special introductory message, then Secretary of Health and Human Services Donna E. Shalala made a bold claim:

“This landmark review of the research on physical activity and health—the most comprehensive ever—has the potential to catalyze a new physical activity and fitness movement in the United States…Its key finding is that people of all ages can improve the quality of their lives through a lifelong practice of moderate physical activity…And if you’re already doing that, you should consider picking up the pace: this report says that people who are already physically active will benefit even more by increasing the intensity or duration of their activity.”

After reviewing and assessing hundreds of peer-reviewed scientific journal articles on exercise and health, the report identified all the ways exercises makes us healthier.

Overall Benefits of Exercise
  • Reduce overall mortality by 64%. Yes, that’s a funny phrase. To clarify, here’s what it means: adults who exercise regularly are 64% less likely to die between regular doctor’s visits than those who don’t.
  • Improve Cardiovascular Health. Exercise improves:
    • Heart strength
    • Stroke output (the amount of blood pumped per beat of the heart)
    • Blood flow
    • Blood pressure
  • Decrease Cardiovascular Disease. Exercise reduces:
    • Heart attack
    • Arterial disease
  • Improve Bone Health. Exercise helps prevent:
    • Osteoarthritis
    • Osteoporosis
  • Improve Muscular Health. Exercise improves:
    • Strength
    • Endurance
    • Metabolism and repair
  • Decrease Cancer Risk. Exercise reduces chances of developing the following cancers:
    • Colon
    • Breast
    • Prostate
    • Testicular
  • Decrease Metabolic Disease. Exercise reduces chances of developing:
    • Diabetes
    • Hypertension
  • Mental Health. Exercise improves:
    • Depression
    • Anxiety
    • Stress tolerance

Remember – this report was published back in 1996, when the medical establishment was still making connections between sedentary lifestyles and obesity. We were still reeling from decades of head-in-the-sand attitudes toward cigarette smoking and other unhealhty norms. The general public was still stuck in a fast-food mentality. Most of us were just beginning to learn the importance of eating whole foods and avoiding prepackaged snacks loaded with carbs, food dyes, additives, preservatives, and sweeteners like high-fructose corn syrup. Practice of complementary therapies – the whole mindfulness suite, as it were – was still relatively new, and mental health professionals were in the early stages of applying the lessons from reports like this to the day-to-day treatment of substance use and mental health disorders.

The Benefits of Exercise for Addiction and Mental Health Treatment

Fast forward twenty years and we know a lot more: we know exercise works, we know mindfulness works, and best of all, we know a combination of talk therapy, mindfulness, and exercise has a profoundly positive effect on recovery from and treatment of substance use and mental health disorders.

But why?

In the years following the seminal Surgeon General’s report, mental health professionals sought evidence to support what many individuals in recovery – therapists and patients alike – already knew anecdotally: exercise can make a huge difference in the early stages of recovery, help people struggling with addiction maintain long-term sobriety, and help people struggling with mental health disorders manage their chronic symptoms. We now have data to explain the exercise effect. Here’s what the past two decades of neuroscience teaches us about what happens in your brain when you get your body moving.

Benefits of Exercise for Your Brain
  1. Increases levels of norepinephrine, a hormone that regulates stress.
  2. Lowers levels of cortisol, a hormone that contributes to stress.
  3. Increases levels of serotonin, a neurotransmitter that combats depression.
  4. Increases levels of dopamine, a neurotransmitter that combats depression and increases sensations of pleasure.
  5. Normalizes levels of dopamine and glutamate, neurotransmitters that play a key role in the reward circuitry of the brain.
  6. Improves executive brain function.

Notice each point above is supported by a link to published peer-reviewed articles. Each of those articles in turn cites upwards of twenty papers each in support of their claims. This research represents thousands of hours of human effort and affirms the inclusion of exercise as a vital component of any high-quality mental health or substance abuse treatment program. To connect the dots, the basic equation confirmed by research vis a vis addiction and mental health treatment has two parts.

1. The presence of stress and co-occurring disorders.

Stress, anxiety, and the symptoms of co-occurring disorders often cause individuals to seek, develop, and maintain substance use disorders. The same factors often cause individuals to relapse after initial sobriety or lose their capacity to manage symptoms of co-occurring disorders.

2. The effect of exercise on stress and co-occurring disorders.

Exercise reduces negative, uncomfortable physical and emotional sensations related to the stress, anxiety, and symptoms of co-occurring disorders that often cause individuals to develop substance use disorders and relapse when attempting to become sober or manage the symptoms of co-occurring disorders.

Researchers have clearly identified the underlying neural pathways responsible for the positive effects of exercise, which are often the same pathways that contribute to substance use and mental health disorders.

But that’s not the entire story.

Research also shows exercise teaches individuals struggling with addiction how to achieve pleasurable states without alcohol or drugs and gives them positive alternatives to drinking and using drugs. Many people early in recovery have another problem. They simply don’t know how to pass the time they used to spend drinking, doing drugs, or suffering from the symptoms of an emotional disorder. Exercise gives them a positive, evidence-based, recovery-supporting activity to fill their time. It can also add a whole new peer group to their lives. And if an individual in recovery connects with another exercise enthusiast who’s also in recovery, then all the better. Studies show that the addition of only one abstinent member to a recovering addict’s social network can increase their chances of maintaining sobriety by as much as twenty-seven percent.

Back to The Future: Back to Basics

We’re lucky to live in a time when research, technology, and innovative approaches to mental health treatment converge to solve the difficult problems posed by substance use and emotional disorders. Intuitive therapists and individuals in recovery have known for decades that exercise helps people manage the difficult initial stages of abstinence, and further, that a regular exercise routine can form the bedrock of successful, long-term, sustainable sobriety. The evidence is no longer anecdotal or subjective. The verdict is in. Exercise works. The evidence also brings us full circle, and reminds us of something our common sense has told us for as long as we can remember: alongside good eating habits and consistent sleep patterns, a regular exercise routine is an essential element of a healthy, happy life, no matter who you are or what challenges you face.

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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