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Do the outdoors provide a mental health benefit?

In the middle of a brutal Adirondack winter, the thought of taking a beach vacation and lounging on the warm sand brings happiness and comfort. However, what is the science behind this? Does resting under the sun bring the same degree of mental wellness as participating in a volleyball game?

A Canadian study explored these questions and found that, for children, “every hour spent outdoors per day was associated with a 31% reduction in odds of reporting peer relationship problems and a 22% lower odds of reporting psychosocial difficulties.” It was also discovered, by Beyer et al., that for adults, spending more time outdoors is associated with decreased symptoms of depression.

There is a continuing rise in research reports that demonstrate, for the adult population, that spending more time outdoors is associated with an improvement in mental wellness. Urban planners are promoting green space in the built environment, and recognize that this greenery may reduce stress and decrease mental fatigue.

A United States study examined the population-based impact of environmental green space and mental health. It was discovered that higher levels of neighborhood green space were associated with lower levels of anxiety, depression and stress. Additional time spent outdoors among children was associated with a decrease of Attention Deficit Hyperactivity symptoms, and an improvement in cognition and improvements in cognition and attention.

From the time we were children, playing outdoors was a part of our lifestyle. There is an association between the two, and it is unclear what impact these memories have on priming us to engage in physical activity when we are outdoors. The outdoors certainly provide a welcoming seque from indoor inactivity to outdoor recreation, especially in North Country, where there are so many stunningly beautiful lakes and mountains. Intuitively, the amount of time spent outdoors is positively correlated, in the young demographic, with an increase in what is termed moderate-to-vigorous physical activity (MVPA). For each hour that is spent outdoors by children, there is an additional 7 minutes of engaging in MVPA. Furthermore, this increase in MVPA is associated with a decrease in anxiety and depressive symptoms. It is also associated with an improvement in self-esteem and mental health in general. This might be mediated by the positive impact of outdoor activity, which can be encouraged by being outdoors.

It is likely that outdoor activities that are sedentary do not improve mental wellness as much as outdoor exercises and sports. In addition, it is also possible that the outdoor activities which adolescents are most involved with, such as studying, playing with mobile devices, or sitting with friends, does not promote mental wellness in the same way that physical activities do. Even when engaged in exercise or sports, it is possible that being outdoors in an urban environment, with all of the auditory distractions and stressors, mitigates the exercise associated benefits of outdoor exercise while in a rural and more peaceful environment.

How MVPA positively impacts mental health is not yet known. It is thought that one possibility is that physical activity serves as a distraction, which provides a temporary respite from life stressors. In fact, one evidence-based treatment is dialectical behavior therapy, which can help people with all psychiatric diagnoses navigate stresses. Originally designed as an intervention for people who suffer from borderline personality and struggle with severe psychological pain, psychological exercises including distraction can help support a more calm, and less frenetic, response to outside stressors. Certainly outdoor exercise and sports can temporarily improve mindfulness and the ability to focus all in with a competitive sports game. In the past, it was thought that enkephalins and endorphins and other chemicals released with strenuous exercise provide a modulating or mediating effect on mood regulation. However, the specifics of this interaction have been largely unknown and hypothesized. A 2021 review article in the International Journal of Molecular Sciences led to the hypothesis that the release of extracellular vesicles, initiated by exercise, has an antidepressant effect. After all, it has been recognized for some time that not exercising is a depression inducing behavior.

Regular physical exercise can not only reduce depression, it can also decrease the propensity to develop metabolic, cardiovascular and neurodegenerative chronic age related disorders.

Dr. Vance Jackson, professor of psychology at Paul Smith’s College, states that more research needs to be done to identify the role of exercise and sports in improving subjective well being and mental wellness. The role of the pandemic in producing anxiety and depression still requires both clinical and physiological data to more accurately identify what is an association and what is causal. He notes that anecdotal evidence demonstrates the increase in depression and anxiety possibly due to the alienation and isolation that such a global health crisis has caused. He notes that people do generally feel better and more resilient when spending time in the beautiful outdoors of Lake Placid, Saranac Lake and Tupper Lake. However, understanding the role of outdoor aesthetics and year-long exercises is still a challenge and an area ripe for detailed physiological and psychological research.

Unlike antidepressant interventions, where each antidepressant pharmaceutical might provide at most a 70% rate of efficacy — and can be frequently accompanied by side effects ranging from stomach upset, headaches, restlessness and, paradoxically, increased depression and suicidal behavior –physical exercise, on the other hand, is not generally accompanied by side effects unless an individual has an underlying physical condition that leaves them physiologically unable to safely participate in it.

Distinct from physical activity, spending time outdoors can be spiritually fulfilling. Being surrounded by magnificent vistas, and the impact of the Adirondack mountains and lakes, can be much more emotionally calming than spending time outdoors on a beautiful day in midtown Manhattan. Ambient traffic and the sounds of sirens and horns can be anxiety provoking. Playing sports outdoors can engage participants and help them to bond with others who are on their team. This bonding, and focus on being part of a team, can help to mitigate against developing anxiety and depression and even provide life meaning. Tolstoy, at the height of his success, wrote “The Confession” and discussed how despite his literary success, his supportive marriage, his wealth and connections to a large social system, he found life meaningless and this caused him great psychic pain. Sports, on the other hand, can remove an individual, albeit temporarily, from being overly cognitive and reflective. While it can be helpful to understand one’s behavior and moods, an overexposure to deep introspection can potentially lead an individual to be more depressed. Engaging in activities which help to mitigate against loneliness can be life saving. Feeling alienated is not localized to certain demographics. Young people during the pandemic described feelings of loneliness and depression and anxiety. These same symptoms have unfortunately been present across the population and age groups, and this has demonstrated the importance of being surrounded by people. Humans are pack animals, and being separated from friends and family, living in isolation, can lead one to emotionally implode. Older citizens who have been separated from their children, grandchildren and friends during the pandemic have left this population feeling deeply alone and sad.

A tool frequently used in therapy, where an individual is asked to focus on a lovely vista, such as the beach or a waterfall, can help to reset one’s mood barometer and help to achieve peace and comfort. Literally being outdoors on a beach or at a waterfall can autonomously create a feeling of peace and calm, and the impact of such an environment on any individual person can be extremely powerful. The release of extracellular vesicles might potentially be a biomarker for its impact in mitigating depression. Importantly there is much promise in this research. However, the exact mechanism by which physical exercise promotes wellness and serves as an antidepressant has not been completely elucidated. But it is thought that physical exercise might impact the brain at the molecular and structural levels. It has been hypothesized that the release of chemicals, known as cytokines, may play a role in creating new nerve cells and in increasing development of the neural components known as dendrites and synapses. Dendrites look like microscopic deer antlers, and receive the signal from other nerve cells to fire an electrical charge. This electrical charge is promulgated down the nerve cell, where it coalesces with another dendritic connection that leads to another nerve cell firing. This ongoing process allows for brain cell to brain cell communication. The uncertainty around how secreted extracellular proteins precisely influence nerve communication and growth may explain why prescriptions for physical exercise have not been globally commensurate with the large numbers of depressed individuals around the world, and which has increased during the pandemic.

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