When asked how they cope with stress a large percentage of people indicate that they use exercise as their primary coping resource.  How can an activity that is physiologically almost identical to the physiological response of psychological stress be helpful as a coping technique?  What follows is a working paper on how physical activity can function as a therapeutic modality.  Also included are recommendations on the use of physical activity to promote emotional health.  If you have other ideas, or are aware of additional research not cited on this page, please communicate with the author.

Click here for a list of scientific references on Exercise and Emotional Health.

1. Detoxification of Stress Related Compounds: During the stress response somewhere in the neighborhood of 1500 biochemical reactions occur in the body.  Neurotransmitters are activated, hormones are released, and nutrients are metabolized. Some body systems (e.g., the cardiovascular system) accelerate their functions and others (e.g., the gastrointestinal system) slow down their operations in response to stress.  This is commonly referred to as the fight of flight response.  The body is being prepared to expend physical energy which in prehistoric times was necessary for survival.  In modern times most human stress is psycho-social in nature, so the need to respond physically in most cases is unnecessary.  Unfortunately the byproducts of the stress response continue to circulate in the body and have the potential to create physical illness (e.g., cortisol secretion's impact on the immune system).  Regular exercise is useful in removing the byproducts of the stress response by providing the opportunity to simulate the fighting or running dictated by the fight or flight phenomenon. As such, regular exercise allows the body to return to homeostasis faster and reduce the physical impact of psycho-social stress.
2. Physical Activity as an Outlet for Anger and Hostility: Recent research has documented the important role that expression or repression of anger and hostility plays in disease progression.  For many, physical activity is a healthy catharsis for this most caustic of emotions.  Used properly (see recommendations below) exercise provides a socially acceptable means of physically releasing negative energy.  Whether one gets in a racquetball court and bangs away at at a ball, or beats up on their pillow, the physical release of energy appears to dissipate feelings of anger in a healthy way.
3. Moving Meditation: Certain forms of exercise (jogging, cross country skiing, swimming, hiking, bicycling) require a fairly consistent repetitive motion that can alter one's state of consciousness.  Described by some as moving meditation, the physiological effects of regular participation in these activities is very similar to what happens when one practices meditation.  Breathing and movement, act as a mantra and may in part be responsible for the feelings of calmness and tranquility claimed by some in response to exercise.
4. Enhanced Feelings of Self Esteem and Self Efficacy: Appropriately high levels of self esteem and self efficacy have been correlated with increased ability to cope with high stress levels.  Exercise cultivates self esteem and self efficacy in a number of ways including; a. when ever an individual knowingly participates in a health enhancing activity it is common to experience increased feelings of self worth as one realizes they are doing something which will ultimately benefit them, b. participation in physical activities that have known social value attached to them, promotes social acceptance and status, c. an added benefit of regular physical activity is that it has the potential to alter one's body image in a socially desirable manner thus increasing self image and improving self esteem,  d. frequent physical activity also promotes consistent physical challenges which when conquered, foster feelings of self efficacy.
5. Periodic Solitude and Introspection: For some, exercise is a solitary escape from the daily toils and pressures of a stressful society.  The escape can be a bicycle ride in the country, the cocoon of a lap pool, an early morning run, or any other form of physical exertion that provides a mini vacation and allows one to recharge their energy levels to deal with conflicts when they return. Others use this time to self reflect on issues of importance, or to stimulate creative problem solving.
6. Opportunities for Social Support: The buffering effects of social support are well documented. Recreational activities (softball, golf, a fun run, a pick up game of basketball) encourage a sense of fun and play with other individuals that have similar interests and can provide a number opportunities to discuss life situations.  The sharing that ensues, ensures one that they are not alone and that help is available for the asking.
7. The Power of Human Touch: A significant volume of research is accumulating on the positive physical properties of human touch. Some of the research has demonstrated a reduction in stress related hormones accompanying positive expressions of human touch.  Recreational and sporting endeavors raise occasions and provide excuses to touch others in a positive way.  As an example, in a culture that breeds homophobia, men are told that it is socially acceptable to hug other men and pat them on the buttocks during sporting events.  This behavior is normally considered taboo and many men would otherwise have few chances to express emotions in such a physical manner.
8. Reduction of Muscular Tension: During stress muscles contract (Bracing) and loose their normal resting muscle tone.  Bouts of physical activity allow muscles to work, thereby releasing stored energy and allowing muscle groups to return to their normal resting potential.  This action also reduces further stress that is precipitated by pain and discomfort associated with muscular tension (e.g., tension headaches, arthritic joint pain, backache, temporomandibular joint dysfunction).  Stretching and yoga are also effective in reducing muscular tension.
9. Endorphin Theories: Catecholamines including ß endorphins have been shown to increase during physical activity of twenty minutes or more.  Chemically similar to opiate compounds this morphine like substance has been shown to provide an analgesic (pain relieving) effect and promote a sense of euphoria.  First suggested as the mechanism of the so called second wind or runner's high, the presence and effect of these chemical compounds in the brain is now controversial (see: Stoll, O. (1997) Endogenous opiates, Runner's High and Exercise Addiction - The rise and decline of a myth (Endogene Opiate, Runner's High und  Laufsucht - Austieg und Niedergang eines Mythos). Leipziger Sportwissenschaftliche Beitraege.).  The physical and emotional symptoms of withdrawal associated with the rapid decrease of physical activity (as occurs with athletic injuries) of physically fit individuals has also been attributed to this hormone.  Most of the controversy in this area has do to with our inability to measure chemical changes that occur on the other side of the blood brain barrier.  Regardless of the neuro chemical reaction or other mechanisms that initiate changes in emotional status, this phenomenon does seem to exist.  The positive mood states associated with frequent exercise are so significant that some have suggested that this is a more effective treatment for clinical depression than either psychotherapy, or the use anti depression drugs.
10. Increased Somatic Awareness: One of the byproducts of relaxation training is that practitioners develop an increased sense of somatic awareness. This means that they become more in tuned with their body.  They are able to detect subtle changes in their physiology that they were previously unaware of (e.g., breathing depth and respiration, muscular tension, heart rate).  This new awareness allows individuals to be able to circumvent the physiological process of stress before it can cause problems.  Regular physical activity will enhance the same awareness.  As a result it is much easier to teach relaxation training to physically fit individuals.  Conversely, those who are the most out of touch with their bodies, have the most difficulty in learning to alter their physiology in a health enhancing way.
11. Decreased Boredom and the Stress of High Risk Activities:  Too little stress in one's life can be just as upsetting as too much stress.  It is natural for humans to seek out stimulation and excitement.  For some the opportunity for physical challenges is the most interesting part of life.  This urge can be expressed through activities such as running as fast as one can, swimming as far as one can, or hitting a golf ball as straight and hard as possible.  On the far end of the continuum are people who voluntarily involve themselves in high risk physical activities such as extreme skiing, hang gliding, scuba diving, and jumping out of perfectly good airplanes.  By constantly testing themselves individuals learn how to take on higher and higher loads of stress.  The learning that ensues transfers over to stress that is experienced in daily life.  For example, it would be difficult to imagine someone spending all day solo rock climbing without the use of ropes for safety, driving back into a city and getting upset over being caught in traffic.
12. Training for Competition: Being related to physical activity, many advocates of competitive sports contend that participants learn a great deal about life and what is necessary for success through their participation.  Knowing what it takes to win, how to accept loss, how to set goals, how to deal with high levels of stress, and how to get along with others are all mentioned as lessons learned through involvement in sports.
13. Improvement in Sleep and Rest:  A symptom of stress overload for some is the inability to sleep or get adequate rest.  A fatigued individual is less able to perform at a high level.  Exercise has been shown to be very effective in helping some individuals fall asleep easily and sleep more soundly.  The assumption is that one is not over doing physical training and becoming exhausted from the activity.
14. Fitter to Fight Stress and Disease:  One who is physically fit has organ systems that are functioning at an optimal level.  If this individual should become ill, or injured, or even pregnant, they will demonstrate more stamina and greater resiliency to fight the discomfort .  It is also likely that fit individuals will recover more quickly.
15. Others?  I am always looking for other explanations of how physical activity may e helpful in dealing with stress.  E-mail me if you have suggestions.

Stressed out individuals often complain that they do not have time to exercise.  This is unusual when one considers that a high percentage of CEOs of fortune five hundred companies indicate that they exercise on a regular basis.  Even the president of our country seems to find time in his busy schedule to jog and play golf.  Don't these folks have anything better to do with their time?  It is more likely that they have learned to be competitive and at their best only when they make the time to sweat and get their hearts pumping. 

• The form of exercise chosen should be enjoyable.  Individuals will be more likely to continue activities that they perceive as fun compared to those that are viewed as pure drudgery.  If you don't like running, then don't run.  Why do that to yourself?  Involvement in negative activities will only work to increase one's depression and stress level.
• Activities should be non-competitive and ego void.  Although competition was highlighted above as a positive function, for some wining becomes the most important part of competition.  The downside of competition for overly competitive people is that they sometimes lose.  This works to decrease esteem and increase depression.  One can either compete against opponents that they will always beat (boring), or choose not to enter competitive activities.  For some this is more difficult than it may seem.  If the classic Type A person takes up running to reduce stress, they will be likely to purchase a running watch and each time they run they will try and run faster than the last time they ran.  That does not do much to reduce stress.
• Choose activities that promote personal satisfaction.  Although some say they play golf to relax, I personally can find few activities that are as stressful.  Trying to hit a tiny ball hundreds of yards into a tiny hole is not relaxing.  Someone once described golf as a good way to screw-up a nice walk.  Perhaps because my skill level is so low, when invited to play with friends I do not enjoy looking like a buffoon as I spend most of my time looking for lost balls.  On the other hand if I am playing with my wife who is also somewhat inept, we can just enjoying being outdoors together and not worry about the score.  In general, try to find activities that promote positive feelings regarding your performance.
• Aerobic Vs. anaerobic activities  Activities performed at a long slow steady interval seem to have a calming effect on people.  One study indicated that male long distance runners experience a decrease in testosterone levels.  Associated with hyper aggressiveness, this hormonal change may very useful to some.  On the other hand, the opposite seems to occur with high intensity training.  Spend time in any busy weight room and you can almost feel the testosterone being pumped up.  The high one gets from lifting weights is not the same as the tranquility experienced by those who condition aerobically.  Weight lifters feel powerful and confident following workouts.  From a physical health perspective aerobic activities are generally considered superior in reducing the risks associated with most diseases (especially heart disease).  Weight training appears to be be more effective in reducing the risk of osteoporosis.  From a mental health perspective I would recommend cross training in both aerobic and anaerobic exercise to increase variety in workouts while encouraging feelings of both powerfulness and tranquility.
• How much exercise?  The frequency and duration of exercise is determined by ones goals.  To get in shape quicker it is recommended that one exercise frequently as opposed to fewer times and longer durations.  Weekend athletes don't cut it.   In most cases fitness will be lost at less than three sessions a week.  Ideally one should attempt to do something physical each day to prepare for the stressors ahead or to decrease the residual effects of stress during the day.
• Sexual activity as exercise  Don't forget to include sexual activity as part of your physical activity.  Orgasm is a great release of muscular and emotional tension.  Like other forms of physical activity, make sure it is fun and not stressful.  It is also good if you can include someone you like in your activity.

• Compulsive Training Like any activity exercise can have its downside.  Overuse of any coping strategy can create additional problems.  For some, physical activity can be escape from taking responsibility for ones actions.  By indulging themselves in their activity, they avoid troubling life situations which are difficult to resolve.  Similarly, although most can benefit from increased levels of self esteem, this is different from the unhealthy narcissistic tendencies others derive from physical training.
• Aggressive Tendencies  Although physical activity can be a useful catharsis for aggression, aggressive sport activities can also act to condition one to become more aggressive.  If one learns to be successful by acting overly aggressive, it is not a far stretch to see how some may use this aggression to get what they want in other areas of life.  Not a very positive consequence of physical activity and certainly one that can increase stress and negative emotional reactions.
• Addiction  Those who exercise on a daily basis often describe being addicted to their activity.  Although considered to be a positive addiction to some, the withdrawal effects of not being able to exercise can create problems.  Whether caused by changes in catecholamines levels (not getting their daily fix of endorphins) or some other mechanism, individuals should be aware of possible increases in hostility, anxiety, irritability and depression associated with not working out.