Unreleased: Tennis court (Photo: Clive Brunskill/Getty Images)
At a time when mental health awareness has never been higher, there is growing recognition of the important role of sports and exercise in promoting health. Dr. Ramaswami Viswanathan, MD, ScD, current President of the American Psychiatric Association (APA), shares his views on the intersection of lifestyle psychiatry, sports, and mental health.
During his term as APA president, Dr. Viswanathan is keen to highlight the six pillars of lifestyle psychiatry, including nutrition, physical activity, restorative sleep, stress management, social connections and avoiding dangerous substances. “Physical activity is critical for mental and physical health,” he explains. “Research, including neuroimaging and biochemistry studies, has shown that exercise increases hippocampal volume and promotes neural synaptic function, which correlates with improved cognitive performance and mental health indicators.”
Participating in sports at a professional level has both positive and negative aspects. While participating in sports can make physical activity more enjoyable and sustainable, it can also lead to concerns about self-image and performance, notes Dr Viswanathan. “Sports participation increases adherence to physical activity habits, and the social aspect of organized sports contributes to improved mental and physical health, including longevity,” says Dr Viswanathan.
One of Dr Viswanathan’s priorities is to eliminate the stigma surrounding mental health, including in sport. He points out that many high-profile athletes have spoken openly about their mental health struggles, which helps normalise these concerns. “Mental health issues are as common as diabetes or high blood pressure. With the right treatment, people can achieve high performance levels in sport, work and social relationships. Public education and athletes speaking openly about their experiences can significantly reduce stigma.”
Exercise as a treatment for mental illness
Dr. Viswanathan is an advocate of incorporating exercise into mental health treatment plans. “Studies have shown that exercise is just as effective as SSRIs in treating depression and anxiety,” says Dr. Viswanathan. “Rather than choosing one or the other, it’s important to recognize that exercise has much more potential than people realise. That’s why I advocate prescribing exercise and physical activity in addition to traditional treatment for anyone with a mental health disorder,” he continues.
He points out that team sports, with their recreational and social components, may offer additional benefits. “The connection and enjoyment we get from sports can enhance the positive impact on mental health,” Dr. Viswanathan notes. He envisions a future where the role of exercise and sports in mental health care is widely recognized alongside the other pillars of lifestyle psychiatry, and he looks forward to promoting this during his term as APA president.
Prioritising mental health in sport
Dr Viswanathan agrees that prioritising mental health is essential in both professional and recreational sport: “Mental health has a significant impact on physical performance.” He also acknowledges that while participation in sport can have a positive impact on mental health, it can also lead to some challenges, and mental health interventions are needed to help athletes cope with these.
He also emphasises the importance of addressing the psychological preparation for returning to competition after a physical injury. “Injuries are not only physical but also psychological and addressing both aspects is essential for recovery. Sports psychiatry plays a key role here as trained sports psychiatrists understand the complexities,” says Dr Viswanathan. He is keen to point out that a calculated approach is essential when returning an athlete to sport as returning too soon can do them harm.
Vision for the future
The APA is committed to promoting the integration of mental health care with lifestyle interventions and the sports environment. “While many psychiatrists focus primarily on pharmacotherapy, a balanced approach is essential. Physical activity is an important component of mental health, but nutrition, sleep, avoiding tobacco and stress management are equally important as these components collectively improve sports performance and mental health,” said Dr. Viswanathan.
APA President Dr. Viswanathan recognizes sports psychiatry as a specialty of psychiatry. “Given the prevalence of sport, we need professionals with expertise on these psychological factors in that environment,” Dr. Viswanathan notes. His vision for integrating sport and exercise into mental health care aligns with his broader platform of lifestyle psychiatry. As APA continues to promote these principles, the future of the intersection of sport, exercise, and mental health looks promising.
President of the American Psychiatric Association Ramaswami Viswanathan, M.D.
