Mental Health

    • Prescription: 150 to 300 minutes of moderate-intensity physical activity per week.

    • Clinical Focus: Strong evidence links greater volumes of physical activity to a lower risk of developing dementia and Alzheimer's disease. Exercise provides acute, short-term improvements in executive function, memory, processing speed, and attention, and significantly lowers the risk of delirium in older hospitalized patients.

    • Prescription: Structured, prescribed exercise routines (walking, jogging, yoga, dance, or strength training) for 45–60 minutes per session.

    • Clinical Focus: Recent AAFP reviews highlight a paradigm shift: exercise is now viewed as an effective monotherapy for mild-to-severe depression, comparable to pharmacotherapy or psychotherapy. Notably, prescribing a specific exercise is much more effective than simply encouraging a patient to "be more active." High-intensity interval training and moderate continuous training both significantly decrease depressive symptoms.

    • Prescription: Moderate-intensity aerobic exercise as an adjunct behavioral therapy.

    • Clinical Focus: While primary addiction treatment focuses on cognitive-behavioral interventions and pharmacotherapy, exercise is recommended to mitigate the physiological stress responses (managing acute anxiety and cravings) associated with withdrawal. It regulates dopamine pathways and decreases the sympathetic nervous system overdrive commonly seen in early recovery.

References

U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition. Washington, DC. (Endorsed heavily by the AAFP as the baseline standard of care for physical activity counseling).

American Academy of Family Physicians (AAFP). (Current). Physical Activity, Health Benefits, and Exercise Prescriptions. AAFP Policies & Clinical Recommendations.

American College of Sports Medicine (ACSM). (2021). ACSM's Guidelines for Exercise Testing and Prescription, 11th edition. Wolters Kluwer.

Singh, B., et al. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. British Journal of Sports Medicine, 57(18), 1203-1209. (A massive recent umbrella review solidifying exercise as a frontline monotherapy for depression).

Erickson, K. I., et al. (2019). Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines. Medicine & Science in Sports & Exercise, 51(6), 1242-1251.

Substance Abuse and Mental Health Services Administration (SAMHSA). (Current). Treatment Improvement Protocols (TIPs) - Incorporating Wellness and Physical Activity into Substance Use Disorder Treatment.