We are now in the midst of summer, and despite the heavy rain in many parts of the country, Canadians from coast-to-coast are making the most of our great outdoors.
Hiking, swimming, biking and other outdoor pursuits are part of our national DNA, and indubitably good for our physical health. But can such activities also benefit our mental health? This question has long fascinated mental health researchers such as myself.
Indeed, it is an ancient belief that exposure to nature, water and sun can facilitate recovery from mental illness. This is not only part of traditional folklore; it is a belief shared by the medical establishment throughout the ages.
For example, in the 19th century a recommended treatment for mental illnesses like depression were regular visits to an open-air spa in an area of outstanding natural beauty. This was known as 'hydrotherapy' and became a common treatment throughout Europe.
Furthermore, mental asylums such as the Douglas Hospital in Montreal were deliberately built in the countryside, often on vast tree-laden manicured grounds near quiet water. The decision to create such hospital environments was based on a belief in the curative power of nature, as well as a belief that industrialized environments worsened mental health.
Are cities bad for mental health?
The belief that mental illness is worse in industrialized and urbanized environments is supported by some evidence. For example, much recent research suggests that rates of mental illness are higher in urban centres, compared with rates in the countryside.
On the one hand, this can be explained by compositional effects whereby people vulnerable to mental illness flock to the inner cities; which contain more shelters, services and supports. On the other hand, it can be explained by contextual effects, where the urban environment can create toxic levels of loneliness, anonymity and stress.
We are currently in an era of biological psychiatry, and conventional medicine tends to ignore the potential role of nature in healing and recovery. This is unfortunate, given that evidence suggests that contact with nature can improve mental health in three ways.
Exercise, sunlight and the great outdoors.
Firstly, walking, hiking, biking and other common outdoor pursuits are common forms of exercise. Exercise releases endorphins which elevate mood and reduce pain. Some recent research indicates that the positive impact of exercise can exceed that of anti-depressant medication. In fact, physicians in countries such as the U.K. can now officially prescribe exercise to treat depression.
Secondly, research suggests that exposure to sunlight can be very important for positive mental health. This sunlight releases serotonin which helps to improve mood, and in turn regulates a normative sleep cycle. Indeed, lack of sunlight has been implicated in high rates of suicide in northern countries such as Greenland and Finland. Thus, being exposed to sunlight, especially in conjunction with exercise, can further improve mental health.
Thirdly, people with the most severe mental illnesses such as schizophrenia often have problems with their physical health. This frequently includes issues of obesity (a common side-effect of psychotropic medication) and sleep difficulties. Outdoor activity in people with severe mental illness can thus help improve their physical health, which in turn can improve their overall quality of life.
Some mental hospitals have programs to promote contact with nature. The Douglas Hospital in Montreal has a horticultural therapy program which involves patients gardening outdoors. It also has an animal-assisted therapy program, which involves patients taking therapeutic dogs on long walks on the hospital grounds. There is little systematic research on the effects of these programs, but a few studies suggest that they can reduce anxiety, stress and loneliness, as well as improve emotional wellbeing.
Overall, the evidence seems clear. Prolonged contact with nature (including animals) can promote positive mental health. As such, this contact should be encouraged for everyone, but especially for people with a mental illness.
So maximize your contact with nature this summer. It is good for your mental health.
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