Around 280 million people worldwide experience depression, contributing significantly to disability. Efforts continue to promote low-cost and accessible treatments. One effort is promoting exercise as an option, as physical activity not only improves physical health but also mental health. The question is what kind of exercise can be considered comparable to psychological therapy?
A physiology and sports medicine expert at the Faculty of Medicine, Public Health, and Nursing of Universitas Gadjah Mada (FK-KMK UGM), Dr. Zaenal Muttaqien Sofro, stated that exercise indeed offers significant benefits for mental health, but it must be understood as a measurable medical intervention rather than merely spontaneous physical activity.
“Exercise is a medicine, meaning it can be regarded as a treatment, especially for diseases that are physical in nature, and it also depends on the type of exercise,” Zaenal said on Thursday (Feb. 26) at the UGM campus.
Like medication, he continued, exercise cannot be prescribed uniformly to everyone. A principle of suitability must be considered to ensure its effectiveness.
“There is a principle of compatibility when we take medicine; what suits our body is what works. Not all exercise can serve as therapy; certain conditions must be met, such as hydration status and when we should drink water,” he explained.
He added that timing matters. Exercise should ideally be performed two hours after eating, when the body is in a stable metabolic state. The physiological responses that arise can be more optimal and safe. According to him, the benefits of exercise are not limited to physical fitness alone.
“What we gain from exercise is not only physical benefits but also a holistic principle, encompassing mental health, spirituality, and social engagement,” he said.
In terms of spirituality, he linked it to the concept of 3C: Connection, Compassion, and Contribution. Exercise can serve as a means of building connections with oneself and others, fostering empathy, and encouraging social contribution.
He further explained the body’s biological mechanisms during exercise using a traffic-light analogy. In this analogy, the yellow light represents the desired intensity zone during exercise, when the sympathetic nervous system is activated, triggering the fight-or-flight response.
In this phase, heart rate increases, blood flow to muscles rises, and energy reserves are broken down to support physical activity. This response is not a sign of danger but rather the body’s adaptive mechanism to controlled stressors.
However, he cautioned that if intensity exceeds individual capacity, the condition may shift into a risk zone. Therefore, monitoring heart rate and being aware of bodily signals are essential to ensure that exercise remains both optimal and safe.
“Our body responds to exercise in three components, like a traffic light: red, green, and yellow. When we exercise, the yellow light is activated, which is called the fight or flight response, and this involves the sympathetic nervous system,” he elaborated.
He went on to explain that the sympathetic nervous system works through catabolism, a process of breaking down stored energy reserves.
“The sympathetic nervous system works by breaking down energy that has been stored and unused,” he clarified.
When exercise is performed at the proper intensity, the body experiences not only physical adaptation but also emotional regulation. Controlled activation of the sympathetic nervous system through the fight-or-flight response actually trains the body to cope with stress in a healthy way.
“The sympathetic nervous system works by breaking down energy that has been stored and unused,” he reiterated.
According to Dr. Zaenal Muttaqien Sofro, this is where the correlation between exercise and mental therapy lies. A biological response that is typically associated with stress, when managed within safe limits, can become a tool for psychological adaptation.
Increased adrenaline during exercise helps the body learn to manage pressure. Therefore, intensity should be maintained at 60 to 80 percent of maximum heart rate to remain in an effective aerobic zone without triggering excessive fatigue.
He stated that exercises that can improve mental health include brisk walking, jogging, stationary cycling, swimming, and aerobic gymnastics. However, the key lies in the aerobic aspect, which refers to maintaining a heart rate that sufficiently stimulates the release of adrenaline, neither too low nor too high, within 60 to 80 percent of maximum heart rate. Meanwhile, optimal oxygen supply to the brain contributes to mood stability, mental clarity, and reduced anxiety.
“Fitness is determined by the body’s ability to use oxygen and distribute it adequately throughout the body, especially to the brain. The brain functions optimally when it receives sufficient oxygen,” he emphasized.
Zaenal stressed that exercising for 30 to 40 minutes allows the body to adapt to stressors without falling into overtraining, which can actually worsen psychological conditions.
“Referring to the traffic light concept, the exercise we seek is in the yellow zone. Within a certain period, 30 to 40 minutes, we avoid exhaustion by training the fight-or-flight response, so that outside that period the body can adapt to stressors. What must not be forgotten is heart rate. If it exceeds the limit, overtraining can occur, causing sleep disturbances and digestive problems,” he said.
He also linked the social aspect of exercise to brain mechanisms. Positive interactions during group exercise can shift the fight-or-flight response into a more enjoyable experience, or into play.
This process involves the Fusiform Face Area (FFA), which helps recognize happy facial expressions, and the amygdala, which processes fear and anxiety. When the received social expressions are positive, amygdala activation associated with anxiety can be suppressed.
“With more friends, fight or flight can turn into play. The keyword ‘play’ depends greatly on our friends’ facial expressions. In the brain, there is the FFA. When friends exercising with us show happy expressions, we perceive those faces and feel happy as well,” he concluded.
Although exercise can function as mental therapy, it does not replace psychological therapy. Rather, it trains biological and emotional systems to adapt to stress in a measurable way, increases oxygen supply to the brain, and strengthens positive social experiences.
Author: Zabrina Kumara Putri
Editor: Gusti Grehenson
Post-editor: Jasmine Ferdian
Photo: Freepik