Mental health, understood from a global perspective as the absence of mental disorders combined with an excellent state of well-being, is a critical component for health and development in adolescence. However, between 10 and 20% of all children in the world experience a mental health problem and almost half of them develop it before the age of 14. In our country the numbers are very alarming; Spain is the European country with the highest prevalence of mental health problems among children and adolescents, according to Unicef. One in five children between the ages of 10 and 19 have some type of diagnosed mental health issue. Depression is the second most prevalent mental disorder among children and adolescents (6.2% globally). Furthermore, we must take into account that the incidence of depressive symptoms at an early age is a strong predictor of mental problems in the future; it has been shown that more than 67% of young people with depressive symptoms are at risk of developing a depressive or anxiety syndrome in adulthood.

Clinical practice guidelines suggest the use of psychological and pharmacological therapy to reduce depressive symptoms in children and adolescents. In addition to limitations that may reduce adherence to treatment, data from recent surveys are worrying, as a large percentage of children and adolescents (80% in the US) who need mental health treatment do not receive adequate medical care. Therefore, it is urgent to explore new treatments that are safe and easy to implement in the daily lives of children and adolescents with depression. Interventions with physical activity have been shown to be effective in reducing depressive symptoms in adults and have been included in international guidelines as an official treatment for these ages.

Faced with this social challenge to improve depressive symptoms in younger people, science strongly proposes intervention with physical activity. The results are very resounding: exercise interventions can significantly reduce depressive symptoms in children and adolescents. In addition, physical activity is generally safer and more affordable than other clinical treatments for depression.

Very recently it was published in JAMA Pediatrics a rigorous meta-analysis that included more than 2,400 children and young people who participated in more than 20 randomized clinical trials. The work includes data from surveys conducted in the United States, China, Chile, Germany, Iran, Brazil, Thailand and the United Kingdom; most of the past 10 years. The authors found a moderate to strong association between decreased depressive symptoms and physical activity interventions for adolescents and young people with diagnosed depression. The results of this meta-analysis are even more conclusive when interventions were performed for participants with high depressive symptoms. In addition, it is also worth noting that the benefits were greater for participants aged 13 years or older than for younger participants.

These findings reinforce the role of physical activity in the treatment of depressive symptoms and highlight the potential of physical education in primary and secondary education to improve the mental health of children and adolescents. The authors, while stating that various physical activity programs (swimming, running, dancing, sports activities, physical education classes…) (duration, frequency, intensity, mode) and knowing the mechanisms underlying the antidepressant properties of physical exercise.

Regarding the dose of exercise, the interventions of three weekly sessions and lasting less than 12 weeks were the ones that produced the greatest benefits in reducing depressive symptoms compared to other frequencies and durations. More research is needed to explain these findings and establish optimal parameters of physical activity for the treatment of depressive symptoms, as there is controversy as to whether more physical activity does not necessarily translate into greater improvements. Likewise, it is pointed out that low doses of physical activity may not reach a minimum stimulus to achieve the desired benefits.

It seems that a combination of biological, psychological and psychosocial factors could explain the relationship between physical activity and depression. Biological factors include activation of the endocannabinoid system to stimulate the release of endorphins, increased bioavailability of neurotransmitters (serotonin, dopamine, or norepinephrine) that are reduced with depression, and changes in brain plasticity that occur over the long term. Psychosocial and behavioral hypotheses were also formulated, according to which physical activity can lead to improvements in self-perception, social interactions and self-confidence.

Approximately 65% ​​of the child and youth population in Spain do not reach the minimum WHO recommendations of 60 minutes daily of moderate aerobic physical activity; this percentage is even more alarming in girls, as it rises to 70% according to the study steps by Fundação Gasol, which included almost 4,000 school-age children. In this national situation, it is difficult for us to think that children and adolescents with depressive symptoms or with diagnosed depression are currently benefiting from physical activity, since they have numerous barriers to participating in physical activity programs.

The promises of physical activity for promoting mental health will not be realized by making physical activity more antidepressant, but by promoting physical activity and making access to it available to children and young people with mental health problems. The evidence that physical activity is an effective remedy for mental health is strong and robust, but now is the time to find the way so that children and young people can easily access it.

INFORM YOURSELF it is the space of EL PAÍS SALUD where we will talk about aspects related to physical activity, sport and physical and mental health. From the Sciences of Physical Activity and Sport, an attempt was made to advance scientific knowledge about the importance of movement and physical exercise in the body, as well as the processes that explain why certain adaptations, modifications or changes occur at different levels. (physiological, anatomical, motor, emotional or cognitive). This space seeks to find scientific explanations that support and justify the reasons that are so beneficial for physical activity and sport. Likewise, it will try to discuss and refute certain myths or false beliefs existing in society about specific issues of physical exercise and health.

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