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Mental Health and COVID-19

Jul 31, 2021
Editor: David L. Joffe, BSPharm, CDE, FACA

Author: Brenda Oppong, PharmD Candidate, LECOM School of Pharmacy

Physical activity is linked to mental health, so how has the COVID-19 pandemic affected exercise options and mental well-being?

Physical activity is known to benefit mental health. A sedentary lifestyle and physical inactivity are associated with many health issues such as type 2 diabetes and heart disease. Although beneficial in minimizing infection rates, lockdown during COVID-19 has increased the rate of physical inactivity and sedentary lifestyle worldwide. The COVID-19 pandemic has impacted the behavior of people worldwide. A survey conducted with 1669 participants was used to understand how and why sedentary behavior and physical activity have changed because of the pandemic, and how those changes affected mental health.


The survey was open to all individuals at least 18 years of age, fluent in English, with the ability to complete the online survey. The participants were predominately well-educated females, 18-29 years of age, living in Canada. The ethnic or racial characteristics of the participants were not reported. Data was collected from the respondents over a two-month data collection period ( April 23 to June 30, 2020). The survey consisted of 30 questions to query the demographic information and current and past physical activity behavior (minutes/week) before the pandemic.

Additionally, they were asked about their past and current mental health status, stress levels, depressive symptoms, and anxiety. All the participants were included in a draw for 20 cash prizes of $100 CAD as compensation for their participation, in the form of an emailed prepaid voucher. The questioner was used to measure physical activity, barriers, and motivators to exercise and mental health. The analyses were carried out using the IBM SPSS® statistics software platform (Version 26).

There was no change in the participants’ physical activity among those who self-identified as “elite athletes.” However, since COVID-19 began, respondents aerobic activity decreased by 22 minutes, strength-based training decreased by 32 minutes, and their sedentary times increased by 33 minutes compared to 6 months before the pandemic. Respondents who had been “recreational athletes,” “moderately active,” or “very active” before the pandemic now identified as being “completely sedentary.” Those whose mental health “got worse” or “much worse” significantly reduced physical activity. In addition, individuals reported higher psychological stress and moderate levels of anxiety and depression due to the pandemic.

Before COVID-19, lack of time was the most common barrier to being physically active, which changed during the pandemic. The results showed that mental health became a barrier for those who were not physically active due to COVID-19. Individuals reported a lack of motivation to be physically active. Barriers to engaging in physical activity such as ‘no facility access,’ ‘no equipment, ‘increased anxiety,’ and ‘lack of support’ significantly increased during the pandemic. Conversely, those who remained physically active were motivated to improve sleep,  reduce stress, relieve anxiety, and improve overall mental health.

Dr. Heisz emphasizes the need for more support for those seeking to maintain their mental and physical health during the COVID-19 pandemic. “Our results point to the need for additional psychological supports to help people maintain their physical activity levels during stressful times to minimize the burden of the pandemic and prevent the development of a mental health crisis.”

Those who maintained physical activity reported fewer mental health symptoms. Conversely, participants who significantly reduced their physical activity struggled most with their mental health. Thus, this study highlighted the importance of physical activity in mental health and the perceived barriers to exercise during the pandemic. The remaining question is, was the reduction in physical activity from the pandemic a cause or consequence of worsened mental health?

Practice pearls:

  • There need to be more studies conducted on the general population with diverse ethnic, racial, and educational backgrounds.
  • More significant support for those seeking to maintain their mental and physical health during the COVID-19 pandemic is imperative.
  • Physical activity during the pandemic is beneficial for mental health.


Marashi, Maryam Yvonne et al. A mental health paradox: Mental health was both a motivator and barrier to physical activity during the COVID-19 pandemic. PLOS ONE; April 2021.


Author: Brenda Oppong, PharmD Candidate, LECOM School of Pharmacy