Blurred Lines by Louise Johnstone

Mental illness; often used alongside the terms crazy, mental and nuts. We’ve seen the media exposure covering the extreme end of the spectrum of mental illness and we’ve seen the films depicting asylums and psychopaths.  However, mental health and illness exist on a continuum from mental illness to mental wellbeing.  Therefore, it incorporates not only those suffering from illness but also those who develop a positive mindset.

So, what is a mental illness? It is a medical condition that can affect an individual’s thoughts, feelings and/ or actions.  Moreover, it can cause this person suffering and difficulty functioning.  There are different types of mental illness including depression, anxiety, schizophrenia, bipolar and obsessive-compulsive disorder.  However, this is not an exhaustive list.

By 2030, approximately 2 million more adults will suffer from mental health problems than in 2013(1).  Mental illness is something that can affect us directly (1 in 4 people will struggle with a mental health condition in their lifetime) or indirectly.

As personal trainers we find ourselves in the privileged position of trust and we have a duty of care to our clients.  It is therefore, crucial for the health and safety of ourselves and our clients that we establish clear boundaries.  In addition to this trust comes a responsibility to put our clients in touch with the best people for their circumstances.

A Common Scenario

We’ve all been faced with a situation where a client has become over-dependent. They require high levels of emotional support, and they divulge information which leaves you feeling uncomfortable, out of your depth and more like a counsellor.

In this situation it is important we know when we’ve reached the boundaries of our expertise and have an awareness of the support options available locally.

Firstly, let’s remember that we are experts in exercise prescription. We know physical activity and exercise and how to match the appropriate volume, frequency and type of exercise for our clients and their goals at any given time.  That is our remit.

Warning Signs

Knowing what signs and symptoms to be aware of when you suspect someone may be struggling is important.

A number of signs to be vigilant for include:

  • Withdrawal
  • Decreased/ Increased appetite/ sleeping habits
  • Decreased enjoyment in normal activities
  • Thinking or talking about suicide/ harming themselves
  • Inability to cope with daily activities
  • Marked changes in personality/ behaviour or mood

Good Practice

  1. Build a network of trusted professionals that you can refer clients on to and/ or work with.
  2. Be clear with yourself on the boundaries of your role and how to communicate those in a variety of scenarios.
  3. Do not encourage clients to divulge issues they have not worked through and dealt with, because this can lead to difficulties in coping and result in further mental health difficulties.  Encourage your client to contact a mental health professional.
  4. Create a safe non-judgemental environment for your clients.

Physical Activity and Mental Health – What can we do?

Anecdotally and personally, most of us know that physical activity and exercise benefit those with mental health challenges. The great news is that the research agrees with this sentiment.

Exercise and physical activity including running, cycling, swimming, dancing and resistance exercise have all been shown to reduce depressive and anxiety symptoms (2,3)according to the research.   However, the NICE guidelines for mild to moderate depression only include recommending group exercise classes three times per week lasting 45 — 60 minutes.

Within sessions we can consider the signs and symptoms of different mental illnesses and make small adjustments in order to ensure we don’t add to the pressure.

For example when someone is suffering from anxiety, try to minimise the number of factors that are changed at any one time, have a relaxed manner rather than a more animated and motivational demeanour.

In dealing with clients who have suffered from depression, it is important to encourage autonomy while not offering too many choices.  In addition, providing opportunities for success on a regular basis is key.

Note: These are examples taken from specific people, while they are generic ideas, it is important to learn the needs of your client and their individual preferences in spite of their diagnosis.


As personal trainers and trusted individuals within our client’s lives, we have a responsibility to normalise mental illness and wellbeing.  To encourage a positive and balanced outlook toward mental and physical health and highlight the interrelatedness of these entities.

Providing a safe environment where your client can be themselves – they are not their illness and they are more than a label.  They are a human being, who has potential, who is physically strong and can demonstrate strength both physically and mentally.  As a personal trainer you can provide that environment by being your best and by bringing your ‘A’ game to every session, irrespective of their mood or yours.  You can also do this by encouraging a level of trust where they know you can adapt a session at a moment’s notice and they will not be judged for not hitting their targets that week.

Above all, you just might be the best part of their day, so be your best every day.


  1.  Royal College of Psychiatrists.
  2.  Sharma, Madaan, Frederick.  2006.  Exercise for mental health primary care comparison. Journal of Clinical Psychiatry. 8 (2); pp. 106.
  3.  Fox. 1999.  The influence of physical activity on mental well-being.  Public Health Nutrition.  2 (3a); pp. 411 – 418

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