Since its creation in the 1920’s, Pilates has been used around the world to increase muscle strength and tone; and to improve flexibility, posture and alignment. On top of these many positive attributes research is suggesting that Pilates also has a wide range of mental health benefits. In this article I will outline some of the ways that Pilates has the potential to help improve mental health with reference to some of the research conducted in this area.

1. Brain health

As we age most of us start to lose volume in our frontal lobe and hippocampus, which are the parts of the brain responsible for cognitive function and memory. In Medical News Today Daniel Murrell MD explains that depression, stress and Alzheimer’s disease seem to be linked to a smaller-sized hippocampus.

Furthermore, studies suggest that the hippocampus in those suffering with severe depression can be an average of 10% smaller than those without depression. A reduction in the size of the hippocampus is also associated with Cushing’s syndrome. This syndrome features a number of symptoms linked to having too much cortisol in the body. Cortisol is a hormone that is produced when people are feeling stressed or anxious.

Don’t panic, it’s not all doom and gloom! Healthdirect tell us that exercise increases the size of the hippocampus and increases the connections between nerve cells in the brain thus improving memory and protecting the brain against injury and disease.

More specifically researchers from the University of Illinois reported in the Journal of Physical Activity & Health that people have significantly superior brain function after a mindful movement practice like Pilates in comparison to doing aerobic exercise.

Basically, automated exercise like running on a treadmill won’t activate the brain in the same way that Pilates can. The focus and attention needed to perform Pilates exercises uses the brain in a more active way by challenging the mind and body simultaneously.

2. Concentration

The practice of Pilates requires concentration, where participants really focus on the movements they are performing. When we concentrate deeply on a task or activity our mind stops thinking about our to-do list or our worries. It brings our minds into a state of presence also called mindfulness This form of mental control is really beneficial when coping with mental health as it enables us to have a quiet mind.

Many people achieve mindfulness through meditation; however, this can be very difficult for those struggling with stress or anxiety as they find it hard to stop their mind chatter. When we concentrate on the form and execution of a movement the mind has an alternative focus so can achieve mindfulness without actively seeking it.

3. Confidence

Pilates facilitates good posture and proper body alignment. As well as being important for us physically, good posture is good for our mental health. Various studies have pointed to the importance of posture and its effect on our sense of self.

A study by Heath Education Professor Erik Peper at the San Francisco State University found that slouching while sitting contributes to depression and anxiety. Respondents noted feeling hopeless, helpless, powerless or defeated when slouching while good posture encouraged confidence and positive thinking.

Another study by Carney et al, 2010 found that ‘power poses’ lead to increased testosterone and decreased cortisol levels. High testosterone levels lead to increased self-confidence whereas, low cortisol reduces anxiety and improves our ability to deal with stressful situations.

As Joseph Pilates said: “Through the Pilates Method of Body Conditioning this unique trinity of a balanced body, mind and spirit can ever be attained. Self-confidence follows.”

4. Sense of achievement

People suffering with conditions like depression and anxiety generally don’t feel good about themselves. The smallest task can feel like a mountain to climb. By creating and sticking to a weekly exercise routine the participant will feel a sense of achievement which helps in building a sense of self-worth. 

5. Routine

Research has consistently shown that having a routine can play an important role in mental health. A study reported in found that implementing a routine could help people better manage stress and anxiety.

When we don’t have a routine and try to randomly fit tasks in to our day life feels chaotic and messy.  This plays into our thinking mind and no one likes a messy mind! Just like a well laid out organised room creates a sense of calm so does an organised mind. By attending regular scheduled classes our minds can be kept in check as we know what we are doing at a given time so don’t need to overthink and create unnecessary or additional stress.

6. Mood Enhancement

Pilates can be used to manage stress and depression as exercise reduces stress hormones like cortisol. It also releases endorphins which are feel-good chemicals that create a natural high and act as painkillers. Those suffering with anxiety often experience physical symptoms of pain so the painkilling aspect of endorphins produced during exercise are of extra benefit. The NHS states that “research suggests that exercise may be as effective as antidepressants at reducing the symptoms of depression”

7. Energy

Low energy is a common symptom that accompanies mental health issues. Pilates as well as increasing mood boosts energy. It’s like a supercharge for the body. The focus on breath helps to oxygenate the blood flow. An exercise called the hundred works specifically to do that – it’s a breathing exercise that circulates the blood around the body. As well as warming the body it also energises it. In the classical mat series (the exercises prescribed by Joseph Pilates) this is the first exercise performed as it sets the body up for the rest of the class. The injection of energy right from the start is crucial to keep up the momentum of the challenging exercises which follow.

A study on the effect of Pilates on postpartum fatigue created a test group of women who performed Pilates five times a week for 8 weeks, the control group did not receive any intervention. The results showed that the test group had lower mean fatigue scores than the control group. The conclusion was that Pilates reduced general, physical and mental fatigue and improved activity and motivation.

8. Sleep

Insomnia and fatigue are commonly associated with mental health conditions. An article in Frontiers in Neurology, highlights a study on the ‘Effect of Pilates on Sleep Quality’. After reviewing the data researchers concluded that “overall, Pilates improved sleep quality”.

Joseph Pilates said that the most important aspect of better and deeper sleep is mental calm and that a troubled nervous system can be calmed with exercise. He also advised that if you are unable to sleep get up and exercise! He specifically recommended spinal rolling exercises which he claimed aid deeper sleep because the massaging effect of the spine relaxes the nerves. Some may agree he had a good point when he said “It is better to be tired from physical exertion than to be fatigued by the poisons generated by nervousness while lying awake”.

9. Breathing

Breath is one of the most powerful tools in calming the mind and is utilised in a wide range of mental health practises. When working with new clients I so often witness shallow breathing patterns and a tendency for them to hold their breath. Both of these habits create tension in our bodies and our minds.

Emotions and breathing are closely connected. Think about how your breathing changes when you are scared, you may breathe faster or hold your breath. Compare this to when you are feeling safe and relaxed, your breath is likely to be deeper and more regular. A study by Pierre Phillipot showed how different breathing patterns can evoke emotions. He concluded that breath alone can create a sense of calm or anxiety.

Breath creates a physiological response that naturally reduces stress and anxiety in the body. Breathing is one of the main Principles of Pilates and is a crucial element of all Pilates exercises. The breath pattern helps to increase the effectiveness of the exercise, oxygenates the blood and stops people holding their breath. Joseph Pilates believed “It is tragically deplorable to contemplate the millions who have never mastered the art of correct breathing”.


MIND statistics reveal that approximately 1 in 4 people in the UK will experience a mental health problem each year. In England alone 1 in 6 people report experiencing a common mental health problem (such as anxiety and depression) in any given week. The MHFA reports that 676 million people are affected by mental health issues worldwide and that mental illness is the largest single source of burden of disease in the UK.

These statistics show how common and widespread these illnesses are. It becomes increasingly likely that you or someone you know will suffer some form of mental health condition. With such a vast impact on our lives finding solutions is ever more important.

The highlights of a 2018 study carried out on the effects of Pilates on mental health outcomes concluded that Pilates resulted in a statistically large reduction in depressive symptoms and anxiety symptoms. It also found a statistically large reduction in feelings of fatigue and a large increase in feelings of energy.

Another study on the mental health benefits of Pilates studied depressed women from a battered women’s refuge. After 12 weeks of regular Pilates classes, the women showed a significant increase in serotonin and a 34% drop in severity of their depression. Such a marked level of improvement is superior to the effects of some SSRIs, which are a class of anti-depressant medications that target serotonin’s action in the brain.

Pilates may assist in the treatment of depression and anxiety by changing the levels of chemicals in the brain (serotonin, cortisol and endorphins), providing a distraction from negative thoughts, releasing stress, enhancing mindfulness and helping to create a self-care routine and a sense of achievement.  Or as the man himself said: “A body free from nervous tension and fatigue is the ideal shelter provided by nature for housing a well-balanced mind, fully capable of successfully meeting all the complex problems of modern living” Joseph Pilates.

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