TED Series โ€“ Part VII: Physical Exercise, Sports Science and Mental Health

Daniel Mirea (October 2025)
NeuroAffective-CBTยฎ | https://neuroaffectivecbt.com


Abstract

In this seventh instalment of the TED (Tiredโ€“Exerciseโ€“Diet) Series, we explore the neuroscience of physical exercise and its central role in emotional regulation, cognitive function, and mental health.

Within the NeuroAffective-CBTยฎ (NA-CBT) framework, exercise represents the โ€œEโ€ in TED – the second pillar of biological stability upon which self-regulation and psychological flexibility depend.

This chapter presents both theoretical foundations and practical guidance for integrating physical and relaxation training, circadian rhythm alignment, and behavioural activation into therapeutic practice.

Drawing from sports science, neuroendocrinology, and behavioural neuroscience, it outlines evidence-based applications for enhancing biological resilience and emotional regulation.

Ultimately, this instalment concludes the biological foundations of the TED model, offering clinicians a cohesive framework for embedding exercise-related interventions into the NeuroAffective-CBTยฎ therapeutic process.

A glossary of key terms is provided at the end of the article to support comprehension and deepen the readerโ€™s learning experience.


Introducing TED within the NA-CBTยฎ Framework

The TED model (Tiredโ€“Exerciseโ€“Diet) integrates neuroscience, psychophysiology, and behavioural science into a cohesive structure for promoting emotional regulation and biological stability. Within NeuroAffective-CBTยฎ, TED forms the foundation of the Bodyโ€“Brainโ€“Affect Triangle, a conceptual model linking physiology, cognition, and emotion (Mirea, 2023; Mirea, 2025).

Earlier instalments in this series examined six primary regulators of mood and cognition:

โ€ข Creatine (Part I)
โ€ข Insulin Resistance (Part II)
โ€ข Omega-3 Fatty Acids (Part III)
โ€ข Magnesium (Part IV)
โ€ข Vitamin C (Part V)
โ€ข Sleep (Part VI) – the neurobiology of fatigue and recovery within the Tired pillar

This chapter extends the model to the โ€œExerciseโ€ component, the dynamic driver of both physical and psychological resilience, while revisiting Tired through the lens of sleep neuroscience and affect regulation to underscore their interdependence within NeuroAffective-CBTยฎ.


The โ€œEโ€ โ€“ Exercise as the Biological Catalyst

โ€œEโ€ stands for Exercise, a symbol of physical strengthening and a reminder that movement is integral to human adaptability and emotional balance. Evidence consistently demonstrates that regular physical activity not only boosts immunity but also regulates hormones, enhances protein synthesis (similarly to sleep), and supports the management and prevention of a wide range of mental health conditions (Nieman, 2018; Mahindru, 2023; Mennitti et al., 2024; Strasser, 2015; Deslandes, 2014).

The forthcoming section, โ€œDโ€, will explore the relationship between muscle size and glucose regulation, providing further evidence that muscle-strengthening activity exerts measurable effects on both body and mind. This connection is deeply evolutionary. Humans were not designed for sedentary living or sugar-rich diets but for creative movement, exploration, and endurance. It was this unique blend of curiosity, resilience, and physical vitality that allowed humans to survive, innovate, and thrive.

TED Takeaway:
โ€ข Movement restores synchrony between body, brain, and affect.
โ€ข Exercise is not ancillary to therapy; it is a biological stabiliser and an emotional educator.


Exercise, Adaptation, and Individualisation

To sustain motivation and promote long-term adherence, physical strengthening programmes should always be individualised, taking into account differences in age, sex, current physical condition, as well as personal preferences and cultural values.

Research consistently shows that when physical activity is enjoyable and personally meaningful, when it connects to an individualโ€™s goals, such as improved strength, confidence, or self-image, both physical and psychological outcomes are significantly enhanced. A foundational paper in Self-Determination Theory by Deci and Ryan (2000) demonstrated that intrinsic motivation – the sense of enjoyment, personal meaning, and autonomy, predicts adherence and well-being across multiple domains, including physical activity, while a comprehensive review by Teixeira et al. (2012) further confirmed that autonomous motivation and enjoyment are key predictors of both exercise adherence and psychological benefit.

Within the NeuroAffective-CBTยฎ framework, exercise recommendations integrate both muscle activation (tensing or strengthening) and muscle relaxation practices. What contracts must also release – this natural cycle of tension and relaxation supports recovery, balance, and emotional regulation.

This principle is exemplified in Progressive Muscle Relaxation (PMR), first introduced by Edmund Jacobson in the 1930s (Jacobson, 1938). PMR combines focused attention with abdominal breathing, guiding individuals through cycles of tensing and releasing specific muscle groups. Over time, this practice develops interoceptive awareness – the ability to sense and modulate bodily tension, recognise signs of stress, and release it through mindful breathing. More recent research shows that enhancing interoceptive awareness can also improve attentional control, focus, learning capacity, and ultimately cognitive flexibility, key components of adaptive emotional regulation and psychological resilience (Farb, Segal and Anderson, 2013; Schulz, 2016).

  • Martial arts training supports individuals struggling with confidence, assertiveness, or low self-esteem, blending controlled power with discipline and focus.
  • Team sports are often beneficial for those with social anxiety, providing gradual social exposure within structured, cooperative settings.
  • Yoga: effective for stress regulation and interoceptive awareness, with added benefits for mobility and strength depending on style (e.g., Hatha/Iyengar for alignment and control; Vinyasa/Ashtanga for conditioning). Can be prescribed on its own or as an adjunct to any of the above. Consider trauma-sensitive formats when relevant; introduce load and range progressively, and use care with generalised hypermobility (prioritise stability and pain-free ranges).
  • Culturally rooted movement practices, such as Capoeira in Brazil, Tai Chi in East Asia, or traditional dance forms found in many Indigenous and Mediterranean cultures, can serve as powerful, identity-affirming exercises. These activities not only promote physical health but also reinforce cultural belonging, foster feelings of acceptance, and build community connection. Such practices can be particularly beneficial for individuals experiencing social isolation or depression, as they combine movement, rhythm, and shared meaning โ€” all of which strengthen emotional resilience and a sense of self within a social context (Koch et al., 2019; Li et al., 2012).
  • For clients with Body Dysmorphic Disorder (BDD), bodybuilding requires careful framing and monitoring; appearance-driven goals can reinforce maladaptive self-evaluation, whereas performance-based strength training may be safer.

Modern therapeutic approaches such as Grounding, Mindfulness-Based Stress Reduction (Kabat-Zinn, 2003), or Mindfulness-Based Cognitive Therapy (Segal, Williams, and Teasdale, 2002) share this same purpose: enhancing body awareness, recalibrating neurophysiological responses, and strengthening emotional self-regulation.

Ideally, when physical health permits, one should train daily, alternating between activation (strength or resistance training) and relaxation (PMR, Grounding or Mindfulness) to maintain both physical tone and emotional equilibrium.

TED Takeaway:
โ€ข Pair strength with release (PMR/yoga/mindfulness) to preserve the physiological rhythm of activationโ€“recovery.
โ€ข Practical cadence (health permitting): train most days, alternating activation (20โ€“40 min) and relaxation (10โ€“20 min) to maintain tone and equilibrium.
โ€ข Enjoyment and meaning are not optional; they are mechanisms of adherence and benefit.


Condition-Specific Exercise: Matching Movement to Mind

Certain exercise modalities align particularly well with specific emotional or cognitive profiles, provided they are introduced with gradual exposure and incremental goals that promote both physical and psychological growth.

Therapeutic exercise selection should always remain person-centred, attuned to both psychological needs and affective drivers of behaviour, while respecting individual and cultural identity.

TED Takeaway:
โ€ข Match the modality to the mechanism you want to train (confidence, social approach, cultural belonging, stress regulation).
โ€ข Keep exposure graded and goals process-focused; adjust style and dose to the person.


NA-CBT Tools for Performance Priming

  1. Breathing, Attention & Arousal Regulation:

Your breathing pattern is one of the fastest ways to change how alert, focused, or calm your body feels, itโ€™s a direct link between the body, brain, and emotions. In simple terms, how you breathe sends a signal to your nervous system about whether itโ€™s time to perform or recover.

When you need to up-regulate, that is, increase alertness, focus, and readiness before a challenging effort, try short, sharp inhales or slightly constrained exhales.
This kind of breathing activates your bodyโ€™s sympathetic nervous system (the โ€œget up and goโ€ system), increasing blood flow, oxygen delivery, and mental sharpness.

For example:

โ€ข Before a sprint, lift, or high-intensity set, take two or three quick inhales through the nose and one strong exhale through the mouth.
โ€ข Youโ€™ll feel your heart rate rise and your focus sharpen, your body preparing to perform.

Then, between sets or after the workout, you want to down-regulate, to shift into recovery mode. This is when you lengthen your exhales or practise relaxation methods such as Progressive Muscle Relaxation (PMR) or breathing and stretching. Long, slow breaths stimulate the parasympathetic nervous system, your โ€œrest and repairโ€ mode, lowering heart rate, easing muscle tension, and improving focus for the next round.

In essence, your breath acts like a volume dial for your nervous system:

โ€ข Faster or shallower breathing turns up the system for performance.
โ€ข Slower, deeper breathing turns it down for recovery and calm.

Learning to consciously move between these two physiological states – activation and recovery – strengthens both performance and resilience. These principles align closely with findings in applied sport psychology, where self-regulation of attention and arousal is central to maintaining consistent, high-level performance (Weinberg and Gould, 2019).

Over time, this skill becomes a cornerstone of self-regulation training within the NeuroAffective-CBTยฎ framework, linking movement, breath, and attention into one coherent system for emotional and physical balance.

2. High-Signal Tools: Music, Caffeine, and Nootropics

Tools such as caffeine, motivational music, or cognitive enhancers (nootropics) can provide a powerful mental and physical boost before exercise. However, the nervous system adapts quickly to these high-signal aids. When they are used in every session, their effects diminish over time, and motivation can begin to depend on them rather than arise naturally.

To prevent this tolerance effect, reserve high-signal tools for key or demanding training days rather than routine sessions. This aligns with the signal-to-noise principle in neuroscience: when stimulation (the signal) becomes constant, the brain starts to tune it out (increasing noise).

TED Takeaway: Using these tools strategically preserves their potency and supports the development of intrinsic focus and self-regulation. Typical caffeine guidance is around 1โ€“3 mg per kilogram of body weight, avoiding late-evening doses. Always consider potential interactions or contraindications (e.g., anxiety, hypertension, pregnancy, or psychotropic medication use).

3. Boundaries that Prime Intent and Focus

Setting a physical or mental threshold before training, such as drawing a line on the floor, standing at the gym door, or taking a moment before stepping onto a platform, can significantly improve performance. This small ritual tells the brain, “Iโ€™m about to begin something important“.

Crossing that boundary only when mentally ready acts like a psychological switch, heightening attention, intention, and effort quality. It helps athletes transition from everyday distraction into a state of focused readiness, where the body and mind align for optimal performance.

In practice, this is less about superstition and more about neuro-behavioural priming, conditioning the brain to associate a specific action (crossing the line) with focus and engagement. Over time, this can strengthen self-regulation and consistency, even on low-motivation days.

TED Takeaway:
โ€ข Faster, shallower breathing โ†’ performance state.
โ€ข Slower, longer-exhale breathing โ†’ recovery state.
โ€ข Save high-signal tools for important sessions to preserve their potency and your intrinsic drive.
โ€ข A brief pre-set boundary ritual improves consistency and effort quality.


Body Temperature & Performance

The bodyโ€™s ability to maintain an optimal temperature range influences far more than endurance โ€” it also affects motivation, muscle efficiency, and mental focus.

A lesser-known but fascinating fact is that glabrous skin – the hairless, thick skin found on the palms, soles, and parts of the face (such as the lips and nasal area) – plays a key role in thermoregulation. These regions are rich in arteriovenous anastomoses (AVAs), specialised blood vessels that allow rapid heat exchange. This is why the hands, feet, and face are particularly effective for cooling or warming the body.

This understanding may also shed light on certain ancestral behaviours, such as the instinctive human tendency to touch natural surfaces or another personโ€™s skin to gauge warmth, comfort, or safety, an evolutionary remnant of how we once regulated both physical and emotional connection through touch.

Research shows that palmar cooling (cooling the hands between sets or during endurance exercise) can substantially increase work output in hot conditions, while reducing thermal fatigue and improving recovery (Grahn, Cao & Heller, 2005; Heller, 2010).

Interestingly, Dialectical Behaviour Therapy (DBT), a third-wave CBT approach developed by Marsha Linehan, also uses temperature-based interventions for emotional regulation. During states of high emotional arousal, clients are taught to cool the body rapidly using ice packs on the face or brief facial immersion in cold water. This activates the mammalian dive reflex, which lowers heart rate and stimulates the parasympathetic nervous system, producing a powerful calming effect (Linehan, 2014).

When the body overheats, muscles work less efficiently, excessive heat disrupts energy production. As temperature rises, the chemical reactions that generate energy through adenosine triphosphate (ATP) begin to falter. A key enzyme in this process, pyruvate kinase, which helps convert fuel into usable energy, slows down or even stops functioning properly. The result is simple: overheated muscles fatigue faster, lose power, and overall performance declines.

Conversely, controlled cooling helps sustain endurance and recovery by maintaining thermal balance. The palms, soles, and face act as natural radiators through their AVAs, enabling rapid heat dissipation and stabilising core temperature.

Simple practical methods include holding cool (not ice-cold) objects or briefly immersing the hands or feet in cool water between training bouts. This straightforward approach can lower perceived effort, extend training capacity, and accelerate post-exercise recovery.

These findings reinforce the importance of temperature regulation as part of recovery and emotional self-regulation within the TED framework.

TED Takeaway:
โ€ข Gentle cooling after exercise helps the body shift more quickly into recovery mode by supporting the parasympathetic nervous system, which governs rest, repair, and relaxation.
โ€ข Rinsing the hands, feet, or face with cool water after exercise stabilises heart rate and calms the body within 30โ€“60 minutes, improving recovery and emotional balance.
โ€ข Excessive or immediate full-body cold exposure โ€” such as jumping straight into an ice bath โ€” can interfere with the bodyโ€™s mTOR repair signalling, slowing muscle growth and adaptation.
โ€ข In short: a little cooling helps the body recover faster, but too much too soon can blunt the benefits of training.
โ€ข Safety note: Cold immersion should be avoided in cases of unmanaged cardiovascular disease, severe Raynaudโ€™s, or neuropathy; seek medical guidance if unsure.


Cortisol isnโ€™t the enemy: time it, donโ€™t flatten it

Because cortisol often rises during stress or anxiety, itโ€™s sometimes misunderstood as purely harmful. In reality, short-term cortisol spikes after training are vital, they mobilise fuel, drive adaptation, and signal recovery.


The goal is rhythmic spikes that return to baseline, not chronic elevation.
Blunting cortisol too early, through overuse of supplements, anti-inflammatories, or excessive carbohydrates, can impair muscle repair. Instead, allow cortisol to rise during exertion and fall gradually post-training. Strategically timed carbohydrate intake can facilitate this recovery phase by naturally lowering cortisol while replenishing glycogen stores and improving sleep quality.

Heart rate (HR) and heart rate variability (HRV) help monitor stressโ€“recovery balance. Low HRV or chronically elevated HR may signal overtraining, poor sleep, or psychological stress. Moderate, consistent exercise combined with rest, hydration, and mindfulness restores autonomic balance and resilience.

TED Takeaway:

โ€ข Evening or post-training carbohydrates (prefer minimally processed, starchy sources) can assist cortisol down-shifting, support sleep, and replenish glycogen.
โ€ข Avoid overuse of โ€œcortisol blockersโ€ heavy alcohol, or sedative strategies, as they can impair adaptation and sleep architecture.


Mirrors, Interoception, and Motor-learning

Technological aids such as mirrors or video feedback can be useful in the early stages of learning new movements. They help individuals understand form and alignment, but the ultimate goal is a felt sense of movement, awareness that comes from within, rather than dependence on external feedback.

Hypertrophy focus (muscle growth and strengthening): Using a mirror occasionally or posing between sets can improve body awareness and help engage the target muscles more effectively during training.

Speed or skill learning (e.g., Olympic lifts, sprints): Avoid mirrors, as they shift attention outward and reduce interoceptive awareness, the ability to sense and adjust body position and movement internally.

TED Takeaway:

โ€ข Mirrors and video feedback can support early learning, but lasting skill comes from internal awareness.
โ€ข Develop a felt sense of movement – coordination and control without reliance on external cues.


Train Recovery and Relaxation: The Pathway to Physiological Resilience

Like any other skill, the ability to switch off, relax, and recover can be trained. Recovery is not fixed, it can be strengthened over time. Just as you build muscle through progressive challenge, you can train your recovery systems by occasionally pushing slightly beyond what feels comfortable (in a safe and controlled way). Each small, well-managed challenge helps your body and mind learn to adapt to stress more effectively.

To build this kind of resilience, focus on the fundamentals:

  • Keep your sleep regular. Get morning light to wake your system and dim evening light to prepare for rest.
  • Eat well. Make sure youโ€™re getting enough energy, protein, and hydration to help your body repair itself.
  • Use temperature wisely. Short, gentle exposures to heat or cold (with enough rest between) train your body to adapt to different environments.
  • Stay connected and mindful. Supportive relationships, journaling, mindfulness, or relaxation exercises such as Progressive Muscle Relaxation (PMR) all help keep your nervous system flexible and balanced.

This rhythmic cycle of effort and restoration forms the biological basis of resilience within the TED framework, teaching the body to recover as deliberately as it performs.

TED Takeaway:

โ€ข Use graded, manageable challenges to expand capacity โ€” always with control and recovery.
โ€ข In NeuroAffective-CBTยฎ, this reflects a core principle: gradual, intentional exposure to small challenges increases the ability to cope with stress while maintaining emotional balance and self-regulation.


Conclusion

Exercise is more than physical conditioning; it is a biological and emotional regulator – a living interface between movement, emotion, and cognition. Behavioural principles long recognised this: Lewinsohnโ€™s model linked reduced engagement with loss of reinforcement; Behavioural Activation (Jacobson, Martell & Dimidjian, 2001) reinstated purposeful activity; Beckโ€™s cognitive therapy integrated behavioural experiments, graded tasks and activity scheduling (Beck et al., 1979).

Within the NeuroAffective-CBTยฎ model, the โ€œEโ€ in TED symbolises this central truth: emotional stability and cognitive clarity arise not in isolation, but through the synchrony of body and mind.

The TED framework demonstrates that emotional regulation is not achieved through thought alone, but through the rhythmic cooperation of the bodyโ€™s systems, when we are tired, exercised, and nourished in balance. In essence, exercise functions both as a biological stabiliser and an emotional educator, a continuous dialogue between movement, mood, and meaning.

The TED model reminds us that resilience is not a fixed trait but a rhythm, cultivated through synchrony, when the body rests, moves, and restores itself in harmony.

In the forthcoming and final section, โ€œDโ€, we will complete the TED model by exploring Diet, the biochemical cornerstone of mental health, and its interdependent relationship with exercise, sleep, and emotional regulation.


Ten TED Takeaways: Physical Exercise and Mental Health

  1. Movement is Medicine. Exercise is a biological necessity that supports immunity, hormone balance, protein synthesis, and emotional regulation.
  2. Cortisol is adaptive, not destructive. It should rise during exertion and fall during recovery.
  3. Evolution Favouring Motion. Human physiology is designed for activity. Movement restores the natural synchrony between body, brain, and affect.
  4. Balance Between Tension and Release. Strength must coexist with recovery. PMR, yoga, and mindfulness sustain this physiological rhythm.
  5. Exercise as Emotional Education. Physical training teaches the bodyโ€“mind connection, transforming tension into awareness and control.
  6. Personalised Movement and Training. Match the type or exercise modality to the person: martial arts for confidence, team sports for social anxiety; use caution with appearance-driven training in BDD.
  7. Embodied Self-Regulation. Within NeuroAffective-CBTยฎ, exercise is the โ€œEโ€, the biological catalyst linking movement with mood and self-regulation.
  8. Use โ€œhigh-signalโ€ tools sparingly. Keep caffeine, music, and stimulants for key days to maintain their effect.
  9. Intentional boundaries prime the mind. Physical thresholds before training enhance focus and effort quality.
  10. Integration, Not Isolation. Emotional stability requires synergy between Tired, Exercise, and Diet – rest, movement, and nourishment.

References

Biddle, S.J.H. and Asare, M. (2011) โ€˜Physical activity and mental health in children and adolescents: a review of reviewsโ€™, British Journal of Sports Medicine, 45(11), pp. 886โ€“895.

Blumenthal, J.A. et al. (2012) โ€˜Exercise and mental health: integrating behavioural medicine into clinical psychologyโ€™, Annual Review of Clinical Psychology, 8, pp. 545โ€“576.

Deci, E.L. and Ryan, R.M. (2000) โ€˜The โ€œwhatโ€ and โ€œwhyโ€ of goal pursuits: human needs and the self-determination of behaviourโ€™, Psychological Inquiry, 11(4), pp. 227โ€“268.

Deslandes, A.C. (2014) โ€˜Exercise and mental health: What did we learn?โ€™, Frontiers in Psychiatry, 5, Article 66.

Farb, N.A.S., Segal, Z.V. and Anderson, A.K. (2013) โ€˜Mindfulness meditation training alters cortical representations of interoceptive attentionโ€™, Social Cognitive and Affective Neuroscience, 8(1), pp. 15โ€“26.

Grahn, D.A., Cao, V.H. and Heller, H.C. (2005) โ€˜Heat extraction through the palm of one hand improves aerobic exercise endurance in a hot environmentโ€™, Journal of Applied Physiology, 99(3), pp. 972โ€“978.

Heller, H.C. (2010) โ€˜The physiology of heat exchange: glabrous skin and performance enhancementโ€™, Stanford University Human Performance Laboratory White Paper, Stanford, CA.

Jacobson, E. (1938) Progressive Relaxation. Chicago: University of Chicago Press.

Kabat-Zinn, J. (2003) โ€˜Mindfulness-based interventions in context: past, present, and futureโ€™, Clinical Psychology: Science and Practice, 10(2), pp. 144โ€“156.

Koch, S.C., Riege, R.F., Tisborn, K., Biondo, J., Martin, L. and Beelmann, A. (2019) โ€˜Effects of dance movement therapy and dance on health-related psychological outcomes: A meta-analysis updateโ€™, Frontiers in Psychology, 10, Article 1806.

Li, F., Harmer, P., Fitzgerald, K. and Eckstrom, E. (2012) โ€˜Tai Chi and postural stability in patients with Parkinsonโ€™s diseaseโ€™, New England Journal of Medicine, 366(6), pp. 511โ€“519.

Mahindru, A. (2023) โ€˜Role of Physical Activity on Mental Health and Well-Beingโ€™, Frontiers in Psychiatry, Article 9902068.

Linehan, M.M. (2014) DBT Skills Training Manual. 2nd edn. New York: Guilford Press.

Mennitti, C., Che-Nordin, N., Meah, M.R., Poole, J.G. and Gonzรกlez-Alonso, J. (2024) โ€˜How Does Physical Activity Modulate Hormone Responses?โ€™, Biomolecules, 14(11), p. 1418.

Mirea, D. (2023) NeuroAffective-CBTยฎ: โ€˜Tired, Exercise and Diet Your Way Out of Trouble: TED is Your Best Friend!โ€™. NeuroAffective-CBTยฎ. Available at: https://neuroaffectivecbt.com/2023/07/18/teds-your-best-friend/ [Accessed: 30 October 2025].

Mirea, D. (2025) NeuroAffective-CBTยฎ: NeuroAffective-CBTยฎ: Advancing the Frontiers of Cognitive-Behavioural Therapy. London: NeuroAffective-CBTยฎ [Accessed 30 October 2025]

Nieman, D.C. (2018) โ€˜The compelling link between physical activity and the bodyโ€™s defence systemโ€™, British Journal of Sports Medicine, 52(13), pp. 789โ€“790.

Ratey, J.J. and Loehr, J.E. (2011) โ€˜The positive impact of physical activity on cognition and brain functionโ€™, Journal of Applied Sport Psychology, 23(4), pp. 373โ€“394.

Salmon, P. (2001) โ€˜Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theoryโ€™, Clinical Psychology Review, 21(1), pp. 33โ€“61.

Schulz, S.M. (2016) โ€˜Neural correlates of heart-focused interoception: implications for neurovisceral integration in emotion regulationโ€™, Frontiers in Psychology, 7, Article 1119.

Segal, Z.V., Williams, J.M.G. and Teasdale, J.D. (2002) Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford Press.

Strasser, B. (2015) โ€˜Role of physical activity and diet on mood, behaviour, and cognitionโ€™, Neuroscience & Biobehavioural Reviews, 57, pp. 107โ€“123.

Stonerock, G.L., Hoffman, B.M., Smith, P.J. and Blumenthal, J.A. (2015) โ€˜Exercise as treatment for anxiety: systematic review and analysisโ€™, Annals of Behavioral Medicine, 49(4), pp. 542โ€“556.

Teixeira, P.J., Carraรงa, E.V., Markland, D., Silva, M.N. and Ryan, R.M. (2012) โ€˜Exercise, physical activity, and self-determination theory: a systematic reviewโ€™, International Journal of Behavioral Nutrition and Physical Activity, 9, Article 78.

Weinberg, R.S. and Gould, D. (2019) Foundations of Sport and Exercise Psychology. 8th edn. Champaign, IL: Human Kinetics.

World Health Organization (2020) Physical Activity Factsheet: Mental Health Benefits of Exercise. Geneva: WHO.

Further Reading & Clinical Resources

NeuroAffective-CBTยฎ Framework:

โ€ข Mirea, D. (2025) NeuroAffective-CBTยฎ: NeuroAffective-CBTยฎ: Advancing the Frontiers of Cognitive-Behavioural Therapy. London: NeuroAffective-CBTยฎ [Accessed 30/10/2025]
โ€ข Official website: https://neuroaffectivecbt.com

Exercise and Mental Health:

โ€ข Weinberg, R.S. and Gould, D. (2019) Foundations of Sport and Exercise Psychology. 8th edn. Champaign, IL: Human Kinetics.
โ€ข World Health Organization (2020) Physical Activity Factsheet: Mental Health Benefits of Exercise. Geneva: WHO.
โ€ข Harvard Medical School (2021) The Exercise Effect: How Physical Activity Boosts Mood and Mental Health. Cambridge, MA: Harvard Health Publishing.
โ€ข Ratey, J.J. (2008) Spark: The Revolutionary New Science of Exercise and the Brain. New York: Little, Brown and Company.

Relaxation and Mindfulness Practices:

โ€ข Kabat-Zinn, J. (2013) Full Catastrophe Living. New York: Bantam.
โ€ข Jacobson, E. (1938) Progressive Relaxation. Chicago: University of Chicago Press.

Therapeutic Integration:

โ€ข Beck, J.S. (2021) Cognitive Behavior Therapy: Basics and Beyond (3rd ed.). New York: Guilford Press.
โ€ข Linehan, M.M. (2015) DBTยฎ Skills Training Manual. 2nd edn. New York: Guilford Press.
โ€ข Davis, M., Eshelman, E.R. and McKay, M. (2019) The Relaxation and Stress Reduction Workbook. 7th edn. Oakland, CA: New Harbinger Publications.


About the TED Series
The TED (Tiredโ€“Exerciseโ€“Diet) Series within NeuroAffective-CBTยฎ explores the biological foundations of emotional regulation. Each instalment connects neuroscience, physiology, and cognitive-behavioural practice to create a unified framework for self-regulation, resilience, and psychological flexibility.
โ€ข Part I โ€“ Creatine and Cognitive Energy
โ€ข Part II โ€“ Insulin Resistance and Emotional Stability
โ€ข Part III โ€“ Omega-3 Fatty Acids and Neural Plasticity
โ€ข Part IV โ€“ Magnesium and Stress Recovery
โ€ข Part V โ€“ Vitamin C and Neuroprotection
โ€ข Part VI โ€“ Sleep and the Neurobiology of Fatigue (Tired)
โ€ข Part VII โ€“ Physical Exercise, Sports Science and Mental Health (Exercise)
โ€ข Part VIII (forthcoming) โ€“ Diet and the Biochemistry of Emotion

Glossary and Key Terms:

Behavioural activation is a CBT approach that helps people improve their mood by reconnecting with meaningful, goal-directed activities, especially when they feel low or unmotivated. When someone is depressed or anxious, they often withdraw from daily life and lose motivation, which makes them feel even worse. Behavioural activation works by re-introducing positive routines, encouraging gradual re-engagement in small, rewarding, or purposeful actions such as exercise, social contact, or creative tasks. In the TED framework, behavioural activation supports both the โ€œExerciseโ€ and โ€œDietโ€ pillars by re-energising the body, increasing motivation, and helping to rebuild emotional stability through movement and engagement.

Circadian Rhythm
Your circadian rhythm is the bodyโ€™s natural 24-hour internal clock that controls when you feel awake, sleepy, and even how your mood, hormones, and energy levels change throughout the day. Itโ€™s regulated mainly by light and darkness, sunlight in the morning tells your brain itโ€™s time to be alert, while darkness at night signals that itโ€™s time to rest. Keeping this rhythm regular (for example, by getting morning light, avoiding late-night screens, and sleeping at consistent times) helps improve sleep quality, mood, focus, and recovery.

Cognitive Corollary
A related mental or thinking process that accompanies a physical or biological change. For example, a cooler body temperature can make effort feel easier, improving focus and learning.

Cortisol
A natural hormone released by the adrenal glands, often called the โ€œstress hormone.โ€ It helps regulate metabolism, inflammation, and the bodyโ€™s response to stress. Healthy cortisol levels rise in the morning to energise you and drop in the evening to help you rest.

HR (Heart Rate)
The number of times your heart beats per minute. Resting heart rate tends to be lower in fitter individuals and can rise with stress, dehydration, or illness.
HRV (Heart Rate Variability). A measure of the small variations in time between heartbeats. High HRV usually means your body can adapt well to stress; low HRV can indicate fatigue, overtraining, or poor recovery.

Hypertrophy Stimuli
Anything that triggers muscles to grow larger and stronger, such as resistance training, mechanical tension, or specific metabolic stress during exercise.

mTOR Repair Pathway
Short for โ€œmechanistic Target of Rapamycinโ€, mTOR is a key biological pathway that helps the body grow and repair cells, especially muscle tissue. After exercise, this pathway acts like a โ€œconstruction managerโ€, signalling the body to build new proteins, repair tiny muscle tears, and grow stronger tissue. If this process is interrupted for example, by too much cold exposure immediately after training, muscle recovery and growth can slow down.

Neuropathy
Damage or dysfunction of the nerves, often causing tingling, numbness, weakness, or pain, most commonly in the hands and feet. It can result from diabetes, injury, infections, or certain medications.

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
A class of medications, such as ibuprofen, naproxen, and aspirin, used to reduce pain, inflammation, and fever. Overuse can sometimes irritate the stomach or affect kidney (renal) and liver (hepatic) function.

Protein synthesis – bodyโ€™s process of building new proteins, which are essential for repairing tissues, producing hormones, and supporting growth and recovery, particularly after exercise. Itโ€™s how your muscles rebuild and strengthen following physical activity, and it also plays a role in brain health, helping support learning, memory, and mood regulation. This process depends on good nutrition, regular exercise, and adequate sleep, all of which are central to the TED model.
In essence, protein synthesis is the bodyโ€™s repair and renewal system, keeping both mind and body in balance.

Raynaudโ€™s / Vascular Disorders / Neuropathy
Conditions that alter blood flow or nerve function – consider when prescribing temperature strategies. Raynaudโ€™s is a condition where blood vessels in the fingers and toes become overly sensitive to cold or stress, causing them to temporarily narrow. This limits blood flow and can make the skin turn white or blue and feel numb or painful.

Renal / Hepatic
โ€œRenalโ€ refers to the kidneys, which filter waste and maintain fluid balance. โ€œHepaticโ€ refers to the liver, which processes nutrients, hormones, and drugs. Both organs are vital for detoxification and energy metabolism.

Tolerance – refers to the bodyโ€™s process of adapting to a substance or stimulus over time, which makes its effects weaker or shorter-lasting.
For example, if someone regularly uses caffeine, certain medications, or motivational tools (like loud music or pre-workout stimulants), the body and brain gradually become less responsive to them. This means that more of the same stimulus is needed to achieve the same effect, or it stops working altogether.
In the context of the TED model, tolerance explains why โ€œhigh-signalโ€ tools, such as caffeine, nootropics, or intense motivation strategies, should be used sparingly, to prevent over-reliance and maintain natural motivation and balance.

TED Series, Part VI: Sleep and Mental Health – The Neuroscience of Restoration and Affective Regulation

Daniel Mirea (October 2025)
NeuroAffective-CBTยฎ | https://neuroaffectivecbt.com

Abstract

In this sixth instalment of the TED (Tiredโ€“Exerciseโ€“Diet) Series, we explore the neuroscience of sleep and its central role in emotional regulation, cognitive function, and mental health. Sleep is not a passive state but a dynamic neurobiological process that restores metabolic balance, consolidates memory, and recalibrates affective and cognitive circuitry. Drawing on advances in neuroscience, psychoneuroendocrinology, and affective regulation, this article outlines how sleep deprivation disrupts the amygdalaโ€“prefrontal network, alters neurotransmitter systems, and amplifies emotional reactivity.

Within the NeuroAffective-CBTยฎ (NA-CBT) framework, sleep represents the โ€œTโ€ in TED, the first pillar of biological stability upon which self-regulation and psychological flexibility depend. Practical guidance for integrating sleep education, circadian rhythm alignment, and behavioural sleep interventions into therapy is provided.


Introducing TED within the NA-CBT Framework

The TED model (Tiredโ€“Exerciseโ€“Diet) integrates neuroscience, psychophysiology, and behavioural science into a cohesive structure for promoting emotional regulation and biological stability. Within NeuroAffective-CBTยฎ, TED forms the foundation of the Bodyโ€“Brainโ€“Affect triangle, a conceptual map linking physiology, cognition, and emotion (Mirea, 2023; Mirea, 2025).

Earlier instalments explored five key nutritional and metabolic regulators of mood and cognition: Creatine (Part I), Insulin Resistance (Part II), Omega-3 Fatty Acids (Part III), Magnesium (Part IV), and Vitamin C (Part V). This chapter returns to the first pillar, Tired, through the lens of sleep neuroscience, affect regulation, and therapeutic practice.


The Science of Sleep and Emotion

Sleep is a biological necessity, not a luxury. Across more than three decades of research, no psychiatric disorder has been identified in which sleep patterns remain normal (Walker, 2017). Disturbed sleep is both a symptom and a cause of emotional dysregulation, stress vulnerability, and cognitive decline.

A landmark neuroimaging study at the University of California, Berkeley, demonstrated that a single night of sleep deprivation increased amygdala reactivity to negative stimuli by 60% (Yoo et al., 2007). Functional connectivity between the amygdala and the medial prefrontal cortex, the brainโ€™s emotional โ€œbrake systemโ€, was significantly weakened. Without restorative sleep, emotional responses become amplified and poorly regulated.

Figure 1. The Emotional Brake System
Healthy sleep strengthens communication between the prefrontal cortex (rational control) and the amygdala (emotional response hub). When sleep is lost, this link weakens, leading to impulsivity and emotional hypersensitivity.

The TED Connection

  • T โ€“ Tired: Adequate sleep keeps the emotional โ€œbrake systemโ€ intact, balancing reactivity with control.
  • E โ€“ Exercise: Physical activity enhances sleep quality and increases prefrontal resilience, improving mood regulation.
  • D โ€“ Diet: Nutrients like magnesium, omega-3s, and vitamin C support neurotransmission and reduce the stress load on emotional circuits.

Together, sleep, movement, and nourishment maintain the brainโ€™s emotional thermostat, preventing small frustrations from turning into major stress responses.


๐Ÿ’กTED Translation: Sleep loss disconnects the brainโ€™s emotional accelerator (the amygdala) from its brakes (the prefrontal cortex). When youโ€™re tired, everyday irritations feel bigger and harder to control. Rest, movement, and balanced nutrition keep your emotional โ€œengineโ€ cool and responsive instead of overheated.


The Circadian Code and Homeostasis

Sleep is governed by two intertwined biological systems that keep the brain and body in rhythmic balance:

  1. The homeostatic drive โ€“ the longer you stay awake, the greater the pressure to sleep.
  2. The circadian rhythm โ€“ a 24-hour internal clock, regulated by the suprachiasmatic nucleus (SCN), which aligns your sleepโ€“wake cycles with light and darkness.

When these systems are in sync, the brain functions like a finely tuned orchestra, hormones, temperature, energy, and mood all moving in harmony.
But when artificial light, screens, caffeine, or late-night work override these signals, the rhythm becomes distorted. This mismatch between the bodyโ€™s internal clock and external demands, known as social jet lag, contributes to fatigue, mood disorders, metabolic changes, and stress dysregulation (Wittmann et al., 2006).


The TED Connection

  • T โ€“ Tired: Regular sleep and wake times reinforce circadian rhythm and stabilise mood.
  • E โ€“ Exercise: Morning or daytime movement strengthens the bodyโ€™s clock by synchronising temperature, cortisol, and energy cycles.
  • D โ€“ Diet: Eating at consistent times and reducing caffeine or heavy meals in the evening helps align metabolic rhythms with the sleepโ€“wake cycle.

When the TED systems are synchronised, the brain maintains homeostasis, a steady state where energy, hormones, and emotions work together in balance.


๐Ÿ’กTED Translation: Your sleepโ€“wake system is like a perfectly timed orchestra. Late nights, bright lights, and random meal times throw the conductor off beat, leading to brain fog, irritability, and poor mood regulation. Keep your rhythm steady with consistent sleep, movement, and mealtimes, and your body will play in tune again.


Sleep and Neurotransmitters

Sleep is among the bodyโ€™s most powerful regulators of neurochemistry. When we lose sleep, the delicate balance of neurotransmitters that govern mood, motivation, and stress becomes disrupted.

  • Serotonin synthesis declines, reducing mood stability and impulse control.
  • Dopamine signalling becomes erratic, impairing motivation, pleasure, and focus.
  • Cortisol levels rise, keeping the body in a state of chronic alertness.
  • GABAergic tone drops, making it harder to relax and fall asleep.

Over time, this imbalance erodes emotional resilience and cognitive clarity. By contrast, adequate and regular sleep restores monoaminergic balance, recalibrates stress hormones, and strengthens the brainโ€™s emotional regulation systems (Goldstein & Walker, 2014).


The TED Connection

  • T โ€“ Tired: Consistent, restorative sleep keeps neurotransmitters like serotonin, dopamine, and GABA in harmony โ€” your brainโ€™s emotional โ€œchemistry set.โ€
  • E โ€“ Exercise: Regular movement boosts dopamine and endorphins, reinforcing motivation and supporting healthy sleepโ€“wake cycles.
  • D โ€“ Diet: Nutrient-rich foods (omega-3s, magnesium, tryptophan, and B-vitamins) provide the raw materials for neurotransmitter production and recovery.

Together, sleep, movement, and nutrition maintain the neurochemical rhythm that underlies focus, motivation, and mood stability.


๐Ÿ’ก TED Translation: When you skip sleep, your brainโ€™s chemistry falls out of tune, more stress, less calm, less focus. Rest, movement, and nourishment reset the brainโ€™s chemical harmony, helping you feel balanced, motivated, and emotionally steady again.


The Immuneโ€“Inflammatory Connection

Even partial sleep loss triggers the bodyโ€™s immune defences as if it were responding to infection. Levels of inflammatory molecules such as interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-ฮฑ) rise, disrupting normal immune balance and leaving the system in a state of chronic, low-grade activation (Irwin & Opp, 2017).

This silent inflammation interferes with neurotransmitters like serotonin and dopamine, fuelling fatigue, irritability, anxiety, and low mood. Over time, a vicious cycle develops: poor sleep increases inflammation, and inflammation in turn further disrupts sleep and emotional regulation.

The TED Connection

  • T โ€“ Tired: Adequate sleep lowers inflammatory markers, restoring immune and emotional balance.
  • E โ€“ Exercise: Moderate physical activity reduces systemic inflammation and improves immune resilience.
  • D โ€“ Diet: Anti-inflammatory foods (omega-3s, magnesium, vitamin C) help counter the stress effects of sleep loss. Alcohol is a highly addictive sedative and a psychological trap, as it convincingly mimics a relaxed state while actually disrupting natural sleep cycles. In contrast, many carbonated (fizzy) drinks act as stimulants, high in glucose and caffeine, which inevitably interfere with restorative sleep.

Together, the TED trio regulates the immuneโ€“inflammatory loop, protecting the brain and body from the emotional โ€œwear and tearโ€ of chronic stress and exhaustion.

๐Ÿ’กTED Translation: When you donโ€™t sleep enough, your body behaves like itโ€™s under attack. This ongoing silent inflammation drains energy, darkens mood, and keeps your stress system switched on. Rest, movement, and nourishment are your bodyโ€™s built-in anti-inflammatory medicine.


Sleep, Memory, and Emotional Learning

During REM sleep (Rapid Eye Movement sleep), the brain processes emotional experiences and consolidates learning without reigniting stress responses (van der Helm et al., 2011). This stage of sleep acts as an internal form of overnight therapy, allowing emotional memories to be reactivated, reorganised, and integrated in a calmer physiological state.

Within NeuroAffective-CBTยฎ, this process is vital: therapeutic insights require offline consolidation to transform intellectual understanding into embodied, automatic regulation. In essence, sleep literally โ€œfiles awayโ€ the dayโ€™s therapy work, embedding emotional learning into long-term stability.

๐Ÿ’กTED Translation: Sleep is therapyโ€™s silent partner. It helps your brain store emotional lessons without reawakening the stress attached to them.
REM sleep is your brainโ€™s emotional reset stage, dream time when the mind replays feelings with the stress dialled down. Think of it as your overnight therapist, quietly helping you process the day, keep the wisdom, and release the worry so you wake up clearer and lighter.

Clinical and TED Practical Guidance

Improving sleep quality is less about effort and more about rhythm, aligning body, brain, and behaviour with the natural cycles that promote restoration. Within the TED framework, each pillar contributes to emotional stability and cognitive resilience through sleep regulation.

T โ€“ Tired: Sleep Hygiene and Restorative Rhythm

  • Aim for 7โ€“9 hours of sleep each night, ideally aligned with natural darkness (around 10 p.m.โ€“6 a.m.).
  • Keep a consistent sleepโ€“wake schedule, even on weekends, to stabilise your internal clock.
  • Create a sleep-supportive environment: cool, dark, and quiet spaces enhance deep sleep quality.
  • Practice digital hygiene: avoid screens, bright light, and stimulating activities 60โ€“90 minutes before bed to allow melatonin release.

E โ€“ Exercise: Movement as a Sleep Stabiliser

  • Engage in regular physical activity, ideally during daylight hours, to promote circadian alignment.
  • Gentle evening movement such as stretching, yoga or progressive muscle relaxation, can calm the nervous system.
  • Avoid vigorous exercise within two hours of bedtime, as it may elevate arousal and delay sleep onset.
  • Movement also improves slow-wave sleep, supporting memory consolidation and emotional regulation.

D โ€“ Diet: Nutritional Support for Rest and Recovery

  • Avoid heavy meals, caffeine, or alcohol within three to four hours of bedtime.
  • Prioritise nutrient-rich foods that support neurotransmitter balance: magnesium, tryptophan, omega-3 fatty acids, and vitamin C.
  • Maintain consistent meal timing, as irregular eating can disturb circadian rhythm and sleep quality.
  • Hydrate well during the day, but reduce fluid intake in the evening to prevent sleep disruption.

Therapeutic Integration

In clinical practice, these habits can be reinforced through cognitive and behavioural interventions for insomnia; techniques such as stimulus control, sleep scheduling, and relaxation training. Within NA-CBT, these methods are integrated with affect regulation, somatic grounding, psychoeducation, and personalised lifestyle adjustments that help clients synchronise biological and emotional rhythms.


๐Ÿ’กTED Translation: Good sleep isnโ€™t about trying harder, itโ€™s about working with your bodyโ€™s natural rhythm. Keep nights dark, meals early, and habits steady. Move during the day, rest at night, and eat in rhythm and your emotional brain will do the rest.


Summary and Outlook

Sleep represents the biological foundation of the TED model; the โ€œTโ€ in Tired, Exercise, Diet. It is the first and most essential pillar supporting affect regulation, learning, and resilience. Within NA-CBT, sleep is viewed as a biopsychological regulator shaping the efficiency of all subsequent therapeutic and behavioural change.

Future TED work should examine how sleep interacts with diet (glycaemic balance, magnesium, vitamin C) and exercise (circadian entrainment, fatigue management), integrating these findings into structured protocols for mood and stress disorders.


Glossary

Amygdalaโ€“Prefrontal Network
A key emotional regulation circuit linking the amygdala (the brainโ€™s emotional response centre) and the prefrontal cortex (responsible for rational control and decision-making). Healthy sleep strengthens communication within this network, promoting balanced emotional responses.

Circadian Rhythm
The bodyโ€™s internal 24-hour biological clock that regulates sleepโ€“wake cycles, hormone release, temperature, and energy levels. It is governed by the suprachiasmatic nucleus (SCN) and synchronised by environmental cues such as light, activity, and mealtimes.

Homeostatic Sleep Drive
The internal biological pressure to sleep that increases the longer one stays awake. Sleep dissipates this pressure, maintaining equilibrium between rest and wakefulness.

NeuroAffective-CBTยฎ (NA-CBT)
A therapeutic framework developed by Daniel Mirea that integrates neuroscience, affect regulation, and cognitiveโ€“behavioural methods. It emphasises aligning biological, cognitive, and emotional systems to enhance self-regulation and psychological flexibility.

Progressive Muscle Relaxation (PMR)
A structured relaxation technique that involves tensing and releasing muscle groups throughout the body to reduce physical tension and activate the parasympathetic nervous system. PMR is commonly used to ease anxiety and prepare the body for sleep.

Rapid Eye Movement (REM) Sleep
A distinct phase of the sleep cycle marked by vivid dreaming, rapid eye movements, and heightened brain activity. REM sleep supports emotional processing, memory consolidation, and the integration of affective experiences.

Relaxation Training
A collection of techniques such as, slow breathing, mindfulness, guided imagery, and PMR, designed to reduce physiological arousal and promote calm. Relaxation training activates the bodyโ€™s โ€œrest-and-digestโ€ system, improving stress recovery and sleep quality.

Sleep Hygiene
A set of behavioural and environmental practices that promote healthy sleep. Core principles include maintaining a consistent sleepโ€“wake schedule, creating a dark and quiet sleep environment, avoiding stimulants before bedtime, and limiting screen exposure in the evening.

Sleep Scheduling
A behavioural intervention for regulating circadian rhythm and improving sleep efficiency. It involves setting fixed bedtimes and wake times, aligning sleep duration with actual sleep need, and gradually adjusting these times to consolidate sleep.

Social Jet Lag
The misalignment between the bodyโ€™s internal clock and social or work schedules. It commonly arises from late nights, weekend sleep shifts, or irregular meal and activity times, leading to fatigue, mood changes, and metabolic disruption.

Stimulus Control
A behavioural therapy principle aimed at strengthening the association between bed and sleep. It includes going to bed only when sleepy, using the bed solely for sleep and intimacy, rising at the same time daily, and avoiding wakeful activities in bed.

T E D Model (Tiredโ€“Exerciseโ€“Diet)
An integrative framework within NeuroAffective-CBTยฎ (the third module out of six) linking biological stability with emotional regulation. The model emphasises three foundational pillars, sleep (Tired), movement (Exercise), and nutrition (Diet), as interdependent systems supporting mental health and resilience.

References

Baglioni C et al., 2011. Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal studies. Journal of Affective Disorders, 135(1โ€“3), pp.10โ€“19.

Goldstein A.N. & Walker M.P., 2014. The role of sleep in emotional brain function. Annual Review of Clinical Psychology, 10, pp.679โ€“708.

Ingram R.E. & Siegle G.J., 2009. Contemporary Issues in Cognitive Therapy. New York: Springer.

Irwin M.R. & Opp M.R., 2017. Sleep health: Reciprocal regulation of sleep and innate immunity. Neuropsychopharmacology, 42(1), pp.129โ€“155.

Mirea D., 2023. Tired, Exercise and Diet Your Way Out of Trouble (TED Model). NeuroAffective-CBTยฎ. Available at: https://neuroaffectivecbt.com [Accessed 27 October 2025].

Mirea D., 2025. TED Series, Part VI: Sleep and Mental Health โ€“ The Neuroscience of Restoration and Emotional Regulation. NeuroAffective-CBTยฎ. Available at: https://neuroaffectivecbt.com [Accessed 27 October 2025].

Segal Z.V., Teasdale J.D. & Williams J.M.G., 2018. Mindfulness-Based Cognitive Therapy for Depression. 2nd ed. New York: Guilford Press.

van der Helm E et al., 2011. REM sleep depotentiates amygdala activity to previous emotional experiences. Current Biology, 21(23), pp.2029โ€“2032.

Thayer, J.F. and Lane, R.D., 2000. A model of neurovisceral integration in emotion regulation and dysregulation. Journal of Affective Disorders, 61(3), pp.201โ€“216.

Walker M.P., 2017. Why We Sleep: Unlocking the Power of Sleep and Dreams. London: Penguin Press.

Wells A., 2009. Metacognitive Therapy for Anxiety and Depression. New York: Guilford Press.

Wittmann M et al., 2006. Social jetlag: Misalignment of biological and social time. Chronobiology International, 23(1โ€“2), pp.497โ€“509.

Yoo S.S. et al., 2007. The human emotional brain without sleep โ€“ a prefrontal amygdala disconnect. Current Biology, 17(20), pp.R877โ€“R878.


Disclaimer

This article is for educational purposes only and is not a substitute for medical or psychological assessment. Individuals experiencing chronic insomnia or mood disturbances should consult a GP, sleep specialist, or licensed psychotherapist before implementing new interventions.

TED Series, Part V: Vitamin C and Mental Health: Neurotransmitters, Stress, and Emotional Resilience

Daniel Mirea (October 2025)
NeuroAffective-CBTยฎ | https://neuroaffectivecbt.com


Abstract

In this fifth instalment of TED (Tiredโ€“Exerciseโ€“Diet) series, of the NeuroAffective-CBTยฎ project, we explore the multifaceted role of Vitamin C in mental health. Emerging evidence suggests optimal neurocognitive benefits occur at daily intakes of 200โ€“500 mg. Beyond its reputation as an immune booster, Vitamin C functions as a key modulator of neurotransmitter synthesis, oxidative stress, and immuneโ€“brain communication. Drawing on recent research in neuroscience, nutritional psychiatry, and psychoneuroimmunology, this article examines how Vitamin C supports emotional regulation, cognitive performance, and resilience under chronic stress. Integrating this evidence within the NeuroAffective-CBTยฎ (NA-CBT) framework, we highlight Vitamin C as a practical component of lifestyle-oriented psychotherapy, bridging nutrition, physiology, and affect regulation.


Introducing TED in the NeuroAffective-CBTยฎ Framework

The TED model (Tiredโ€“Exerciseโ€“Diet) synthesises neuroscience, psychophysiology, and behavioural science into an integrated scaffold for emotional regulation and biological stability. Within NeuroAffective-CBTยฎ, TED interventions are introduced early in therapy to restore homeostasis across the Bodyโ€“Brainโ€“Affect triangle, the physiological foundation of affective regulation, motivation, and self-concept (Mirea, 2023; Mirea, 2025).

Following earlier TED instalments on Creatine (Part I), Insulin Resistance (Part II), Omega-3 (Part III), and Magnesium (Part IV), this chapter focuses on Vitamin C, a micronutrient that bridges diet, stress, immunity, and cognition. Despite being essential to brain and body function, humans have lost the genetic capacity to synthesise Vitamin C, making dietary intake or supplementation critical for maintaining mental and metabolic health.


Evolutionary Context: A Necessary Deficiency

Unlike most mammals, humans lack the gulonolactone oxidase gene required for endogenous Vitamin C synthesis. Evolutionarily, this was likely pruned due to ancestral diets rich in fruits and vegetation (Harrison & May, 2009). Consequently, Vitamin C must be obtained through food, primarily fruits, vegetables, and, more recently, supplementation.

This evolutionary dependency aligns with human dietary anatomy: our dentition and digestive tract are optimised for plant-based, nutrient-dense foods rather than raw animal flesh. Thus, our reliance on Vitamin C-rich diets is biologically hardwired, linking nutrition directly to both immune and psychological resilience.

From a TED perspective, this represents a fundamental Dietโ€“Affect relationship: emotional and physiological stability rely on the consistent intake of nutrients we cannot make ourselves.


Vitamin C and Neurotransmitter Synthesis

Vitamin C plays a pivotal biochemical role in neurotransmitter regulation. It acts as a cofactor for dopamine ฮฒ-hydroxylase, the enzyme converting dopamine into norepinephrine (adrenaline), essential for motivation, attention, and stress response (Otte et al., 2016). It is also necessary for the metabolism of tryptophan into serotonin, the neurotransmitter most associated with emotional regulation and well-being (Young, 2020).

Low Vitamin C levels have been linked to reduced serotonin and norepinephrine activity, contributing to low mood, fatigue, and anxiety. In turn, adequate Vitamin C enhances the synthesis and stability of these neurotransmitters, improving energy and affective balance.

๐Ÿ’ก TED Translation:
Vitamin C acts as a โ€œbiochemical connectorโ€ in the Tired and Diet domains, fuelling the brainโ€™s ability to convert nutrients into emotion-regulating signals. When Vitamin C is low, dopamine and serotonin pathways slow down, leading to fatigue, irritability, and low resilience under stress.


Stress, Cortisol, and Oxidative Load

Vitamin C is among the most concentrated antioxidants in the brain and adrenal glands, the latter being the bodyโ€™s cortisol-producing centres. Chronic psychological or physical stress depletes Vitamin C rapidly, while low Vitamin C status impairs the bodyโ€™s ability to modulate cortisol output (Brody et al., 2002).

Experimental studies show that supplementation can reduce stress-induced cortisol elevations and improve mood under high-pressure conditions, such as academic or occupational stress (de Oliveira et al., 2015). The relationship is reciprocal: stress depletes Vitamin C, and deficiency heightens the physiological stress response.

๐Ÿ’ก TED Translation:
This is where Tired meets Diet: stress โ€œburns throughโ€ Vitamin C reserves, and depletion feeds back into higher cortisol and anxiety. Maintaining adequate Vitamin C helps keep the stress response efficient rather than overreactive.


Vitamin C, Immunity, and the Gutโ€“Brain Axis

Vitamin C supports both innate and adaptive immunity, promoting leukocyte function, barrier integrity, and antioxidant defence (Carr & Maggini, 2017). Its influence extends to the gutโ€“brain axis, the bidirectional communication between intestinal microbiota and the central nervous system.

Figure 1: The Vitamin Cโ€“Neurotransmitterโ€“Stress Interaction Loop

Deficiency in Vitamin C increases intestinal permeability (โ€œleaky gutโ€) and systemic inflammation, which can trigger neuroinflammatory cascades linked to depression and anxiety (Otte et al., 2016). Adequate Vitamin C intake may therefore modulate mood indirectly by maintaining gut integrity and reducing inflammatory load.

๐Ÿ’ก TED Translation:
Within TED, Vitamin C stabilises both the body and the mind, supporting the โ€œDietโ€ domain by maintaining gut health and the โ€œAffectโ€ domain by reducing the inflammatory signals that disrupt mood regulation.


Epigenetic and Cognitive Dimensions

Emerging research suggests Vitamin C contributes to epigenetic regulation, influencing DNA methylation and histone modification processes involved in early neurodevelopment and long-term emotional outcomes (de Beni et al., 2021).

High concentrations of Vitamin C are found in the brain and cerebrospinal fluid, particularly in the hippocampus and cortex, regions essential for memory and emotional learning. Even when blood levels fall, the brain retains Vitamin C preferentially, highlighting its role in preserving neurocognitive function under stress.

๐Ÿ’กTED takeaway:

Your brain treats Vitamin C like gold, it holds onto it even when the rest of your body runs low. Thatโ€™s because Vitamin C helps protect brain cells, supports memory, and keeps emotional circuits flexible under stress. New research shows that Vitamin C doesnโ€™t just work in the moment, it may even influence how certain genes involved in brain development and emotional balance get โ€œswitched onโ€ or โ€œoff.โ€ In simple terms, Vitamin C helps your brain stay adaptable, protecting your mood and mental sharpness over time. In TED language, vitamin C fuels both Diet and Affect, nourishing your brainโ€™s chemistry while helping it handle lifeโ€™s stress without burning out.


Clinical and TED Practical Guidance

Recommended dietary intake for adults is 75โ€“90 mg/day, but emerging data suggest higher doses (200โ€“500 mg/day) may optimise antioxidant and neurochemical benefits (Carr & Rowe, 2020).

Natural sources:

  • Citrus fruits (orange, lemon, grapefruit)
  • Kiwi, strawberries, papaya
  • Bell peppers, broccoli, spinach, kale

Supplementation:

  • Divide doses (e.g., 250 mg twice daily) for better absorption.
  • Combine with flavonoid-rich foods (e.g., berries, green tea) to enhance bioavailability.
  • Avoid smoking and chronic alcohol use, which accelerate Vitamin C depletion.

๐Ÿ’กTED Translation:
Think of Vitamin C as your brainโ€™s โ€œdaily maintenance nutrientโ€, keeping neurotransmitters balanced, inflammation low, and energy steady. Consistent intake, alongside sleep and exercise regulation, reinforces the biological base for emotional stability and therapeutic progress. This is such a vital hormone, clinicians may consider psychoeducating clients on Vitamin Cโ€™s stress-buffering role when addressing fatigue or anxiety, integrating nutritional discussions within TED-based behavioural activation plans.


Summary & Outlook

Vitamin C exemplifies the TED principle that emotional health begins with biological balance. It supports neurotransmitter synthesis, moderates stress responses, protects against oxidative damage, and sustains gut and immune integrity. Within NeuroAffective-CBTยฎ, Vitamin C functions as both a preventive and adjunctive intervention, enhancing emotional resilience and amplifying the effects of psychotherapeutic change.

Like Omega-3, Magnesium, and Creatine in earlier TED modules, Vitamin C represents a key neuro-metabolic pathway where diet and mood converge. However, supplementation should never replace clinical care, it must be introduced under professional guidance and viewed as a supportive component of comprehensive mental health treatment.

Emerging evidence suggests that optimal neurocognitive benefits occur at daily intakes of 200โ€“500 mg of slow release (or time release) Vitamin C, the type that stays longer in the system. Future research should explore Vitamin C supplementation within structured TED protocols for mood, stress, and cognitive disorders, bridging nutritional neuroscience with applied behavioural interventions.


โš ๏ธ Disclaimer

These articles are for educational purposes only and do not replace medical or psychological evaluation. Individuals should consult their GP or prescribing clinician before starting supplementation, especially if taking psychiatric or cardiovascular medication.


Series context: Mirea, D. (2025) TED Series, Part IV: Magnesium and Mental Health. NeuroAffective-CBTยฎ. Available at: https://neuroaffectivecbt.com/2025/10/21/ted-series-part-iv-magnesium-and-mental-health/ [Accessed 22 October 2025].

References

Brody, S., Preut, R., Schommer, K. and Schรผrmeyer, T. (2002) โ€˜Vitamin C high-dose supplementation reduces anxiety and cortisol levelsโ€™, Psychopharmacology, 159(3), pp. 319โ€“324.

Carr, A.C. and Maggini, S. (2017) โ€˜Vitamin C and immune functionโ€™, Nutrients, 9(11), 1211.

Carr, A.C. and Rowe, S. (2020) โ€˜The emerging role of vitamin C in health and diseaseโ€™, Nutrients, 12(9), 2736.

de Beni, R. et al. (2021) โ€˜Vitamin C and epigenetic regulation of brain development and functionโ€™, Frontiers in Neuroscience, 15, 690341.

de Oliveira, I.J. et al. (2015) โ€˜Effects of oral vitamin C supplementation on anxiety in students: A double-blind, randomized, placebo-controlled trialโ€™, Pak J Biol Sci, 18(1), pp. 11โ€“18.

Harrison, F.E. and May, J.M. (2009) โ€˜Vitamin C function in the brain: vital role of the ascorbate transporter SVCT2โ€™, Free Radical Biology and Medicine, 46(6), pp. 719โ€“730.

Mirea, D. (2023) Tired, Exercise and Diet Your Way Out of Trouble (TED Model). NeuroAffective-CBTยฎ. ResearchGate.

Mirea, D. (2025) TED Series, Part IV: Magnesium and Mental Health. NeuroAffective-CBTยฎ. Available at: https://neuroaffectivecbt.com/2025/10/21/ted-series-part-iv-magnesium-and-mental-health/ [Accessed 22 October 2025].

Otte, C., Gold, S.M., Penninx, B.W. et al. (2016) โ€˜Major depressive disorderโ€™, Nature Reviews Disease Primers, 2, 16065.

Young, S.N. (2020) โ€˜Tryptophan metabolism and serotonin synthesis: relevance for psychiatric disordersโ€™, Journal of Psychiatry & Neuroscience, 45(3), pp. 151โ€“161.