Can we treat depression with exercise?
I don’t know that a lot of people discuss depression in the fitness industry. If you take a peek at most fitness gurus on social media, a lot of them seem to be grinning ear to ear and very pleased with their appearance. They do not seem to have had a depressed day in their very tan lives. Even outside of the fitness industry we still don’t talk a lot about depression. It’s kind of a taboo subject. I have suffered from depression and taken medication for it. I am not ashamed of it. Regular exercise has helped me manage my depression and improved my quality of life. Does that mean I’m fixed, never suffer from feelings of depression and always feel like exercising? No. It’s ongoing, but I know what I need do to feel better. I also have a solid support system of friends and family in place. As cliché as it sounds, movement has truly been my medicine and one of the main reasons I became interested in coaching and training. There have been studies examining the effect that exercise can have on depression. These studies on those with mild to moderate depression seem to demonstrate that regular exercise at a certain intensity may have similar effects to antidepressants. While exercise in and of itself may not be enough in many cases to treat depression, a combination of therapies may be useful long term.
Let’s discuss the reality of depression. When depressed, people may not feel like doing a damn thing. Exercise is probably the furthest thing from people’s minds when they are truly depressed and want to stay in bed. It is going to be challenging as hell to actually exercise when feeling truly depressed. Depression can make activities of daily living feel damn near impossible, so expecting someone to move more who does not feel like getting out of their pajamas may be quite difficult. To make things even more complicated, you can’t just exercise once and experience the antidepressant level benefits of physical activity to lift your mood. To have significant effects on depression, the exercise must be done regularly and a certain intensity must be sustained per week. According to the exercise study, the benefit is seen at 17.5/kcal/kg per week, which equates to 1505 kilocalories expended for a 190 pound (86 kg) individual. That is a good amount of exercise or intensity. Benefits were not seen at lower doses of exercise, however, that does not mean a person can’t or shouldn’t start with a smaller amount and ramp up from there.
We have two components to treating depression with exercise. The dose (17.5/kcal/kg per week) and being consistent. The exercise intensity must be sustained long term to obtain the antidepressant effects. The study lasted 12 weeks to achieve the results. Exercise is not a quick fix, which may be daunting and problematic for those facing depressive episodes. In my experience, it’s good to have a solid support system of people cheering you on to do the hard stuff. Friends, therapists, personal trainers, significant others, and online forums can all provide encouragement to get you motivated to start and maintain a program. I get that it won’t always be easy, and we’ll all experience some days where we don’t feel ourselves and want to stay in bed. For me, I think the key was to begin exercising when I wasn’t feeling completely down. Medication is always an option too. There is no shame in taking prescribed medications to treat depression. I have been prescribed medications and have experienced firsthand how negative people can be toward the idea of it. Depression is a treatable condition. If we take an ibuprofen for a headache, why can’t we take Prozac to get ourselves feeling better when we know that the reason for feeling the way we do is due to chemicals in our brains?
While exercise may be an effective treatment for depression, the exercise prescription for depression is not without its challenges. Those facing depressive episodes may find it difficult to motivate themselves to exercise regularly and to the intensity required to be beneficial, as per the 12 week study. Although this study found the exercise treatment to be as effective as one antidepressant, the dropout rate of the study was quite high, at more than half, which raises the issue of compliance. The combination of medication and exercise therapies may be an option, as they may work well together to lift feelings of depression or encourage compliance in multiple treatment options, such as therapy, antidepressants, and an exercise program. Please don’t hesitate to ask for help, as this is something that many people you know are likely to have dealt with or are dealing with currently. I hope that through this post, more people are able to have a conversation about this subject and ask for help if they need it. It may seem overwhelming at first, but none of these changes or treatments have to occur all at once.
Here are some helpful tips if you are feeling down:
1. Go for a walk. If you find it difficult to commit to any type of regular exercise on your own, schedule a time with a friend to meet up and just get some exercise that way. Start small.
2. Ready to join a gym? Talk to the trainers there and get a feel for their personalities and training styles. Most gyms offer intro sessions for free and you can learn something, and at the very least, make a friend if you don't decide to keep training.
3. If you have an office job a lot of places offer counseling to their employees. Ask your HR if this is a service offered. Schools are also a great resource and offer counseling. I've made use of both of these services through an office job and in college.
4. Phone a friend or family member. I'm sure they'd be glad to hear from you. Just talking to someone, whether it's friends of family can be a boost.
If you ever find yourself having feelings of depression, just know you are not alone. There is help out there, and the thoughts or feelings will pass, even though it may not feel like it in the moment. Let me know what you think. If you have any thoughts or feelings on the topic please don't hesitate to reach out.
Dunn, A., Trivedi, M., Kampert, J., Clark, C. and Chambliss, H. (2018). Exercise treatment for depression. https://www.ajpmonline.org/article/S0749-3797%2804%2900241-7/fulltext