Decreasing Depression with Exercise
What if your prescription for depression could be less about taking a pill forever and much more about something that will help you look great, feel great and mentally ready to take on the day?
I was sitting in the doctor's office staring at the boxes, “Do you feel exhausted? Do you feel overwhelmed? Do you have difficulty concentrating? My eight-week-old sat beside me in her car seat, quietly staring at me. The answer to most of the depression questions was a yes. I argued with myself silently, nevertheless, that I didn’t need to check yes. I had a 17-month-old at home in addition to the newborn and averaged 4-5 hours of sleep a night. Who wouldn’t feel overwhelmed and exhausted? I talked myself out of talking to someone because I didn’t think I could work it into my schedule. Just making time to cook dinner daily seemed like a considerable effort. I was breastfeeding and didn’t want medication. So slowly, I worked through my rough days. Slowly I got back to doing enjoyable things, but I could have made it easier by talking to someone or getting back into a regular exercise routine. Yep, exercise.
Talk therapy and medications have starring roles in treating depression. Depression is more common, you might know, with 6%-8% of people having a depressive episode this year, and 72% of them will go without treatment. Depression hugely affects your ability to get to what you need to in life and connect with friends and family. Finding a good provider for talk treatment can be difficult. People aren’t always willing to take medication for side effects or other personal reasons. A third part of what should be a star in the treatment plan for depression is regular exercise. Using exercise to treat mood disorders is like using Chuck Norris to go after bad guys. It is always a good idea so let’s explore why exercise works.
Exercise for Depression: Does it Work?
What do we know about exercise decreasing the effects of depression? When you look at the impact of exercise and medication, exercise is equally able to treat depression. Multiple studies have compared medication and exercise head to head with the result that they come out with the same results--they both work.
There is also research to say that exercise makes a difference throughout your life in managing various mood disorders like depression or anxiety. One of the best examples is the Alameda county study which was a study that looked at the same people over a span of years. The Alameda study looked at the effect of being physically active and if that changed the risk of depression. For this study, they surveyed 8,023 people for twenty-six years. The people in the study who became inactive were 1.5 times more likely to have depression by the end of the study.
This means if you primarily watch daytime television as your “activity” after retirement, your odds of getting depression each year go from 6%-8% to 10%-12%. It is even worse for each generation that is born. My grandparents had a 12% chance of having depression throughout their lives. Those aged 30-44 have a 25% chance of having a major depressive disorder in their lifetime. The depression rates for children today will likely be 50%. And I know what you are thinking now, “Gah, this is depressing, so now I will watch a cat video.” But don’t leave because this is where I get to the good stuff.
How Exercise Treats Depression
Okie Dokie, so we are about to get some Latin on and learn some long words, BUT I think it is important that you understand how exercise helps to treat depression. It makes it more legitimate. Plus, you will sound like a smartie when you chat with your coworkers about this amazing Substack you started reading (that would be this one), so they can subscribe. And now, onto a deep dive into how exercise affects the brain after that shameless plug.
Exercise immediately elevates levels of norepinephrine in certain areas of the brain. It wakes up the brain and gets it going. Norepinephrine increases alertness and arousal and helps with focus and concentration—improved ability to tackle the day after exercise because you feel focused and alert can help self-esteem, which is one aspect of depression.
Exercise also boosts dopamine which improves mood and feelings of wellness and jump-starts the attention system. Dopamine is all about motivation and attention. Exercise equally affects serotonin, vital for mood, impulse control, and self-esteem. It also helps stave off stress by counteracting cortisol, that pesky hormone that plagues us when we are under constant stress.
Dr. Stephen Ilardi, a clinical psychologist at the University of Kansas and author of The Depression Cure, notes that “researchers have assessed the Kaluli people of the New Guinea, modern-day hunter-gatherer bands, for the presence of mental illness. They found that clinical depression is almost completely nonexistent among such groups.”
The reason depression is so rare, Ilardi argues, is that people like the Kaluli live a lifestyle that’s congruent with their biology and psychology. We were meant to move, not to sit. Their way of life essentially acts as a natural antidepressant. They’re too busy to sit around. They get lots of physical activity because they still hunt and gather. Their diet is unprocessed, their level of social connection is extraordinary, and they regularly have as much as 10 hours of sleep. I do not think we need to move to New Guinea so we can all start over, mainly because I REALLY love indoor plumbing and toilet paper. However, we can take some of this new information and use exercise to tackle and defeat depression. The biggest question we have to answer is how does someone start to add in exercise, and what do you pick? Or maybe you fu#!ing hate exercise, so are you still screwed to live in the depths of despair? Nope. Luckily exercise nerds have lots of tricks up their sleeves. There is still hope.
Choosing Your Exercise
Many people who come to see me are inactive and don’t have a lot of positive experiences with exercising. Most of them think about running in gym class or running outside when it is hot or cold or raining. Basically, there are a lot of people that assume they hate all exercise because high school gym class was traumatic.
There is so much out there that does not involve running! Most of the time, it will be trial and error to find the exercise that you would prefer to do. Be mentally prepared to discover things you don’t like and find something you really like. I once took a pole aerobics class that even included the stripper boots. It was a killer arm workout. Bottom line, if you hate it, there is something else out there for you--Barre, Pilates, CrossFit--the options are plentiful, and most of them are available on a guided workout app you can get on your phone.
The biggest thing to do when you start is to write a goal that you will move your body ___minutes each day or Monday, Wednesday, or Friday, etc. BE REALLY FU@!ING SPECIFIC!!! On the days that you move, take two minutes and write on a piece of paper on your fridge what you feel like mentally at the end of the day. This is part of what will motivate you to keep it up.
Often feeling isolated and alone is a significant contributing factor in depression. If so, an exercise program with a community feel can be more effective than even an exercise you prefer alone. The social aspect of it and someone knowing your name or asking where you have been is huge for decreasing the feelings of being alone. If a larger group will be too much, connect with a friend who does work out. Have them give you their left shoe, and you give them yours. If you don’t show up, they can’t walk or exercise, and the same goes for you. Again, journal how your mood at the end of the day. Talk to your friend about how it feels to exercise.
The longer you exercise, the easier it will be to keep depression at bay. The SMILE study out of Duke University that compared exercise and antidepressants immediately and at ten months found that those who used exercise only had a relapse rate of 9% as compared to 38% of the antidepressant group. How we think and feel is governed by our brain cell connections. So become your electrician and start making exercise a part of your regular daily and weekly routine.
DIG Deep Action Steps:
Get Deliberate: There is no such thing as getting too much help from other mentally healthy adults. If you haven’t tried talk therapy with a counselor many of them are available virtually now. They can help you with setting up exercise goals and other goals for treating and keeping depression at bay. Setting up very specific goals for exercise is key to making movement a part of your regular weekly routine. Check out this post on goal writing for some guidance.
Get Inspired: Think about that feeling you get when you have just finished a workout. Even if it has been a while close your eyes and mentally get into that post-exercise zone. Write down what it feels like, type it up, and put it on your fridge or mirror with the title “why I exercise.”
Get Going: Put on your walking/running shoes first thing in the morning or as soon as you get home from work. Decrease the barriers to making exercise happen in your day-to-day life!