Getting Physical With Depression: Small Steps, Big Benefits
Back in 2013 I wrote an article entitled, "How Effective is Exercise for Depression?" I stated that a few questions still needed to be answered as to how exercise was meant to relieve depression and which type of exercise might be better than others. At the time the received wisdom went something along the lines of "any exercise is better than no exercise," but the more intense and physical exercises were likely to have the greatest benefits.
Just over four years later, we’ve learned a few things. The good news is that far less exercise may be required for a therapeutic effect than was previously thought.
We don’t all run marathons
You may be familiar with the notion of the so-called "runner’s high." This is a state of wellbeing and near euphoria that some (typically long-distance) runners achieve while running. During exercise, higher concentrations of neurotransmitters such as dopamine, norepinephrine, and serotonin are produced which may contribute to the high. All these neurotransmitters have been shown to help reduce depression. Exercise therefore has been considered helpful both in reducing the risk of depression and speeding its recovery.
So far so good, but how well do these assumptions translate to most people who are not marathon runners and are also clinically depressed?
In her article, "Can Exercise Prevent Depression?," Emily Deans M.D., makes some useful observations. She points out that to achieve the endorphin effect quite a lot of high intensity exercise is required. But in order to achieve a pharmacologic effect (therapeutic effect) it would also need to be fairly frequent. We begin to see the problem. This level of exercise excludes much of the population. And as anyone who has ever felt in a low mood will understand, exercise comes way down on his or her priority list. Scale this up to clinical depression and it’s almost impossible to imagine exercise as a viable option.
Less is more
An interesting study was reported in 2017 in the American Journal of Psychiatry. The authors of the study asked the question, does exercise actually protect against new-onset anxiety and depression, and if it does, how much exercise is actually required? They also wanted an explanation of the mechanisms involved.
A huge research study, established in Norway, began tracking more than 33,000 healthy volunteer adults for a period of 11 years. Just over 22,000 people completed the study and the results revealed some surprises. As expected, the people who exercised were less likely to develop depression. Less expected was the fact that it didn’t really matter what a person did so long as it constituted “a deliberate physical activity” for as little as a mere hour per week!
What does this mean? Well, in terms of mental health, a good walk to feed the ducks can be just as effective as an aerobics fitness class or cycling for 50 miles or more. Intensity of exercise is far less of an issue than previously thought. The real therapeutic effect, suggest the authors, may be rooted in the fact that just getting out and possibly socializing has the beneficial and positive effects.
Start small and build
I’m sure that it may come as a relief to know that exercise doesn’t mean having to buy a gym membership. If the Norwegian research tells us one thing it’s that a little regular activity doing something you enjoy is far more effective than being involved in something you tolerate simply because you believe it’s good for you. Patient Expert Carol Bradley Bursack points to the fact that simple group activities have been shown to reduce depression in the older population.
A minimum of one hour’s “deliberate physical activity” each week is certainly within the grasp of most physically healthy adults. Still, if you’re currently depressed, probably the best thing to do is start small and build. Try a few stretches, some deep breathing exercises or maybe a gentle dance to some favorite music. It doesn’t matter. What matters is that you start, build, and maintain.
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