Exercise and depression: What you need to know
Exercise and depression: What you need to know
Note: This is a brief summary of the evidence on exercise and depression. Consult your doctor prior to commencement of any exercise program. A list of references used is at the bottom.
Depression is a debilitating and common mental illness which remains a challenging illness to treat due to its treatment-resistant and recurrent nature. Major Depressive Disorder (MDD) is the type of depression that's usually referred to when talking about depression, and with good reason; it remains incredibly prevalent, affecting ~17% of all adults at some point during their lifetime. Not only is it affecting a large percentage of adults, but the diagnosis rates are growing, having increased by 18% in the past ten years.
Before we can dive into the nitty-gritty about exercise and depression, it's important to know how the treatment is categorised. Current treatments for depression are divided into pharmaceutical (e.g. using anti-depressants) and non-pharmaceutical interventions (e.g. psychotherapy, exercise). Exercise, in particular, has been promising due to its long term sustainability, low cost and low barriers to entry.
Exercise has been recommended as a treatment for depressed individuals for a long time being consistently found to reduce symptoms of depression. The promising news is that any type of exercise has been found to reduce depressive symptoms in those who exercised compared with those who didn't. The even better news is that we’ve found the type of exercise that is most effective for people with depression: aerobic exercise.
Running away from depression
For those unfamiliar with the definition, aerobic exercise is just exercise that works your aerobic energy system, or basically, stuff that gets you puffing. The guidelines for using aerobic exercise as a treatment for depression lines up with the recommendations for aerobic exercise for improving general health: exercising for 45 minutes at a moderate-high intensity, 3 times a week. What type of cardio? It doesn’t seem to matter if you are getting your heart rate between 55-90% of your HRmax (the maximum number of beats per minute your heart can beat) you will be getting the benefits. The good news is that even doing light exercise is correlated with reduced depressive symptoms, with the bottom line being that consistent exercise, irrespective of intensity, will be beneficial to people with depression. To calculate your own HRmax this site uses a reliable calculation.
How exercise can reduce depression
So how can exercise reduce depression? Exercise doesn’t just work your muscles, it sends a cascade of signals throughout your body, some hormonal, some neurological, and some psychological, and in combination, these can have a potent effect on our health. Now pinpointing which of these things, in particular, is helping people with depression is still difficult but we’ve narrowed it down into three categories, physiological (physical), neurological (brain) and psychological (mental) changes.
Physiological effects: Changes in hormones such as endorphins, monoamine levels and reducing cortisol levels
Neurological effects: Exercise is linked to neurogenesis or the creation of new neurons through upregulation of different transmitters and proteins.
Psychological: Psychological changes have also been noted with regular exercise, with improvements in self-confidence and self- efficacy (believing in your own ability to do something) having a mood-enhancing effect.
Something to note is that how effective exercise seems to be is individualised with some people responding far better than others. What causes exercise to be so incredibly effective for some people while only having small effects in others? The truth is, we don’t currently know, but potential explanations could be that a depressed individual with poor physical health would see a far greater improvement from exercise, which would also have a far greater impact (whether perceived or actual) on their quality of life. Does this mean that an already fit person won’t see a benefit from depression? Absolutely not, not only is exercise very beneficial for someone who is currently depressed, but exercise is also a potent protective factor for preventing depression.
Depression isn’t a weakness
A common misconception about depression is that it’s sadness, that’s a generalisation to the point of being completely wrong. it’s not sadness, a depressed mood is a symptom of depression, but depression is incredibly individualised, with a total of 7 different symptoms listed in the DSM-5 (the manual psychologists use to diagnose people). To even be diagnosed with MDD patients must have a minimum of five out of the seven symptoms listed and these must persist for a minimum of two weeks. Depression isn’t a weakness, and it says nothing about the person who has it, other than the fact they have an illness. You wouldn’t tell a person with diabetes or IBS to will it away by smiling, so telling someone with a mental illness to ‘cheer up’ won’t do anything to help them.
A quick disclaimer about anti-depressants
It is dangerous to generalise depression, so I’ll do my best not to, but keep in mind that depression is incredibly complicated, and sometimes analogies are the only effective way to talk about such a complicated illness.
Few drugs have as many misconceptions and fear surrounding them as anti-depressants and thankfully very little of that fear is grounded in reality. Anti-depressants can be monumentally helpful for some people with depression, giving them a new lease on life that they weren't able to have prior. A helpful analogy to think about anti-depressants is as a 'supplement'; your brain isn't doing its job-producing enough serotonin, so anti-depressants help your body hold onto that serotonin longer so it can do its job. Can there be side effects? Yes, but for most people on anti-depressants they are very well tolerated, and any symptoms are mild. While anti-depressants will not suit everyone with depression, it’s important to talk to your GP before making any decisions.
Take-home points
Aerobic lasting ~45 minutes done 3 times/week has consistently been shown to have an anti-depressant effect.
Resistance training has also been correlated to reduced depression, although to a reduced degree to aerobic exercise
Some exercise is infinitely better than nothing – start small, even light exercise done consistently can have a great impact on your wellbeing.
Depression acts in a way that it starts to make doing the very things that help you get out of a depression harder to do. Depression isn’t your fault, but it is your responsibility, so fight against it, as hard as you can, every day.
References
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