Exercise and Major Depression
Exercise is prescribed for a wide variety of health conditions—from heart disease to diabetes. Science shows that being active can improve your physical and mental health and make positive changes in your brain chemistry, but if you’re battling major depression, the thought of working out may seem unthinkable. Here’s some information about the benefits of exercise that may change your mind.
Exercise and Nerve Growth
Early brain chemistry research found that mice living in an exercise-friendly environment stopped acting depressed after a stressful social experience, while mice who didn’t exercise stayed depressed. Scientists attribute the mice’s recovery to the growth of new brain nerves caused by exercise. This and other research has led scientists to understand how brain nerve growth works in humans, too. Adults affect their brain chemistry through experiences, such as physical activities, and how they respond to them. The proteins largely responsible for the brain’s ability to adapt and change are called neurotrophins. Antidepressants affect neurotrophins in the brain, and so does exercise.
Benefits of Exercise Therapy for Depression
In addition to stimulating new nerve growth and improving your ability to think, remember, and learn, exercise boosts serotonin, dopamine, norepinephrine, and endorphins in your brain. These neurotransmitters help you calm down and focus. In studies, exercise therapy has also shown an antidepressant effect.
One Duke University researcher, James Blumenthal, PhD, has been studying exercise and major depression for more than a decade. “Based on the best available evidence to date,” Dr. Blumenthal believes that “exercise may be generally comparable to medication in the treatment of MDD.” Similar studies continue to find at least modest clinical benefit for exercise and better mental health. Talk to your doctor about treatment and self-care options—including exercise - that are right for you. Don’t self-treat your depression symptoms or try to get through your recovery with exercise alone.
Adding Exercise to Your Treatment Plan
Once you start exercising, you’re likely to notice some changes in your symptoms right away. “Simply moving more and sitting less will make a difference in how you feel,” says exercise physiologist and dietitian Amy Ogle, MS, RD. “If you typically exercise alone, consider working out with a group or partner because the social connection helps lessen depressive symptoms.”
Shoot for at least 2 1/2 hours of exercise in a week. Strength training counts toward that time, too. Just remember to check with your doctor first, especially if you have another medical condition.
Try these strategies to help reduce stress and overcome major depression:
Recognize what causes your stress. “Each person needs to know [his or her] particular vulnerabilities to certain kinds of stress,” Buccino says. Maybe too little sleep or too many commitments at work put you over the edge. “Figure out your limits and then try to manage them,” Buccino says.
Exercise. Moderate-intensity exercise, such as walking at talking speed, can help lift people out of anxiety, stress, and depression, Rego says. Exercise isn’t a substitute for medical treatment for major depression, but it can help support your recovery.
Tap into social support. “People who are stressed and depressed tend not to use social support networks,” Rego says. “Reaching out to friends or trusted colleagues can buffer stress and offer an outside opinion on stressors, and connections can create a sense of belonging, which lessens depression.” Connections don’t always have to be in person: Start out with a text or an e-mail, or Skype.
Challenge your perspective. “When people stress, they tend to see only threatening information,” Rego says. “Examine your thoughts to see if they’re as negative as you think. For instance, if you’re stuck in a traffic jam, instead of thinking you’ll never arrive on time, ask yourself, ‘What’s the worst that can happen if I’m late?’”
Sign up for therapy. If you have clinical depression, psychotherapy is probably part of your treatment. It’s a great tool to treat major depression and address stress, Buccino says. “You’re forming a useful working alliance with another person, whether to gain insight or make changes.”
“Sticking to a plan and following your progress will renew your sense of self-mastery and control,” Ogle adds. You can progress to the following routine:
Warm up for 5 to 10 minutes, gently moving your upper and lower body in full range of motion.
Do 30 minutes of aerobic exercise, such as walking, light jogging, swimming, biking, or a group exercise class. You should be able to talk, but not comfortably sing.
Cool down and stretch for 5 minutes.
Exercise for Major Depression- Evidence of Effectiveness
Randomized trials have shown that exercise is effective in reducing depressive symptoms in patients with MDD, on its own and in conjunction with other treatments, such as antidepressant medication and/or psychotherapy. Exercise may help to meet the need for cost- effective and accessible alternative therapies for depressive disorders- particularly for the substantial number of patients who don’t recover with currently available treatments.
Based on the available data, aerobic exercise is the preferred form of exercise for patients with MDD- although there is also support for resistance training, Drs Rethorst and Trivedi note. In terms of session frequency and duration, they recommend that patients participate in three to five exercise sessions per week, for 45 to 60 minutes per session.
In terms of intensity, for aerobic exercise, they recommend achieving a heart rate that is 50 to 85 percent of the individual’s maximum heart rate (HRmax). For resistance training, they recommend a variety of upper and lower body exercises - three sets of eight repetitions at 80 percent of 1- repetition maximum (RM- that is, 80 percent of the maximum weight that the person can lift one time).
Data suggest that patients may experience improvement in depressive symptoms as little as four weeks after starting exercise. However, Drs Rethorst and Trivedi emphasize that the exercise program should be continued for at least ten to twelve weeks to achieve the greatest antidepressant effect. Some people have questioned whether patients with MDD will be willing to participate in an exercise program. But Drs Rethorst and Trivedi note that, in the studies they reviewed, only about fifteen percent of patients dropped out of exercise programs- comparable to dropout rates in studies of medications and psychotherapy.
The authors discuss strategies that may help improve adherence to exercise programs, such as consulting patients about their preferred types of exercise and providing individualized educational materials and feedback. They also provide some practical tips for clinicians on how to estimate exercise intensity using readily available information.
Even if the depressed patient can’t reach the target intensity and frequency levels, exercise can still be helpful. “Taken as a whole, these findings suggest that exercise doses below the current recommendations may still be beneficial for patients with MDD,” Drs Rethorst and Trivedi add. “Therefore, clinicians should encourage patients to engage in at least some exercise, even if they do not exercise enough to meet current public health recommendations.”
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Provided by Wolters Kluwer Health