How Exercise Can Help Treat Depression and Anxiety
Anyone can experience a bout of the blues when a favorite character on Game of Thrones dies, but clinical depression can be long-lasting and debilitating. Symptoms include a change in appetite, loss of energy, and feelings of helplessness; and those who suffer from depression often experience significant anxiety as well.
But one route to recovery may start with some sneakers: Consistent exercise can join the ranks with other treatments for depression and anxiety, helping to boost mood, combat feelings of gloom, and prepare the brain to better handle stress ((Exercise for depression. Mead, G.E., Morley, W., Campbell, P., et al. School of Clinical Sciences and Community Health, University of Edinburgh, Edinburgh, UK. The Cochrane Database of Systematic Reviews, 2008 Oct 8;(4):CD004366.)) ((Physical exercise prevents stress-induced activation of granule neurons and enhances local inhibitory mechanisms in the dentate gyrus. Shoenfeld, T.J., Rada, P., Pieruzzini, P.R., et al. Department of Psychology, Neuroscience Institute, Princeton University, Princeton, New Jersey, USA. Jouranl of Neuroscience 2013 May 1;33(18):7770-7.)).
Battling Blues — What's the Deal?
Health professionals give regular exercise a gold star for helping prevent disease, keeping off excess weight, and even spicing up that sex life. Another benefit is that different types of physical activity, from aerobic exercise to qigong, can help lessen depressive symptoms ((Effects of Exercise and Weight Loss on Depressive Symptoms Among Women and Men with Hypertension. Smith, P.J., Blumenthal, J.A. and Sherwood, A. Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA. Journal of Psychomatic Research 2007 November;63(5):463-489.)) ((Qigong as a psychosocial intervention for depressed elderly with chronic physical illnesses. Tsang, H.W., Cheung, L., Lak, D.C., et al. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong. International Journal of Geriatric Psychiatry, 2002 Dec;17(12):1146-54. )). One study found walking and jogging a few times a week was generally as effective as antidepressants in reducing symptoms of depression ((Exercise and Pharmacotherapy in the Treatment of Major Depressive Disorder. Blumenthal, J.A., Babyak, M.A., and Sherwood, A. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. Psychosomatic Medicine 2007;69(7):587-96.)). But it’s not only aerobic workouts that do the trick— researchers found depressed elderly people who trained at high intensities several times weekly saw improvement in their quality of life and sleep ((A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. Singh, N.A., Stavrinos, T.M., Scarbek, Y., et al. Royal Prince Alfred Hospital, Central Sydney Health Service, New South Wales, Australia. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2005 Jun;60(6):768-76.)). (Extra credit for older folks hitting the weight room, too!)
Besides increasing levels of feel-good endorphins, scientists suggest physical activity may work like some antidepressant drugs to alter brain chemistry ((An Overview of Brain-Derived Neurotrophic Factor and Implications for Excitotoxic Vulnerability in the Hippocampus. Murray, P.S. and Holmes, P.V. Neuroscience Program, Biomedical and Health Sciences Institute, The University of Georgia, Athens, GA, USA. Internatioal Journal of Peptides 2011;2011:654085.)) ((Endorphins and Exercise. Harber, V.J., Sutton, J.R. Sports Medicine. 1984 March-April;1(2):154-71.)). Recent research (albeit on mice) found that those who voluntarily ran on wheels had greater amounts of the brain cells that produce the neurotransmitter GABA (associated with feelings of calm) than those who just sat in their cages ((Physical exercise prevents stress-induced activation of granule neurons and enhances local inhibitory mechanisms in the dentate gyrus. Shoenfeld, T.J., Rada, P., Pieruzzini, P.R., et al. Department of Psychology, Neuroscience Institute, Princeton University, Princeton, New Jersey, USA. Jouranl of Neuroscience 2013 May 1;33(18):7770-7.)). When all the rodents were placed in ice-cold water, the runners’ brains released more of that GABA, meaning they likely felt less anxious in the stressful situation.
Moreover, staying in shape can also help us gain confidence and distract us from worries. And research suggests this effect isn’t just temporary: In patients diagnosed with clinical depression, exercise may not only relieve sad symptoms, but could also help diminish symptoms for good. Some psychologists even advocate that mental health professionals prescribe physical activity to treat anxiety and depression the same way they would recommend medication.
Sweat Away Sadness — The Answer/Debate
Gearing up for a workout is rarely a bad idea. But while exercise may help reduce depression and anxiety once they've become an issue, so far, research hasn’t proven that a few laps around the track will prevent the blues from arriving in the first place. One study failed to find evidence that exercise could reduce the risk of depression in vulnerable populations. Other research suggests exercise improves depressive symptoms only moderately ((Exercise for depression. Mead, G.E., Morley, W., Cambell, P., et al. School of Clinical Sciences and Community Health, University of Edinburgh, Edinburgh, UK. The Cochrane Database of Systematic Reviews, 2008 Oct 8;(4):CD004366.)). Plus, exercise may not help treat depression the same way across the board: According to one study, light exercise helps depressed women slightly more than it helps men ((Depression and exercise in elderly men and women: findings from the Swedish national study on aging and care. Lindwall, M., Rennemark, M., Halling, A., et al. School of Social and Health Sciences, Halmstad University, Halmstad, Sweden. Journal of Aging and Physical Activity, 2007 Jan;15(1):41-55.)). And when it comes to anxiety, some scientists say exercise works best in conjunction with medication ((Exercise for the treatment of depression and anxiety. Carek, P.J., Laibstain, S.E., Carek, S.M. Department of Family Medicine, Medical University of South Carolina, Charleston, USA. International Journal of Psychiatry in Medicine 2011;41(1):15-28.)).
Still, it’s especially important to make physical activity a priority when feeling down, since research suggests people who are depressed are less likely to exercise. A therapist can help create an individual treatment plan for depression that might include some exercise. Along with eating well, getting enough sleep, and spending time with family and friends, getting a move on for 30 minutes a day, three to five days a week, can help keep that smile around.
When feeling sad, do you find working out helps? Share your experiences in the comments below or tweet the author at @lschwech.
Photo by Jordan Shakeshaft
This article originally posted December 2011. Updated July 2013.
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