The idea that regular exercise can improve symptoms of depression and anxiety is not new. Hippocrates was the first Western physician to prescribe this treatment 2,500 years ago, and doctors have been recommending it to their patients ever since. All the evidence accumulated by modern science says it works. If you suffer from major depression, exercise probably won’t be the only treatment you’ll need, but it will help along with your treatment plan. Whereas medication and counseling can take weeks to work, you can start feeling the positive effects of exercise right away.
Anti-depressant medications that affect levels of the brain chemicals serotonin and norepinephrine appear to reduce the negative feelings and thoughts associated with depression, as well as many of the physical symptoms, such as changes in appetite and sleep, fatigue, muscle tension, and soreness. But people react differently to medications, seeing changes in some areas but not others. Some don’t respond to these medications at all. Exercise can enhance the benefits of antidepressant medications, and even produce similar results.
Research shows that exercise:
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Positively effects the same neurotransmitters that antidepressant medications target
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Produces feel-good brain chemicals called “endorphins,” which promote the sense of well-being and satisfaction
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Releases tension in muscles that contributes to depression-related soreness and insomnia
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Reduces levels of the stress hormone cortisol, relieving feelings of anxiety and agitation
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Raises body temperature, which appears to have calming effects
In addition to these physiological benefits, exercise can promote the following psychological and emotional changes:
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Distraction. One of the most debilitating effects of depression is that it causes you to focus on what’s wrong and dwell on the negative. Exercise compels you to focus on something else for a little while. With the right approach, it can help you find some pleasure in a sea of apparent troubles.
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Confidence. The hopelessness, helplessness, and fatigue that come with depression often cause people to withdraw from normal activities and pursuits, leading to a loss of self-confidence. By setting and meeting a goal, like a small amount of exercise each day, you can begin to rebuild confidence and self-efficacy.
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Self-respect. As people sink deeper into withdrawal and inactivity, they begin to feel useless and worthless, and may even come to despise themselves. They may resort to substance abuse or other self-destructive behaviors to manage these feelings. Exercise can provide a positive alternative to these negative coping strategies. Taking the time to do something positive to help yourself every day can help you reconnect with the part of yourself that wants to be healthy and productive.
But if you’re already depressed, exercising may be the last thing you want to do. You may feel fatigued and pessimistic, thinking that exercise won't be able to help you. These thoughts are normal for people with depression, part of the "mental battle" you'll face when considering a fitness program. Here's how to overcome them.
Choose Sides
You can overcome the mental and physical inertia that often keeps you from doing what you can to help yourself. The first thing you have to do is to decide whose side you want to be on–your own side, or your depression’s side.
This sounds like a simple and obvious decision, but when it comes down to putting on those sneakers and actually doing something, it may require a real leap of faith—especially if you’ve tried to start exercising in the past and failed. Depression causes you to dwell on how badly you feel, how hopeless everything seems, and what an undeserving and pathetic person you are for not being able to do what you need to do. These feelings and thoughts may seem more “real” and “honest” to you than anything positive you can say to yourself.
When you’re struggling against an opponent as powerful as depression, you need to know your enemy and its weaknesses. Use this information to choose effective strategies and fight back. Because the most troubling symptoms of depression are emotional and cognitive, people often forget that how they think and feel is directly related to what’s going on chemically in their brain and body.
Find a way to distract yourself from those thoughts just long enough to get your exercise session started. To do this, remind yourself that those negative thoughts are your depression talking, not the part of you that wants to be healthy cares about what happens. When those negative thoughts creep in, stop, take a deep breath, and make the decision to be on your own side this time, even if you don’t think it will help.
Move Into Action
Now you know why exercise is so important in managing depression, and what it can do for you. But how do you get started, when simple things like taking a shower, getting dressed in the morning, or doing the dishes seem like more than you can handle?
The answer is: Just do it! Remember, you’ve already decided that you’re going to be on your own side. This is where you make that decision mean something. The issue here isn’t whether or not you can muster up the willpower to make yourself exercise—it’s about giving yourself a fair chance to see if it can actually help you.
To make this easier, here are some suggestions to help you get the most out of your fitness program:
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Talk to your doctor before starting an exercise program.
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Find activities you enjoy (or that you enjoy when you’re not depressed). It could be walking the dog, playing tag or basketball with the kids, going for an easy bike ride, walking to the grocery store, working in the garden—anything at all. The last thing you want to do is make exercise seem like another thing you “should” do. You want it to become one of the highlights of your day.
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Set reasonable goals. You don’t have to commit to 90 minutes of intense exercise every day. Research indicates that at least 30 minutes per day results in maximum depression-fighting benefits, but you don’t have to start there if that seems overwhelming at first. Start with any duration and intensity level that you're pretty sure you can easily manage on most days, and go from there.
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Identify potential problems and barriers in advance. Create a “Plan B” to deal with them before they happen. If your biggest problem is letting your depression talk you out of exercising, think about what’s different about the days when that doesn’t happen and figure out how to make that happen more often. If you need someone to give you a little push sometimes, find an exercise buddy or someone you can call for a pep talk when you need it. If you normally like to exercise outside, but the weather is fickle, line up some alternative exercises you can do at home.
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Prepare for setbacks. Regular exercise isn’t always easy or fun. It's common to allow one missed workout to confirm all the worst things you think about yourself—that you’re a hopeless failure, or that nothing works no matter what you do. The best defense against this kind of depressive thinking is a good offense. Give yourself full credit for the times you manage to do the exercise, and especially, the times when you manage to get right back to it after missing a session or two. Keep a written record of these times, with some brief notes about how you felt afterward, and look at it when those negative feelings arise again.
If you're like most people who struggle with depression, believing (and doing) most of the things listed here is going to feel a little unnatural and uncomfortable at first—especially if you’ve dealt with chronic depression for a long time. But if you can manage to make the leap of faith it takes to believe things can change for the better, the results will prove that your efforts are well worth the work.
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