The Doctor Is In: Rx: Exercise for Depression

Have you ever noticed that artistic renditions of the past depict well-to-do folks as pale and plump? This was a manifestation of their socioeconomic status. Unlike the majority of their lower- income counterparts, they had an abundance of aliment and no need to perform hearty manual labor while being exposed to the elements. Ironically, esteemed and well-to-do folks of our time have evolved to appear tan and slim, also a symbol of socioeconomic status. Their appearance suggests they have the time and money to live what is now known to be a healthy lifestyle; exercising, eating healthy/well prepared foods and spending stress-free time outside of a cubicle.
Exercise is a creation of modern times within developed nations, as most people lived an active lifestyle prior to the Industrial Revolution and the non-stop inventions of apparatuses that have moved the human race to the state of modern life we now know. However, depression, unlike exercise, is an unremitting and pervasive disorder that has existed through the continuum of time, without physical or socioeconomic boundaries.
Although depression is a treatable and/or curable disorder, antidepressants alone do not adequately treat many patients. It has been well known that adjunctive psychotherapy has a higher success rate than antidepressants alone. Of note, recent studies show the benefits of exercise may be comparable to those of psychotherapy. This news flash may not be surprising as positive lifestyle changes, particularly exercising to improve mood have been well known for some time.
The mechanisms of exercise on mood include:
• Increased levels of endorphins in the central nervous system (AKA runner’s high) which is your brains natural opioid/narcotic system that provides euphoria and pain control during more intense levels of exercise.
• Changes on neurotransmitters (chemicals in the brain) similar to antidepressants (serotonin and norepinephrine) which are associated with increased mood, energy and ability to focus/concentrate.
• Improved self-esteem.
• Distraction from daily stressors.
• Body-mind “biofeedback” that induces a relaxed state.
Although all of these benefits sound great, there may be serious barriers to exercising. A significant concern is the lack of motivation that depressed individuals tend to experience. Other barriers may include lack of time, northern latitudes (long, cold winters), fear, negative experiences or perceiving exercise as monotonous or boring.
All this talk of exercise does not entail signing up for the next local marathon and starting a strict and vigorous exercise regime, unless that is your thing. To obtain the antidepressant effect of exercise, a brisk walk around the neighborhood is sufficient. The American Heart Association offers helpful tips for increasing daily exercise at home, at work and at play.
“Walking is the best possible exercise.”
-Thomas Jefferson

Christopher J. Helfer, MD