Medically reviewed by Susan Kerrigan, MD and Marianne Madsen, University of Utah
At some point, everyone has probably heard the advice to go for a walk or to work out when they’re feeling down. Something about “endorphins,” “getting out of a rut,” or “changing your environment” is usually included in this advice as well. Turns out this isn’t just talk–studies have shown that exercise can help prevent depression in those who are genetically inclined and help improve conditions for those who are already suffering from depression. Dr. Michael Craig Miller of Harvard Medical School is quoted saying: “for some people it works as effectively as antidepressants, although exercise alone isn’t enough for someone with severe depression.”
Why does this work at all? Although there are several hypotheses, there is actually no clear answer. One theory proposes that exercise causes a rise in core body temperature, which reduces depression symptoms. The endorphin hypothesis, of course, is probably a familiar one to most–after exercising there’s elevated release of endorphins, the “feel good” chemicals in the body, which are related to a positive sense of well being. When analyzing the benefits of exercise over time, neuroscientists have also seen an improvement in brain function, particularly in the hippocampus (or mood regulator), through the growth and new connections of nerve cells. Scientists have noticed that the hippocampus is smaller in those with depression, which has led to the hypothesis that this building of nerve cells helps reduce depression. Another theory suggests that exercise works as a distraction technique which can help in managing depression. Yet another hypothesis proposes that exercise builds self-efficacy which can provide a depressed person with a feeling of achievement in bringing positive change to their lives. Exercise also has the added benefit of improving health and sleep as well as increasing energy. These are definitely added benefits that can help a person better cope with depression.
As a lot of us who have tried are well aware, one of the main problems with exercise is actually getting started. Even when someone starts with good mental health, it often takes tremendous motivation to work out, and depression can decrease general motivation and make this lifestyle change feel mammoth. Therefore, some of the recommendations to get started are about making this change as easy as possible. Dr. Miller recommends starting with something small and workable–even a daily workout of 5 minutes is a start that can build up over time. Picking something that is enjoyable is important as well to keep up the activity long term. Adding a social element can also help–if you exercise with a friend, they can provide motivation and encouragement.
It’s important to remember that exercise doesn’t just mean treadmills, gyms, and weights. Often elderly patients suffer from depression or their physical condition may cause depression–and exercising is something that can help them too. Although many of these patients are treated with antidepressants, about 30-35% of patients either don’t respond to medication or the medications cause problematic side effects. Research showed that depressed older patients actually benefited from an exercise program with comparable results to medically treated patients.
Ultimately, it’s always good to remember that while exercise done for the purpose of medical treatment offers no guarantees, working on working out comes with little to lose–except perhaps a few pounds and a grey cloud or two.
- Craft LL, Perna FM. The Benefits of Exercise for the Clinically Depressed. Prim Care Companion J Clin Psychiatry. 2004;6(3):104–111. doi:10.4088/pcc.v06n0301
- Blumenthal JA, Babyak MA, Moore KA, et al. Effects of Exercise Training on Older Patients With Major Depression. Arch Intern Med. 1999;159(19):2349–2356. doi:https://doi.org/10.1001/archinte.159.19.2349