If you feel an improvement after exercise, you’re in good company. Movement can lift your mood, and according to the results of a new study, it can also help alleviate symptoms of depression.
As part of an evidence review by the Cochrane collaboration — an independent network of researchers —, scientists evaluated 73 randomized controlled trials that included about 5,000 people with depression, many of whom also tried antidepressant medications.
“We found that exercise was as effective as pharmacological treatments or psychological therapies as well,” says Andrew Clegg, professor at the University of Lancashire, in the UK.
The findings don’t surprise psychiatrist Dr. Stephen Mateka, medical director of psychiatry at Inspira Health. “This new Cochrane review reinforces the evidence that exercise is one of the most evidence-based tools for improving mood,” says Mateka.
He explains how this mirrors some of the effects of medication. “Exercise can help improve the function of neurotransmitters, like serotonin, as well as dopamine and endorphins. So, there is certainly an overlap between exercise and how antidepressants provide relief,” says Mateka.
In other words, exercise helps release chemicals in the body known to lift mood.
And there’s another powerful effect too. Exercise can trigger the release of brain growth factors, explains Dr. Nicholas Fabiano from the University of Ottawa. He says that depression can reduce neuroplasticity, making it harder for the brain to adapt and change.
“The brain in depression is considered less plastic. So, there’s less of what we call neurotrophic factors, or BDNF,” explains Fabiano. He calls it Miracle-Gro for the brain. “And we know that exercise can increase it too. So, I think exercise is a fundamental pillar that we really need to recommend to patients,” he says.
And while medications and therapy are important tools, Fabiano says exercise is recognized as a preferred treatment for depression.
“Exercise has been adopted as a first-line treatment in global guidelines for depression, with good acceptability and safety,” he writes. However, he says it remains undervalued and underutilized.
“It’s much easier for a primary care doctor to prescribe medication to a patient. You just write it on a pad,” says Fabiano. It’s harder to prescribe exercise, which requires time and effort and can be difficult to start for depressed people.
Fabiano says exercise may work best as part of a combination of treatments. “We can start someone on an antidepressant — maybe that improves their mood, and they can engage in therapy. And from there, maybe now they’re more interested in starting some of those lifestyle habits, like exercise,” says Fabiano.
How Much Exercise Is Enough?
The evidence shows that light to moderate exercise — where you raise your heart rate enough to feel slightly out of breath — can be as beneficial as vigorous or intense exercise, at least at the beginning. And Fabiano says it’s okay to start with a “low dose”.
“In the end, you want to progress. But going from completely sedentary to just going for a walk every day, that’s where you start to see those exponential gains,” he says, emphasizing the importance of starting with modest amounts.
The study found that a combination of aerobic exercise and resistance training appears to be more effective than aerobic alone. The meta-analysis found that between 13 and 36 workouts led to improvements in depressive symptoms, although long-term follow-up was rare. Researchers say there’s more to learn about how regular exercise can help prevent depression.
Mateka says there are many options. “When it comes to exercise, it’s about finding the exercise that works for you, like something like yoga or tai chi versus something like walking and running,” he says. For some, group activity can add psychosocial benefits.
At the end of the day, it’s best to choose something you enjoy or return to an activity or sport you enjoyed in childhood.
“Exercise is something with extremely low cost. It’s very accessible. It has minimal side effects. And it has the opportunity to impact you positively, mentally, emotionally, socially, and physically,” says Mateka.
Source: npr.org by Allison Aubrey