It's always on the to-do list for disease prevention and overall good health, but regular physical activity appears to have antidepressant qualities, too. While questions remain, the picture on exercise and depression is becoming clearer: Getting up and moving seems to help people get on top of a bout of depression or keep a recurrence at bay. Here's the skinny so far:
There is some relationship, not fully understood, between mood and movement. A good body of observational research suggests that people who are physically active are less likely to be depressed than those who tend to sit on their couch instead. "The problem is you don't know which came first," says James Blumenthal, exercise researcher and professor in the department of psychology and neuroscience at Duke University. It is simply not yet clear if such people are physically active because they're less depressed to begin with. Alternatively, researchers wonder if exercise holds some preventive powers that either stop symptoms of depression from cropping up altogether or somehow lessen depression's effects by dampening its edge.
You don't have to overdo it. The jury is still out on the optimal dose of exercise to fight depression. But Blumenthal thinks the benefit is "in going from zero to something" rather than from getting some exercise to adding much more. Besides, the risk of injury with too much exercise could put you on the disabled list—depriving you of any of exercise's antidepressant benefits. In the absence of definitive research on the amount of exercise needed to glean a benefit, experts agree that the general recommendations for physical fitness apply here: about 30 minutes a day on most days of the week. A 2009 analysis by the Cochrane Collaboration, an independent research group that does systematic reviews of healthcare interventions, found in studies that looked at depression and anxiety in people 20 or younger that the intensity level of the exercise did not appear to make a difference.
Probably best to try aerobic activity for a brain benefit. Most research has looked at the effect of aerobic activities—like running, biking, or walking—on mood. The particular type of aerobic exercise doesn't seem to matter, says Andrea Dunn, an exercise science researcher in Golden, Colo., and a principal investigator on a pilot study exploring the impact exercise has on mood in depressed adolescents. Some preliminary research has suggested that weight lifting and strength training might also provide a benefit, but the evidence is less robust. "I have confidence in aerobic exercise," says Blumenthal. "There is less data on strength training."
Using an exercise log could help. Suiting up to go for a jog might be the last thing a person battling the lows of depression will find appealing. But research has suggested that depressed patients who document their exercise are helped to keep at it. Experts advise clinicians who write their depressed patients "a prescription" for regular physical activity to add a second prescription to track their progress in a physical activity log.
The benefit is both psychological and physiological. The impact of exercise on the depressed brain appears to take several forms, but the long-touted "feel good" endorphins aren't necessarily the answer, says Dunn. "Exercise induces all these neural growth factors," she says, and "creates new neurons in your brain." The result: bolstered connectivity that could play a critical role in the depressed brain, which is often operating with a deficit of these connections. Also very important, explains Blumenthal, is the fact that keeping up a regular workout regimen seems to reinforce self-confidence and a sense of being in control of one's health.
Try it on your own, but don't be afraid to get professional help. Dunn suggests working your way up to three hours of moderate-intensity exercise per week—about 30 minutes, six days a week—while monitoring your mood. "If there's not an improvement, you need to see a professional." Bringing a bout of depression into abeyance might require tackling it from multiple angles. People who don't have a complete remission of depression symptoms with an antidepressant medication or talk therapy might benefit by adding a regular workout regimen, says Dunn.