The Influence Of Regular Exercise On Depression: Evidence-Based Strategies For Mental Health Enhancement

  • Muhammad Iqbal Master of Science -MSc, Pharmacology and Drug Discovery, Coventry University, UK

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Depression is more than just a few days of feeling down or upset. While most people have periods of sadness, depression is characterised by a continuously depressing emotion that lasts for weeks or months.1 An estimated 3.8% of people suffer from depression, including 5.7% of individuals over 60, and 5% of adults (4% of males and 6% of women). Depression affects about 280 million people worldwide.2 

The last thing you usually want to do when you are depressed or anxious is to work out. However, exercise can have a significant impact once you start and keep going.3 Engaging in physical activities can help reduce feelings of anxiety and depression, and improve your mood. Once you are feeling better, exercise may also help prevent depression and anxiety from returning.3

Understanding depression

The American Psychiatric Association defines depression as low mood and the lack of a positive effect (a loss of interest and delight in commonplace objects and events), accompanied by a variety of related emotional, cognitive, physical, and behavioural symptoms.4

Depression can be exceedingly challenging to diagnose because a large proportion of patients who seek treatment in a primary care setting only report physical symptoms. There is more to the biological relationship between physical pain and sadness than just cause and effect. Depression and related painful physical symptoms must be treated in combination to achieve remission because pain and depression share the same neurochemical route that is regulated by serotonin and norepinephrine (noradrenaline).5

Psychological therapy is important in treating depression in addition to medication. Several studies have demonstrated its potential benefits. Psychological treatment outcomes depend upon various aspects, including the intensity of your symptoms, the quality of your relationship with the therapist, and your particular circumstance.6

The science behind exercise and depression

Research linking exercise and mental health

In addition to its obvious benefits for physical health, physical activity positively impacts mental health. Empirical research has shown a beneficial link between physical activity and specific mental health characteristics. The most notable effects of exercise on body image and self-concept have been observed in nonclinical studies. Exercise has been demonstrated to enhance several mental health conditions and aid in sleep.

Researchers have been examining the relationship between exercise and depression since the turn of the 20th century. Exercise regimens that are structured have been effective in reducing clinical depression symptoms. Moderate-intensity exercise should help with depression and improve mood, according to early case studies, at least for some. 

Numerous studies have examined how well exercise works to lessen depressive symptoms, and the vast majority have found benefits to participating in exercise. For instance, thirty men and women who were living in the community and were moderately depressed were randomised to either the exercise intervention group, the social support group, or the wait-list control group. For six weeks, the fitness regimen included walking three days a week for 20 to 40 minutes each. The exercise programme reduced the depression symptoms related to the body (somatic symptoms) more successfully than the other two groups and also lessened overall symptoms of depression.8

Effect of exercise on brain chemistry

Exercise has been shown to improve brain function in animal models and in numerous human clinical investigations. Exercise has many mechanisms that contribute to its brain-enhancing benefits, including vascularisation (blood vessels growing into the tissue), antioxidation, neuroinflammation, and energy adaptability. Exercise also affects the control of neurotrophic factors, needed for brain cell survival and neurotransmitters, molecules used by brain cells to communicate with each other, such as dopamine, noradrenaline, and serotonin.9

The brain's organic components allow physical exercise to affect neuro-cognition. Neurotrophic factors are among the organic molecules that make up neurotransmitters. Repeatedly performing regular exercise over time may raise or lower the baseline neurochemical level and aid in improving neuro-cognition.10

The most well-established benefits of exercise include enhancing memory and learning, preventing neurodegeneration, and lowering depression, particularly in older individuals. Exercise directly affects synapse formation and potentiates synaptic strength. It also strengthens the underlying mechanisms that support synaptic plasticity, such as neurogenesis, metabolism, and vascular function. More studies have focused on the hippocampus than any other area of the brain, where it has been demonstrated that exercise alters both its structure and function.11

Benefits of exercise on depression

Frequent exercise can reduce anxiety and depression by:

  • Releasing feel-good endorphins. Endorphins have the power to raise feelings of wellbeing and are released after moving your body. 
  • Removing worry from your thoughts. Instead of worrying, exercise can divert your attention from the negative thought patterns that exacerbate anxiety and sadness.

Frequent exercise also provides numerous emotional and mental health advantages. It can assist you in:

  • Developing your self-confidence. Reaching fitness objectives and challenges, no matter how minor, can increase your self-assurance. Gaining physical fitness can also improve your self-esteem.
  • Increasing your social engagement. Engaging in physical activity and exercise may present opportunities for socialising and meeting new people. Your mood might be improved by just grinning and saying hello to people as you go around your neighbourhood or the gym.
  • Healthily dealing with stress. Healthy coping strategies include taking constructive action to control anxiety or despair. Worsening symptoms of melancholy and anxiety might result from trying to feel better with alcohol, obsessing about your feelings, or holding out hope that the condition will pass on its own.12

Types of exercises recommended for depression

A programme of supervised aerobic exercise, consisting of walking indoors or outdoors, stationary cycling, or cross-trainer exercise individually, in a group, or in combined formats, is beneficial for treating depression, according to a study.13 It should be performed three to four times a week, at low to moderate intensity or at the participant's preferred intensity, during 30 to 40-minute sessions. This seems to work well for a variety of co-interventions, such as electroconvulsive treatment, psychotherapy, behavioural interventions for adherence, and medication. Programmes for exercise should last for a minimum of nine weeks. Pre-screening for co-morbid conditions, individualised exercise plans tailored to each client's preferences, facility access, and guaranteeing supervision and follow-up are likely to improve long-term outcomes.13

“Mind-body exercise”, a type of fitness, has been shown in several studies and commentator reports to be beneficial in reducing symptoms of anxiety and sadness in the elderly. Physical and psychological components are integrated in "mind-body exercise". Its goal is to support both physical and mental well-being by emphasising the synchronisation of mental and physical processes. Exercises like yoga, tai chi, pilates, qigong, and dance are commonly included in this practice. Since mind-body exercise is simple to learn and requires little space or equipment, it is popular among older individuals as a complementary and alternative therapy. For instance, studies on older persons have shown that yoga lowers their anxiety and depression levels, and tai chi practice enhances their mental well-being.14

Practical tips for getting started

Perhaps one of the best things you can do for your health is to start with a fitness habit. Engaging in physical activity helps enhance balance and coordination while reducing the chance of chronic illness. It can support self-esteem, sleep, and weight loss. You can start a fitness program in only a few steps.15

  1. Determine your level of fitness: Before you begin your training programme, find out how fit you are and record your results. Utilise the results as a reference point for evaluating your progress and start with small goals that can be reached.
  2. Move forward gradually and begin slowly: Start slowly if you have never exercised before. Gradually increase the level of intensity to a moderate or vigorous one. Try not to increase your weekly activity by more than 10%. Speak with your exercise instructor or healthcare provider if you have any injuries or medical conditions. You, along with anyone supporting you, can create a fitness regimen that gradually increases your strength, endurance, and range of motion.
  3. Make sure to incorporate a variety of activities: Engaging in several exercises, often known as cross-training, can prevent you from growing weary or bored of your workout regimen. By incorporating low-impact activities into your training regimen, you can reduce your risk of overusing or hurting a particular muscle or joint. Cycling and swimming are examples of low-impact exercises. Make sure the exercises you choose each time you work out target various body areas. You might do weight training and then walk or swim the next day.
  1. Give yourself time to heal: Many people have a lot of energy when they first start exercising. However, they exercise for too long or too intensely leading to sore joints or muscles. Ultimately, this can make an individual give up. Allocate time in between workouts to allow your body to recuperate.
  1. Be flexible: It is okay to take one or two days off if you are not feeling well.15 It could allow you to come back stronger and healthier. 

Summary

In summary, the overwhelming body of research demonstrates the positive effects of regular exercise on depression and general mental health. Exercise raises mood and increases general well-being in addition to lowering anxiety and depressive symptoms. Its favourable effects are attributed to the release of feel-good endorphins, the diversion from negative thought patterns, and the opportunity for social involvement. Exercises that target the mind and body, such as yoga and tai chi, as well as cardio and strength training, are also beneficial in treating depression symptoms.

As a result, people must emphasise physical activity as part of their regimen to improve their mental health. When starting an exercise regimen, the three most important things to remember are to start slowly, mix things up, and give yourself time to heal. To succeed over the long run, one must be consistent and make modest growth.

Nevertheless, it is vital to understand that not everyone who struggles with depression will benefit from exercise alone. Comprehensive treatment depends on getting professional assistance as needed, such as counselling or medication. Since mental health is complex, the best chance for recovery and long-term well-being is to take a multidisciplinary strategy that incorporates both professional help and physical activity. Recall that maintaining both your physical and mental well-being are equally crucial, and you should prioritise them simultaneously.

References

  1. ‘Overview - Depression in Adults’. Nhs.Uk, 15 Feb. 2021, https://www.nhs.uk/mental-health/conditions/depression-in-adults/overview/.
  2. Depressive Disorder (Depression). https://www.who.int/news-room/fact-sheets/detail/depression 
  3. ‘Depression and Anxiety: Exercise Eases Symptoms’. Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495. 
  4. Depression in adults: treatment and management. NICE, https://www.nice.org.uk/guidance/ng222 
  5. Trivedi, Madhukar H. ‘The Link Between Depression and Physical Symptoms’. Primary Care Companion to The Journal of Clinical Psychiatry, vol. 6, no. suppl 1, 2004, pp. 12–16. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC486942/
  6. ‘Depression: How Effective Is Psychological Treatment?’ InformedHealth.Org [Internet], Institute for Quality and Efficiency in Health Care (IQWiG), 2020. www.ncbi.nlm.nih.gov, https://www.ncbi.nlm.nih.gov/books/NBK430661/
  7. Mahindru, Aditya, et al. ‘Role of Physical Activity on Mental Health and Well-Being: A Review’. Cureus, vol. 15, no. 1, p. e33475. PubMed Central, https://doi.org/10.7759/cureus.33475
  8.  Craft LL, Perna FM. The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry [Internet]. 2004 [cited 2024 May 6];6(3):104–11. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC474733/ 
  9. Lin, Tzu-Wei, and Yu-Min Kuo. ‘Exercise Benefits Brain Function: The Monoamine Connection’. Brain Sciences, vol. 3, no. 1, Jan. 2013, pp. 39–53. PubMed Central, https://doi.org/10.3390/brainsci3010039
  10. Bhattacharya, Puneet, et al. ‘Impact of Exercise on Brain Neurochemicals: A Comprehensive Review’. Sport Sciences for Health, vol. 19, no. 2, June 2023, pp. 405–52. Springer Link, https://doi.org/10.1007/s11332-022-01030-y
  11. Cotman, Carl W., et al. ‘Exercise Builds Brain Health: Key Roles of Growth Factor Cascades and Inflammation’. Trends in Neurosciences, vol. 30, no. 9, Sept. 2007, pp. 464–72. PubMed, https://doi.org/10.1016/j.tins.2007.06.011
  12. ‘Depression and Anxiety: Exercise Eases Symptoms’. Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495
  13. Stanton, Robert, and Peter Reaburn. ‘Exercise and the Treatment of Depression: A Review of the Exercise Program Variables’. Journal of Science and Medicine in Sport, vol. 17, no. 2, Mar. 2014, pp. 177–82. ScienceDirect, https://doi.org/10.1016/j.jsams.2013.03.010
  14. Dong, Yangjian, et al. ‘The Effects of Mind-Body Exercise on Anxiety and Depression in Older Adults: A Systematic Review and Network Meta-Analysis’. Frontiers in Psychiatry, vol. 15, Feb. 2024. Frontiers, https://doi.org/10.3389/fpsyt.2024.1305295
  15. ‘5 Steps to Start a Fitness Program’. Mayo Clinic, https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/fitness/art-20048269 

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Muhammad Iqbal

Master of Science -MSc, Pharmacology and Drug Discovery, Coventry University, UK

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