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[EXERCISE IS MEDICINE]

[PATIENT ADVISER]

Mobilize Against Depression

Michal Artal, MD, with Carl Sherman

Series Editor: Nicholas A. DiNubile, MD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 26 - NO. 10 - OCTOBER 2021


Mainstay treatments for depression—psychotherapy and prescribed drugs—are extremely effective. But there are also things you can do for yourself to feel better, and one of the best of these is exercise.

While exercise cannot take the place of medical care and therapy, it often is highly beneficial. Studies have shown that regular physical activity can brighten mood, increase energy, and improve sleep. It may not work this way for everyone, but most exercisers of all ages increase their stamina and reduce their risk of diseases like diabetes, heart disease, and osteoporosis. Especially when you are depressed, it is good to know that you are taking positive action for your health.

What Kind of Exercise?

No one form of exercise has been shown to be superior for depression. Aerobic activities (for example, brisk walking, jogging, swimming, and biking) and nonaerobic activities (stretching and weight training) are both beneficial. Walking at any pace, the most readily available exercise, may be an especially handy option.

What is important is to choose a physical activity that you enjoy—and to do it regularly. You do not need to push yourself to extremes. In fact, studies have shown that moderate exercise improves mood more than excessively long, hard workouts. Your goal should be to feel pleasantly tired, a normal feeling after any physical activity.

A program that many people find easy, pleasurable, and valuable is 30 to 45 minutes of walking, three to five times a week. The American College of Sports Medicine also recommends strength training two to three times a week and flexibility workouts two to three times a week.

But if you are not used to exercise, you may need to work up to this level gradually. Just a few minutes of walking (or other exercise) is a good place to start, and you may find that in a few weeks you want to do it longer and more often.

Be Realistic

Many people who have depression experience a lack of energy, fatigue, and difficulties with motivation, which can present significant exercise hurdles. The key is to start slowly and be patient with yourself: Time is on your side. As your depression lifts with the help of treatment, you will probably find it easier to exercise. The half-hour walk that looks impossible today may feel invigorating 3 weeks from now.

Don't let exercise become a burden. Try to fit it into your schedule as much as you can: Taking a 15-minute walk at lunchtime may make a lot more sense than getting up an hour earlier for a morning workout. You get similar fitness benefits when you break your exercise into smaller, more manageable chunks throughout the day.

Maximize the Pleasure

What kind of exercise is most enjoyable for you? Choose activities and settings that will increase the fun. Here are a few things that others have found useful:

Make it social. Exercise is a good way to spend time with other people. Join an aerobics class or a regular walking group, or simply arrange for a lunchtime stroll with a health-minded coworker.

Exercise outdoors. Trees, grass, pleasant surroundings—nature has a way of lifting spirits and putting things in new perspectives. Outdoor light has been shown to improve mood, especially during the winter months.

Create a positive environment. Put on your favorite music while you work out at home, or wear headphones when you jog or stroll, as long as you're away from heavy traffic.

Remember: This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.

Dr Artal is assistant professor of psychiatry at Saint Louis University in Missouri. Mr Sherman is a freelance writer in New York City. Dr DiNubile is an orthopedic surgeon in private practice in Havertown, Pennsylvania, specializing in sports medicine and arthroscopy, and a member of the editorial board of The Physician and Sportsmedicine.


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