Research shows that 24% of women and 13% of men in England are diagnosed with depression in their lifetime. Anxiety and depression are at an all time high as a result of the global pandemic.
I have struggled recently, as many of us have, trying to cope with the uncertainties and challenges the global pandemic has thrown at us. My main coping mechanisms when things are hard are exercise, mindfulness meditation and self compassion.
I’ve written about all three topics before in the following blog posts:
- Exercise and mental health: why is it so good for our minds
- Self-compassion and being kind to yourself: how it can help you feel your best self
- Feel good with mindfulness meditation
Here I am focusing on exercise as an effective treatment for depression and a natural alternative to antidepressants.
Exercise as an antidepressant: the science
There is a wealth of literature supporting the notion that exercise is as effective an intervention for depression as medication. In fact, many GPs are now actively prescribing exercise as a treatment for depression.
Dr Brendon Stubbs has written extensively about this topic. Stubbs refers to a study, by Schuch et al, published in the American Journal of Psychiatry, in 2018 which followed 260,000 people and their exercise habits over 7 years. The study showed that people following recommended activity guidelines were 30% less likely to develop depression. Stubbs’s research has shown that even if you are predisposed in your genetic make-up to develop depression, exercise can act as a preventative measure.
Studies on sedentary behaviour, in people who were previously active, have shown that after just a week of low activity, signs of stress, anxiety and depression start to emerge. This is something a lot of us know intuitively but it’s great to see the research base growing in this area.
Exercise as preferable to antidepressants
Exercise doesn’t carry the same stigma as medication and can empower individuals to have ownership over their illness. This can then also help to treat the symptoms of depression by providing a sense of hopefulness and optimisim for the future. Exercise does not pose the same risks in terms of negative side effects as medication. In fact, it does the opposite and reduces the risk of developing heart disease, stroke, high blood pressure and many cancers. Once exercise becomes an engrained habit it can safely be done for the long term.
So why does exercise make us feel so good
Exercise taps into our body’s reward system and triggers the release of feel-good chemicals like endorphins, adrenaline and dopamine. This is what people experience when they talk of the “runner’s high”.
How exercise benefits the brain
Low-intensity aerobic exercise has a powerful effect on brain growth. Dr. Michael Craig Miller, assistant professor of psychiatry at Harvard Medical School notes: “In people who are depressed, neuroscientists have noticed that the hippocampus in the brain—the region that helps regulate mood—is smaller. Exercise supports nerve cell growth in the hippocampus, improving nerve cell connections, which helps relieve depression,” So exercise can actually rewire the brain!
Endocannabinoids and exercise
In her book The Joy of Movement kelly McGonigal explores the lesser understood endocannabinoid system also known as the “don’t worry, be happy” chemicals. The amygdala and the prefrontal cortex, areas of the brain that regulate the stress response system, are rich in receptors for endocannabinoids. When endocannabinoid molecules lock into these receptors they reduce anxiety and induce a state of contentment. Endocannabinoids also increase dopamine in the brain’s reward system which further fuels feelings of optimism. Research shows that exercise increases the endocannabinoid system in the brain.
McGonigal writes “endocannabinoids alleviate pain and boost mood… and many of the effects of cannabis are consistent with descriptions of exercised induced highs, including the sudden disappearance of worries or stress, a reduction in pain, the slowing of time and a heightening of the senses”.
McGonigal talks about sticking with something which raises your heart rate for 20 minutes which will then ensure a high of some sort. Interestingly research has shown that when endocannabinoids are inhibited feelings of anxiety or depression are more likely to increase.
The more active we are the more our brains change and the more dense the binding sites in the brain become for endocannabinoids. The brain then starts to crave the feeling of exercise. This is fascinating and explains a lot in terms of why some people really need the buzz and the feel good factor they get from exercise.
Myokines and mental health
McGonigal also clearly outlines the role of Proteins called myokines in this process. Every time we move a muscle myokines are released by the muscles into the blood stream . There are 35 different types of myokines all producing positive effects on the body.
Myokines have been shown to demonstrate positive effects on mental health. They can help to protect brain cells and even generate new neurons. They reduce the impact of anxiety, depression and neurological conditions such as Parkinson’s.
It’s not surprising that they are dubbed by scientists as the “hope” molecule. The most exciting thing about this is that you don’t need to move that much for myokines to be released into your bloodstream. Walking, running, jogging, swimming, cycling, hiking and high intensity workouts have been shown to release myokines. The more you move the more myokines!
The challenges of exercise and depression
Exercise might be the last thing an individual feels like doing when they are depressed. Sometimes it’s hard enough to muster the willpower to get out of bed let alone go for a run. From experience I know how hard this can be. It’s all about starting small and setting managable goals. Getting out for a 5 minute walk could all that it takes to get moving and onto a positive pathway.
The National Institute for Health and Care Excellence (NICE) recommends that people with mild to moderate depression take part in about 3 sessions a week. Each session lasting 45 minutes – 1 hour.
Doing an activity you like and enjoy is also super important. See my post how you can learn to like exercise for life.
