Exercise not only changes your body, it changes your mind, attitude and mood. – Unknown
The unknown author of the quote obviously knew what he was talking about. Last week, Newswire published an article citing the results of a study conducted at the Royal College of Surgeons in Dublin and published in Psychosomatic medicine.
A study of patients with heart disease and depression
The study examined three treatment options for heart disease patients who suffer from depression. Options include psychotherapy, antidepressants, exercise, and combined psychotherapy and medication. Lead author Dr. Frank Doyle concluded that “exercise is likely to be the best treatment for depression after coronary artery disease. Our findings further highlight the clinical importance of exercise as a treatment, as we see that it improves not only depression but also other important aspects of heart disease, such as lowering blood pressure and cholesterol in these patients.
As a psychiatrist who treats many patients with co-occurring physical and mental problems, I recommend regular exercise as part of a multifaceted approach to treating depression and anxiety. Not only for weight control, managing sleep problems and a host of physical disorders, it’s also good for your brain – the computer in your head where psychiatric symptoms occur. Not only do I recommend this, but I practice what I preach, and I was one of the many who purchased Peloton at the start of the pandemic. Unlike those who now use it as an expensive clothes hanger, I continue to use mine regularly.
According to the World Health Organization, the global prevalence of anxiety and depression increased by 25 percent in the first year of the COVID-19 pandemic. In the United States, 40 million adults suffer from anxiety disorders. Earlier this month, the U.S. Preventive Services Task Force recommended anxiety screening for adults under age 65. The draft recommendations are designed to help primary care clinicians identify early signs of anxiety during routine care.
How Exercise Treats Depression and Anxiety
How does exercise treat depression and anxiety? In my review of multiple clinical studies, exercise treats depression and anxiety in the following ways:
- Psychosocial and cognitive factors: Using data from individual physical therapy aerobic exercise regimens over a period of up to 10 weeks, researchers found that exercise can increase your sense of self-worth, self-esteem, sleep quality, and life satisfaction. Some studies document that during exercise, you may seek social support, which reduces loneliness. Based on psychological and social benefits, group exercise may be more effective than individual exercise.
- Anti-inflammatory factors: It is well known that inflammation is involved in the development of depression. Stress can cause your brain to release chemicals that lead to an experience of depression and/or anxiety. In a 12-week study of adult patients with depression, aquatic exercise reduced depression and anxiety, as well as inflammation.
- Brain Growth: The antidepressant effects of exercise are linked to neurogenesis, the process by which your brain increases the number of brain cells. In addition, exercise is positively associated with increased neuroplasticity—the brain’s ability to form new connections and pathways and change the way its circuits are connected.
- Release of natural chemicals that make you feel good: Endorphins, the natural brain chemicals similar to cannabis, are elevated during vigorous exercise. This probably explains the well-known “runner’s breath”.
- Reducing stress hormones: Cortisol is one of the stress hormones in your body that is released as part of the fight or flight reflex. It turns off less critical functions like reproduction and immunity to focus on fighting a perceived threat. This would be very useful if you were held at knifepoint. However, this is not ideal when we live in our modern world where stress is everywhere. Too much cortisol for too long can have serious negative effects. Elevated cortisol leads to tissue breakdown, decreased protein production, and the conversion of protein to glucose, which can decrease muscle content and increase belly fat. It also suppresses growth hormone and sex hormone levels, which can reduce your libido and fertility. It reduces your body’s use of glucose and raises blood levels, potentially predisposing you to diabetes. It can also lead to calcium reabsorption, increasing the risk of osteoporosis. Exercise is perceived by the body as a form of stress and initially stimulates the release of cortisol. However, the more your fitness improves, the better your body becomes at handling physical stress. This means that less cortisol will be released during exercise and, more importantly, in response to emotional or psychological stressors.
- distraction: When you engage in vigorous exercise, it takes your mind off the things that worry you. You can take a break from the cycle of negative thoughts that fuel depression and anxiety.
Okay, so the thought of hopping on a spin bike or going for a run isn’t your idea of a good time, especially if you’re feeling depressed. But exercise can include a wide range of activities that can increase your heart rate. Gardening, washing the car, or cleaning the house can all count as exercise. Any physical activity that gets you off the couch can improve your mood. Even better, all your exercises don’t have to be done in one session. Most experts recommend 30 minutes of vigorous exercise five times a week for maximum benefit. You can break this up into two 15-minute sessions or even three 10-minute sessions per day. When it’s broken down like that, it doesn’t seem too overwhelming, does it?
According to a study published in International Journal of Environmental and Public Health Research, 11.4 suicides occur for every 100,000 people worldwide, representing 804,000 deaths. Available data shows that the number of suicides among young people continues to rise rapidly. The researchers wondered whether physical activity might be a protective factor against suicidal ideation in different populations. They conducted a systematic review that documented individuals with high levels of physical activity as having lower levels of suicidal ideation than those with low levels of activity.
A study published in British Journal of Sports Medicine found that exercise was equivalent to antidepressants in the effective treatment of mild to moderate depression. Interestingly, adding an antidepressant to an exercise regimen did not increase the drug’s effectiveness. In the study population, exercise alone as a treatment worked as well as medication.
This in no way negates the need and usefulness of antidepressants, which for many can be life-saving. However, for those who would prefer to avoid medication and suffer from mild to moderate symptoms, a regular exercise program can be part of a holistic health approach to treating common psychiatric symptoms such as depression and anxiety. Along with diet, limited alcohol, quality sleep and social interaction, exercise can make a positive difference to the health of your body and mind.