Whether you are newly diagnosed with depression or simply searching for more information, this article covers things you should know about exercise and depression. We intend to share some powerful research that shows how exercise can be used as a preventive, adjunctive, or alternative treatment for depression. You’ll also read about myths and widely-disputed facts about exercise for depression and, most importantly, what you should be doing to get the most from your daily exercise routine.
What is Depression?
Before we can debunk myths about exercise and depression, it is important to define what depression even is. Depression is not the same as simply feeling sad and can manifest in many different ways. According to the American Psychiatric Association (2013), depression involves two or more weeks of depressed mood in a way that significantly impacts the individual’s functioning in one or more areas of life (social relationships, work, etc.).
Some common symptoms include:
- Changes in sleep (too much or too little)
- Loss of interest in things that previously were engaging
- Feelings of guilt and/or worthlessness
- Decreases in energy
- Difficulties with cognition (concentration, slow mental processes)
- Appetite changes (increase or decrease)
- Anhedonia: the inability to feel pleasure
- Suicidal thoughts or preoccupation with death
Depression affects 1 in 15 adults each year and 1 in 6 people will experience it in their lifetime. It tends to emerge in the late teens to mid-twenties, but people can experience depression at any age.
More on Exercise and Depression
We’re all aware of the most common treatments for depression: medication and psychotherapy. And while no one is denying their effectiveness, some may be wondering what else can be done.
Truthfully, many have questioned the ability of exercise to prevent and/or treat depression due to popularized misconceptions about the topic. However, a recent study found that people with higher levels of physical activity were 17% less likely to develop depression than those with lower levels (Schuch et al., 2018). This supports older research that showed people with lower exercise habits to be at a greater risk of developing depression (Mammen and Faulkner, 2013; Teychenne et al., 2010).
Because of studies like these, people are asking important questions about the specific benefits of exercise on depression and how to take advantage of them. Follow along as we debunk 5 of the most common myths about exercise and depression.
Debunking 5 Popular Myths about Exercise and Depression
Myth: Exercise works for people with depression because it releases endorphins in the brain.
Fact: Despite their best efforts, researchers aren’t quite sure how to describe the complex relationship between exercise and depression. Their best guess is that exercise affects multiple pathways in the brain, including the release of endorphins, which may explain the depth of its effects on depression.
Tell me more. There’s no denying that exercise triggers chemical changes in everyone’s brain. However, these changes are more pronounced in those with depression due to faulty brain chemistry associated with the condition (Albert, Benkelfat, & Descarries, 2012).
Experts have determined that certain areas in the brain are more affected by depression than others. Importantly, depression affects the hippocampus, an area of the brain that is responsible for processing emotion and regulating stress. And although we know that exercise can promote brain plasticity, aka the brain’s ability to change and adapt, researchers are not yet sure how to best take advantage of that process in people with depression.
But, that’s not to say that it’s not possible. Neuroplasticity could very well be the answer that explains why we experience an endorphin-like effect that Elle Woods’ mentions in the movie, Legally Blonde. It should come as no surprise that more research needs to be conducted on this topic, especially if we want to understand how to stimulate neuroplasticity in those with depression.
Another promising exercise and depression study showed that levels of brain derived neurotrophic factor (BDNF) are lower in people with depression (Krogh et al., 2017). Interestingly, this protein plays a key role in so many healthy processes, including cell growth, learning, protection, and energy use in the brain. Therefore, it makes sense that low BDNF levels might contribute to the chemical changes that are commonly seen in those with depression.
Finally, it’s been well documented that exercise lowers inflammation in the body and improves upon our response to physical stressors (Paolucci et al. 2018). Experts have identified a relationship between chronic levels of inflammation and depression and state that exercise is an effective treatment to address both.
Myth: Exercise can only help my depressive symptoms because it makes me feel better about my body.
Fact: While the mind-body connection means that improvements in physical health will also contribute to improvements in mental health, there are actually many psychological mechanisms that are directly related to both depression and exercise that help with alleviating symptoms of depression.
Tell me more. First, exercise helps generally to improve our mood. Even as little as 10 minutes of exercise demonstrates significant improvements in people's mood (Chan et al., 2019). In particular, the dorso-lateral prefrontal cortex (dlPFC) and temporal region (TMP) within the brain are highly related to our mood states. Moderate and high-intensity exercise have both shown to improve participants’ self-reported mood (Ligeza et al., 2021).
Next, exercise increases our self-esteem (general feelings about our worth and competence). One study examining the effects of exercise on self-esteem in women showed that participation in exercise (in this case, exercise circuits, softball, fitball, aerobics, and tae-bo) improved self-esteem after the exercise (Giurgiu & Hantiu, 2010). Furthermore, this improvement in self-esteem is general, but exercise can also make us feel greater competence and worth in relation to our education, family, and social life (Mousavi Gilani & Dashipour, 2017).
Lastly, exercise does have the ability to enhance our sense of social support, particularly for older adults. One study found that for older adults with depression, out-of-home exercise significantly increases their social support systems and can reduce their symptoms of depression (Herbolsheimer et al., 2018). Additionally, recent research responding to experiences during the COVID-19 pandemic suggests that exercise has served as a source of resilience and social support for people of all ages, including those with depression (Carter & Alexander, 2021).
Each of these components (mood states, self-esteem, and social support) serve as protective factors against depression. Therefore, engaging in exercise helps to manage depressive symptoms at least in part because of these associated changes.
Myth: Working out after pregnancy can reduce the risk of developing postpartum depression.
Fact: Turns out what you do during pregnancy matters, too. Research shows that lower physical activity levels during pregnancy can have domino effects on physical and mental health, even after the baby is born.
Tell me more. Exercise and depression studies on women during and after pregnancy have found startling results. They reveal that being sedentary during pregnancy is linked to an increased risk for postpartum depression (PPD), whereas those who exercise during pregnancy are less likely to develop PPD or depressive symptoms (Kandola et al., 2019). Plus, given how difficult it can be to transition into parenthood, it’s likely that sedentary behavior during pregnancy will continue afterwards, thus doubling the risk of developing PPD.
New parents should take comfort in knowing that there is promising research that supports exercise in preventing and treating PPD. Recommendations include aerobic exercise, stretching, yoga, and weightlifting, once your physician deems these activities to be safe for your body. Women who have a personal or family history of depression may have an increased risk of developing PPD and should definitely prioritize safe exercise habits during pregnancy.
Our bodies change dramatically during the pre- and postnatal stages and while not all people struggle with body image during/after pregnancy, it is a common concern (Roomruangwong et al., 2017). Physical activity does show benefits for improved confidence, body image, and mood. Particularly for women, higher levels of physical activity are strongly linked with improvements in body image (Campbell & Hausenblas, 2019). Resistance training, in particular, increases body satisfaction, appearance evaluation, and decreases anxiety about one’s physique (SantaBarbara et al., 2017). Therefore, exercise may be an important factor in maintaining a positive (or at least neutral) body image.
Admittedly, when exercise could be most efficacious, it typically occurs when a caregiver/new parent might be less likely to undertake exercise due to the physical symptoms of depression (i.e. fatigue, diminished concentration, disturbed sleep, appetite, etc.), thus, adversely affecting motivation and activity levels.
Myth: You should be doing low-intensity workouts to lower your risk for depression (or reducing current symptoms).
Fact: This myth couldn’t be further from the truth. Experts now recommend doing moderate-intensity exercise if you want to lower your risk for depression. Also, those with depression should engage in moderate-intensity exercise to reduce ongoing symptoms.
Tell me more. More and more studies on people with depression have found that moderate-intensity exercise reduces depressive symptoms and can enhance other treatments (such as medication or psychotherapy). You also may be interested to know that some research studies consider higher intensity aerobic exercise, like cycling or running, to have a similar effect.
What about everyone’s favorite method of exercise, high-intensity interval training (HIIT)? According to some experts, proceed with caution if you’re using HIIT to combat depression (Paolucci et al., 2018). Although it can effectively lower depressive symptoms, HIIT has also been known to increase levels of perceived stress, probably due to more strenuous exercise. Those who are used to a high-intensity workout pace should be fine, but newer HIIT lovers may want to take a gradual approach to interval training.
Other forms of exercise, like resistance training (weight lifting) elicit a divergent physiological response to aerobic exercise and may have a differential impact on the brain and psychosocial factors, such as self-esteem. One study examining the effects of a 12-week resistance exercise program on self-esteem showed significant improvements in both self-esteem and physical self-worth after engaging in weight training (Moore et al., 2011). Incorporating weight training into your physical activity each week may be particularly helpful if your depression is characterized by poor self-image.
Myth: Exercise will only help you feel better if you are already depressed.
Fact: While exercise does help to manage depression, it can also serve as a preventive measure to ensure that one doesn’t develop depression throughout their lives. You don’t have to already feel symptoms of depression in order to reap the long-term psychological benefits of exercise.
Tell me more. Exercise helps to improve our mental health (like depression), but we can also use exercise as a means of preventing future mental health concerns (Pascoe & Parker, 2019). Regular leisure-time exercise of any intensity can decrease the risk for depression in the future (Harvey et al., 2018). However, there is an optimal amount of exercise to get in a given week that will help to prevent the development of depressive symptoms in the future. Too little exercise and our chances of developing depression increase. However, after a certain point (which is unique to each person), more exercise is not always better (Kim et al., 2019). While too much exercise doesn’t necessarily directly increase the chance of developing depression, overtraining can lead to injuries and burnout, which can lead to mental health concerns.
We’re wondering what myths you have heard about depression and exercise? Share your questions and comments below!
Written for Fitness Blender by Haley S, PhD
Licensed Psychologist
and
Kayla C, PT, DPT
Board-Certified Neurological Clinical Specialist
References
Albert, P. R., Benkelfat, C., & Descarries, L. (2012). The neurobiology of depression--revisiting the serotonin hypothesis. I. Cellular and molecular mechanisms. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 367(1601), 2378–2381. https://doi.org/10.1098/rstb.2012.0190
American Psychological Association (2013). Depressive Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.CautionaryStatement
Campbell, A., & Hausenblas, H. A. (2009). Effects of exercise interventions on body image: A meta-analysis. Journal of health psychology, 14(6), 780-793.
Carter, T., Bastounis, A., Guo, B., & Jane Morrell, C. (2019). The effectiveness of exercise-based interventions for preventing or treating postpartum depression: a systematic review and meta-analysis. Archives of women's mental health, 22(1), 37–53. https://doi.org/10.1007/s00737-018-0869-3
Carter, A., & Alexander, A. C. (2021). “It’s a whole different atmosphere”: A qualitative examination of social support as a facilitator of exercise during the COVID-19 pandemic. Health Promotion Practice, 22(5), 622-630.
Chan, J. S., Liu, G., Liang, D., Deng, K., Wu, J., & Yan, J. H. (2019). Special issue–therapeutic benefits of physical activity for mood: A systematic review on the effects of exercise intensity, duration, and modality. The Journal of Psychology, 153(1), 102-125.
Giurgiu, A., & Hanțiu, I. (2010). The impact of physical activity on body fat and self-esteem in adult women. Health, Sports, & Rehabilitation Medicine, 21(3), 179-184.
Harvey, S. B., Øverland, S., Hatch, S. L., Wessely, S., Mykletun, A., & Hotopf, M. (2018). Exercise and the prevention of depression: Results of the HUNT cohort study. American Journal of Psychiatry, 175(1), 28-36.
Herbolsheimer, F., Ungar, N., & Peter, R. (2018). Why is social isolation among older adults associated with depressive symptoms? The mediating role of out-of-home physical activity. International Journal of Behavioral Medicine, 25, 649-657.
Kandola, A., Ashdown-Franks, G., Hendrikse, J., Sabiston, C. M., & Stubbs, B. (2019). Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neuroscience and biobehavioral reviews, 107, 525–539. https://doi.org/10.1016/j.neubiorev.2019.09.040
Kim, S. Y., Park, J. H., Lee, M. Y., Oh, K. S., Shin, D. W., & Shin, Y. C. (2019). Physical activity and the prevention of depression: A cohort study. General Hospital Psychiatry, 60, 90-97.
Krogh, J., Hjorthøj, C., Speyer, H., Gluud, C., & Nordentoft, M. (2017). Exercise for patients with major depression: a systematic review with meta-analysis and trial sequential analysis. BMJ open, 7(9), e014820. https://doi.org/10.1136/bmjopen-2016-014820
Ligeza, T. S., Nowak, I., Maciejczyk, M., Szygula, Z., & Wyczesany, M. (2021). Acute aerobic exercise enhances cortical connectivity between structures involved in shaping mood and improves self-reported mood: An EEG effective-connectivity study in young male adults. International Journal of Psychophysiology, 162, 22-33.
Moore, J. B., Mitchell, N. G., Bibeau, W. S., & Bartholomew, J. B. (2011). Effects of a 12-week resistance exercise program on physical self-perceptions in college students. Research quarterly for exercise and sport, 82(2), 291-301.
Mousavi Gilani, S. R., & Dashipour, A. (2017). The effects of physical activity on self-esteem: A comparative study. International Journal of High Risk Behaviors and Addiction, 6(1), 1-6.
Pascoe, M. C., & Parker, A. G. (2019). Physical activity and exercise as a universal depression prevention in young people: A narrative review. Early intervention in psychiatry, 13(4), 733-739.
Schuch, F. B., & Stubbs, B. (2019). The Role of Exercise in Preventing and Treating Depression. Current sports medicine reports, 18(8), 299–304. https://doi.org/10.1249/JSR.0000000000000620
Paolucci, E. M., Loukov, D., Bowdish, D., & Heisz, J. J. (2018). Exercise reduces depression and inflammation but intensity matters. Biological psychology, 133, 79–84. https://doi.org/10.1016/j.biopsycho.2018.01.015
Roomruangwong, C., Kanchanatawan, B., Sirivichayakul, S., & Maes, M. (2017). High incidence of body image dissatisfaction in pregnancy and the postnatal period: Associations with depression, anxiety, body mass index and weight gain during pregnancy. Sexual & Reproductive Healthcare, 13, 103-109.
SantaBarbara, N. J., Whitworth, J. W., & Ciccolo, J. T. (2017). A systematic review of the effects of resistance training on body image. The Journal of Strength & Conditioning Research, 31(10), 2880-2888.