The Breakthrough Depression Solution

Integrative medicine for mental health.

Fight Depression with Exercise

Exercise Can Lift Depressed Moods

Lately, exercise has been at the forefront of every conversation about health. No doubt this careful attention is due to the increasing concerns over obesity and sedentary lifestyles.

And it's true that exercise can improve our health by reducing high blood pressure, high cholesterol, and the risk of developing diabetes. Did you realize though that exercise also has amazing positive psychological effects?

Besides the obvious physical health benefits, exercise can also:

  • Lift depressed moods
  • Reduce stress
  • Enhance self-esteem and body image
  • Produce feelings of euphoria

A great deal of research dating as far back as the 1980s has shown that exercise can effectively reduce cases of mild to moderate depression. Yet, psychiatrists, particularly those in the US, tend to underestimate the benefits of exercise and rarely prescribe it. British physicians, on the other hand, can actually prescribe exercise as a treatment for depression, with the National Health Service subsidizing some or all of the cost. Imagine being given the green light to take a walk at lunch every day by your doctor!

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It's clear that there is no real downside to moderate exercise, so let's get to the particulars.
What type of exercise is best? When and where should we exercise?

In the United States we are constantly bombarded with the latest exercise crazes from bootcamps to kettle ball classes. What if exercise in its truest, yet mundane form-a physical action that's an escape from the daily grind-had as meaningful an effect?

A recent 2010 study in the British Journal of Psychiatry found that people who engaged in regular physical activity-even non-sweat inducing mild activity-were less likely to be depressed than their sedentary counterparts. The intensity didn't make a difference! A brisk walk and a long run had the same effect on reducing negative thoughts and feelings.

Surprisingly, only exercise carried out in people's spare time helped relieve depression for those in the study. People who do heavy lifting or extensive walking at work were just as likely to be depressed as those with desk jobs.

Researchers concluded however that the most important factor in lifting depression was the social benefits of exercise-having a walking partner or a tai chi group, for example. A friend is worth a great deal more than any exercise ball!

In terms of where to exercise, a 2011 study in Environmental Science & Technology further clarified the best setting to engage in physical activity. After examining 11 studies with 833 participating adults, the author's concluded that when compared to indoor exercise, outdoor exercise led to:

  1. greater improvement in mental well-being,
  2. greater feelings of revitalization,
  3. increased energy and positive engagement, and
  4. greater decreases in tension, confusion, anger and depression.

When we put this altogether it is clear that in order to get the most anti-depressive effects out of exercise we should:

  • Engage in any form of exercise (mild activity is fine if you don't want to over-exert yourself)
  • Exercise in our spare time (even if you only have 10 minutes, take advantage and increase your mood)
  • Exercise with someone or in a group
  • Exercise outdoors

But what if you don't have the energy to exercise?

The most common physical symptom of depression is feeling fatigued, weak or simply tired. Although patients may know and want to exercise to relieve their depression, they may find it difficult to overcome their feelings of hopelessness and lack of energy.

We can always find reasons not to exercise: It's raining. It's cold. I'm tired. I have too much work. I forgot my I-Pod.

And many people say it's easy to overcome those obstacles: Just go to the gym. Make a commitment to a class. Make it a part of your daily routine.

For someone with depression, it's not that easy. In addition to feelings of hopelessness and lack of energy, low motivation leads to ambivalence about exercise, particularly when it's in a social setting. Being told to just do it will never work.

But what if the motivation necessary for exercise was less about psychological "willpower" and more about physiological roadblocks?

It's clear that the mind and body is connected. When the mind is in balance so is our body.

The lack of motivation, fatigue and weakness that someone with depression is struggling with is related to the body's mitochondria, tiny structures found within every cell of the human body. These mitochondria generate energy for the cell and poor mitochondrial function leads to less energy, fatigue, and weakness.

It seems simple. To deal with the relentless fatigue and other physical symptoms associated with depression, we must support the mitochondria!

In The Breakthrough Depression Solution, I address this issue by recommending energy-boosting supplements. Supplements that can help you overcome fatigue so that you can start exercising include:

  • Ribose - The sugar ribose, which is found in the body, produces adenosine triphosphate (ATP) which energizes cells. Physicians and researchers have used ribose to improve the energy of patients with chronic fatigue syndrome. Typically, I recommend 5 grams of ribose taken 3 times per day.
  • B12 - B12 plays a vital role in energy metabolism, and a shortage of the vitamin can lead to a lack of energy. Indeed, fatigue is one of the most common symptoms of B12 deficiency. Although the normal range for B12 is usually given as 200 - 900 pg/mL (picograms per milliter), I find that levels in the upper end of the range, 800 - 900, lead to more energy.
  • Carnitine - One of carnitine's key functions is helping to produce energy in the mitochondria. Taking advantage of carnitine's energy boosting powers, many physicians use carnitine to treat chronic fatigue, fatigue related to cancer, and even for weight loss. For patients I typically recommend 1 gram of carnitine before breakfast and another before lunch.
  • CoQ10 - Carnitine often works well with CoQ10 (coenzyme Q10), a natural, vitamin-like substance found in the energy-producing mitochondria. CoQ10 supplements have been used to treat chronic fatigue syndrome and help improve athletic performance. For the treatment of depression, I recommend at least 200 mg per day. Because these are fat-soluble they should be taken with food that contains some fat.

Exercise is free and the effects on both mind and body are long lasting. It doesn't matter if you train for a marathon or take a walk in the neighborhood, simply carving out time in your day to do something other than work or being sedentary, will positively affect you both physically and mentally. Your endorphins will increase while cortisol decreases, providing you with instant relief.

As summer approaches and the days get longer and warmer, be sure to grab a friend and exercise outdoors (of course with sunscreen on!). If you find yourself lacking energy, consider the supplements that I recommended to give you the boost you need as you become a person living depression free!

James M. Greenblatt, M.D., a dually certified child and adult psychiatrist, is a pioneer in integrative medicine. His latest book is The Breakthrough Depression Solution.

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