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Exercise Your Blues Away

You can beat depression.
You can beat depression.

Her life was a series of tragic country songs. When a client I'll call "Jane" first stopped by to see me for a consultation, things around her were spinning out of control. A few months before, she had ended a long-term relationship, lost her dream job and managed to pack on almost 70 pounds of fat.

Everything had become a struggle. With all the extra weight, her regular clothes no longer fit and she quit going out. Doing things around the house was exhausting, so she stopped cleaning. The thought of making a bowl of oatmeal was so tiring she just ate candy bars and chips instead. She was clinically depressed and her doctor started her on antidepressant medication. But Jane's doctor told her to do one other thing. As part of her therapy, Jane was required to start exercising at least three days a week.

Jane's doctor was prescribing a kind of "combination therapy" for depression. In 1999, Researchers at Duke University Medical Center in Durham, North Carolina, published the results of a depression study. They were trying to see if regular physical exercise could be associated with reduced symptoms of depression.

Subjects were assigned randomly to a program of aerobic exercise, antidepressants (sertraline hydrochloride), or combined exercise and medication. People who got medication alone showed the fastest initial response, but "after 16 weeks of treatment exercise was equally effective [as antidepressants] in reducing depression among patients with Major Depressive Disorder."

The goal for Jane was to have the medication start providing immediate relief, but to have the mood-elevating effects of exercise eventually take over. There was good reason to believe it would work.

Those researchers at Duke University followed up on their test subjects six months after treatment had ended. What they found was a surprise. The people who exercised had "significantly lower relapse rates [into depression] than subjects in the medication group." People who were exercising were better at keeping the blues at bay, "especially if exercise is continued over time."

Additional studies at Duke University found equally impressive results. In one published by Psychosomatic Medicine, Journal of Behavior Medicine in September of 2007, Duke researchers found that the effectiveness of exercise is generally comparable to giving patients antidepressant medication.

The trick is getting a depressed person to exercise. I did that by giving Jane a schedule and letting her know she was expected to show up. The first few times Jane came in because she didn't want to disappoint me. After a couple of weeks, it started becoming a habit and her mood was beginning to improve. You can do the same thing without a trainer by working out with a friend. Set a schedule and even when you don't feel like it, having someone waiting for you can be a powerful motivator.

After a few weeks, you create a "positive feedback loop." The exercise pumps up your mood, your body gets stronger and people around you start noticing and complimenting how you've changed. Running into people you haven't seen after a couple of months who say, "you look great" can be an emotional boost.

Mood and Exercise Chart
If you want to track your mood and see if it's improving or not, we've prepared this chart to help you out.

It's simple. Use one sheet per month. Find the date, write the day of the week beside it, then what exercise you did and how long it took. Mark underneath the happy/sad faces what your mood was in the morning (M) and evening (E).

Over time you may see patterns emerge. Notice the days you're feeling better and see what steps you're taking to feel that way.

To avoid sabotaging your efforts, there are a couple of things you might want to avoid. First, don't overthink your decision. Don't agonize over picking the perfect program; just get out there and do something. A 15-minute walk every day is a great place to start. As your body improves, you can explore more rigorous activities.

Second, don't make promises you might not be able to keep. It's OK to tell people you've started exercising, but don't tell them, "I'm going to be in perfect shape in 60 days!" You want support for your efforts, not criticism if you don't meet unrealistic goals. If it's someone who's typically not supportive, don't bother telling them at all. Let your body's results surprise them and speak for you.

Exercise can help in so many ways, all you have to do is give it a try.

UPDATE: Researchers believe they've found one of the reasons why exercise helps improve our mood. Exercise produces a compound called PGC-1 alpha 1. That compound in turn, neutralizes a stress-induced toxin called kynurenine.

Researchers found that when subjects exercised more, PGC-1 alpha 1 levels increased, and the depression causing kynurenine was converted into a form that couldn't pass into the brain. By reducing or "filtering" out the kynurenine, depression levels dropped. Exercise more and be happy!

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CAUTION: Check with your doctor before
beginning any diet or exercise program.

Updated 12/17/2011
Updated 4/22/2014
Updated 11/24/2014