The Truth About Using Exercise as a Tool Against Depression

No wordy lead in this time. Let’s jump into it:

[…] researchers found several large-scale past studies that met their criteria. Together, they contained data on more than 1,140,000 adult men and women.

Among these million-plus people, the links between fitness and mental health turned out to be considerable. When the researchers divided the group into thirds, based on how aerobically fit they were, those men and women with the lowest fitness were about 75 percent more likely to have been given diagnoses of depression than the people with the greatest fitness. The men and women in the middle third were almost 25 percent more likely to develop depression than those who were the most fit. [source]

So, this is a weird form of comparative qualification. Those who are most fit can be most unlikely to develop depression because, chances are high, the depression makes it difficult to get out of the house, let alone on a regular basis, let alone to commit to an activity that you very well may not enjoy. It doesn’t necessarily mean that the physical activity is what’s keeping the depression at bay. Not only that, but there is so much that contributes to fighting off “the blues” that it’s hard to use something like physical fitness as a tell.

The link is important and worthy of discussion, but we have to be careful with the way we draw connections. It’s not specifically that the fitness begets the protection from depression—it could simply be that the varying levels of depression, the access to healthy coping mechanisms, and a potential for better access to protective measures is making a difference. I’d be much more interested in research of income level among people who’ve reached out to therapists for help.

So much more can impact a person’s size, that it feels irresponsible to me to compare and use this as a measure in this way. It’s a hard reality, sure, that the same foods that people can overeat can contribute to diminished mental health and, yes, weight gain. But something about this particular research doesn’t sit right with me.

Second quote:

In a separate study (some of the scientists were involved in each of the reviews), researchers looked at whether exercise might be useful as a treatment for depression. In that analysis, which was published in June in the Journal of Psychiatric Research, they pooled data from 25 past studies in which people with clinically diagnosed depression began some type of exercise program. Each study had to include a control group that did not exercise and be otherwise methodologically sophisticated.

The pooled results persuasively showed that exercise, especially if it is moderately strenuous, such as brisk walking or jogging, and supervised, so that people complete the entire program, has a “large and significant effect” against depression, the authors wrote. People’s mental health tended to demonstrably improve if they were physically active. [source]

Annnnnnd finally:

The final review offers some hints about why. Published in February in Neuroscience and Biobehavioral Reviews, it took on the difficult issue of what happens within our bodies during and after exercise that might affect and improve our moods. The researchers analyzed 20 past studies in which scientists had obtained blood samples from people with major depression before and after they had exercised. The samples on the whole indicated that exercise significantly reduced various markers of inflammation and increased levels of a number of different hormones and other biochemicals that are thought to contribute to brain health. [source]

One of the frustrating things that I’ve learned in reading about depression is that people rely heavily on the idea that you should just be able to work out, and boom—problem solved.

And this is sort of accurate—exercise tends to stimulate the corners of the brain that depression tends to, well, depress. Where hormones like serotonin are lowered because of a neurochemical (neuro = brain; chemical = hormone) imbalance caused by depression, exercise gives you a rush of these very hormones in a way that can help bring the sufferer relief. That’s a pretty indisputable fact.

The thing that so much of this misses, however, is what depression truly is and does to a person.

You have to consider what serotonin is and what it does in our brains—it allows different parts of our brain to talk to each other as well as talk to other parts of our body. Serotonin helps ensure that the message gets delivered. If the message is of pleasure and happiness, that’s related to a hormone known as dopamine. When we do things, it’s because we recognize an active or passive reward for it, and dopamine is how we register that positive benefit—also known as an incentive—in our brains in order to remember it in the future. This cycle is how we understand motivation on a neurochemical level.

You might not like paying your bills, but you like the comfort of knowing your bills are paid. Dopamine registers that comfort as an incentive in your brain, and makes it that much easier to pay those bills and keep them paid. In contrast, eating certain foods can give you a rush of dopamine, and your body registers this incentive, as well. The next time you smell those incentivized foods, your brain will remember that sense of “feeling good” and will make it that much easier to indulge next time.

Depression impacts the way these hormones work and changes how they work together, so that your ability to realize the incentive to completing any task is negatively impacted. In other words, depression removes the incentive you feel inside to doing things… thereby leaving you unlikely to do them. Whereas depression doesn’t change the incentive you feel when you binge on junky food, it does change how motivated you might be to overindulge—if we’re referring to something you keep in your home and in your face, it can make you more encouraged to overindulge, because the effort required to indulge is greater.

Running is different—it requires effort, leaving your house, putting in effort, and literally not talking yourself out of it every step of the way. The more effort the reward—the reward being “feeling good”—requires, the less desirable it will become to you. This is a phenomenon known to psychologists as “delay discounting”—each step of the way, you are attempting to downplay the benefit obtained from putting in that effort. It’s something virtually everyone does, unless you have it ingrained in you as a habit to ignore the process of getting ready to go workout and just… well.. go work out. Or, unless you suffer from depression on a hormonal level.

This is why prescribing “exercise” for those with depression feels so dangerous to me—the percentage of people who fully comply with prescribed exercise routines isn’t high, and that’s for people who haven’t been diagnosed; how reliable do we think it’s going to be for people who have depression?

When you look at the second quote I shared above from the article, it specified that the exercise regimen needed to be “supervised, so that people complete the entire program.” How many people living through depression have the time or money to be able to endure that?

The truth about using exercise to fight depression, is that we’re doing it all wrong. I am glad that exercise is being researched as a reliable coping mechanism. It truly is, I know that from personal experience, and I encourage everyone to give it a shot. Get up, get out of the house, and go move. And, if you can muster it, do it again… and again… and again.

But.

We have to realistically discuss what depression is, what it means, how it impacts people’s lives, and what it would realistically take to get someone to stick to a regimen when they’re in this condition. Because this quickly can turn into blaming the sufferer instead of blaming research that didn’t go far enough. And no one benefits from that.