For exercise enthusiasts and those who study the mind-body connection鈥攐r perhaps better put, the mind-body system鈥攊t has long been known that physical activity helps with depression. And yet听even as evidence for this effect continues to mount, 鈥渢he incorporation of exercise as a key component in the treatment of depression is inconsistent,鈥 听Felipe Barreto Schuch and Brendon Stubbs听in the most recent issue of . Schuch and Stubbs,听researchers at the University of Santa Maria in Brazil and King鈥檚 College in London, respectively, go on to explain听that exercise ought to be more seriously considered and prescribed in treatment protocols, in the same way that talk therapy听and medication, the two most common responses to depression, are. To support this recommendation, Schuch and Stubbs recently undertook a of exercise and depression. Here is a summary of the results.听
Can Exercise Prevent Depression?
show that the more someone exercises, the less likely they are to have depression. This听is . The challenge with these studies is that they are associative only. Yes, people may not experience depression because they exercise. But it鈥檚 also quite possible that people don鈥檛 exercise because they are depressed.听
In an attempt to tease out the causal effect of exercise鈥攖hat is, whether or not exercising is actually protective against depression鈥擲chuch and Stubbs only reviewed studies听that were designed as prospective cohorts. This means that a group of people who had no signs of depression were followed for at least one year. Researchers could then look at whether or not the people who exercised more had a lower incidence听of depression. For their review, Schuch and Stubbs included 49 such studies that, taken together, followed 267,000 people and included different types of exercise. They found that exercise reduced the chances someone would experience depression by between 17 and 41 percent鈥攁 substantial effect that was observed across different countries, ages, and sexes.听
Put simply: exercise helps prevent depression. Just because you exercise doesn鈥檛 mean you won鈥檛 ever become depressed, but it certainly reduces the chances that you will.
Can Exercise Treat Already-Existing Depression?
鈥淓xercise can improve depressive symptoms in people with depression,鈥 write Schuch and Stubbs. 鈥淗owever, similar to other treatments, exercise is not a panacea and may not work equally for all.鈥澨
Every part of the above statement is important. Exercise can鈥攁nd often does鈥攈elp, but not always and not for everyone. I know many people who experience (or have experienced) depression and who get so fed up when they are told, 鈥淛ust exercise more.鈥 If it were that easy, everyone would do it.
That said, there is convincing evidence that exercise should absolutely be included in a broader tool kit to help people who are experiencing depression. Schuch and Stubbs conducted a review of 25 studies that surveyed听a total of听1,487 people and found that between 40 and 50 percent of people with depression respond to exercise, with an effect that, on a of small,听medium,听or large,听is considered large.听This on par with talk therapy听and medication. And while the dropout rate for exercise is around 18 percent, it is 19 percent for talk therapy and between 26 and 28 percent for medication. It鈥檚 also important to note that these treatments are not exclusive听and can be used together to great benefit.听
How Does Exercise Prevent and Treat Depression?
According to Schuch and Stubbs, the neurobiological mechanisms underpinning the antidepressant effects听of exercise are still unclear. However, there are a few hypotheses. Depression is associated with chronic inflammation, and regular exercise reduces inflammation. Depression is also associated with lower levels of a chemical called BDNF, which helps the brain grow and remodel. Regular exercise increases BDNF,听so听it could help a depressed brain outgrow its patterns.
Exercise is also associated with positive psychological changes. It increases confidence and听self-determination听and often takes place in a community, all of which are helpful for depression. Though pharmaceutical companies would surely love to zero in on a singular pathway for exercise鈥檚 positive effects on depression (so they could make a drug to mimic it), they shouldn鈥檛 get their hopes up. Exercise鈥檚 benefit is probably in the combination of all these pathways, and likely others we aren鈥檛 even aware听of yet.
If you听or someone you love is听experiencing depression and needs听help now, call the听听at 1-800-273-8255, or听.
Brad Stulberg () is a performance coach and writes听国产吃瓜黑料鈥檚 Do It Better column. He is also bestselling author of the books听听and听. Subscribe to his newsletter听.