Depression
The Best Way to Manage Depression, and Why It Can Be So Hard
Moving more improves mood, but depression saps the motivation to move.
Posted June 29, 2024 Reviewed by Ray Parker
Key points
- Although moving more can reduce depressive symptoms, clinical depression stifles people's motivation to move.
- Clinical depression can reduce activity levels for years, but exercise's antidepressant power is short-lived.
- Cultivating lifelong exercise habits and staying active every day defangs depression's immobilizing power.
Staying physically active can act as a drug-free antidepressant that offsets depression risk better than taking prescription medication such as selective serotonin reuptake inhibitors (SSRIs) (Prozac, Zoloft, Lexapro, etc.) to treat depressive symptoms, according to a 2023 overview of other systematic reviews.
"We found doing 150 minutes each week of various types of physical activity—such as brisk walking, lifting weights and yoga—significantly reduces depression, anxiety, and psychological distress, compared to usual care, such as medications," first author Ben Singh said in a February 2023 news release.
This meta-analysis found that about 30 minutes of moderate-intensity physical activity five days per week was associated with roughly 1.5 times better outcomes than taking pills to treat depression. That said, it's often difficult for people experiencing enervating depression to arouse enough motivation to stay physically active most days of the week.
Nevertheless, accumulating evidence suggests that small doses of relatively easy physical activity can reduce the risk of future depression if done consistently day in and day out from week to week. A recent umbrella review published in March 2024 identified an evidence-based association between low-to-moderate intensity exercise most days of the week and fewer depressive symptoms.
In an April 2024 news release about this umbrella review, senior author Lee Smith said,
"The fact that even low to moderate levels of physical activity can be beneficial for mental health is particularly important, given that these levels of activity may be more achievable for people who can make smaller lifestyle changes without feeling they need to commit to a high-intensity exercise program."
Chicken or the Egg: Does Exercise Make Us Happier or Do Happy People Exercise More?
As discussed above, numerous studies have shown that people who exercise regularly have lower rates of depression and fewer depressive symptoms. Yet the million-dollar question remains: Does exercise make people happier, or do people who feel happy exercise more consistently than those who feel sad and depressed?
When depression stifles someone's motivation to move, it can create a vicious cycle and downward spiral where depressive symptoms make a depressed person less able to tap into exercise's antidepressant effects because they're unmotivated to move. Subsequently, the lack of movement compounds their depressive symptoms and immobility, which can make depression worse and reduce happiness.
A recently published, decades-long study (Soli Dubash, 2024) on the reciprocal relationship between exercise and depression shows how regular physical activity leads to fewer depressive symptoms and how having a major depressive episode reduces the motivation to move, which exacerbates depression. These bidirectional insights on the interplay between depression symptoms and physical activity over 25 years were recently published in the peer-reviewed journal Mental Health and Physical Activity.
This study followed a representative sample of 3,499 U.S. adults from 1986 to 2011. It focused on the lasting effects and baseline differences of physical activity levels and depression symptoms. Soli Dubash also analyzed how past physical activity predicts future physical activity, how past depression symptoms predict future depression symptomology, and the stability of this relationship during adulthood.
The biggest takeaway from this longitudinal study is that depression's immobilizing effects seem to have long-term consequences on future rates of physical activity. In contrast, the antidepressant effects of physical activity are much shorter-lived.
Depression's Immobilizing Effects Are Long-Lasting
One of this study's main research questions is: Does depression symptomatology have a greater substantive effect on physical activity, or vice versa? The 25-year study's findings suggest that depression symptomatology is ultimately stronger and longer lasting than the antidepressant benefits of physical activity, which are short-lived.
"This study suggests that depression symptomatology (DSx) has a greater substantive effect on physical activity (PA) both cross-sectionally and over time," Dubash writes in the paper's conclusion. This study also suggests that adults who developed the habit of exercising regularly earlier in life—during adolescence or young adulthood—tend to stay active as they age.
Notably, from week to week, people who stayed physically active on a daily basis had fewer depressive symptoms and improved mood. Although being inactive didn't always predict future depression, once depression symptomatology set in, the odds of someone becoming physically active in the future decreased significantly.
Daily Activity May Help Keep Depression at Bay
If you're prone to depression, research suggests that staying physically active can lower your risk of having a debilitating major depressive episode. However, habit formation and religiously sticking to a daily workout routine from week to week is key to tapping into the prophylactic power of exercise to keep depression at bay.
Because the antidepressant effects of exercise are short-lived, you need daily doses of physical activity to keep depression at bay. On the flip side, depression's immobilizing effects are like Kryptonite and can sap your motivation to move, creating a vicious cycle of chronic inactivity and compounding depression.
Knowing that depressive symptoms are ultimately more powerful than the antidepressant effects of physical activity can be a source of motivation to make physical activity a part of your daily routine and to stick with it. By staying physically active most days of the week, it may be possible to outrun the long arm of depression and prevent its enervating power from sapping your motivation to move.
When choosing physical activities you'll likely stick with for the long haul, find things you enjoy that fit your lifestyle. Also, if vigorous exercise is an overwhelmingly disagreeable experience or your schedule doesn't allow 150 minutes of moderate-intensity exercise weekly, remember that small doses of light activity throughout the day can make a huge difference in lowering depression risk across a lifespan.
Facebook image: panitanphoto/Shutterstock
References
Soli Dubash. "The Interplay of Depression Symptoms and Physical Activity: Bidirectional Insights From 25-Years of the Americans’ Changing Lives Panel." Mental Health and Physical Activity (First published: May 05, 2024) doi:10.1016/j.mhpa.2024.100599
Masoud Rahmati, San Lee, Dong Keon Yon, Seung Won Lee, Raphael Udeh, Mark McEvoy, Hans Oh, Laurie Butler, Helen Keyes, Yvonne Barnett, Ai Koyanagi, Jae Il Shin, Lee Smith."Physical Activity and Prevention of Mental Health Complications: An Umbrella Review." Neuroscience & Biobehavioral Reviews (First published: March 29, 2024) doi:10.1016/j.neubiorev.2024.105641
Ben Singh, Timothy Olds, Rachel Curtis, Dorothea Dumuid, Rosa Virgara, Amanda Watson, Kimberley Szeto, Edward O'Connor, Ty Ferguson, Emily Eglitis, Aaron Miatke, Catherine E.M. Simpson, Carol Maher. "Effectiveness of Physical Activity Interventions for Improving Depression, Anxiety and Distress: An Overview of Systematic Reviews." British Journal of Sports Medicine (First published: September 29, 2023) doi:10.1136/bjsports-2022-106195