Could exercise be the answer to feeling better?

Depression and low mood are one of the most common reasons that people visit their healthcare practitioner, with symptoms including chronic fatigue, low motivation, increased irritability or sadness, appetite changes, problems with sleep, and in more severe cases social withdrawal and self-harm. It’s estimated that one in 6 people will experience some form of depression in their lifetime, and women are at a higher risk for a variety of reasons including hormonal fluctuations. 

Treatment frequently involves antidepressant medications, with over 12 million prescriptions written in Australia every year. There are some different types of drugs used to treat depression, but the most common are Selective Serotonin Reuptake Inhibitors or SSRI’s. They work by increasing the amount of serotonin, a neurotransmitter that is involved in mood, sleep and appetite. Some people respond well to these medications but there are others who report little or no benefit. Other treatments that don’t involve medications have always held some merit but have not been studied for their efficacy. These include diet and lifestyle modifications.

A 2023 meta-analysis by the British Medical Journal (BMJ) of 218 clinical trials of treatment for depression that included exercise alone, exercise alongside medications or other therapies such as Cognitive Behavioural Therapy or CBT, reports that exercise is a clinically effective treatment for depression. Interestingly, the exercise didn’t need to be intense or high impact, in fact modalities such yoga, walking and strength training were all shown to be effective. The other finding from the studies was that the exercise sessions didn’t need to be long, with 30 minutes of daily exercise resulting in clinically important benefits.

While the authors of this report are not suggesting that people stop taking their medications, they are suggesting that healthcare practitioners could be more proactive in prescribing exercise as a treatment for depression, and trialing it before using medications. 

Naturopathy has always approached mood related symptoms from a holistic perspective. This means addressing the underlying cause, rather than treating only the presenting symptoms. Diet and lifestyle play such an important role in our wellbeing and lack of balance in these areas can and do result in poor health. 

There are many benefits from being physically active. Regular exercise helps to regulate blood glucose and cortisol levels and it has a positive effect on neurotransmitters such as serotonin and dopamine that are known for their role in mood and sleep. Exercise is also beneficial for healthy cardiovascular function with lack of movement being a risk factor for the development of chronic diseases such as cardiovascular disease and type 2 diabetes. There is also evidence that regular physical exercise is beneficial for conditions including PCOS and endometriosis due to its role in hormone regulation. 

Making the commitment to do regular exercise can seem daunting when you are experiencing depression or low mood. Research also shows that people tend to have better outcomes when they feel supported while they make changes to their lifestyle. This may mean joining an exercise class or group, or regularly checking in with your healthcare practitioner to review your progress. 

Noetel M, Sanders T, Gallardo-Gómez D, Taylor P, del Pozo Cruz B, van den Hoek D et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials BMJ 2024; 384 :e075847 doi:10.1136/bmj-2023-075847