19 Feb EXERCISE & DEPRESSION: HOW MUCH, HOW OFTEN & WHAT TYPE WORKS BEST?

Exercise can help to both prevent and manage depression symptoms. But what kinds of exercise work best? And what specific considerations apply to those living with depression?

IS ONE TYPE OF EXERCISE BETTER THAN ANOTHER?

Firstly, it is important to distinguish between depression as symptom of our mood (experienced by ‘healthy’ people on a daily basis) compared to major depressive disorder (MDD), which is a diagnosed mental illness. There’s now extensive research indicating the benefits of physical activity in managing depressive symptoms in both the general population and people with MDD.

Research doesn’t favour one exercise modality over another for managing depressive symptoms. However, the evidence does suggest that there is a dose-response relationship between exercise and depression symptoms. That means those who achieve the recommended physical activity guidelines (150 minutes of moderate to vigorous physical activity per week) gain the greatest benefits.

Despite this, these recommended guidelines may be unrealistic for many people living with depression. Exercise prescription must therefore be graded (starting low and going slow). It’s also important to consider the individuals’ current levels of physical activity, preferences, physical capacity and motivation levels. A good starting point may simply be reducing sedentary behaviour.

From my personal experience, I’ve noticed people respond really well to exercises that;

• Are socially stimulating and ‘fun’ e.g. social sport, walking groups or sessions with an Exercise Physiologist
• Encourage variety in the program i.e. not doing the same thing each session
• Support the learning of a new skill e.g. boxing or yoga

SHOULD YOU MIX UP YOUR ROUTINE?

I think having variety is so important in supporting regular physical activity. Depression is not a constant state, and symptoms can fluctuate day to day. Allowing some flexibility in the program prevents perceived ‘failure’ and allows for maintenance of a routine. For instance, if depressive symptoms are quite bad one day, the thought of performing your regular circuit training session may seem unrealistic, so you don’t even bother. If you have flexibility to your program you might be able to swap this circuit for a different, less intense activity (e.g. going for a walk and doing a yoga session).

HOW CAN YOU MAINTAIN EXERCISE FREQUENCY?

I often see a pattern when people are referred (or re-referred) to me. Initially, they’ll be really motivated, attending every exercise session (and more). Eventually, engagement in exercise sessions starts to decline. This can be for a variety of reasons, including:

• Fluctuations in symptoms (particularly for people with bipolar disorder)
• Boredom with the exercise program
• Unrealistic expectations for self (unachievable goals)
• Injury or pain

This is why education from the start is so important. Specifically, education around the benefits setting realistic and achievable goals. Motivational interviewing and counselling techniques are commonly used by Accredited Exercise Physiologists to support long term engagement in physical activity.

I like to remind people that “something is better than nothing, and something more is better than something”.

SHOULD YOU EXERCISE WITH OTHERS?

Both group and individual exercises are can lead to improvements in symptoms of depression. Whether I encourage one or the other is completely dependent on the individual. I know I sound repetitive, but it’s because there are so many factors that need to be considered. What works for one person won’t always work for another, and that’s why individualisation is so important.

If you’re living with depression and want to start exercising, I recommend chatting to your local Exercise Physiologist. They understand the complexities of exercising with depression, and will be able to prescribe exercise that is safe, effective and specific to your individual needs. To find one near you, click here.

This feature article is from Exercise Right

Oscar is an Accredited Exercise Physiologist who specialises in prescribing exercise to promote positive mental health.