Guess what, it's free.
By: Dr. Vijay Subramaniam
Have you felt down, depressed, or hopeless? What about feeling overwhelmed, frustrated, or having chest pain? If so, you may be experiencing symptoms of anxiety or depression. According to the NIH, “From 2015 to 2019, there were widespread increases in depression without equally needed increases in treatment, and in 2020, past 12-month depression was prevalent among nearly 1 in 10 Americans and almost 1 in 5 adolescents and young adults." It is not just depression that has increased; as the NIH also reports, “Nearly 7% of adults and 15% of young adults reported anxiety in 2018." So if you’re feeling anxious or depressed, you are not alone.
In a time of amazing medical advancements, therapy apps, and big Pharma, we are quick to jump to the easy and instant fix of a medication or supplement. However, despite the many benefits of selective serotonin reuptake inhibitors, abbreviated as SSRI, the first medication usually chosen to treat depression and anxiety, lack of access to doctors or cost can be a barrier to care. Not to mention the unwanted side effects such as erectile dysfunction (ED), decreased sex drive, drowsiness, weight gain, and concerns about dependence on an external substance. However, what if I told you there was a treatment for depression and anxiety that was free of charge, flexible, and provided to be just as effective as the commonly prescribed medications?
If you were thinking exercise, you would be correct. Many of us know about the importance of exercise to improve our physical health, reduce our risk of dementia and strokes, and strengthen our hearts. However, the best benefit of exercise may be its ability to improve our mood, make us feel in control, and treat both the physical and mental aspects of mild to moderate anxiety and depression. Now, what do I mean when I say mild or moderate depression?
Mild to moderate depression or anxiety refers to patients who are not actively suicidal, have thoughts of killing themselves, or have no history of harming themselves or others. It is based on the number and severity of symptoms such as low energy, poor focus, loss of interest in hobbies, and appetite, which are measured in a tool called the Patient Health Questionnaire, or PHQ-9. The PHQ-9 has a total of 27 points, with a score of 20–27 indicating severe depression. Your doctor may ask you these questions at your yearly checkup, but you can also click the link below to find a free copy of the questions online. Now you are asking, How does exercise help treat my depression or anxiety?
Exercise serves as a natural mood enhancer by increasing the release of endorphins and neurotransmitters such as serotonin and dopamine, which are also known as “feel-good hormones." While SSRIs work by increasing the amount of serotonin in the brain by blocking our brain from taking the free serotonin back up, endorphins released when exercising work to relieve pain, boost mood, and increase happiness without the unwanted side effects. Not only does it improve mood, but exercise also provides a sense of achievement by breaking your personal fitness goals and boosting confidence and self-esteem. In addition, exercise encourages social connection, whether that be by going to the gym with a partner, joining a new fitness class, participating in a team sport in a recreational league, or going on a hike with your family or friends. According to the nearly 80-year-old Harvard study examining the key to happiness, relationships, and positive social connection. Isolation and loneliness are commonly associated with both depression and anxiety, and exercise can help create a positive connection that can help bring us all closer together.
You may be wondering how much exercise you need to feel these benefits. According to a study by the American Journal of Preventative Medicine, the amount of exercise needed to see benefits in treating mild to moderate depression is around the public health recommendation of at least 30 minutes of moderate-to-intense physical activity daily spaced out between 3 and 5 times a week.
While I believe there is a need and place for antidepressant medications like SSRIs, naturally increasing your mood, avoiding side effects, building resilience, and social connection are all amazing benefits that exercise can offer free of charge to reduce your anxiety and depression. So if you’re having a hard time getting started, just start small with a walk around your block or one fitness class and build up from there. By adding physical activity to your routine, you will be able to combat depression and anxiety and improve your overall well-being and quality of life.
References
1.The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry. 2004; 6(3): 104–111 doi: 10.4088/pcc.v06n0301
2. Trends in U.S. Depression Prevalence From 2015 to 2020: The Widening Treatment Gap
Goodwin RD, Dierker LC, Wu M, Galea S, Hoven CW, Weinberger AH. Trends in U.S. Depression Prevalence From 2015 to 2020: The Widening Treatment Gap. Am J Prev Med. 2022;63(5):726-733. doi:10.1016/j.amepre.2022.05.014
3. Trends in anxiety among adults in the United States, 2008–2018: Rapid increases among young adults
Goodwin RD, Weinberger AH, Kim JH, Wu M, Galea S. Trends in anxiety among adults in the United States, 2008-2018: Rapid increases among young adults. J Psychiatr Res. 2020;130:441-446. doi:10.1016/j.jpsychires.2020.08.014
4. Good genes are nice, but joy is better
5. Stanford Patient Health Questionaire
6. Cillian P. McDowell, Rodney K. Dishman, Brett R. Gordon, Matthew P. Herring,Physical Activity and Anxiety: A Systematic Review and Meta-analysis of Prospective Cohort Studies, American Journal of Preventive Medicine,Volume 57, Issue 4,2019, Pages 545-556, ISSN 0749-3797,https://doi.org/10.1016/j.amepre.2019.05.012. Assessed and Endorsed by the MedReport Medical Review Board