Can exercise lift my long-​term depression?

Jane mugshot for JQAI used to be slim, fit and act­ive but two years ago I developed depres­sion, began comfort-​eating and put on a lot of weight. I’ve read that reg­u­lar exer­cise is as effect­ive as med­ic­a­tion for depres­sion. I’d like to get a reg­u­lar routine going but need advice on how to start and stay motiv­ated.

You are right: exer­cise can be a highly effect­ive treat­ment for less severe depres­sion. The NHS recom­mends it as an altern­at­ive to “talk­ing ther­apies”, such as CBT coun­selling, and says both treat­ments are prefer­able in the first instance to anti-​depressants. However, two years is a long time to have lived with depres­sion, and your comfort-​eating weight gain com­plic­ates mat­ters. It’s worth ask­ing your GP for some CBT ses­sions, along­side any exer­cise régime you decide on, because a com­bined approach may be your best way of ensur­ing good res­ults.

As to the best kind of exer­cise, it seems to mat­ter less what you do than the fact that you enjoy it enough to keep it up reg­u­larly. As you say, motiv­a­tion is the key, so here’s a few point­ers.

  • Set a routine and stick to it, come what may. Aim for three ses­sions a week (eg, every other day), last­ing 30 to 60 minutes. Fix time slots that work for you and do not devi­ate.
  • Decide on which activ­it­ies to do, based on what you used to enjoy. Remember to start gently and build up so your body can adapt – don’t expect to swim 30 lengths, shimmy through a salsa class or play a fast net­ball game in your first week of return­ing to exer­cise
  • Set some goals. The first might be simply to achieve three ses­sions a week for the next month. Then set another goal – per­haps to be able to jog a cer­tain dis­tance in three months’ time, or have moved up to the inter­me­di­ate level step class…
  • Tackle your com­fort eat­ing, and take care not to increase your food “allow­ance” now that you are exer­cising. Add a real­istic weight loss tar­get to your goals (0.5kg to 1kg a week).
  • Join a music-​based class – spin­ning (fun, fast cyc­ling at the gym), aquafit, body-​pump or sim­ilar. The music and the other people will lift your mood.
  • Do some exer­cise out­doors – jog­ging, cyc­ling or fit­ness walk­ing in the park. Exercising out­doors is another mood-​booster, even on chilly winter morn­ings. Take a friend or dog for com­pany.

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