Summary: If you do exercise instead of therapy for your mental health, you may improve your mood temporarily, but exercise cannot replace professional treatment and support for a clinical mental health disorder.
Key Points:
- Exercise – or plenty of physical activity – is essential for overall health
- Daily exercise can improve mood
- Daily exercise can help reduce stress
- Exercising can get you out in nature, get you out and about with other people, and give you a sense of accomplishment, all of which support positive mental health
- Exercising alone cannot offer the insight, experience, direct, honest feedback, or help you develop practical tools to manage a mental health disorder in the way therapy with a mental health professional can
Yes to Exercise and Yes to Therapy
Most people agree: when we exercise, we feel better.
In fact, that’s one reason many people exercise. They like being in shape, of course. And they like feeling strong, too. They like the camaraderie of group classes or the meditative aspect of going for a long run, bike ride, or walk. They love how they feel when the workout is done: spent, tired, hungry – all in the best possible way – and kind of like a badass.
So why don’t physicians – or therapists – prescribe exercise for mental health disorders like depression?
After all, it improves mood, self-esteem, and overall health.
And research clearly indicates exercise can reduce symptoms of depression and other mental health diagnoses. To check just a small amount of the scholarship on exercise and depression, click through and read these peer-reviewed journal articles:
- Effect of Exercise on Depression
- Exercise Interventions for Mental Health: A Quantitative and Qualitative Review
- Depression and Exercise: A Clinical Review and Management Guideline
- Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcome
The thing about those articles is that they show exercise can help reduce depressive symptoms. That’s a good thing. However, not a single one advises people to do exercise instead of therapy. And not a single one reports that exercise can lead to a remission of symptoms. That’s what a treatment program for depression can do, if it includes the components evidence shows are effective: psychotherapy, medication, and lifestyle changes.
Exercise is part of lifestyle changes – so we can say exercise is one aspect of one component of successful treatment for depression. Yes, it helps, but no – people with depression should not get the idea that they can do exercise instead of therapy, or that all they need to do is exercise for their depression will go away.
Let’s explore several reasons why.
Some People Don’t Like Exercise
First, if someone hates exercise, then all bets are off: it’s probably not going to help.
Even if they don’t actively hate exercising, it still probably won’t help. If you don’t like something and don’t want to do it, being forced to by a doctor is not going to help anything at all.
For exercise to help a mental health disorder like depression, for instance, a person needs to find something they like about it. Exercise takes commitment and enthusiasm. Without a personal connection or internal drive, forcing yourself to exercise in response to external stimuli can lead to negative patterns of thought.
That leads us to something everyone who exercises needs to do:
Check Your Why
For your personal psychological health and wellness – i.e. your mental health – it’s important to understand your motivation and completely understand your why. Your why may be healthy, life-affirming, and productive, or your why may be something different. It may be counterproductive, and contribute degrade, rather than improve, your overall mental health.
Productive Whys:
Exercise…
…makes me feel better physically.
…improves my mood.
…improves my overall physical health
…helps reduce stress in my life.
Non-productive Whys:
I have to exercise…
…because I really want to be skinny.
…because if I don’t I feel bad about myself.
…even if it means cancelling plans with friends.
…because I don’t want to face my emotions.
…because I feel obligated.
We need to remember the evidence-based benefits of exercise, which are physical, psychological, and emotional.
What Exercise Actually Does
Most of us understand that exercise improves our overall physical health. According to the Centers for Disease Control (CDC), it makes our muscles, bones, joints and tendons stronger. It can help us lose weight. It improves the health of all our major organ systems, including our nervous system – which includes our brain – and strengthens our immune system. The CDC identifies the following additional benefits of exercise that some people may not know about:
- Increases life expectancy
- Reduces risk of heart disease, hypertension, and diabetes
- Reduces risk of some types of cancer
- Mitigates risk of infectious diseases
- Reduces complications of infectious and chronic disease
- Reduces risk of falls and injuries from falls
Those are the physical benefits of exercise. By keeping us healthy and strong, all those benefits have an indirect but significant positive impact on mental health. But most of us also know, subjectively, that exercise can improve our mood.
But how does it do that?
Evidence from peer-reviewed studies such as “The Impact of Exercise on Depression: How Moving Makes Your Brain and Body Feel Better” shows that exercise:
1. Boosts serotonin:
- Antidepressant medications are designed to increase serotonin in our brain. Antidepressants are called serotonin reuptake inhibitors – SSRIs – which means they prevent serotonin from returning to cells, and increase the presence of this essential neurotransmitter in the brain, thereby increasing overall feelings of wellbeing.
2. Boosts dopamine:
- Exercise increases levels of dopamine in our brain. Dopamine is commonly considered the reward molecule, although it’s involved in a wide array of physiological processes unrelated to mood or motivation, such as memory, sleep, concentration, and movement. When we exercise and increase levels of dopamine, we may feel a sense of accomplishment and success, which can boost mood, and help alleviate the negative symptoms of depression.
3. Increases endorphins:
- Exercise stimulates the release of endorphins in our brain and body. Endorphins, like serotonin and dopamine, are hormones that function as neurotransmitters. They’re directly involved in positive mood, feelings of wellbeing, and pain reduction.
If all of that is true, then why wouldn’t we tell people that don’t like exercise to try it anyway, because it’s so good for them? And why don’t we simply warn people to exercise not to get thin or fit, but just because it feels good?
Exercise Instead of Therapy, Exercise in Context: One Tool Among Many
The thing is, we do that already.
Most therapists recommend increasing exercise and activity as part of an overall approach to depression, but the key words there are as part of an overall approach. Even when patients say they really don’t like exercise, therapists will typically reply by asking, “How about walking? Taking a walk after dinner or lunch might not feel like the kind of exercise you dislike, but it counts as exercise.”
Here’s the reality of the situation, with regards to exercise and treatment for mental health:
Exercise is an excellent lifestyle choice that supports a mental health treatment program, but exercise is not, and cannot, replace psychotherapy with a mental health professional.
We opened this article with a list of articles that showed the positive impact of exercise on depressive symptoms. That information is important, because as part of a whole, and for people that like it exercise can be an important part of recovering from depression. However, and I reiterate, as good as it is, exercise is not a be-all/end-all treatment for depression, and no one should think that it can replace therapy provided by a skilled, experienced, mental health professional.
Even exercise experts and advocates agree. Consider these articles:
- Why the Phrase “Exercise is My Therapy” Is Harmful from Livestrong, an exercise-friendly organization.
- Running Isn’t Therapy. Therapy is Therapy. From Women’s Running and Outside Magazine.
- Running To, or From? Why Exercise Isn’t Therapy from the website “Fit is a Feminist Issue.”
- No, Working Out Is Not a Replacement for Going to Therapy from Well+Good, a health and lifestyle magazine.
All those articles will tell you something similar: exercise is amazing – but it’s not therapy.
What’s So Great About Therapy?
In talk therapy – what we call psychotherapy above – you work one-on-one with a trained professional. They help you identify and process events that may have led to the development of depression, and help you develop coping mechanisms for processing the uncomfortable and sometimes overwhelming emotions associated with depression, and teach you techniques to regulate stress and manage challenging situations that you experience in daily life.
Exercise does not listen, reply, and offer suggestions about how to process emotions, manage disappointments, or help you correct cognitive distortions. Exercise might help you feel good after a therapy session where a therapist does all of those things, but that’s all: it doesn’t give you any new tools, insights, or techniques for managing your symptoms.
Medication is also an important component of depression treatment that people may think exercise can replace. Exercise does boost serotonin, which is the ultimate goal of antidepressants, but, in contrast to medication, we don’t have a reliable way to regulate dosage, which is critical in gauging the relationship of
We’ll close by saying the best way to use exercise to help depression is to make it one component in a comprehensive plan – a treatment plan for depression and a healthy plan for living – that includes professional support, peer support, family support, physical activity, healthy eating, and stress management.
