Every time I see my primary care physician he talks to me about a healthy diet, sufficient sleep, and regular exercise.  Since I’m in to see my doctor a minimum of once per quarter (to help keep asthma managed and under control) I hear this advice a lot.  “Eat right, sleep well, and exercise regularly.”  While I don’t really feel like I need to hear this EVERY time I see him, I do think it’s pretty good advice.

In fact, I give it to all my clients suffering from depression (along with the caveat that I am not a physician and they should check with their own doctor before starting an exercise program).

Most research shows that exercise has a positive effect on mild to moderate levels of depression.  No one is claiming that hitting the gym regularly will solve all your problems; just that it will help – especially if exercise is an adjunct to psychotherapy.

The theory behind exercise helping with depression is two-fold.  First, exercise increases the action of endorphins.  Endorphins reduce the perception of pain and improve the body’s natural immunity.  Some believe exercise directly stimulates the production of norepinephrine which may improve one’s mood.

Then there is the idea of promoting self-sufficiency; that is, doing something to help yourself has a more positive impact than simply waiting for life to change.  In other words, it may not be the exercise itself that helps as much as the idea that you are taking action.

The two controversial questions related to exercise and depression are: Does exercise help with severe levels of depression?  And is exercise effective enough to be thought of as a replacement for medication?

In my opinion, the answer to the first is yes, exercise does help with even severe levels of depression but only a little and only as an adjunct to therapy combined with medication.  The answer to the second question depends upon the level of severity.  I don’t make referrals for medications for my clients with mild or moderate levels of depression; I only do that when the depression is severe and exercise is unlikely to ever be an effective replacement for the conventional combination of therapy and anti-depressant medication.