Strategy #4: Exercise—The Silver Bullet

The following questions come to mind when considering exercise for depression relief:

  • Why is exercise so critical to the success of a depression treatment and prevention program?
  • What if I just don’t feel like exercising?
  • How do I find what exercise program is best for me and how do I get started?

Exercise—A Critical Component of Success

Exercise gives immediate benefits… “After just 25 minutes, your mood improves, you’re less stressed, you have more energy—and you’ll be motivated to exercise again tomorrow. A bad mood is no longer a barrier to exercise; it is the very reason to exercise.” So says Jasper A. J. Smits, PhD, an expert in the treatment of anxiety and mood disorders. Dr. Smits is an Assistant Professor of Psychology and Director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas.

Dr. Smits and his colleagues analyzed numerous clinical studies and determined exercise should be more widely prescribed by mental health care providers because of its potential in helping depression victims. They presented their findings to researchers and mental health care providers at the Anxiety Disorder Association of America’s annual conference in Baltimore in 2010. Earlier research by Smits and four other experts in psychiatric disorders and exercise was very revealing and was published in the May 2007 issue of The Journal of Clinical Psychiatry. A summary of their key findings:

  • Exercise is effective for many different depressive patient sub types across genders and ages, regardless of the severity of depression.
  • Recent clinical trials have surprised many clinicians by showing how effective exercise is in helping depression symptoms.
  • The studies so far show that exercise for depression compares favorably with traditional treatments for depression—that is, it is as effective as anti-depressant drugs or cognitive behavioral therapy.
  • In addition to depression relief, exercise benefits many other aspects of health. The researchers reported that exercise is extremely powerful in fighting cardiovascular disease and reduces the risk of heart attack and stroke. It is particularly important for individuals who have hypertension, diabetes, or cholesterol abnormalities. It also reduces the risk of developing certain cancers, such as colon cancer and breast cancer. Exercise has been shown as having far-reaching effects which include improving resiliency to stress and treating panic disorder. Also, if aging people are physically active, their overall quality of health and quality of life are improved.
  • The risks of exercise are relatively minimal if the individual understands the importance of starting slowly and building up the activity over time.
  • The research shows a key idea in using exercise, as a treatment for depression is that of building up intensity over time. However, although studies have found a greater reduction in depression with a greater intensity of exercise, exercise does not have to be lengthy or intense for an individual to benefit.
  • The primary conclusion of this research—the effectiveness of exercise as a treatment for depression is gaining recognition among researchers and clinicians. Exercise needs to become an accepted treatment option for depressive patients.

Get Started and Keep Going

So where do you start on an exercise program to help fight depression? Here are some ideas:

Start with what you’re willing to do for right now—and stay at that level the next few days. Commit to do it every day for the next week. If you feel more energetic and motivated, increase the intensity to a level you think you can perform without injuring yourself. Do that for one week.

Commit to a reevaluation after the first week. At that time, make adjustments based on your experience from the first week and commit to another two weeks at the new adjusted level. If you can’t do any more than what you’ve done in the first week, that’s okay. Do that level again for another two weeks.

Keeping depression from coming back. Once you begin to feel relief from your depressive symptoms, you’ll be able to up the intensity even more and device an exercise game plan that you can stick with for a lifetime. Remember that exercise is the silver bullet for not only relieving your depressive symptoms but also for preventing a recurrence in the future. You’ll feel so much better and be so much more productive if you figure out a way to get exercise into your life on an ongoing basis. But that’s a major commitment and a major undertaking.

Here is a six-step process that covers all the bases for starting and maintaining an exercise plan for life:

Step 1: Determine Primary Motivations

Unless you fix in your mind the specific reasons for why you want to get going with this program, you’ll never start or stick with it. Use this motivation to help you get started and, in the future, help you stick with your program when things get too busy.

What are your motivations? Write down at least three or four (or more) that are really big for you. Putting it in writing will confirm these important motivators in your mind, and if you’re like everyone else, one day you’ll need those to keep you going.

Step 2: Make a Firm Commitment

Example: “I will start and stay on a regular exercise program for 90 days or at least until xyz date.”

Making a commitment to get started is about half the battle. Make sure you commit to doing it long enough to begin to see the positive effects. After that, those benefits will motivate you to keep going. You’ll generally need to commit to at least 90 days, but you may want to commit for a longer period. You may want to put this commitment in writing and tape it on your mirror in the bathroom. Do whatever is necessary to finalize a firm agreement with yourself to take this positive step for the good of your health and for all those reasons you wrote down in Step #1. Now if you have problems sticking with commitments you make to yourself, what are some ways to make this one stick? Here are some ideas.

  • Give your written commitment note to a friend and ask them to check up on you every two weeks or so.
  • Better yet, find a friend to join you on your exercise program.
  • Hire a trainer.
  • Do your workout the same time each day—just build it into your schedule.
  • If you cannot do any of these but still need a strong motivation to stick with your commitment, put aside $100 in an envelope addressed to your least favorite charity or cause or person. Give it to a friend to keep and ask them drop it in the mail if they see you have not stuck to your commitment. That will cause you to think twice about quitting!

Step 3: Check with Your Doctor 

Although exercise is immensely beneficial to everyone, some will need to get an okay from their doctor before proceeding. Common sense is the main ingredient here. Have you been sedentary for so long that exercise might trigger health problems? Do you have chronic health conditions or take medications that could be affected by exercise? If so, ask your doctor to advise you concerning any precautions you may need to take, especially if you have one of the following:

  • You’ve had a heart attack.
  • You have asthma or lung disease.
  • You have diabetes or heart, liver, or kidney disease.
  • You feel pain in your chest, joints, or muscles during physical activity.
  • You have arthritis or osteoporosis.
  • You’ve had joint replacement surgery.
  • You experience symptoms such as loss of balance, dizziness, or loss of consciousness.
  • You take medication to manage a chronic condition.
  • You have an untreated joint or muscle injury, or persistent symptoms after a joint or muscle injury.
  • You’re pregnant.
  • You’re unsure of your health status.

Make sure your current physical condition allows you to exercise and you’ve ruled out any safety or health issues that your doctor might be concerned about.

Step 4: Establish Fitness Goals

Map out the specific exercise routine you’ll be following. Here are the possible components:

Aerobic exercise: Also known as cardio or endurance training, aerobic exercise is the cornerstone of most fitness training programs. Aerobic exercise causes you to breathe faster and more deeply with the huge beneficial result being that your blood gets flooded with oxygen that can be sent to all the organs and tissues. If you intend for your exercise routine to include aerobics, you’ll need to incorporate activities such as walking, jogging, elliptical training, biking, swimming, dancing, and water aerobics. The recommended amount is about 150 minutes of moderate aerobic activity per week.

Resistance training: Resistance training is also known as strength training or weight-bearing exercise or muscular fitness—all names for exercise that works against some form of resistance. Examples include a set of free weights, your own body weight, or weight machines—all of which stress a sequence of muscles and bones.

A combination that works for many busy people is to do aerobic exercise three days a week and strength training for two days a week.

Stretching exercises: A vital component to every fitness program, these exercises stretch the major muscle groups that are tight; the result is increased flexibility. This allows the muscles and joints to work more efficiently and decreases the frequency of muscle injuries and falls. Stretching also improves circulation and relieves stress by relaxing the tense muscles that often accompany stress. Ideally, you’ll stretch whenever you’re doing one of the other exercise types. In between your weight stations at the gym is a great time. But for some people, stretching may be the only type of exercise they get; doing so on a daily basis could go a long way toward maintaining flexibility.

Core strength training: Your body has 29 core muscles located mostly in your back, abdomen, and pelvis. This group of muscles provides the foundation for movement throughout your entire body, and toning them can help protect and support your back, keep your posture good and help you gain greater balance and stability. Strong core muscles help protect you from injury, a fall, and from low back pain. Along with stretching, aerobic, and strength training, core strength training should be a part of every well-rounded exercise routine. The good news is that you can incorporate your core exercises into both your stretching routine and your resistance training routine. Just remember when you’re setting up your routine to not forget some specific exercises for this critical area of the body.

Interval training: This involves simply alternating bursts of intense activity with intervals of lighter activity. For example, if you routinely get aerobic exercise by walking, you could incorporate interval training by adding short bursts of jogging into your regular brisk walks. If you’re less fit, you could simply walk faster for specific periods during your overall walk (between certain mailboxes, trees, or other landmarks, for example). This type training was once the domain of elite athletes, but it has now become a powerful tool for the average exerciser as well.

Any risks associated with interval training? If you have a chronic health condition or haven’t been exercising regularly, consult your doctor before trying any type of interval training. If you rush into a strenuous workout before your body is ready, you may hurt yourself. Instead, start slowly. Try just one or two higher intensity intervals during each workout at first. If you think you’re overdoing it, slow down. As your stamina improves, challenge yourself to vary the pace. Interval training allows you to get the maximum benefit from whatever amount of time you have to devote to your exercise program.

Step 5: Plan to Stay Motivated

What this means is that there are some things that you can do now—at the beginning of your exercise program—that will help you stick with your plan when life gets busy and you just don’t seem to have the motivation or time or energy to continue it. Choose several or most of these actions now and you’ll be much more likely to stick with your plan in the long run. Here they are:

➧ Plan the exercise time into your schedule. It will never happen if you just wait for a “spare minute”. Generally you’ll be better off having a similar schedule each week for your exercise to help consistency. That is, if you want to exercise five times each week, you need to plan when that will happen. Will it be Monday through Friday with the weekend off or will it be M-W-F and both Saturday and Sunday or some other combination? If your work schedule is erratic and does not allow such routine scheduling, then how will you get your five sessions in? You must decide now or else you’ll eventually find yourself falling away.

➧ Use a daily exercise chart. Place this schedule somewhere visible (on your refrigerator, bathroom mirror, or desktop at work) and it will serve as an extremely motivating way to stick to your routine. It provides a visible, tangible record of your fitness routine. You can use it as simply a tangible way to mark off which days you successfully exercised or you can use it as a reminder of what exercises you did yesterday, how many sets and reps, what weights, etc. Here are a couple of examples. You can make your own.

➧ Give early morning exercise a try. Many busy people who exercise regularly day in and day out do it first thing in the morning before their schedule gets hectic and while they have plenty of energy. If you struggle with exercise consistency, try getting up 45 minutes early two mornings a week for a walk in your neighborhood or a strength-training routine in your home. You’ll be amazed how much clearer your mind is for the days demands. Once you’ve adjusted to this routine, add one to three more days of getting up early. But people who struggle with early morning exercise often rob themselves of this alternative by not being willing to give up their late night activity the night before. You may have to give up a TV show or that sporting event, but you’ll feel so much better the next day after your exercise you’ll forget you missed it.

➧ Don’t get discouraged about results! Many people quit because they don’t see outward visible results as quickly as they would like. Remember in advance that before you get thin and buff, your organs will be cleansed of fat and toxins, your joints will become supple, and your muscles and immune system will strengthen. Keep in mind that although you can’t see it, those amazing internal benefits we discussed earlier are all taking place. Give it some time and eventually you’ll begin to feel more energy, think more clearly, feel better about yourself and those will reinforce your willingness to stay with your program. Most exercisers who are consistent stick with their routine not to avoid becoming sick; rather, they exercise because they love the way it makes them feel. But you’ve got to stick with it long enough for those outward benefits to begin to kick in. For some that could be just a few weeks. For others it could be several months. Stick with it.

➧ Plan on rewarding yourself after a certain period of time when you have adhered to your planned exercise program. You decide what is an appropriate reward and at what frequency, but you’ve earned it, and you need to celebrate! But don’t reward yourself with a piece of chocolate cake. Treat yourself to a real luxury like a massage, a hot sauna, a round of golf, or an active day on the slopes or at the beach. This way, you get a long, rich reward with great memories attached to it. If you want extra motivation, promise yourself after a significant period of consistent exercise that you’ll reward yourself with a new “toy,” like a flat-screen TV, or a new outfit. Whatever it is, it should motivate you to do whatever is necessary to get that or a similar reward again after the next successful period of exercise perseverance.

➧ Take a picture. Although it will take a few months to begin to really notice some visible changes, a before-and-after picture is terribly motivating. Take a picture of how you currently look and place it somewhere that you can’t miss seeing it every day. Now carry on with your program and hang up a new picture every 6 weeks. The changes you see and the positive comments from your supporters will provide gobs of motivation.

➧ Fight boredom. It’s natural to grow weary of a repetitive workout day after day, especially when you’re going it alone. But exercise doesn’t have to be boring. Here are several suggestions to not get bored:

  • Do something you like! If you hate to run, don’t get on the treadmill. You will not enjoy yourself, and you’ll be inclined to give up if you dread the exercise. Instead, choose something you enjoy doing, whether it is aerobics classes, hiking, gardening, a walk around the neighborhood, or a workout in front of the TV. Just be sure you’re doing it regularly and the intensity is enough to be reaching your fitness goals.
  • Vary the routine and try some new things. Rotate among several activities —such as walking, elliptical training, and cycling.
  • Be sociable. Join forces with a friend, relative, neighbor, or co-worker. Enjoy the camaraderie, and offer encouragement and accountability to one another when the going gets tough.
  • Join a group. Exercise classes or sports leagues at the recreation center or health club will generally motivate you to get there because you’ve made a commitment and you’ll be missed if you’re absent. Plus you can learn new skills—volleyball, basketball, badminton—and have a lot of fun in the process.

➧ Refer frequently back to your main motivations for exercise. There are too many good reasons to not be exercising regularly. This will keep those that are most important to you on the sticky side of your brain.

Step 6: Get Going!

You’re motivated, have a firm commitment, got your exercise routine in mind and have planned multiple ways to stay motivated. Now is the time. Get going! Go for it! Carpe diem!

Alas, there still are a few things to think about as you launch into your new schedule and exercise program.

➧ Start slowly. If you push yourself too hard at first, you may be forced to abandon your program because of pain or injury. Start slowly; progress gradually.

➧ If you’re overweight, start with walking. It’s a low-risk and inexpensive routine. Starting out in poor shape? Slow-paced walking will produce benefits. If you’re starting out in better condition, you’ll need to walk faster and/or farther to see any results.

➧ Listen to your body. Be careful with your exercise; done improperly, it may actually worsen your health. So if exercise aggravates your symptoms, modify your program (usually by simply reducing the number of reps or the intensity or duration of the exercise until you find the point where your body begins to adjust and starts improving). If need be, stop and adopt a different exercise. 

➧ Increase your intensity gradually but regularly. Ideally you should exercise at an intensity that makes it somewhat difficult to talk to the person next to you (the “talk test”). This prevents you from having to measure your pulse or use a heart-rate monitor. If you can comfortably talk to the person next to you, you aren’t working hard enough to produce the benefits you need to lose weight or gain fitness. If you’re breathing so heavily that you can’t carry on a conversation at all, then you’re exercising too hard and need to cut back.

➧ Monitor your program and make adjustments as necessary. Are you enjoying your routine? Are you seeing the results (after a period of time) that you desire? Has your work schedule changed? Is there a life event change like a new job or kids or grandkids that will force a change in your routine. This is a dynamic process and needs to change as your life does. The key is to make sure this “silver bullet” of good health is a partner with you in making your life more fulfilling all along the way.

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