The Exercise Connection: Pushing Through the Veil of Depression and Anxiety
We live in a world where seemingly everything can fit into nice little compartments and the easiest solutions are often just a click away. You would imagine, when walking through the magazine aisle of the grocery store or flipping through channels on TV, that we would all be walking around, happy, skinny, rich, and enlightened. Everyone is promising us that wonder drug that is going to change our lives!
There’s a reason that two-thirds of us are overweight, fifty percent of Americans are pre-diabetic, and the number of diagnosed mental illness cases is on the rise. Why is this? The answer is complicated. There is no magic bullet or quick fix to these ailments. The trifecta that is our minds, bodies, and spirits is not compartmentalized; they are inter-connected. The ways we take care of these precious parts of ourselves must be addressed in a holistic way.
We are not one-dimensional. We are very complex beings who sometimes must strive against what we are naturally inclined to do. For instance, when our mouthes salivate at the sight of a cupcake, yet we resist our natural inclination to inhale said cupcake, we are achieving a complex mental action.
Biologically, our bodies react to stress in the same way they have since time immemorial. When danger is present, organs that aren't needed for our immediate survival shut down. This is why people with a fear of public speaking sometimes react as if they were running from a tiger before a big speech. Fear helps us work up the courage to RUN!!! For someone with a lesser fear of public speaking, the same adrenaline may just boost performance, instilling in them the urge to fight for example.
Stress, anxiety, and depression contribute to chronic diseases like type 2 diabetes, chronic pain, hypertension, heart disease, and respiratory illness. The inverse is also true; if you have one of these chronic diseases, you are more likely to suffer from or to develop depression and anxiety. It's a vicious cycle that is hard to break. And, the more ill we become, the harder it is to reverse the progression, especially when complicated by depression, a factor that can suppress our motivation to get out of bed, let alone work out.
On top of having to naturally fight these biological conditions and illness, we have those other pesky “conditions” that keep us from doing the things that we know help us to be our best selves. A sick child at home. A maxed out credit card. Another business dinner. A tight deadline at work that throws off your entires schedule. Even that annoying alarm clock waking you up from a really good dream. We can all relate to one "condition" or another.
There is another factor contributing to the uplift in anxiety and depression in our society. These days, life in America can often be very sedentary. Everything around us is engineered for maximum convenience. Most people will choose to drive a few blocks than to walk them, yet our bodies aren't used to remaining immobile for long periods of time. We need to compensate for the built-in conveniences of modern life. An active body helps balance a restful mind.
We have our own biology fighting against us, combined with the pressures and demands of our everyday lives, and complicated by our sedentary cultural lifestyle. Despite all this bad news, I am about to explain that there is hope. We can choose to exercise and create a healthy mindset, conditions, and habits to build exercise into our lives. However, exercise cannot be bottled and sold; it takes work.
Depression and Anxiety
There is much more research and attention given to what exercise does to improve physical health, and much less awareness on all the ways exercise boosts mental health and the brain. Furthermore, there is even less attention focussed on methods to actually translate the exercise/mental health connection into action.
For depression, exercise does the following:
- Boosts mood. Five minutes into a work out, you should begin to feel better. Exercise increases Serotonin, the neurotransmitter targeted by antidepressants.
- Better outlook. By accomplishing a regular, meaningful activity, a feeling of accomplishment is generated.
- Increases energy and concentration. Working out increased your metabolism and normalizes sleep It reduces stress and anxiety allowing for greater focus.
Anxiety symptoms show up in the body to prepare for fight or flight, our pre-programming from our days of living in caves. So, using our friend Freddy Kruger as an example, if he were to appear at our window at 6 am every morning- maybe we would be more inclined to RUN! Since Freddy's appearance isn't likely, we will have to develop a more “adaptive response” by conditioning ourselves to achieve the same bodily responses (i.e. sweating, increased heart rate, shortness of breath) through exercise. In essence, exercise can act like exposure therapy in reducing these bodily symptoms and helping us get comfortable with them. It also serves to alleviate those same symptoms by unleashing trapped and useless anxious energy. Exercise also helps distract us, getting our minds off of our worries and allowing us to clear our minds to help us focus. Another study also found that an increase in body temperature can also have a calming effect.
Just do it. There’s a fancy term for this in cognitive behavioral therapy (CBT) called ‘behavior activation”. Behavior activation recognizes the power of physical activity in promoting improved mental health. Behavior activation, although instigated by a physical activity, affects the relationship of the mind, body, and spirit. We will explore activities that help address all of these parts of ourselves. For ideas on solutions to overcome typical barriers to beginning an exercise regimen, please see the image on the left, which can also be downloaded in PDF form here.
In my work with people who struggle with depression, anxiety, and chronic illness, the following strategies are very effective in helping you "just do it."
Set short-term, focused goals, in addition to long-term goals. It's helpful to think of the acronym SMART (Specific, Measurable, Achievable, Realistic and Timely) when setting your goals. Short-term focus means being present in the exercise as you are experiencing it, and paying attention to what you are gaining from each session. Think about how you feel and the changes in mood or energy you are experiencing. Take time to have gratitude for what your body is able to do for you, rather than feeling limited by what you don't like about yourself. Set a goal based on what you will accomplish when you begin like, I will complete 25 push ups at the end of my work out today. If you are feeling particularly low and unmotivated, remember this: you are NOT going to feel WORSE after a brisk walk, swim, or cycling session is finished. That is a fact.
Keep an exercise log to monitor and track your efforts and how exercise is impacting your symptoms and moods. Click here to download a PDF of this log. Weekly affirmations can be motivating when you are feeling particularly low in your confidence or mood.
Schedule your workout in your calendar. In the entry for the scheduled workout write down a typical sabotaging thought or excuse that might prevent you from exercising when the alarm goes off or you’re about to leave work. Next, write down an adaptive response-i.e. what thought will motivate you? Think of the adaptive response as standing up to the bully that is the sabotaging thought. List one or two other things that will motivate you. Read them aloud before working out for encouragement.
Buy new work out clothes. Colorful, stylish, and flattering workout clothes can help boost your mood and build your confidence. You won't want them to go to waste in your drawer!
Smile during the intense parts of your workout or when you feel like you want to quit. Smiling when things get tough is another "behavior activation strategy". It will automatically lift your mood and hopefully help you power through difficult exercise. It seems silly, but it works! Try it.
“Take time to have gratitude for what your body is able to do for you, rather than the way you feel limited by what you don’t like about yourself.”
Make new play lists. Spotify for example is one of many a music streaming service that offers free accounts and playlists. A $9.99/month upgrade means you can play whatever song and in whatever order you like (the free version only allows random shuffle). I like the Nike Running playlists.
Accountability-I hold my clients gently accountable to their goals and we explore what the challenges are each week, as well as ways to overcome them. We develop assignments together during our sessions and I check in on them over the course of the week. You don’t have to have a CBT therapist or personal trainer to do this yourself. Ask a spouse, coworker, or friend to be your accountability buddy. The people around you who love you and care about you will be honored.
Practice self-compassion. Ask yourself: what do I want from this body? What do I want from this life? How do I tap into the amazing potential within me? Be gentle with yourself. Think to yourself, "I am not out of shape", I am getting in shape". If your illness is preventing you from exercising and you are fatigued, listen to your body and give it the time it needs to heal and rest. Also remember that the best remedy for fatigue, ironically, is physical activity.
If you are new to an exercise program, check with your doctor before starting to make sure exercising is safe for you. If you exercise regularly but anxiety and depression symptoms still interfere with your daily living, then therapy may be the next step for you. Exercise is a great way to ease symptoms of anxiety and depression, however you may feel better with exercise as a compliment to psychotherapy and medication.
More resources:
NAMI (The National Alliance on Mental Illness) has some terrific resources and information in their campaign called "Hearts and Minds". Click here for more info.
Kerrie Thompson is a Licensed Clinical Social Worker practicing cognitive behavioral therapy in NYC. For more information on how to work with her, please reach out here.
