Ryan Sheridan, NP
Exercise vs Prescriptions for Depression
Updated: Feb 17
Learn how prescriptions and exercise can work on similar chemical in our brain to improve mood and reduce symptoms of mood disorders like depression.
In some cases exercise can reduce or replace the need for medication for certain mental health disorders, like depression and anxiety.
Exercise, like certain medications, works to increase key neurotransmitters that are involved with mood, our anxiousness, and executive functioning.
Integrative psychiatry provides a platform where whole-body focused treatments, like exercise, can be incorporated into a holistic approach for mental health disorders, especially depression and anxiety.
Exercise and prescriptions
I'll bet you know that exercise has physical health benefits. And you may know from my other blog post how exercise and mental health are related. But did you know exercise can be used as a treatment or remedy for depression instead of or in conjunction with prescription options? The use of exercise in mental health often yields great results - even as a stand alone treatment for things like depression!
A quick lesson in how prescriptions work for depression
Let’s talk about antidepressants, the most commonly prescribed medications in mental health. Selective serotonin re-uptake inhibitors (SSRIs), like Lexapro, are the most common antidepressants prescribed. They work by preventing serotonin from being reabsorbed in the cells in our brain. When we prevent the serotonin from being reabsorbed, the result is more serotonin is available. Wait, what is serotonin? Ahh yes! Serotonin is one of the chemicals in our brains that is used by cells to communicate with other cells. Serotonin helps regulate mood (and other functions too). So when it’s off balance, we can feel depressed! Recap: SSRIs allow there to be more serotonin floating around up there in our brains, so that can help us feel happier.
There are a few problems that result from using medications exclusively. Our bodies are great at adapting, which means that the medications don’t usually work forever. Another problem? Medications have side effects! Also, exclusively using a medication may not really address the problem. I like to think of training wheels. Training wheels are great to learn how to get better at riding a bike, but we don't want to use them forever. Medications for depression are kind of like training wheels. The medications give us the support we need in the short term, but our growth can be hindered if we rely solely on them over the long haul.
How does exercise replace the need for certain prescriptions (or prescriptions mimic exercise)?
Now that you're a psychopharmacologist! So, remember that chemical serotonin? Well, exercising can increase it too! In fact, exercise can increase all the chemicals in our brains that help us feel good. But how? Exercise increases the rate at which serotonin is used to communicate from one cell to the another. Our bodies end up saying “hey, we need more of those chemicals, make more!” Another benefit: exercise actually increases the size of our brains in key areas that help us think, regulate mood, and develop memories.
Our bodies are not made to be sedentary. We are naturally hunters and gathers – we are designed to be constantly in search of food and shelter. Given this, it is reasonable to suggest that a lack of physical activity can contribute to depression or other mental health problems. In integrative psychiatry we look for root causes, and if a lack of physical activity is an area of concern, correcting can be an effective means of treatment.
There is more! Recent studies have compared exercise to some of the leading antidepressants and found some interesting results. Believe it or not, exercise was more effective than antidepressants in treating depression in some cases. This is huge! Yes, I am actually telling you that, for some people, exercise can replace the need for a pill for depression. The reality is, exercise doesn't mimic prescriptions. Prescriptions aren't naturally occurring. Exercise itself is the natural alternative to prescriptions. We should look to options like exercise at the first evaluation and include them in any treatment plan where exercise is lacking.
Bonus: exercise can even help prevent depression. As we discussed, the feel-good chemicals increase with exercise. So when someone who is not depressed exercises, the feel-good chemicals are still increased. Think of it like a savings account, exercise can actually build a buffer for a rainy day. And again, it is not just the serotonin, our brains enlarge in key areas that improve mood, cognition, and even long-term memory.
Okay Ryan, what kinds of exercise do I need to do to help with depression?
You might be surprised. You don’t need to go run a marathon every day to reap the mental health rewards from exercise. I encourage everyone to start small and build from there. Take stock in the current situation and how much is realistic. Start with a 15-20 minute walk a few days per week.
Ideally, we are looking for 30 minutes, 3-4 days per week of moderate intensity aerobic exercise. A good way to identify moderate intensity means you that should not be able to carry a normal conversation while exercising. You should be huffing and puffing a little bit! This isn’t running-for-your-life-from-a-monster kind of thing. The target for everyone is different and should be somewhere in between a walk and sprint, not too easy but not too hard.
There are all kinds of activities that are great: powerwalking, running, jumping rope, swimming, burpees, going up and down stairs, rowing, biking, hiking, the list goes on. Find out what works best for you and give it a go. Try switching things up – take a run one day and jump rope the next. This can be social. Find a friend to join in on the fun!
But I’m too depressed or anxious to get out of bed, let alone exercise!
If you’re feeling down or anxious, please find someone you can talk to who can help. Get in touch with a provider as soon as you can. You deserve to feel whole again! I am not privy to your situation nor is this blog able to diagnose you. What I can say, though, is that if you can find the strength to even go for a quick walk, you’re taking healthy steps to improve your mental wellness. Again, find help. I believe in you!
Exercise has a positive impact on mental health. As we discussed, exercise increases the feel-good chemicals as well as the size of key areas in our brains. Compared to prescriptions like SSRIs, exercise can have a similar, or even better, impact on our mental health. Something as simple as taking a walk can have significant and lasting benefits. If you have more questions, I’m only an e-mail away!
If you have questions about integrative psychiatry, are interested in seeking care, or are interested in learning about how to practice integrative psychiatry, please reach out to me via email at firstname.lastname@example.org. Feel free to repost this blog, just give me a backlink!