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How to keep moving if you are feeling down or depressed

How can someone who is depressed, and at the bottom of their bed, become more active?

It’s a question I often pondered myself when afflicted by two severe depressive episodes in my thirties. Of course I knew that exercise was a good idea: it is a commonplace that it affects every system in the body, from our cardiovascular to our muscular-skeletal. And it’s particularly helpful for those of a nervous disposition like me.


Dr Carla Croft is a clinical psychologist, and head of Psychological Wellbeing at Barts Health NHS Trust. “The most important thing we get from moving is a boost for mental wellbeing,” she tells me.

“Movement for weight loss is less successful, but the mental health benefits of movement are numerous, including indirect benefits like improving sleep. We think exercise has an impact on brain chemistry, tension in the body, motivation and energy and other processes that contribute to strain like bowel function.”


Yet ironically, I found that knowing quite how much physical movement can help our wellbeing was an added pressure. It felt more and more important to get moving, but I felt less and less able to do so.


I found a different approach helped. What if I became more sympathetic to myself? And became gentler to that person who resisted exercise? And understood a bit more about how we evolved to be active in certain ways?


Counter-intuitively, and odd as it sounds, it was acknowledging that I found exercise hard, and finding compassion for that person, that helped me tip-toe out from under the duvet.


The fact is that we never evolved to do exercise for the sake of exercise. Far from it. We evolved to avoid needless exertion.


The reason is that physical activity costs calories, that until recently were always in short supply (and still are for many people). When food is limited, every calorie spent on physical activity is a calorie not spent on other critical functions, such as maintaining our bodies, storing energy, and reproducing. It is a modern idea to undertake physical activity for the sake of fitness.


However, we did evolve to be active in two ways, ways that might suit us resistant exercisers who are feeling low, or haven’t always got the time or inclination to go to the gym anyway. Firstly, we moved because we had no choice. We either moved to get food, or to gather wood, or some other task; and sometimes we moved in a frantic rush to escape predators, be they other tribes or tigers. Secondly, we moved because it was fun and what we wanted to do, mainly playing games or dancing. Let’s take both in turn.


First, the short, sharp shock school of movement, as if you were being chased by a lion. For me, as I was recovering from my depression and still mainly home-based, this initially translated into sprinting up the stairs to tell my teenagers it was supper. Later on, as I returned to work, it meant cycling up the hill in a hurry.


How much do we need this kind of intense cardiovascular exercise? I am wary of recommending any amount or type of exercise, as many such prescriptions are arbitrary. How much to exercise depends on dozens of factors, such as your fitness, age, injury history and health concerns.


Research suggests that getting your heart rate up is one of the quickest and most effective ways to improve your mood. One reason is that this kind of cardiovascular exercise causes a chemical change in your brain like the one created by antidepressants. You will be bathed in a ‘runner’s high’, the kind of endorphin rush which follows this high-intensity exercise.

Getting your heart rate up also raises your blood pressure, which in turn helps you become more alert. This will in turn make you more productive. If you can exercise outside, this will amplify the effect: we know that many people cheer up even more when exposed to natural light because of the mood-boosting impact of Vitamin D after this kind of intense activity.


The second way I found myself exercising more was by abandoning the idea that exercise is something we should do, and instead think of it as something we might enjoy in the manner of our ancestors, as something fun.


When we are young, we do not have to think about doing exercise at all. Small children naturally delight in their physicality: they adore jumping and skipping and their ability to move. Sadly, we lose this instinctive enjoyment in our bodies’ ability to move as we grow up. How then to re-awaken this sense of fun?

I found the first step to enjoying exercise in this way is to dismantle many of the rules and judgements about how and when we should move. There are so many exhortations – that we should and should not exercise in certain ways, in certain clothes and in certain places, that many of us feel guilty and not good enough. Exercise can become a form of punishment. The very word exercise is often associated with the hard work, sweating, and goal setting that often accompanies trips to the gym. It also seems to be associated with the weight loss industry, and body image. The result is that some people find that exercising makes them feel judged, not good enough at getting results and fearful of failing.


Maybe if you conceive of exercise as fun, you might find it easier to get fit. What is fun will look different for all of us, but for many of us, it involves other people. Dr Croft says: “Mental health research suggests that you can add to the benefits of exercising by making it social. Our brain chemistry is impacted positively by socialising and movement, so we get a double whammy if we do it in a group or with a friend. This is an easy way to keep motivated as well".


You might also consider moving with others who are similarly resistant to exercise normally. If you agree to meet friends, you’ll be obliged to show up, you’ll enjoy feeling socially connected, and you’ll keep each other going. Like our ancestors, we are more likely to be active in groups. Find a group or class that is friendly and involves movement such as a Zumba class. Give it a try and commit to going a few times. 


In my 'exercise as fun' category comes stretching and flexing. It is just such a pleasant feeling to feel your limbs lengthen. When we don’t stretch, muscles become shorter and tighter which reduces our range of motion and flexibility. Research suggests activities such as stretching or yoga benefit both flexibility and mood. They can reduce anxiety by focusing on the present moment, and concentrating on one aspect of your body, non-judgmentally, in a simple way.


I like the idea that being more physically flexible can make us feel more mentally flexible. It also helps to open out muscle groups that may have become tight or restricted if you are in threat mode, therefore reducing the symptoms of anxiety.  


I recently had a conversation with Consultant psychiatrist Dr Jamie Arkell, who noted that this kind of stress-reducing exercise is especially important as we get older, and indeed potentially more anxious.


He explained, “we need to keep cortisol levels low because after the age of 30, the DHEA hormone which manages stress, reduces.” In addition, the stress hormone cortisol drives muscle loss. Dr Arkell recommends keeping up social relationships and using the “4’2’4” breathing approach: take a slow breath in through your nose, breathing into your lower belly for about four seconds. Hold your breath for one or two seconds. Then exhale slowly through the mouth for about four seconds.


Such breathing exercises are now part of my own mental health toolkit, as is exercise. It’s been a long journey to become more active, but one I would recommend to anyone else who is finding life hard.




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