Frequently Asked Questions (FAQ's) about exercise and depression

What is depression?


Depression is a very common problem - affecting about one in six people at some point in their lifetime. It can be described as a persistent low mood which can make people feel unable to cope and hopeless about the future. People who are depressed often lose their appetite and have difficulty sleeping, feel guilty or worthless, become anxious and tired, and find it difficult to concentrate. They may also have thoughts about death or suicide.


How can depression be treated?


There are several different treatments for depression. The most commonly used include antidepressant medication, which may be prescribed by your doctor, and certain forms of counselling, which can help people explore different ways of thinking about and coping with their problems.

However, there is another treatment for depression - exercise therapy - that can be as effective as antidepressants and counselling. Several scientific studies have shown that a regular programme of exercise can help people recover from depression - lifting their mood, reducing anxiety and improving self-esteem and concentration. They have also found that taking regular exercise can help protect people against becoming depressed in the first place.


Why does exercise work?


There's probably a range of reasons why exercise helps people with depression.
Exercise leads to an increased release of endorphins in the body. These chemicals may help combat depression and make us feel happier.
Exercise helps us to get active and meet new people. This stops us from feeling isolated and unsupported.
Exercise can give us new goals and a sense of purpose - we have something positive to focus on and aim for.
Exercise can boost our self-esteem - it can improve the way we look and how we feel about ourselves.


Can people with depression get help with starting an exercise programme?


In lots of areas, yes. Many GPs can 'prescribe' exercise for their patients, referring them to schemes where they will be helped to develop their own personal exercise programme, under supervision from a qualified trainer. It is estimated there are now around 1300 such schemes operating in the UK.


What happens when a GP prescribes exercise?


First of all, the GP will want to discuss with their patient whether exercise is a suitable treatment for them - this will depend on such factors as their physical health and whether they are willing to try an exercise programme. If both agree that exercise is the right option, the GP will fill in a form that is passed on to the local 'exercise referral' scheme. These are schemes that have been set up especially to help those who might benefit from an exercise programme - such as people with heart disease, diabetes, obesity, high blood pressure and depression.



Once a patient has been referred, they will be asked to come for an initial assessment with a qualified trainer, who will be able to discuss what kind of exercise programme will best help them. This might include swimming or gym sessions, structured classes together with other people on the scheme, and even yoga or belly-dancing lessons. The sessions are usually provided at a significantly discounted price, and the trainer will arrange regular follow-up meetings, as well as being available to give further advice and support during the programme. The programmes most often last for between 3 and 6 months, and progress is monitored both by the professional trainer and the GP.


When I'm depressed, I feel like I don't have any energy. How would I be able to keep up an exercise programme?



It is true that starting an exercise programme can be challenging, especially if we feel down, and maybe haven't done much physical activity for a while. That's why it's important to start gently, and to develop a personal programme that is going to be manageable and fun. Staff on exercise referral schemes have been specially trained to help people who may not be 'superfit' or 'athletic' types - they are able to guide, motivate and support you, and can help you modify the programme if it does not feel right.


I like the idea of trying an exercise programme. What should I do?

The first step is to go to your GP and discuss it with him or her. Ask if he or she knows about the link between exercise and depression, and whether you can be referred to a local scheme. You could also show him or her this booklet.


What can I do if my GP says he does not have access to an exercise referral scheme?

It is important that you don't start an exercise programme without professional supervision, especially if you have not been physically active for a while. If your GP says s/he cannot refer you to a scheme, ask if s/he can recommend other ways in which you might be able to make exercise a part of your recovery. Many local authorities run walking schemes, while some offer opportunities for doing conservation work under supervision (these are called Green Gyms - see <!-- m --><a class="postlink" href="http://www.greengym.org.uk">http://www.greengym.org.uk</a><!-- m -->). Staff at your local leisure centre may also be able to provide advice on how you might safely begin an exercise programme.


My doctor has prescribed antidepressants for my depression. Can I ask for exercise referral as well?

Yes - often, people with depression feel like they do not have any choices, so having access to a range of different strategies may in itself help you to feel better. Your GP should be able to help you devise a broad-ranged and balanced plan to help you recover, which may include medication, counselling and/or exercise.


My GP hasn’t mentioned exercise referral. Does that mean there is no scheme in my area?

Not necessarily - some GPs do not know they can refer patients with depression for exercise, and others don’t think about offering exercise referral to their patients with depression. If you’d like to try exercise, it is worth asking your GP if there is a scheme in your area, rather than waiting for him or her to suggest it.

One of the problems that goes alongside depression is a lack of dopamine reaching certain parts of the brain and the suffer becomes inactive producing a vicious circle, by carrying out a physical activity which the suffer might under normal conditions enjoy - say swimming, jogging, salsa, the flow of dopamine is increased as well as 5-HT and noradrenaline (norepinephrine) levels. In some cases this is enough for the suffer to come to terms with their underlying problems without further assistance.