How Much Exercise Does it Take to Fight Depression?

Writing prescriptions for exercise may be the future of depression treatment, says new paper

Can exercise literally be a prescription for lifting your mood?

We’ve all read articles touting the mental health benefits of working out, and have posted a few ourselves on The Active Times.

The American Psychiatric Association has included “exercise” among their latest treatment recommendations for major depressive disorder (MDD), but without much instruction for doctors or patients.

Now, a new analysis of existing studies by researchers at the University of Texas Southwestern Medical Center looks into what such a prescription might look like, and makes specific recommendations to doctors about how much exercise, and what kind, works best.

In summary:

Type of exercise: Aerobic exercise such as running, walking and cycling, works, and seems to work well. Resistance/weight training appears to work just as well as cardio, but fewer studies have looked into it.

Frequency and duration: Best results occur at 45 to 60 minutes a session, 3 to 5 times a week. The difference between 3 and 5 sessions appears to be insignificant as long as your total weekly burn is the same.

Intensity: For aerobic exercise, you should aim to work out at 50 to 85 percent of your maximum heart rate—your maximum is about 220 minus your age, according to the American Heart Association.

For resistance training, you should aim for 3 sets of 8 reps for each of a variety of upper and lower body exercises. Each rep should be at 80 percent of the maximum weight you can lift on a single rep.

Number of weeks: You’ll start to see the best sustained effects on your mood at 10 to 12 weeks, but benefits are usually noticeable at 4 weeks.

According to authors Chad Rethorst and Madhukar Trivedi, patients were just as likely to stick with an exercise regimen as they were to keep taking pills or going to therapy—only around 15 percent of patients receiving exercise as treatment dropped out of their respective studies. However, the authors advise doctors to encourage adherence by working with patients to find an exercise program that they’re likely to enjoy and using web-based monitoring and goal-setting.

But even if a prescribed regimen proves to be beyond a patient's willpower, Rethorst and Trivedi say that exercise at lower “doses” can have a measurable effect on depression.

“Taken as a whole, these findings suggest that exercise doses below the current recommendations may still be beneficial for patients with MDD,” they wrote.

“Therefore, clinicians should encourage patients to engage in at least some exercise, even if they do not exercise enough to meet current public health recommendations.”