Walking Helps Beat the Blues

By Michael Lasalandra

BIDMC Correspondent


Feeling down in the dumps? Stressed out? Depressed? It turns out that a modest exercise program, like taking regular walks, can reduce your stress and improve your mood significantly. Walking can even help those diagnosed with clinical depression.


“There is scientific proof,” says Dr. Claudia Epelbaum, Director of the Latino Mental Health Program at Beth Israel Deaconess Medical Center. “Many experimental, as well as observational studies, show that moderate intensity exercise, where you are breathing a little more rapidly than usual, is actually an effective treatment for mild to moderate clinical depression.”


The recommended amount of walking is at least 3 times a week for 30 minutes a session. Other types of aerobic exercise such as swimming, golf, climbing, or dancing, or anaerobic exercise such as weight lifting, for example, will provide a similar benefit. But most studies thus far have focused on walking.


“We prescribe this for many moderate to high functioning patients who are able to adhere to a plan that requires a certain level of discipline and motivation, as well as organizational skills, and who suffer from clinical depression,” Epelbaum says. “Often, we prescribe this as an adjunct recommendation coupled with other lifestyle modifications, such as a healthy diet, and in addition to medications and psychotherapy. Exercise can also be used as a single treatment strategy but only in those with mild to moderate depression.”


Patients with a lower level of functioning will benefit from this strategy, as well, but physicians must make sure those individuals have the right network of support in order to implement this recommendation, she says.


According to Epelbaum, a walking program, in many cases, can eliminate the need for antidepressant medications. But exercise, as a treatment, is often underutilized, despite the fact that it has a long lasting effect, often more sustained than medications or psychotherapy, she adds.


How is it that something as simple as walking can relieve stress, improve mood and fight depression?


There are several possible mechanisms.


One is that exercise improves circulation and oxygen uptake to the brain, boosting all cognitive functions.


Many people suffering from depression complain that they can’t concentrate, can’t remember things, or can’t focus, Epelbaum notes. “All areas of the brain will work better if there is a consistent supply of oxygen,” she says.


A 1999 study of people over 60 found that walking 45 minutes a day at a 16-minute mile pace increased their thinking skills. Subjects started at 15 minutes of walking and built up their time and speed. The result was that they were found to be mentally sharper after taking up the walking program.


At the same time, exercise boosts the release of endorphins, which are central nervous system neurotransmitters that reduce pain and improve mood. “This is what causes the infamous ‘runner’s high,’ “ Epelbaum explains.


Release of endorphins can relieve pain and tension and cause pleasure and a sensation of well-being. “You feel happier,” she says. “You have a more positive outlook and make better decisions. There’s a whole cascade of positive events.”


A very promising theory is that exercise also boosts levels of serotonin, dopamine and norepinephrine, other neurotransmitters that are thought to contribute to feelings of well- being and happiness. Most modern antidepressants are designed to boost levels of these neurotransmitters, particularly serotonin.


The maximum effect of exercise comes when it is performed on a regular basis, says Dr. Epelbaum. “But with every single session, you get a boost and some of the symptoms of depression may start to get better, ” she says. For example, it may become easier to sleep, self-esteem may improve, and energy levels may increase.


A study by University of Texas researchers had people with major depressive disorders either rest quietly or walk on a treadmill for 30 minutes and tested their mood afterwards. Both groups saw improvements in mood, but those who walked had more positive feelings.


But the more a person exercises, the more evident and long lasting the benefits will be on general well being and mental health in particular.


Patients with depression have numerous issues, including mood, fatigue, sleep problems and low self-esteem, among them. Walking addresses all of them.


The more serious the depression, the longer it may take to work and medications or psychotherapy may be needed for a robust and more rapid effect. “For those with clinical depression, it may take many weeks, but results can be impressive and sustained over time with lower rates of recurrence, she says.


Experts recommend picking an exercise program that is easy and enjoyable to do for an extended period of time. That’s why walking is such a popular way to go.


And they say to just start by doing what you can. For the average sedentary person, even walking ten minutes a day is helpful.


Even little things like parking a little farther away from your workplace than usual or walking up and down stairs instead of taking the elevator can make a huge difference.



Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.